1 00:00:04,129 --> 00:00:06,665 WELCOME TO 2 00:00:06,665 --> 00:00:08,367 THE 2025 DIETARY GUIDELINES 3 00:00:08,367 --> 00:00:09,501 ADVISORY COMMITTEE MEETING 6. 4 00:00:09,501 --> 00:00:11,537 WE'RE SO HAPPY TO HAVE THE 5 00:00:11,537 --> 00:00:13,339 COMMITTEE BACK TOGETHER TO 6 00:00:13,339 --> 00:00:16,408 RECORD UPDATES SINCE THEIR FIFTH 7 00:00:16,408 --> 00:00:16,842 MEETING. 8 00:00:16,842 --> 00:00:17,843 NEXT SLIDE PLEASE. 9 00:00:17,843 --> 00:00:19,778 I'M HAPPY TO SHARE ALL OF THE 10 00:00:19,778 --> 00:00:22,514 MEMBERS ARE PARTICIPATING TODAY. 11 00:00:22,514 --> 00:00:26,785 WE HAVE TWO MEMBERS, JERNIGAN 12 00:00:26,785 --> 00:00:28,220 AND RAYNOR, PARTICIPATING 13 00:00:28,220 --> 00:00:29,288 VIRTUALLY. 14 00:00:29,288 --> 00:00:29,588 NEXT SLIDE. 15 00:00:29,588 --> 00:00:31,490 AS I MENTIONED, YOU CAN SEE ON 16 00:00:31,490 --> 00:00:33,459 THE TIMELINE, THIS IS THE SIXTH 17 00:00:33,459 --> 00:00:34,460 MEETING OF THE COMMITTEE AND 18 00:00:34,460 --> 00:00:40,232 THERE WILL BE ONE ADDITIONAL 19 00:00:40,232 --> 00:00:42,434 MEETING OCTOBER 21 AND 22 TO 20 00:00:42,434 --> 00:00:44,837 PRESENT RESULTS OF SCIENTIFIC 21 00:00:44,837 --> 00:00:45,170 REPORT. 22 00:00:45,170 --> 00:00:46,672 REGISTRATION WILL OPEN SOON. 23 00:00:46,672 --> 00:00:49,108 NOW I'D LIKE TO TURN IT OVER TO 24 00:00:49,108 --> 00:00:53,278 OUR COMMITTEE CHAIRS, DOCTORS 25 00:00:53,278 --> 00:01:00,853 BOOTH AND ODOMS-YOUNG FOR THE 26 00:01:00,853 --> 00:01:01,086 UPDATE. 27 00:01:01,086 --> 00:01:03,022 >> WELCOME, EVERYBODY, TO 28 00:01:03,022 --> 00:01:05,324 MEETING NUMBER 6. 29 00:01:05,324 --> 00:01:07,292 TO THOSE LISTENING IN, I CAN 30 00:01:07,292 --> 00:01:08,394 ASSURE YOU THIS COMMITTEE HAS 31 00:01:08,394 --> 00:01:11,030 BEEN WORKING AROUND THE CLOCK 32 00:01:11,030 --> 00:01:13,966 SINCE WE LAST GOT TOGETHER AS A 33 00:01:13,966 --> 00:01:14,233 COMMITTEE. 34 00:01:14,233 --> 00:01:18,270 AND WE HAVE A REALLY EXCITING 35 00:01:18,270 --> 00:01:18,504 AGENDA. 36 00:01:18,504 --> 00:01:20,873 NEXT SLIDE PLEASE. 37 00:01:20,873 --> 00:01:28,080 SO, TODAY WE'RE GOING TO START 38 00:01:28,080 --> 00:01:29,948 WITH FOOD PATTERN MODELING LED 39 00:01:29,948 --> 00:01:32,251 BY CHRIS TAYLOR. 40 00:01:32,251 --> 00:01:34,653 DATA ANALYSIS, STRATEGIES FOR 41 00:01:34,653 --> 00:01:40,459 INDIVIDUALS AND FAMILY RELATED 42 00:01:40,459 --> 00:01:42,961 TO DIET QUALITY AND WEIGHT 43 00:01:42,961 --> 00:01:45,464 MANAGEMENT AND DIETARY PATTERNS 44 00:01:45,464 --> 00:01:47,199 AND SPECIFIC DIETARY COMPONENTS 45 00:01:47,199 --> 00:01:49,468 ACROSS LIFE STAGES. 46 00:01:49,468 --> 00:01:52,905 EACH OF THESE PRESENTATIONS WILL 47 00:01:52,905 --> 00:01:54,239 INVOLVE PRESENTATIONS BY 48 00:01:54,239 --> 00:01:56,442 MULTIPLE MEMBERS OF EACH OF THE 49 00:01:56,442 --> 00:01:57,342 GROUPS. 50 00:01:57,342 --> 00:01:58,710 THESE ARE THE LEAD. 51 00:01:58,710 --> 00:02:00,946 NEXT SLIDE PLEASE. 52 00:02:00,946 --> 00:02:05,451 AND THEN TOMORROW WE'LL DO MORE 53 00:02:05,451 --> 00:02:07,619 UPDATES WITH THE DIET AND 54 00:02:07,619 --> 00:02:09,354 PREGNANCY AND BIRTH THROUGH 55 00:02:09,354 --> 00:02:09,655 ADOLESCENCE. 56 00:02:09,655 --> 00:02:11,990 WE'RE GOING TO CONTINUE FOOD 57 00:02:11,990 --> 00:02:15,160 PATTERN MODELING, AND THEN WE 58 00:02:15,160 --> 00:02:20,532 ARE GOING TO DISCUSS HEALTH 59 00:02:20,532 --> 00:02:21,066 EQUITY. 60 00:02:21,066 --> 00:02:22,701 JANET DEJESUS WILL PROVIDE SOME 61 00:02:22,701 --> 00:02:27,206 INFORMATION ON NEXT STEPS, AND 62 00:02:27,206 --> 00:02:29,608 THE EXCITING DISCUSSION, WE'LL 63 00:02:29,608 --> 00:02:33,312 HAVE A TWO-HOUR DISCUSSION ABOUT 64 00:02:33,312 --> 00:02:35,981 INTEGRATING OUR FINDINGS, AND WE 65 00:02:35,981 --> 00:02:38,050 ANTICIPATE A LOT OF ENGAGED 66 00:02:38,050 --> 00:02:38,383 CONVERSATION. 67 00:02:38,383 --> 00:02:44,389 NEXT SLIDE PLEASE. 68 00:02:44,389 --> 00:02:45,724 EACH SUBCOMMITTEE AND WORKING 69 00:02:45,724 --> 00:02:50,295 GROUP WILL BE PRESENTING 70 00:02:50,295 --> 00:02:51,163 PROGRESS MADE SINCE MEETING 5 71 00:02:51,163 --> 00:02:53,031 FOR COMMITTEE DISCUSSION. 72 00:02:53,031 --> 00:02:55,167 WE HAVE MORE DRAFT CONCLUSION 73 00:02:55,167 --> 00:02:56,001 AND SYNTHESIS STATEMENTS FOR 74 00:02:56,001 --> 00:02:57,302 SCIENTIFIC QUESTIONS REVIEWED. 75 00:02:57,302 --> 00:03:01,773 WE HAVE NEW ANALYSIS OF FOOD AND 76 00:03:01,773 --> 00:03:02,207 BEVERAGE INTAKE BY 77 00:03:02,207 --> 00:03:03,408 SOCIODEMOGRAPHIC GROUPS. 78 00:03:03,408 --> 00:03:07,479 AND WE ALSO ARE GOING TO DO 79 00:03:07,479 --> 00:03:11,550 RESULTS OF AN EVIDENCE SCANS ON 80 00:03:11,550 --> 00:03:13,218 CULTURALLY TAILORED DIETARY 81 00:03:13,218 --> 00:03:13,652 INTERVENTIONS. 82 00:03:13,652 --> 00:03:18,323 NEXT SLIDE PLEASE. 83 00:03:18,323 --> 00:03:23,529 SO, SINCE MEETING 4, WE HAVE -- 84 00:03:23,529 --> 00:03:28,767 WOW, WE HAVE IN TOTAL, ACTUALLY 85 00:03:28,767 --> 00:03:32,471 WE'VE HAD 8443 WRITTEN PUBLIC 86 00:03:32,471 --> 00:03:32,738 COMMENTS. 87 00:03:32,738 --> 00:03:38,143 PUBLIC, THANK YOU FOR YOUR 88 00:03:38,143 --> 00:03:39,311 ENGAGEMENT. 89 00:03:39,311 --> 00:03:41,980 WE HAVE 417 CONTINUING 90 00:03:41,980 --> 00:03:42,781 PROFESSIONAL EDUCATION 91 00:03:42,781 --> 00:03:46,351 CERTIFICATES GRANTED, AND THESE 92 00:03:46,351 --> 00:03:47,986 CONTINUING EDUCATION 93 00:03:47,986 --> 00:03:48,887 CERTIFICATES ARE GRANTED FOR 94 00:03:48,887 --> 00:03:51,623 DIETITIANS THAT WATCH THE 95 00:03:51,623 --> 00:03:53,225 COMMITTEE MEETINGS. 96 00:03:53,225 --> 00:03:55,160 WE'VE HAD, AS I SAY, THE NUMBERS 97 00:03:55,160 --> 00:03:57,296 ARE GROWING. 98 00:03:57,296 --> 00:03:59,398 MY DATA WAS INDICATING 296, SO 99 00:03:59,398 --> 00:04:02,367 GO DIETITIANS FOR YOUR 100 00:04:02,367 --> 00:04:02,668 ENGAGEMENT! 101 00:04:02,668 --> 00:04:04,670 AND WE JUST WANT TO SAY PLEASE 102 00:04:04,670 --> 00:04:07,739 GET INVOLVED, GO TO OUR WEBSITE. 103 00:04:07,739 --> 00:04:09,374 YOU'RE GOING TO HEAR A LOT OF 104 00:04:09,374 --> 00:04:11,009 CONVERSATION OVER THE NEXT TWO 105 00:04:11,009 --> 00:04:11,677 DAYS. 106 00:04:11,677 --> 00:04:15,414 AND WE REALLY WOULD LIKE TO HEAR 107 00:04:15,414 --> 00:04:16,815 YOUR FEEDBACK ON WHAT YOU HEAR 108 00:04:16,815 --> 00:04:19,351 IN THE NEXT TWO DAYS. 109 00:04:19,351 --> 00:04:21,486 NEXT SLIDE PLEASE. 110 00:04:21,486 --> 00:04:24,890 SO, JUST AS A REMINDER, I'M SURE 111 00:04:24,890 --> 00:04:26,992 MANY OF YOU ARE, HMM, WE'VE SEEN 112 00:04:26,992 --> 00:04:28,727 THIS BEFORE. 113 00:04:28,727 --> 00:04:31,496 BUT I THINK IT'S REALLY, REALLY 114 00:04:31,496 --> 00:04:32,965 IMPORTANT TO REMIND EVERYBODY 115 00:04:32,965 --> 00:04:37,169 THAT YOU'RE GOING TO BE HEARING 116 00:04:37,169 --> 00:04:40,672 A NUMBER OF GREAT CONCLUSION 117 00:04:40,672 --> 00:04:42,207 STATEMENTS. 118 00:04:42,207 --> 00:04:44,309 THE COMMITTEE USES NESR 119 00:04:44,309 --> 00:04:46,378 METHODOLOGY TO CONDUCT REVIEWS, 120 00:04:46,378 --> 00:04:47,913 AND THIS SLIDE IS A BRIEF 121 00:04:47,913 --> 00:04:49,982 OVERVIEW OF METHODS USED TO 122 00:04:49,982 --> 00:04:55,254 DEVELOP AND GRADE CONCLUSION 123 00:04:55,254 --> 00:04:56,121 STATEMENTS. 124 00:04:56,121 --> 00:04:57,556 THE NESR'S COMPLETE METHODOLOGY 125 00:04:57,556 --> 00:04:59,358 IS AVAILABLE ON ITS WEBSITE, 126 00:04:59,358 --> 00:05:01,493 WHICH IS INDICATED AT THE BOTTOM 127 00:05:01,493 --> 00:05:09,167 OF THE GREEN. 128 00:05:09,167 --> 00:05:11,203 SO, JUST AGAIN TO REINFORCE, 129 00:05:11,203 --> 00:05:13,405 THIS COMMITTEE IS ENTIRELY 130 00:05:13,405 --> 00:05:15,607 EVIDENCE DRIVEN. 131 00:05:15,607 --> 00:05:16,908 THEY SYNTHESIZE, DEVELOP 132 00:05:16,908 --> 00:05:20,846 CONCLUSION STATEMENT, GRADED 133 00:05:20,846 --> 00:05:22,914 STRENGTH OF THE EVIDENCE, A 134 00:05:22,914 --> 00:05:24,683 PROCESS WHICH THE COMMITTEE 135 00:05:24,683 --> 00:05:28,287 REVIEWS ALL OF THE INCLUDED 136 00:05:28,287 --> 00:05:29,221 EVIDENCE. 137 00:05:29,221 --> 00:05:30,689 IT THOROUGHLY DESCRIBES, 138 00:05:30,689 --> 00:05:32,424 COMPARES, CONTRASTS, AND 139 00:05:32,424 --> 00:05:34,192 COMBINING ALL THE EVIDENCE TO 140 00:05:34,192 --> 00:05:36,395 EXAMINE WHETHER THE INTERVENTION 141 00:05:36,395 --> 00:05:38,730 OR EXPOSURE IS RELATED TO THE 142 00:05:38,730 --> 00:05:43,935 OUTCOME OR OUTCOMES, IN THE 143 00:05:43,935 --> 00:05:45,037 POPULATIONS OF INTEREST. 144 00:05:45,037 --> 00:05:46,605 A CONCLUSION STATEMENT IS A 145 00:05:46,605 --> 00:05:49,007 SUMMARY STATEMENT. 146 00:05:49,007 --> 00:05:50,409 IT IS CAREFULLY CONSTRUCTED 147 00:05:50,409 --> 00:05:53,478 BASED ON EVIDENCE REVIEWED TO 148 00:05:53,478 --> 00:05:56,948 ANSWER THE QUESTION BEING ASKED. 149 00:05:56,948 --> 00:05:58,517 NEXT SLIDE PLEASE. 150 00:05:58,517 --> 00:06:02,287 SO, SINCE OUR LAST MEETING, WE 151 00:06:02,287 --> 00:06:04,623 HAVE A LOT OF DISCUSSION ABOUT 152 00:06:04,623 --> 00:06:07,025 OUR CONCLUSION STATEMENTS. 153 00:06:07,025 --> 00:06:07,693 THE CONCLUSION STATEMENTS 154 00:06:07,693 --> 00:06:10,962 COMMUNICATE THE STRENGTH OF THE 155 00:06:10,962 --> 00:06:12,698 EVIDENCE BY CLEARLY STATING THE 156 00:06:12,698 --> 00:06:15,767 GRADE AS PART OF THE STATEMENT, 157 00:06:15,767 --> 00:06:23,008 AND BY FORMALLY PRESENTING THE 158 00:06:23,008 --> 00:06:28,380 GRADE IN PARENTHESES AFTER THE 159 00:06:28,380 --> 00:06:29,581 CONCLUSION, CRITICAL FOR 160 00:06:29,581 --> 00:06:30,048 INTERPRETATION. 161 00:06:30,048 --> 00:06:33,719 THIS COMMITTEE FELT WE NEEDED TO 162 00:06:33,719 --> 00:06:35,587 FURTHER PROMOTE CLARITY AND 163 00:06:35,587 --> 00:06:37,456 ACCURATE INTERPRETATION OF OUR 164 00:06:37,456 --> 00:06:39,658 CONCLUSION STATEMENTS. 165 00:06:39,658 --> 00:06:42,828 AND WE THEN DECIDED TO CHANGE 166 00:06:42,828 --> 00:06:47,099 THE FORMAT OF OUR CONCLUSION 167 00:06:47,099 --> 00:06:47,399 STATEMENTS. 168 00:06:47,399 --> 00:06:50,068 SO THE CHANGE, AS HIGHLIGHTED IN 169 00:06:50,068 --> 00:06:52,804 THIS TABLE HERE, INCLUDES MOVING 170 00:06:52,804 --> 00:06:55,006 THE STATEMENT REGARDING THE 171 00:06:55,006 --> 00:06:57,309 STRENGTH OF THE EVIDENCE TO THE 172 00:06:57,309 --> 00:07:01,113 END OF THE STATEMENT. 173 00:07:01,113 --> 00:07:05,951 AN EXAMPLE HERE IS DIETARY 174 00:07:05,951 --> 00:07:07,152 PATTERNS WITH OUTCOMES OF TYPE 2 175 00:07:07,152 --> 00:07:10,455 DIABETES IN THE PRIOR FORMAT WE 176 00:07:10,455 --> 00:07:12,958 SAID STRONG EVIDENCE 177 00:07:12,958 --> 00:07:14,393 DEMONSTRATES, AND THE GRADE IN 178 00:07:14,393 --> 00:07:19,664 PARENTHESES, NOW IT'S A SEPARATE 179 00:07:19,664 --> 00:07:20,866 STATEMENT. 180 00:07:20,866 --> 00:07:23,034 SO THE CONCLUSION STATEMENT HERE 181 00:07:23,034 --> 00:07:26,438 DOES NOT -- WE WANT TO EMPHASIZE 182 00:07:26,438 --> 00:07:27,973 DOES NOT DRAW IMPLICATIONS, AND 183 00:07:27,973 --> 00:07:31,576 IT SHOULD NEVER BE INTERPRETED 184 00:07:31,576 --> 00:07:35,180 AS DIETARY GUIDANCE. 185 00:07:35,180 --> 00:07:37,582 THE GRADES ARE ASSIGNED TO EACH 186 00:07:37,582 --> 00:07:39,217 CONCLUSION STATEMENT BASED ON 187 00:07:39,217 --> 00:07:40,652 ASSESSMENT OF UNDERLYING 188 00:07:40,652 --> 00:07:42,854 EVIDENCE FOR FIVE ELEMENTS, 189 00:07:42,854 --> 00:07:47,225 CONSISTENCY, PRECISION, RISK OF 190 00:07:47,225 --> 00:07:51,263 BY AS, DIRECTNESS, 191 00:07:51,263 --> 00:07:51,663 GENERALIZABILITY. 192 00:07:51,663 --> 00:07:53,231 THE GRADE COMMUNICATES OUR LEVEL 193 00:07:53,231 --> 00:07:55,967 OF CERTAINTY ON THE EVIDENCE, 194 00:07:55,967 --> 00:07:59,070 AND THE DEFINITION OR 195 00:07:59,070 --> 00:08:02,140 INTERPRETATION OF THE GRADES 196 00:08:02,140 --> 00:08:04,342 WERE PRESENTED IN THE PRIOR 197 00:08:04,342 --> 00:08:05,310 SLIDE. 198 00:08:05,310 --> 00:08:08,814 I ALSO WANT TO EMPHASIZE WE HAVE 199 00:08:08,814 --> 00:08:11,550 NOT CHANGED THE CONCLUSIONS. 200 00:08:11,550 --> 00:08:13,952 WE'VE ONLY CHANGED THE FORMAT. 201 00:08:13,952 --> 00:08:15,720 I ALSO WANT TO EMPHASIZE 202 00:08:15,720 --> 00:08:16,822 PARTICULARLY TO THOSE LISTENING 203 00:08:16,822 --> 00:08:19,224 IN, YOU MUST READ THE WHO 204 00:08:19,224 --> 00:08:20,292 SENTENCES. 205 00:08:20,292 --> 00:08:21,426 THEY GO TOGETHER. 206 00:08:21,426 --> 00:08:26,231 SO WE WANTED TO INFORM THE 207 00:08:26,231 --> 00:08:29,734 COMMITTEE BUT ALSO THE GENERAL 208 00:08:29,734 --> 00:08:31,203 PUBLIC ABOUT THIS REASONING AND 209 00:08:31,203 --> 00:08:33,772 JUST TO EMPHASIZE WE HAVEN'T 210 00:08:33,772 --> 00:08:34,973 CHANGED OUR CONCLUSION; WE'RE 211 00:08:34,973 --> 00:08:36,541 JUST CHANGING HOW WE'RE 212 00:08:36,541 --> 00:08:40,879 FORMATTING IT TO IMPROVE 213 00:08:40,879 --> 00:08:41,880 CLARITY. 214 00:08:41,880 --> 00:08:46,818 SO, WITH THAT, I AM NOW 215 00:08:46,818 --> 00:08:47,752 TRANSITIONING, NEXT SLIDE 216 00:08:47,752 --> 00:08:51,389 PLEASE, TO THE FOOD PATTERN 217 00:08:51,389 --> 00:08:57,095 MODELING AND DATA ANALYSIS LED 218 00:08:57,095 --> 00:08:58,396 BY CHRIS TAYLOR. 219 00:08:58,396 --> 00:08:59,498 >> THANK YOU, SARAH. 220 00:08:59,498 --> 00:09:01,800 AND SO WE'RE GOING TO TALK ABOUT 221 00:09:01,800 --> 00:09:03,969 SOME NEW DATA FROM FOOD PATTERN 222 00:09:03,969 --> 00:09:07,239 MODELING AND WRAPPING UP OUR 223 00:09:07,239 --> 00:09:12,277 ANALYSES ON THIS ASPECT. 224 00:09:12,277 --> 00:09:14,579 SO, NEXT SLIDE PLEASE. 225 00:09:14,579 --> 00:09:16,214 AGAIN, TO LIST OUT OUR AMAZING 226 00:09:16,214 --> 00:09:19,718 SUBCOMMITTEE MEMBERS THAT WE 227 00:09:19,718 --> 00:09:22,254 HAVE THAT HAVE TACKLED AN 228 00:09:22,254 --> 00:09:23,989 INORDINATE AND MOUNDS OF DATA 229 00:09:23,989 --> 00:09:26,391 WE'VE USED TO COLLECT ALL THIS 230 00:09:26,391 --> 00:09:27,926 INFORMATION TO EVALUATE ALL 231 00:09:27,926 --> 00:09:32,197 THESE QUESTIONS AND TO REALLY 232 00:09:32,197 --> 00:09:33,732 MAKE THESE DETERMINATIONS 233 00:09:33,732 --> 00:09:35,600 MEETING NUTRIENT GOALS, BASED ON 234 00:09:35,600 --> 00:09:37,903 THE DIETARY PATTERN. 235 00:09:37,903 --> 00:09:39,504 AND INCLUDED WITHIN THIS SET ARE 236 00:09:39,504 --> 00:09:41,072 ALSO SEVERAL MEMBERS OF THE 237 00:09:41,072 --> 00:09:43,174 HEALTH EQUITY WORKING GROUP SO 238 00:09:43,174 --> 00:09:45,544 IT ALLOWS US TO OVERLAY THOSE 239 00:09:45,544 --> 00:09:48,313 HEALTH EQUITY LENS WITHIN THE 240 00:09:48,313 --> 00:09:51,683 WORK THAT WE'RE DOING. 241 00:09:51,683 --> 00:10:02,193 AND ALSO TODAY PRESENTING WILL 242 00:10:04,663 --> 00:10:07,999 BE DR. TAREGAWKAR 243 00:10:07,999 --> 00:10:09,467 TOBIAS, AND MILLER PRESENTING 244 00:10:09,467 --> 00:10:09,801 THE RESULTS. 245 00:10:09,801 --> 00:10:11,836 NONE OF THIS WORK WITHOUT THE 246 00:10:11,836 --> 00:10:12,804 POSSIBLE WITHOUT THE AMAZING 247 00:10:12,804 --> 00:10:17,075 STAFF THAT WE HAVE THAT SUPPORT 248 00:10:17,075 --> 00:10:25,417 US, SO JUST ONCE AGAIN. 249 00:10:25,417 --> 00:10:26,818 TRANSITIONS INTO FINALIZING ALL 250 00:10:26,818 --> 00:10:29,654 THESE DATA AND GETTING US READY 251 00:10:29,654 --> 00:10:31,856 FOR INTEGRATION HAS BEEN A 252 00:10:31,856 --> 00:10:36,461 MASSIVE LIFT, AND THE STAFF HAVE 253 00:10:36,461 --> 00:10:37,963 BEEN AN AMAZING RESOURCE TO HELP 254 00:10:37,963 --> 00:10:39,631 US TRANSLATE THESE HUNDREDS OF 255 00:10:39,631 --> 00:10:40,498 THOUSANDS OF DATA POINTS INTO 256 00:10:40,498 --> 00:10:44,769 SOMETHING THAT WE CAN TURN INTO 257 00:10:44,769 --> 00:10:45,236 ACTIONABLE INTEGRATION 258 00:10:45,236 --> 00:10:46,638 DISCUSSION, BOTH TOMORROW FOR 259 00:10:46,638 --> 00:10:49,374 OUR SUMMARY AS WELL AS FOR THE 260 00:10:49,374 --> 00:10:52,677 INTEGRATION DISCUSSION IN THE 261 00:10:52,677 --> 00:10:53,011 AFTERNOON. 262 00:10:53,011 --> 00:10:54,412 NEXT SLIDE PLEASE. 263 00:10:54,412 --> 00:10:56,715 SO, THE COMMITTEE IS CHARGED 264 00:10:56,715 --> 00:10:59,351 WITH ANSWERING ONE SINGLE 265 00:10:59,351 --> 00:11:00,452 OVERAMPING QUESTION, WHICH IS 266 00:11:00,452 --> 00:11:01,519 CONSIDERING EACH LIFE STAGE 267 00:11:01,519 --> 00:11:07,158 SHOULD CHANGES BE MADE TO THE 268 00:11:07,158 --> 00:11:10,729 U.S. DIETARY PATTERNS INCLUDE 269 00:11:10,729 --> 00:11:13,665 HEALTHY U.S. PATTER, 270 00:11:13,665 --> 00:11:14,766 MEDITERRANEAN, OR HEALTHY 271 00:11:14,766 --> 00:11:16,201 VEGETARIAN PATTERN AND SHOULD 272 00:11:16,201 --> 00:11:17,402 ADDITIONAL PATTERNS BE DEVELOPED 273 00:11:17,402 --> 00:11:19,270 OR PROPOSED? 274 00:11:19,270 --> 00:11:21,206 WE DEVELOPED MULTIPLE ANALYSES 275 00:11:21,206 --> 00:11:23,975 DEFINED IN THE 11 PROTOCOLS 276 00:11:23,975 --> 00:11:30,749 POSTED, AND POSTED ON DIETARY 277 00:11:30,749 --> 00:11:33,585 GUIDELINES.GOV AND IMPLEMENTED 278 00:11:33,585 --> 00:11:34,352 FOR OUR WORK. 279 00:11:34,352 --> 00:11:39,324 THIS IS THE GRAPHICAL DEPICTION 280 00:11:39,324 --> 00:11:42,260 OF THE WORK WE'VE CONDUCTED THAT 281 00:11:42,260 --> 00:11:43,895 WE STARTED WITH NUTRIENT PROFILE 282 00:11:43,895 --> 00:11:49,067 DEVELOPMENT, MOVED INTO THE FOOD 283 00:11:49,067 --> 00:11:52,904 GROUPS AND SUBGROUPS ANALYSIS, 284 00:11:52,904 --> 00:11:54,105 TODAY WHAT YOU'LL SEE, NEXT 285 00:11:54,105 --> 00:11:55,974 SLIDE PLEASE, WITH STARS ARE THE 286 00:11:55,974 --> 00:11:58,143 INFORMATION THAT WILL BE 287 00:11:58,143 --> 00:12:04,149 PRESENTED FOR BOTH REDUCING 288 00:12:04,149 --> 00:12:04,949 ANIMAL-BASED FOODS, REDUCING 289 00:12:04,949 --> 00:12:05,650 CARBOHYDRATE-CONTAINING FOODS 290 00:12:05,650 --> 00:12:10,955 AND RANGES OF FOOD DENSITY, OUR 291 00:12:10,955 --> 00:12:13,425 LAST PHASE OF RECORDING. 292 00:12:13,425 --> 00:12:18,396 TOMORROW WE'LL TALK ABOUT DIE 293 00:12:18,396 --> 00:12:20,131 'EM SIMULATION, EVALUATION AND 294 00:12:20,131 --> 00:12:21,232 RYE FINING OF DIETARY PATTERNS, 295 00:12:21,232 --> 00:12:22,100 ANSWERING THE EVIDENCE WE NEED 296 00:12:22,100 --> 00:12:23,368 FOR THE FULL QUESTION. 297 00:12:23,368 --> 00:12:25,870 THAT GIVES A CONTEXT. 298 00:12:25,870 --> 00:12:29,240 TODAY WE'LL WRAP UP WITH THE 299 00:12:29,240 --> 00:12:30,208 REMAINING RESULTS, AND SYNTHESIS 300 00:12:30,208 --> 00:12:34,913 AND INTEGRATION WILL BE A LARGE 301 00:12:34,913 --> 00:12:36,448 PART OF TOMORROW'S CONVERSATION. 302 00:12:36,448 --> 00:12:37,982 ALL OF THIS WILL BE DONE 303 00:12:37,982 --> 00:12:42,620 CONSIDERING EACH LIFE STAGE AND 304 00:12:42,620 --> 00:12:44,322 SHOULD CHANGES BE MADE WITHIN 305 00:12:44,322 --> 00:12:47,292 THE PATTERN SO WE'VE BEEN 306 00:12:47,292 --> 00:12:48,159 INCORPORATING SYSTEMATIC 307 00:12:48,159 --> 00:12:51,463 REVIEWS, DATA ANALYSIS, FOOD 308 00:12:51,463 --> 00:12:53,298 PATTERN MODELING RESULTS 309 00:12:53,298 --> 00:12:54,833 TOGETHER AS WE CARRIED FORWARD 310 00:12:54,833 --> 00:12:57,602 LOOKING AT POPULATION NORMS, 311 00:12:57,602 --> 00:13:05,910 PREFERENCES, NEEDS OF DIVERSE 312 00:13:05,910 --> 00:13:06,678 COMMUNITIES, FACTORING TOGETHER 313 00:13:06,678 --> 00:13:08,179 WITH THE DATA WE HAVE. 314 00:13:08,179 --> 00:13:13,451 NEXT SLIDE PLEASE. 315 00:13:13,451 --> 00:13:16,187 SO, AGAIN, WE'LL BREAK THIS UP 316 00:13:16,187 --> 00:13:17,822 WITH REMAINING RESULTS, WHICH 317 00:13:17,822 --> 00:13:20,759 WILL BE REMOVING ANIMAL-BASED 318 00:13:20,759 --> 00:13:21,359 FOODS, REDUCING 319 00:13:21,359 --> 00:13:23,294 CARBOHYDRATE-CONTAINING FOODS, 320 00:13:23,294 --> 00:13:25,029 RANGES OF NUTRIENT DENSITY. 321 00:13:25,029 --> 00:13:29,667 TOMORROW WE'LL TRANSITION INTO 322 00:13:29,667 --> 00:13:30,835 OUR SYNTHESIS AND INTEGRATION 323 00:13:30,835 --> 00:13:33,471 OUTCOMES FROM OUR FOOD PATTERN 324 00:13:33,471 --> 00:13:34,239 MODELING WORK. 325 00:13:34,239 --> 00:13:37,308 AND WITH THAT, I WOULD LIKE TO 326 00:13:37,308 --> 00:13:40,512 PASS THIS OVER TO SAMIRA TO LEAD 327 00:13:40,512 --> 00:13:42,480 US IN THE FIRST SET OF RESULTS. 328 00:13:42,480 --> 00:13:44,516 >> I'LL BE PRESENTING RESULTS 329 00:13:44,516 --> 00:13:46,718 FOR THE PROTOCOL WE DISCUSSED AT 330 00:13:46,718 --> 00:13:48,920 THE LAST MEETING, MOVING 331 00:13:48,920 --> 00:13:50,421 ANIMAL-BASED FOODS. 332 00:13:50,421 --> 00:13:51,723 INDIVIDUALS MAY AVOID ANIMAL 333 00:13:51,723 --> 00:13:55,794 SOURCES OF FOODS AND BEVERAGES 334 00:13:55,794 --> 00:13:57,428 FOR VARIOUS REASONS, RESULTING 335 00:13:57,428 --> 00:13:59,197 DIETS VARY IN COMPOSITION, 336 00:13:59,197 --> 00:14:00,298 BASICALLY IMPLICATIONS FOR 337 00:14:00,298 --> 00:14:02,167 NUTRIENT INTAKES. 338 00:14:02,167 --> 00:14:04,869 WE CURRENTLY DO NOT HAVE 339 00:14:04,869 --> 00:14:06,604 NATIONALLY REPRESENTATIVE DATA 340 00:14:06,604 --> 00:14:07,939 ON PREFERENCE OF VEGETARIAN 341 00:14:07,939 --> 00:14:14,179 DIETS AND THOSE ARE NO ANIMAL 342 00:14:14,179 --> 00:14:15,380 SOURCES, HOWEVER SURVEYS 343 00:14:15,380 --> 00:14:16,181 ESTIMATE THE PREVALENCE OF THESE 344 00:14:16,181 --> 00:14:23,388 DIETS IN THE U.S. IS LOW. 345 00:14:23,388 --> 00:14:24,923 REMOVING ANIMAL SOURCED FOODS 346 00:14:24,923 --> 00:14:30,795 AND BEVERAGES HAS NOT NOT BEEN 347 00:14:30,795 --> 00:14:32,363 EXAMINED SINCE 2010. 348 00:14:32,363 --> 00:14:37,168 SUPPORTED BY THE SUBINTEREST AND 349 00:14:37,168 --> 00:14:38,703 THESE ANALYSES WERE INCLUDED TO 350 00:14:38,703 --> 00:14:40,138 EXPLORE POTENTIAL FOR FUTURE 351 00:14:40,138 --> 00:14:41,873 DIETARY PATTERNS. 352 00:14:41,873 --> 00:14:46,678 NEXT SLIDE PLEASE. 353 00:14:46,678 --> 00:14:50,315 SO THESE FOOD ANALYSES EXAMINED 354 00:14:50,315 --> 00:14:51,282 HYPOTHETICAL MODIFICATIONS AND 355 00:14:51,282 --> 00:14:53,685 IMPLICATIONS ON COMPOSITION AND 356 00:14:53,685 --> 00:14:55,453 CONTRIBUTIONS OF 2020 HEALTHY 357 00:14:55,453 --> 00:14:56,754 VEGETARIAN DIETARY PATTERNS 2 358 00:14:56,754 --> 00:14:59,057 YEARS AND OLDER WHEN ANIMAL 359 00:14:59,057 --> 00:15:01,159 SOURCES CONTRIBUTING TO THE 360 00:15:01,159 --> 00:15:02,961 PATTERN WERE REMOVED. 361 00:15:02,961 --> 00:15:04,195 SPECIFICALLY THE ANALYSIS 362 00:15:04,195 --> 00:15:06,264 REMOVED ALL ANIMAL PRODUCTS FROM 363 00:15:06,264 --> 00:15:09,968 THE DAIRY AND FORTIFIED SOY 364 00:15:09,968 --> 00:15:12,036 ALTERNATIVE GROUP AND EGG 365 00:15:12,036 --> 00:15:13,137 SUBGROUP FROM PROTEIN FOODS 366 00:15:13,137 --> 00:15:13,605 GROUP. 367 00:15:13,605 --> 00:15:15,139 IT IS IMPORTANT TO NOTE HERE 368 00:15:15,139 --> 00:15:18,076 THAT THE DAIRY AND FORTIFIED SOY 369 00:15:18,076 --> 00:15:19,410 GROUP ALREADY INCLUDE AN OPTION 370 00:15:19,410 --> 00:15:21,045 FOR NON-ANIMAL SOURCE WHICH IS 371 00:15:21,045 --> 00:15:21,813 FORTIFIED SOY. 372 00:15:21,813 --> 00:15:24,415 SO WE ALSO LOOKED AT ANALYSES 373 00:15:24,415 --> 00:15:26,951 WITHOUT EGGS AND WITH AND 374 00:15:26,951 --> 00:15:27,952 WITHOUT FORTIFIED SOY. 375 00:15:27,952 --> 00:15:30,889 THE GOAL OF THESE ANALYSES WAS 376 00:15:30,889 --> 00:15:33,191 TO MODEL ANY POTENTIAL 377 00:15:33,191 --> 00:15:34,158 NUTRITIONAL GAPS THAT MAY RESULT 378 00:15:34,158 --> 00:15:36,361 FROM THE REMOVAL FROM ANIMAL 379 00:15:36,361 --> 00:15:37,962 SOURCES THAT ARE RECOMMENDED AS 380 00:15:37,962 --> 00:15:40,198 PART OF THE 2020 HEALTHY 381 00:15:40,198 --> 00:15:41,599 VEGETARIAN DIETARY PATTERN 382 00:15:41,599 --> 00:15:43,902 WITHOUT MAKING OTHER DIETARY 383 00:15:43,902 --> 00:15:44,669 SUBSTITUTIONS. 384 00:15:44,669 --> 00:15:48,406 AS YOU MIGHT RECOLLECT, AT 385 00:15:48,406 --> 00:15:52,010 MEETING 5 THIS PROTOCOL WAS 386 00:15:52,010 --> 00:15:52,277 PRESENTED. 387 00:15:52,277 --> 00:15:54,078 THE COMMITTEE DECIDED THESE 388 00:15:54,078 --> 00:15:56,581 WOULD NOT INCLUSION ADDITIONAL 389 00:15:56,581 --> 00:15:58,016 ANALYSES THAT WOULD MODIFY FOOD 390 00:15:58,016 --> 00:15:59,450 GROUPS AND SUBGROUPS TO ACHIEVE 391 00:15:59,450 --> 00:16:03,054 ENERGY TARGET OR DEVELOP A NEW 392 00:16:03,054 --> 00:16:03,488 PATTERN. 393 00:16:03,488 --> 00:16:05,356 THIS WAS BASED ON LIMITED DATA 394 00:16:05,356 --> 00:16:07,225 IN THE SCIENTIFIC LITERATURE ON 395 00:16:07,225 --> 00:16:09,727 THE DIETARY INTAKES AND 396 00:16:09,727 --> 00:16:10,828 POTENTIAL VARIATION AND 397 00:16:10,828 --> 00:16:13,765 RESULTING REPLACEMENT OF FOODS 398 00:16:13,765 --> 00:16:16,634 AND BEVERAGES AMONG THOSE WHO 399 00:16:16,634 --> 00:16:18,703 AVOID ANIMAL SOURCE PRODUCTS. 400 00:16:18,703 --> 00:16:20,438 THE RESULTS HELPED THE COMMITTEE 401 00:16:20,438 --> 00:16:21,873 DISCUSS DEGREE TO WHICH 402 00:16:21,873 --> 00:16:24,075 NUTRITIONAL GOALS MIGHT BE MET 403 00:16:24,075 --> 00:16:26,577 AFTER REMOVAL OF ANIMAL SOURCES 404 00:16:26,577 --> 00:16:28,780 AND USED TO PROVIDE ADVICE 405 00:16:28,780 --> 00:16:30,748 AROUND REMOVAL, TO INFORM FUTURE 406 00:16:30,748 --> 00:16:33,451 DECISIONS SUCH AS ADDITIONAL 407 00:16:33,451 --> 00:16:35,320 INTAKE DATA AND NUTRITIONAL 408 00:16:35,320 --> 00:16:35,853 COMPOSITION PRIORITIES FOR 409 00:16:35,853 --> 00:16:37,455 REPLACEMENT FOODS. 410 00:16:37,455 --> 00:16:37,956 NEXT SLIDE PLEASE. 411 00:16:37,956 --> 00:16:40,892 SO THIS IS OUR SUMMARY STATEMENT 412 00:16:40,892 --> 00:16:44,729 BASED ON THE ANALYSES CONDUCTED. 413 00:16:44,729 --> 00:16:45,964 SEVEN NUTRIENT GAPS INTRODUCED 414 00:16:45,964 --> 00:16:47,999 WHEN ALL ANIMAL SOURCES ARE 415 00:16:47,999 --> 00:16:51,202 REMOVED FROM THE 2020 HEALTHY 416 00:16:51,202 --> 00:16:53,471 VEGETARIAN PATTERNS FOR 2 YEARS 417 00:16:53,471 --> 00:16:54,172 AND OLDER. 418 00:16:54,172 --> 00:16:55,506 SPECIFIC NUTRIENTS THAT 419 00:16:55,506 --> 00:16:58,443 DECREASED FROM THIS REMOVAL 420 00:16:58,443 --> 00:17:05,583 INCLUDE PROTEIN, A, D, E, 421 00:17:05,583 --> 00:17:12,924 RIBOFLAVIN, NIGH SIGN, B 6 AND 422 00:17:12,924 --> 00:17:15,526 12, CHOLINE, MAGNESIUM AND SINK. 423 00:17:15,526 --> 00:17:16,894 FORTIFIED SOY IS CURRENTLY 424 00:17:16,894 --> 00:17:20,031 INCLUDED IN THE DAIRY GROUP. 425 00:17:20,031 --> 00:17:21,466 WHILE THIS MAY AMELIORATE 426 00:17:21,466 --> 00:17:23,101 NEGATIVE IMPLICATIONS FOR 427 00:17:23,101 --> 00:17:25,169 SEVERAL NUTRIENTS, OTHER 428 00:17:25,169 --> 00:17:28,406 NUTRIENT GAPS PERSIST. 429 00:17:28,406 --> 00:17:30,708 NEXT SLIDE PLEASE. 430 00:17:30,708 --> 00:17:33,111 WE BASED SUMMARY STATEMENT ON 431 00:17:33,111 --> 00:17:34,612 EVIDENCE THAT EXCLUSION OF EGGS 432 00:17:34,612 --> 00:17:37,782 AS WELL AS DAIRY AND FORTIFIED 433 00:17:37,782 --> 00:17:39,984 SOY ALTERNATIVES WITHOUT 434 00:17:39,984 --> 00:17:42,053 REPLACEMENT HAD NEGATIVE 435 00:17:42,053 --> 00:17:43,187 IMPLICATIONS ON VARIOUS 436 00:17:43,187 --> 00:17:44,455 NUTRIENTS AS PREVIOUSLY 437 00:17:44,455 --> 00:17:44,722 MENTIONED. 438 00:17:44,722 --> 00:17:46,324 SOME OF THESE ARE FOR ONLY 439 00:17:46,324 --> 00:17:48,626 CERTAIN AGE AND SEX GROUPS BUT 440 00:17:48,626 --> 00:17:52,563 OTHERS ARE FOR ALL AGE AND SEX 441 00:17:52,563 --> 00:17:53,231 GROUPS. 442 00:17:53,231 --> 00:17:54,198 CALCIUM AND VITAMIN B-12 IS 443 00:17:54,198 --> 00:17:57,035 ACROSS ALL AGE AND SEX GROUPS. 444 00:17:57,035 --> 00:17:59,670 SEVERAL OF THESE NUTRIENTS ARE 445 00:17:59,670 --> 00:18:02,206 OF CONCERN FOR LIFE STAGES, 446 00:18:02,206 --> 00:18:05,043 PROTEIN AN B-12 FOR ORDINARY 447 00:18:05,043 --> 00:18:07,979 ADULTS, CALCIUM FOR ADOLESCENT 448 00:18:07,979 --> 00:18:09,347 GIRLS. 449 00:18:09,347 --> 00:18:10,314 NEXT SLIDE PLEASE. 450 00:18:10,314 --> 00:18:15,019 WE ALSO AS I MENTIONED MODELED 451 00:18:15,019 --> 00:18:16,888 FORTIFIED SOY ALTERNATIVES, SUCH 452 00:18:16,888 --> 00:18:18,089 AS SOY MILK, REPLACEMENT FOR 453 00:18:18,089 --> 00:18:19,624 MILK IN THE PATTERN. 454 00:18:19,624 --> 00:18:22,427 THIS PATTERN WAS MODELED USING 455 00:18:22,427 --> 00:18:24,529 FORTIFIED SOY MILK. 456 00:18:24,529 --> 00:18:25,530 THIS REPLACEMENT LESSENED 457 00:18:25,530 --> 00:18:28,399 NEGATIVE IMPLICATIONS SEEN IN 458 00:18:28,399 --> 00:18:29,367 DAIRY AND FORTIFIED SOY 459 00:18:29,367 --> 00:18:30,234 ALTERNATIVE FOOD GROUP REMOVED 460 00:18:30,234 --> 00:18:34,739 NOT ALL GAPS ARE ADDRESSED. 461 00:18:34,739 --> 00:18:35,373 INDIVIDUALS AVOID OR LIMIT 462 00:18:35,373 --> 00:18:38,342 ANIMAL SOURCE FOODS FOR VARIOUS 463 00:18:38,342 --> 00:18:39,343 REASONS, AND REPLACEMENT 464 00:18:39,343 --> 00:18:41,846 DECISIONS VARY GREATLY. 465 00:18:41,846 --> 00:18:50,088 THE COMMITTEE DID NOT MODEL 466 00:18:50,088 --> 00:18:51,622 SCENARIOS WITH REPLACEMENT 467 00:18:51,622 --> 00:18:52,590 ALTERNATIVES. 468 00:18:52,590 --> 00:18:55,660 THE COMMITTEE CAUTIONS AGAINST 469 00:18:55,660 --> 00:18:58,830 EXCLUDING GROUPS WITHOUT CAREFUL 470 00:18:58,830 --> 00:19:09,540 PLANNING WITHOUTED WITHOUT ADEM 471 00:19:12,376 --> 00:19:22,587 DIETARY SOURCES. 472 00:19:27,058 --> 00:19:27,892 >> NOW CARBOHYDRATES. 473 00:19:27,892 --> 00:19:30,461 >> WITH THE -- NEXT SLIDE 474 00:19:30,461 --> 00:19:31,229 PLEASE. 475 00:19:31,229 --> 00:19:33,631 WITH THE REDUCTION OF 476 00:19:33,631 --> 00:19:35,032 CARBOHYDRATE-CONTAINING FOODS 477 00:19:35,032 --> 00:19:37,001 OUR ANALYSIS PLAN WAS TO REMOVE 478 00:19:37,001 --> 00:19:39,871 THE FOOD GROUPS THAT USED 479 00:19:39,871 --> 00:19:43,174 HIGHLIGHTED IN RED, MAJOR 480 00:19:43,174 --> 00:19:44,242 CONTRIBUTORS TO CARBOHYDRATES AT 481 00:19:44,242 --> 00:19:46,777 THE FOOD LEVEL, AND I WILL 482 00:19:46,777 --> 00:19:50,748 EMPHASIZE AGAIN UNLIKE THE LAST 483 00:19:50,748 --> 00:19:52,250 PROTOCOL CARBOHYDRATES ARE A 484 00:19:52,250 --> 00:19:54,118 MACRONUTRIENT, AND WE EAT FOODS, 485 00:19:54,118 --> 00:19:57,522 SO THIS IS NOT JUST THE GRAINS 486 00:19:57,522 --> 00:20:00,258 GROUP LIKE YOU MAY THINK BUT 487 00:20:00,258 --> 00:20:01,459 MORE PERSISTENT ACROSS SEVERAL 488 00:20:01,459 --> 00:20:03,995 OF THESE FOOD GROUPS. 489 00:20:03,995 --> 00:20:05,630 SO DAIRY, GRAINS, FRUITS, 490 00:20:05,630 --> 00:20:08,699 STARCHY VEGETABLES WERE INCLUDED 491 00:20:08,699 --> 00:20:12,136 IN THESE REDUCTIONS. 492 00:20:12,136 --> 00:20:13,171 NEXT SLIDE PLEASE. 493 00:20:13,171 --> 00:20:15,540 SO STRAIGHT TO THE SUMMARY 494 00:20:15,540 --> 00:20:19,877 STATEMENT, SEVERAL GAPS ARE 495 00:20:19,877 --> 00:20:20,878 INTRODUCED WHEN 496 00:20:20,878 --> 00:20:21,412 CARBOHYDRATE-CONTAINING 497 00:20:21,412 --> 00:20:24,482 NUTRIENTS DENSE FOODS AND 498 00:20:24,482 --> 00:20:25,116 BEVERAGES ARE REMOVED, 499 00:20:25,116 --> 00:20:27,018 EMPHASIZING THIS IS STARTING 500 00:20:27,018 --> 00:20:30,588 FROM NUTRIENT DENSE FOOD AND 501 00:20:30,588 --> 00:20:31,489 BEVERAGES WITHIN RECOMMENDED 502 00:20:31,489 --> 00:20:35,226 QUANTITIES ACROSS ALL SUBGROUPS 503 00:20:35,226 --> 00:20:37,728 AND FOOD GROUPS. 504 00:20:37,728 --> 00:20:40,264 FURTHER REMOVAL THAT OF THOSE 505 00:20:40,264 --> 00:20:46,170 HIGHLIGHTED ILLUSTRATED GAPS IN 506 00:20:46,170 --> 00:20:50,007 VITAMIN A, THIAMIN, RIBOFLAVIN, 507 00:20:50,007 --> 00:20:50,975 NIACIN, POTASSIUM, FIBER, ACROSS 508 00:20:50,975 --> 00:20:53,844 ALL AGE GROUPS AND CALORIE 509 00:20:53,844 --> 00:20:55,880 LEVELS, AND THESE DROPPED BELOW 510 00:20:55,880 --> 00:20:56,647 RECOMMENDED INTAKES ACROSS ALL 511 00:20:56,647 --> 00:20:58,216 OF THEM. 512 00:20:58,216 --> 00:21:02,587 THERE WERE ADDITIONAL DROPS 513 00:21:02,587 --> 00:21:04,455 AMONG PREGNANCY AND LACTATION 514 00:21:04,455 --> 00:21:07,325 FOR VITAMIN C, B 6, B-12. 515 00:21:07,325 --> 00:21:10,361 WE'LL WALK THROUGH THE 516 00:21:10,361 --> 00:21:12,463 SUPPORTING INFORMATION BEHIND 517 00:21:12,463 --> 00:21:12,897 THIS. 518 00:21:12,897 --> 00:21:16,400 SO THE MACRONUTRIENT MAKEUP OF 519 00:21:16,400 --> 00:21:18,469 THE HUSS PATTERN ACROSS A 520 00:21:18,469 --> 00:21:22,306 NUTRIENT-DENSE FORM OF FOODS AND 521 00:21:22,306 --> 00:21:23,808 BEVERAGESES IS 52% CALORIES FROM 522 00:21:23,808 --> 00:21:28,412 CARBS ACROSS ALL OF THE CALORIE 523 00:21:28,412 --> 00:21:29,313 LEVELS. 524 00:21:29,313 --> 00:21:32,083 THE FOOD GROUPS AND SUBGROUPS 525 00:21:32,083 --> 00:21:35,853 THAT WE'VE REMOVED IN THE MODEL 526 00:21:35,853 --> 00:21:37,922 TO EVALUATE INCLUDED GRAINS 527 00:21:37,922 --> 00:21:41,492 WHICH ARE SHOWN THERE, RANGING 528 00:21:41,492 --> 00:21:45,396 FROM 48 TO 160 GRAMS HER DAY 529 00:21:45,396 --> 00:21:47,365 DEPENDING ON CALORIE LIVE, 530 00:21:47,365 --> 00:21:54,372 FRUITS 24 TO 62, STARCHY 531 00:21:54,372 --> 00:21:57,074 VEGETABLES 10 TO 30 AND 532 00:21:57,074 --> 00:21:58,175 FORTIFIED BEVERAGES. 533 00:21:58,175 --> 00:22:00,478 ADDED SUGARS IN THIS MODELING 534 00:22:00,478 --> 00:22:02,346 REPRESENT LESS THAN 2% OF TOTAL 535 00:22:02,346 --> 00:22:04,148 CALORIES PER DAY, NOT REMOVING 536 00:22:04,148 --> 00:22:06,717 LUCKY CHARMS. 537 00:22:06,717 --> 00:22:08,152 THIS IS REMOVING THE NUTRIENT 538 00:22:08,152 --> 00:22:12,757 DENSE FORMS OF THE FOOD GROUPS 539 00:22:12,757 --> 00:22:13,724 LISTED HERE. 540 00:22:13,724 --> 00:22:15,493 NEXT SLIDE PLEASE. 541 00:22:15,493 --> 00:22:19,664 SO REMOVING THE GRAINS, FRUITS, 542 00:22:19,664 --> 00:22:21,766 DAIRY FORTIFIED SOY 543 00:22:21,766 --> 00:22:23,434 ALTERNATIVES, STARCHY VEGETABLES 544 00:22:23,434 --> 00:22:25,002 REDUCED TOTAL CALORIES BY 63%, 545 00:22:25,002 --> 00:22:26,637 SO THAT'S JUST THE STRAIGHT UP 546 00:22:26,637 --> 00:22:30,808 FOOD GAP THAT WE'RE SEEING IN 547 00:22:30,808 --> 00:22:32,777 THIS MODEL. 548 00:22:32,777 --> 00:22:36,947 THAT WOULD BE REMOVED ALTOGETHER 549 00:22:36,947 --> 00:22:38,582 IN A CARBOHYDRATE-RESTRICTED 550 00:22:38,582 --> 00:22:39,350 DIET. 551 00:22:39,350 --> 00:22:42,320 THIS TOOK WITH IT 54% OF THE 552 00:22:42,320 --> 00:22:44,722 PATTERN'S PROTEIN, AGAIN 553 00:22:44,722 --> 00:22:50,861 REMOVING FOODS NOT 554 00:22:50,861 --> 00:22:51,228 MACRONUTRIENTS. 555 00:22:51,228 --> 00:22:51,962 FOODS ARE COMPLICATED, PROTEIN 556 00:22:51,962 --> 00:22:54,365 IS FOUND IN HALF OF THE 557 00:22:54,365 --> 00:22:55,566 CARB-CONTAINING FOODS THAT WERE 558 00:22:55,566 --> 00:22:56,867 LISTED AND REMOVED. 559 00:22:56,867 --> 00:23:00,371 AS WELL AS 27% OF TOTAL FAT. 560 00:23:00,371 --> 00:23:02,340 SO THIS IS JUST RECAPPING WHAT 561 00:23:02,340 --> 00:23:05,076 WAS IN THE SUMMARY STATEMENT. 562 00:23:05,076 --> 00:23:06,711 THE LIST OF NUTRIENTS THAT FELL 563 00:23:06,711 --> 00:23:09,447 BELOW THE GOALS WITH THIS 564 00:23:09,447 --> 00:23:09,980 REMOVAL. 565 00:23:09,980 --> 00:23:14,385 A LOT MAY BE ANTICIPATED BECAUSE 566 00:23:14,385 --> 00:23:16,454 YOU'RE REDUCING CALORIES BY 63%, 567 00:23:16,454 --> 00:23:17,988 DIET OF VOLUME IS REDUCED, BUT 568 00:23:17,988 --> 00:23:20,491 AS WE'LL SEE ON THE NEXT SLIDE 569 00:23:20,491 --> 00:23:22,693 IN A MINUTE THESE ARE INTRODUCED 570 00:23:22,693 --> 00:23:24,962 BY SPECIFIC FOOD GROUPS IN 571 00:23:24,962 --> 00:23:25,963 PARTICULAR, WHICH MAKES SENSE, 572 00:23:25,963 --> 00:23:28,833 NUTRIENTS CLUSTER IN CERTAIN 573 00:23:28,833 --> 00:23:30,134 FOODS, AND REMOVING THEM 574 00:23:30,134 --> 00:23:31,235 ALTOGETHER DEPENDING ON THE 575 00:23:31,235 --> 00:23:33,537 GROUP YOU REMOVE MAKES SENSE. 576 00:23:33,537 --> 00:23:37,708 PREGNANCY AND LACTATION, YEAH. 577 00:23:37,708 --> 00:23:38,476 OKAY. 578 00:23:38,476 --> 00:23:41,312 SO, FOR THE GROUP-SPECIFIC 579 00:23:41,312 --> 00:23:43,414 REMOVAL, THIS IS WHEN JUST 580 00:23:43,414 --> 00:23:46,016 GRAINS ARE REMOVED, JUST FRUITS, 581 00:23:46,016 --> 00:23:47,985 JUST STARCHY VEGETABLES, AND 582 00:23:47,985 --> 00:23:53,924 JUST DAIRY AND FORTIFIED SOY 583 00:23:53,924 --> 00:23:59,697 ALTERNATIVE YOU CAN SEE THE 584 00:23:59,697 --> 00:24:00,464 REMOVAL. 585 00:24:00,464 --> 00:24:01,565 THIAMIN AND NIACIN FELL BELOW 586 00:24:01,565 --> 00:24:04,735 AND CREATED A GAP AMONG OLDER 587 00:24:04,735 --> 00:24:09,006 MEN 51 AND PLUS, AND PREGNANCY, 588 00:24:09,006 --> 00:24:10,441 CHILDREN, FEMALE ADOLESCENTS FOR 589 00:24:10,441 --> 00:24:13,511 WHICH CALCIUM IS PARTICULARLY 590 00:24:13,511 --> 00:24:16,013 IMPORTANT AND FOLATE, A GAP WAS 591 00:24:16,013 --> 00:24:17,448 INTRODUCED WITH REMOVAL OF 592 00:24:17,448 --> 00:24:21,619 GRAINS AND SO FORTH. 593 00:24:21,619 --> 00:24:23,788 FRUITS, VITAMIN C WERE THE MAIN 594 00:24:23,788 --> 00:24:25,322 CONTRIBUTOR TOWARDS REDUCTION IN 595 00:24:25,322 --> 00:24:27,191 PREGNANCY AND LACTATION, 596 00:24:27,191 --> 00:24:30,795 INTRODUCTION OF THAT GAP, AS 597 00:24:30,795 --> 00:24:32,096 WELL AS MAGNESIUM AND POTASSIUM 598 00:24:32,096 --> 00:24:33,964 FOR CERTAIN GROUPS. 599 00:24:33,964 --> 00:24:36,400 FIBER FROM GRAINS AND FRUITS WAS 600 00:24:36,400 --> 00:24:39,670 SEEN ACROSS ALL AGE RANGE AND 601 00:24:39,670 --> 00:24:41,472 LIFE STAGES. 602 00:24:41,472 --> 00:24:43,274 DAIRY AND FORTIFIED SOY 603 00:24:43,274 --> 00:24:50,181 ALTERNATIVES HAVE MICRO NUTRIENT 604 00:24:50,181 --> 00:24:56,086 IMPLICATIONS LISTED THERE. 605 00:24:56,086 --> 00:24:58,255 STARCHY VEG, VITAMIN A AND 606 00:24:58,255 --> 00:25:02,593 FIBER, HIGHLIGHTING THE 607 00:25:02,593 --> 00:25:04,528 COMPLEXITY, REMOVAL OF A CERTAIN 608 00:25:04,528 --> 00:25:06,730 MACRONUTRIENT OR FOODS THAT 609 00:25:06,730 --> 00:25:07,531 CONTAIN IT IS COMPLICATED, AND 610 00:25:07,531 --> 00:25:09,433 THIS IS ONE OF THE REASONS THAT 611 00:25:09,433 --> 00:25:12,169 PRECLUDED US FROM BEING ABLE TO 612 00:25:12,169 --> 00:25:14,371 DEVELOP A PATTERN ASSUMING WHAT 613 00:25:14,371 --> 00:25:17,441 THAT SORT OF 63% OF CALORIES WAS 614 00:25:17,441 --> 00:25:21,445 REMOVED WOULD BE MADE UP WITH, 615 00:25:21,445 --> 00:25:23,747 BASED ON THE REMAINING FOODS 616 00:25:23,747 --> 00:25:27,618 THAT DID NOT GET EXCLUDED FOR 617 00:25:27,618 --> 00:25:29,019 THE CARB CONTENT. 618 00:25:29,019 --> 00:25:31,522 AND THEN MY LAST SLIDE. 619 00:25:31,522 --> 00:25:41,031 YEAH, SO THANK YOU. 620 00:25:41,031 --> 00:25:45,102 >> I THINK WE'LL OPEN UP FOR 621 00:25:45,102 --> 00:25:47,505 DISCUSSION. 622 00:25:47,505 --> 00:25:50,875 623 00:25:50,875 --> 00:25:51,876 CHRISTOPHER, THEN CHRISTINA. 624 00:25:51,876 --> 00:25:53,744 >> THANKS FOR A GREAT 625 00:25:53,744 --> 00:25:54,044 DISCUSSION. 626 00:25:54,044 --> 00:25:55,713 SO, MAYBE I MISSED IT. 627 00:25:55,713 --> 00:25:58,115 I SAW DEE DEE PRESENT 63% OF 628 00:25:58,115 --> 00:25:59,750 CALORIES WOULD BE REMOVED IF YOU 629 00:25:59,750 --> 00:26:02,253 GOT RID OF ALL THOSE GROUPS BUT 630 00:26:02,253 --> 00:26:03,254 REMOVING ANIMAL SOURCES, WAS 631 00:26:03,254 --> 00:26:05,990 THERE A PERCENT OF CALORIES 632 00:26:05,990 --> 00:26:08,392 REMOVED IN THAT SLIDE? 633 00:26:08,392 --> 00:26:10,995 >> THERE WAS, BUT I -- YES, 634 00:26:10,995 --> 00:26:12,563 THERE WAS DECREASE IN CALORIES 635 00:26:12,563 --> 00:26:13,197 AS WELL. 636 00:26:13,197 --> 00:26:15,399 >> NO, BUT WHAT WAS IT? 637 00:26:15,399 --> 00:26:17,268 WHAT WAS THE MAGNITUDE? 638 00:26:17,268 --> 00:26:19,103 DOESN'T MATTER IF YOU FIND IT. 639 00:26:19,103 --> 00:26:20,538 I'D LOVE TO -- I MAY HAVE 640 00:26:20,538 --> 00:26:22,273 PROPOSED THIS LAST TIME. 641 00:26:22,273 --> 00:26:26,977 ONE OPTION WOULD BE TO TAKE THE 642 00:26:26,977 --> 00:26:29,880 HEALTHY U.S. PATTERN AND REDUCE 643 00:26:29,880 --> 00:26:30,514 THE NUMBER OF PATTERNS ACROSS 644 00:26:30,514 --> 00:26:32,349 THE BOARD AND SEE HOW MANY 645 00:26:32,349 --> 00:26:33,684 NUTRIENTS WOULD BE DEFICIENT. 646 00:26:33,684 --> 00:26:36,086 PART OF THE ISSUE HERE IS NOT 647 00:26:36,086 --> 00:26:36,353 REPLACING. 648 00:26:36,353 --> 00:26:38,389 HOW MANY NUTRIENTS WOULD BE 649 00:26:38,389 --> 00:26:38,656 DEFICIENT? 650 00:26:38,656 --> 00:26:40,057 LET'S SAY 40% OF CALORIES FROM 651 00:26:40,057 --> 00:26:42,026 ANIMAL SOURCE FOOD. 652 00:26:42,026 --> 00:26:44,862 IF YOU TOOK AWAY 40% OF CALORIES 653 00:26:44,862 --> 00:26:46,730 YOU WOULD BE LOW IN MANY 654 00:26:46,730 --> 00:26:47,398 NUTRIENTS. 655 00:26:47,398 --> 00:26:49,033 IF YOU'RE JUST TAKING AWAY 656 00:26:49,033 --> 00:26:50,768 ANIMAL SOURCE FOODS YOU'RE 657 00:26:50,768 --> 00:26:52,503 OBVIOUSLY -- AND NOT REPLACING, 658 00:26:52,503 --> 00:26:54,138 YOU'RE DEFICIENT IN MANY 659 00:26:54,138 --> 00:26:54,772 NUTRIENT. 660 00:26:54,772 --> 00:26:57,441 MIGHT BE AN INTERESTING 661 00:26:57,441 --> 00:26:59,276 COMPARISON TO TAKE ACROSS THE 662 00:26:59,276 --> 00:27:01,946 HEALTHY U.S. VERSUS ANIMAL 663 00:27:01,946 --> 00:27:02,646 SOURCED FOODS. 664 00:27:02,646 --> 00:27:05,115 A SECOND SUGGESTION COULD BE TO 665 00:27:05,115 --> 00:27:07,618 START WITH HEALTHY VEGETARIAN 666 00:27:07,618 --> 00:27:08,919 DIET, WHICH IS ALREADY GOTTEN 667 00:27:08,919 --> 00:27:12,323 RID OF ALL THOSE FOODS, AM I 668 00:27:12,323 --> 00:27:13,190 BEING REDUNDANT? 669 00:27:13,190 --> 00:27:14,725 >> THAT WAS WHAT WE STARTED 670 00:27:14,725 --> 00:27:14,925 WITH. 671 00:27:14,925 --> 00:27:16,026 >> OH, IT WAS THE HEALTH 672 00:27:16,026 --> 00:27:16,327 >> I. 673 00:27:16,327 --> 00:27:23,033 >> YES, AND REMOVED REMOVED ANL 674 00:27:23,033 --> 00:27:24,568 SOURCE FOODS AND VEGETABLES. 675 00:27:24,568 --> 00:27:31,041 >> SO JUST REMOVING DAIRY AND 676 00:27:31,041 --> 00:27:31,675 EGGS FROM VEGETARIAN? 677 00:27:31,675 --> 00:27:32,576 >> YES. 678 00:27:32,576 --> 00:27:33,010 >> DAK IT. 679 00:27:33,010 --> 00:27:33,777 >> CHRIS, I THINK YOU WERE 680 00:27:33,777 --> 00:27:35,946 REDDER IN YOUR LAST TIME YOU 681 00:27:35,946 --> 00:27:36,714 MENTIONED THIS. 682 00:27:36,714 --> 00:27:41,885 >> SORRY FOR GETTING THAT ONE 683 00:27:41,885 --> 00:27:42,186 WRONG. 684 00:27:42,186 --> 00:27:43,954 >> I DON'T UNDERSTAND ALL THE 685 00:27:43,954 --> 00:27:45,589 SIMULATION THINGS. 686 00:27:45,589 --> 00:27:47,791 BEAR WITH ME. 687 00:27:47,791 --> 00:27:49,493 IF SOMEONE REMOVES, FOR EXAMPLE, 688 00:27:49,493 --> 00:27:51,662 GRAINS, WOULDN'T THEY REPLACE IT 689 00:27:51,662 --> 00:27:53,931 WITH SOMETHING ELSE LIKE IF YOU 690 00:27:53,931 --> 00:27:55,499 REMOVE GRAINS, WOULDN'T YOU 691 00:27:55,499 --> 00:27:56,767 INCREASE YOUR VEGETABLES? 692 00:27:56,767 --> 00:28:01,672 SO WHAT HAPPENS IF YOU DO THAT? 693 00:28:01,672 --> 00:28:04,108 >> SO, WE DO NOT HAVE 694 00:28:04,108 --> 00:28:04,875 INFORMATION IN SCIENTIFIC 695 00:28:04,875 --> 00:28:06,510 LITERATURE TO FIND OUT WHAT 696 00:28:06,510 --> 00:28:08,545 EXACTLY ARE PEOPLE REPLACING IT 697 00:28:08,545 --> 00:28:08,912 WITH. 698 00:28:08,912 --> 00:28:10,114 THAT'S AN INDIVIDUAL LEVEL 699 00:28:10,114 --> 00:28:11,649 PERSONAL CHOICE OR DECISION. 700 00:28:11,649 --> 00:28:13,517 WE DID NOT HAVE INFORMATION FROM 701 00:28:13,517 --> 00:28:14,818 THE DATA TO ACTUALLY INFORM 702 00:28:14,818 --> 00:28:15,719 THOSE ANALYSES. 703 00:28:15,719 --> 00:28:18,355 SO WHEN WE DID NOT HAVE THAT, WE 704 00:28:18,355 --> 00:28:20,524 ACTUALLY HAD TO STOP THE 705 00:28:20,524 --> 00:28:22,159 ANALYSES AND SAY WE DON'T KNOW 706 00:28:22,159 --> 00:28:24,028 ENOUGH TO FIND OUT LIKE WHAT ARE 707 00:28:24,028 --> 00:28:26,230 PEOPLE REPLACING IT WITH. 708 00:28:26,230 --> 00:28:29,933 THERE'S ANECDOTAL OR CASE 709 00:28:29,933 --> 00:28:30,834 STUDIES, NOT REALLY 710 00:28:30,834 --> 00:28:32,236 REPRESENTATIVE DATA THAT SAYS 711 00:28:32,236 --> 00:28:33,437 PEOPLE ARE REPLACING WITH THIS 712 00:28:33,437 --> 00:28:35,406 SO WE COULD NOT MODEL THOSE 713 00:28:35,406 --> 00:28:39,576 ANALYSES. 714 00:28:39,576 --> 00:28:43,180 >> YEAH, AND FOR CARBOHYDRATE 715 00:28:43,180 --> 00:28:47,351 MODELING IN TOOK, IT WAS SUCH A 716 00:28:47,351 --> 00:28:50,721 LARGE GAP WITH THE REMAINING 717 00:28:50,721 --> 00:28:51,722 FOODS WOULD REQUIRE EXCEEDING 718 00:28:51,722 --> 00:28:54,091 FOR MANY OF THEM THE 719 00:28:54,091 --> 00:28:54,692 QUANTITATIVE RECOMMENDATIONS. 720 00:28:54,692 --> 00:28:58,562 SO IF YOU MADE UP FOR IT BY 721 00:28:58,562 --> 00:29:00,998 INCREASING WITH ANY OF THE OTHER 722 00:29:00,998 --> 00:29:01,765 FOOD GROUPS, THEN MAYBE THERE 723 00:29:01,765 --> 00:29:04,201 WOULD BE CONCERNS ON THE OTHER 724 00:29:04,201 --> 00:29:04,635 END. 725 00:29:04,635 --> 00:29:05,936 ALSO, WE DIDN'T REMOVE EVERY 726 00:29:05,936 --> 00:29:09,039 SINGLE CARB. 727 00:29:09,039 --> 00:29:10,874 WE REMOVED THE LIKE CARBOHYDRATE 728 00:29:10,874 --> 00:29:11,875 RICH FOODS AND SUBGROUPS. 729 00:29:11,875 --> 00:29:13,844 SO IF YOU SORT OF LIKE INCREASE 730 00:29:13,844 --> 00:29:15,379 AND TAKE FROM EVERYTHING ELSE, 731 00:29:15,379 --> 00:29:17,815 YOU MAY STILL END UP DEFEATING 732 00:29:17,815 --> 00:29:19,983 THE 733 00:29:19,983 --> 00:29:23,787 THE PURPOSE OF A LOW CARB DIET 734 00:29:23,787 --> 00:29:25,189 BECAUSE OTHER FOODS CONTAIN 735 00:29:25,189 --> 00:29:29,393 SMALL AMOUNTS, DO YOU REMOVE 736 00:29:29,393 --> 00:29:30,928 THOSE AS WELL AND SO FORTH? 737 00:29:30,928 --> 00:29:33,530 SO WHAT WOULD MAKE UP WHAT THE 738 00:29:33,530 --> 00:29:35,733 PATTERN COULD LOOK LIKE BUT 739 00:29:35,733 --> 00:29:37,701 THAT'S AN AREA OF FUTURE 740 00:29:37,701 --> 00:29:41,105 RESEARCH, HOW COULD THAT BE DONE 741 00:29:41,105 --> 00:29:43,407 AND CONSISTENT, AS WELL AS BEING 742 00:29:43,407 --> 00:29:44,608 CONSISTENT WITH OTHER 743 00:29:44,608 --> 00:29:45,709 QUANTITATIVE RECOMMENDATIONS FOR 744 00:29:45,709 --> 00:29:46,710 REMAINING FOODS. 745 00:29:46,710 --> 00:29:48,645 BUT ALSO TO ADDRESS THE NUTRIENT 746 00:29:48,645 --> 00:29:50,380 GAPS WHICH MAY OR MAY NOT EVEN 747 00:29:50,380 --> 00:29:51,482 BE FEASIBLE WITH SOME OF THE 748 00:29:51,482 --> 00:29:53,250 FOOD GROUPS THAT ARE REMOVED 749 00:29:53,250 --> 00:29:55,886 BEING LIKE A PRIMARY SOURCE OF 750 00:29:55,886 --> 00:29:56,420 THOSE. 751 00:29:56,420 --> 00:30:00,691 >> I'LL FOLLOW UP. 752 00:30:00,691 --> 00:30:02,359 ARE YOU RECOMMENDING SPECIFIC 753 00:30:02,359 --> 00:30:03,060 FUTURE RESEARCH RECOMMENDATIONS 754 00:30:03,060 --> 00:30:07,030 SO WE CAN GET THAT DATA AND HOW 755 00:30:07,030 --> 00:30:11,401 WOULD THAT LOOK LIKE? 756 00:30:11,401 --> 00:30:17,174 >> WELL, AND AS BOTH MENTIONED, 757 00:30:17,174 --> 00:30:18,876 SUBSTITUTION BECOMES JUST AS 758 00:30:18,876 --> 00:30:19,409 IMPORTANT AS REMOVAL. 759 00:30:19,409 --> 00:30:21,145 THERE'S A LOT OF CONVERSATION ON 760 00:30:21,145 --> 00:30:24,081 REMOVAL OF THIS AND REMOVAL OF 761 00:30:24,081 --> 00:30:26,617 THAT INDEPENDENT OF NUTRITIONAL 762 00:30:26,617 --> 00:30:26,950 IMPLICATIONS. 763 00:30:26,950 --> 00:30:29,686 WHAT YOU PUT BACK IN BECOMES 764 00:30:29,686 --> 00:30:31,421 JUST AS IMPORTANT AS WHAT YOU 765 00:30:31,421 --> 00:30:32,422 PUT BACK IN. 766 00:30:32,422 --> 00:30:34,691 JUST FILLING WITH WHAT THE REST 767 00:30:34,691 --> 00:30:36,026 OF THE DIETARY PATTERN HAS -- 768 00:30:36,026 --> 00:30:38,095 YOU SEE WHAT DEE DEE SHOWED WAS 769 00:30:38,095 --> 00:30:40,831 THE NUTRIENTS THAT WERE SPECIFIC 770 00:30:40,831 --> 00:30:42,032 TO CORE FOOD GROUPS, WHEN YOU 771 00:30:42,032 --> 00:30:43,467 TAKE OUT THAT FOOD GROUP THEY 772 00:30:43,467 --> 00:30:45,669 MAY NOT BE RICH IN OTHER FOOD 773 00:30:45,669 --> 00:30:46,303 GROUP SOURCES. 774 00:30:46,303 --> 00:30:49,273 SO WHEN YOU TAKE SOMETHING OUT, 775 00:30:49,273 --> 00:30:51,008 THERE MAY NOT BE THE SAME 776 00:30:51,008 --> 00:30:53,410 NUTRIENTS IN ANOTHER FOOD SOURCE 777 00:30:53,410 --> 00:30:54,344 SO THE NUTRITIONAL ADEQUACY 778 00:30:54,344 --> 00:30:56,380 BECOMES AS MUCH OF A QUESTION AS 779 00:30:56,380 --> 00:30:58,982 IT IS THE REMOVAL. 780 00:30:58,982 --> 00:31:03,387 SO YOU NEED EVIDENCE AROUND WHAT 781 00:31:03,387 --> 00:31:05,155 ARE PEOPLE AVOIDING OR REMOVING 782 00:31:05,155 --> 00:31:05,722 FROM THESE DECISIONS. 783 00:31:05,722 --> 00:31:07,424 AND THEN WHAT ARE THE FOODS 784 00:31:07,424 --> 00:31:09,860 BEING PUT BACK IN SO THEN YOU 785 00:31:09,860 --> 00:31:12,930 HAVE AN UNDERSTANDING OF HOW DO 786 00:31:12,930 --> 00:31:14,565 YOU CREATE A PATTERN BASED ON 787 00:31:14,565 --> 00:31:15,766 THAT CONSUMPTION AND THEN CAN 788 00:31:15,766 --> 00:31:18,202 YOU EVALUATE THE PATTERN FOR IF 789 00:31:18,202 --> 00:31:19,736 YOU TAKE OUT ALL OF THE GRAINS 790 00:31:19,736 --> 00:31:21,138 THERE'S THE LIST OF NUTRIENTS, 791 00:31:21,138 --> 00:31:24,107 IF YOU PUT EVERYTHING ELSE BACK 792 00:31:24,107 --> 00:31:27,077 IN, THAT'S THE WAY IT'S TESTED, 793 00:31:27,077 --> 00:31:29,613 DO NUTRIENTS REEMERGE OR DO 794 00:31:29,613 --> 00:31:31,081 THOSE NUTRIENT GAPS PERSIST? 795 00:31:31,081 --> 00:31:34,318 SO EVIDENCE NEEDS TO COME ON NOT 796 00:31:34,318 --> 00:31:38,488 ONLY REMOVAL OF -- WE SEE THIS 797 00:31:38,488 --> 00:31:39,590 ACROSS OUR DIETARY PATTERNS, 798 00:31:39,590 --> 00:31:41,291 IT'S A DISTINCT DESCRIPTION OF 799 00:31:41,291 --> 00:31:46,563 WHAT THE PATTERN IS AND NOT JUST 800 00:31:46,563 --> 00:31:47,798 AN ESTIMATION OF CARBOHYDRATE 801 00:31:47,798 --> 00:31:50,634 INTAKE. 802 00:31:50,634 --> 00:31:51,301 >> GREAT. 803 00:31:51,301 --> 00:31:54,471 I THINK JENNY GOES NEXT AND 804 00:31:54,471 --> 00:31:54,872 FATIMA. 805 00:31:54,872 --> 00:31:58,642 >> MOTHER OF A -- MORE OF A 806 00:31:58,642 --> 00:31:59,810 COMMENT THIS PART OF THE 807 00:31:59,810 --> 00:32:03,513 DISCUSSION IS IMPORTANT IN THIS 808 00:32:03,513 --> 00:32:03,714 VENUE. 809 00:32:03,714 --> 00:32:05,849 MOST NUTRITIONISTS, LONG HISTORY 810 00:32:05,849 --> 00:32:13,857 ON SATURATED FAT, IT'S NOT JUST 811 00:32:13,857 --> 00:32:16,793 ABOUT REPLACING FAT, WHAT TO 812 00:32:16,793 --> 00:32:18,228 REPLACE IT WITH, MOVING FORWARD 813 00:32:18,228 --> 00:32:19,630 HOW THIS WILL PROGRESS WITH 814 00:32:19,630 --> 00:32:22,900 THOSE GOALS IN MIND. 815 00:32:22,900 --> 00:32:23,867 >> FATIMA AND SHERRILL. 816 00:32:23,867 --> 00:32:25,235 >> MY QUESTIONS IS WHETHER OR 817 00:32:25,235 --> 00:32:30,374 NOT YOU COULD UTILIZE A.I. TO 818 00:32:30,374 --> 00:32:31,675 SIMULATE THE SUBSTITUTION AS 819 00:32:31,675 --> 00:32:34,444 OPPOSED TO WAITING FOR THAT DATA 820 00:32:34,444 --> 00:32:35,746 TO BE GENERATED. 821 00:32:35,746 --> 00:32:37,915 SO MY QUESTION REALLY RELIES ON 822 00:32:37,915 --> 00:32:39,917 THAT SINCE WE KNOW THERE IS THE 823 00:32:39,917 --> 00:32:42,419 RISE OF A.I. AND BEING ABLE TO 824 00:32:42,419 --> 00:32:44,821 INCORPORATE THAT AND SIMULATE 825 00:32:44,821 --> 00:32:45,822 WHAT SUBSTITUTIONS COULD LOOK 826 00:32:45,822 --> 00:32:53,463 LIKE IN REAL LIFE. 827 00:32:53,463 --> 00:32:54,464 SO THAT'S MY QUESTION. 828 00:32:54,464 --> 00:32:58,435 >> I THINK THE BLACK BOX BEHIND 829 00:32:58,435 --> 00:33:00,404 A.I. IS DRIVING THAT DECISION. 830 00:33:00,404 --> 00:33:01,939 WHERE IS THE INFORMATION A.I. IS 831 00:33:01,939 --> 00:33:03,340 USING TO GENERATE THE 832 00:33:03,340 --> 00:33:05,409 SUBSTITUTION? 833 00:33:05,409 --> 00:33:07,110 ARE WE GETTING A COMPUTER-BASED 834 00:33:07,110 --> 00:33:08,845 MODEL THAT IDENTIFIES FOODS BUT 835 00:33:08,845 --> 00:33:11,348 DO THE COMPUTERS FULLY 836 00:33:11,348 --> 00:33:12,883 UNDERSTAND THE IMPLICATIONS OF 837 00:33:12,883 --> 00:33:15,819 THE COMPLEX NATURE OF DIET THAT 838 00:33:15,819 --> 00:33:16,787 DEE DEE WAS DESCRIBING? 839 00:33:16,787 --> 00:33:19,456 >> SO THEN A FOLLOW-UP TO THAT 840 00:33:19,456 --> 00:33:22,526 WOULD BE UTILIZING REAL LIFE, 841 00:33:22,526 --> 00:33:24,795 REAL WORLD DATA TO THEN GENERATE 842 00:33:24,795 --> 00:33:25,929 THE A.I. MODEL. 843 00:33:25,929 --> 00:33:27,130 SO, FOR EXAMPLE, IF A PATIENT 844 00:33:27,130 --> 00:33:28,398 COMES INTO AN OFFICE AN STATES 845 00:33:28,398 --> 00:33:31,068 TO ME, THIS IS WHAT MY DIET IS, 846 00:33:31,068 --> 00:33:34,805 SO I ASK MY PATIENTS WHAT IS A 847 00:33:34,805 --> 00:33:36,440 TYPICAL BREAKFAST LUNCH SNACK, 848 00:33:36,440 --> 00:33:37,741 LUNCH SNACK, DINNER SNACK, MANY 849 00:33:37,741 --> 00:33:41,812 PATIENTS HAVE DIETS THAT MAY BE 850 00:33:41,812 --> 00:33:44,014 WITHOUT, LET'S SAY, A MEAT 851 00:33:44,014 --> 00:33:44,982 SOURCE, ANIMAL-BASED SOURCE, AND 852 00:33:44,982 --> 00:33:48,485 THEY TELL ME WHAT THEIR 853 00:33:48,485 --> 00:33:50,454 SUBSTITUTIONS ARE, HAVE X NUMBER 854 00:33:50,454 --> 00:33:53,523 OF PATIENTS DO AND TELL YOU 855 00:33:53,523 --> 00:33:54,558 SUBTUITIONS, EXTRAPOLATE THAT 856 00:33:54,558 --> 00:33:58,762 INTO A REAL WORLD MODELING 857 00:33:58,762 --> 00:33:59,296 SITUATION. 858 00:33:59,296 --> 00:34:00,764 >> YEAH, AND I THINK THAT'S 859 00:34:00,764 --> 00:34:03,166 ALWAYS BEEN OUR CHALLENGE, 860 00:34:03,166 --> 00:34:04,968 COLLECTING COMPREHENSIVE DIETARY 861 00:34:04,968 --> 00:34:07,471 INTAKE DATA IN A SHORT PATIENT 862 00:34:07,471 --> 00:34:08,005 VISIT. 863 00:34:08,005 --> 00:34:10,741 GETTING IT TO AN ANALYSIS 864 00:34:10,741 --> 00:34:13,143 STANDPOINT, TO A POINT OF A 865 00:34:13,143 --> 00:34:15,645 LARGE DATASET WILL BECOME ONE OF 866 00:34:15,645 --> 00:34:16,646 THE CHALLENGES AND 867 00:34:16,646 --> 00:34:17,447 IMPLEMENTATION. 868 00:34:17,447 --> 00:34:19,850 IT BECOMES AN OPPORTUNITY, ALSO 869 00:34:19,850 --> 00:34:21,718 COMPARING IT USUAL INTAKES WE'VE 870 00:34:21,718 --> 00:34:23,420 SEEN ARE FAR BELOW WHAT MODEL 871 00:34:23,420 --> 00:34:25,088 THAT WE'RE USING WITHIN THE 872 00:34:25,088 --> 00:34:27,290 PATTERN SO WE'VE GOT TO PUT 873 00:34:27,290 --> 00:34:29,459 THOSE TWO THINGS TOGETHER IN 874 00:34:29,459 --> 00:34:31,995 TERMS OF WHAT ARE USUAL INTAKES 875 00:34:31,995 --> 00:34:37,901 AND RECOMMEND ATIONINGS IN THE 876 00:34:37,901 --> 00:34:43,640 PATTERN, THAT'S AN IMPORTANT 877 00:34:43,640 --> 00:34:45,809 STRATEGY DEE DEE? 878 00:34:45,809 --> 00:34:47,778 >> I'LL STOP TILL CHERYL HAS THE 879 00:34:47,778 --> 00:34:47,978 FLOOR. 880 00:34:47,978 --> 00:34:49,079 >> I DON'T HAVE A QUESTION SO 881 00:34:49,079 --> 00:34:50,247 MUCH AS A COMMENT. 882 00:34:50,247 --> 00:34:52,149 IN THINKING ABOUT THE QUESTION 883 00:34:52,149 --> 00:34:55,552 AT HAND, WHICH IS SHOULD A 884 00:34:55,552 --> 00:34:58,622 CHANGE BE MADE, RIGHT, TO THE 885 00:34:58,622 --> 00:35:01,591 EXISTING PATTERNS, IN THIS 886 00:35:01,591 --> 00:35:05,295 SHOULD WE REMOVE ANIMAL FAT IN 887 00:35:05,295 --> 00:35:06,196 VEGETARIAN PATTERN, CARB HYDRATE 888 00:35:06,196 --> 00:35:15,272 IN THE HEALTHY U.S. PATTERN, I 889 00:35:15,272 --> 00:35:17,340 COMMEND THE SUBCOMMITTEE FOR NOT 890 00:35:17,340 --> 00:35:19,876 ONLY ANSWERING THAT QUESTION, 891 00:35:19,876 --> 00:35:20,477 SHOWING THE NEGATIVE 892 00:35:20,477 --> 00:35:22,179 IMPLICATIONS, WHERE THEY WOULD 893 00:35:22,179 --> 00:35:26,216 BE MAKING THOSE ADJUSTMENTS BUT 894 00:35:26,216 --> 00:35:27,317 PARTICULARLY APPRECIATED THE 895 00:35:27,317 --> 00:35:29,619 SUMMARY OF DO IT IF YOU WANT, 896 00:35:29,619 --> 00:35:32,122 HOWEVER YOU REALLY HAVE TO BE 897 00:35:32,122 --> 00:35:33,657 CAREFUL ABOUT HOW WE'RE GOING TO 898 00:35:33,657 --> 00:35:35,692 ROUND OUT AND ENSURE ADEQUACY 899 00:35:35,692 --> 00:35:36,626 ACROSS THE ENTIRE DIET. 900 00:35:36,626 --> 00:35:37,627 I GET IT. 901 00:35:37,627 --> 00:35:38,829 THERE AREN'T DATA RIGHT NOW FOR 902 00:35:38,829 --> 00:35:40,230 US TO ANSWER THAT QUESTION OF 903 00:35:40,230 --> 00:35:42,432 HOW WE'RE GOING TO ROUND OUT TO 904 00:35:42,432 --> 00:35:43,033 ENSURE ADEQUACY. 905 00:35:43,033 --> 00:35:45,502 AND THAT'S WHAT WE DO. 906 00:35:45,502 --> 00:35:47,771 WE USE DATA TO INFORM THE 907 00:35:47,771 --> 00:35:49,172 SUMMARY STATEMENTS. 908 00:35:49,172 --> 00:35:51,942 SO I THOUGHT IT WAS A REALLY 909 00:35:51,942 --> 00:35:54,678 NICE JOB DONE, AND I REALLY, 910 00:35:54,678 --> 00:35:56,880 REALLY GOT IT WHEN THAT LAST BIT 911 00:35:56,880 --> 00:36:01,184 WAS ADDED TO THE STATEMENT. 912 00:36:01,184 --> 00:36:01,818 >> THANKS. 913 00:36:01,818 --> 00:36:02,919 DEE DEE? 914 00:36:02,919 --> 00:36:03,553 >> YEAH, THANK YOU. 915 00:36:03,553 --> 00:36:05,655 I THINK -- I AGREE, I THINK IT'S 916 00:36:05,655 --> 00:36:07,924 IMPORTANT WE DID LOOK AT THIS 917 00:36:07,924 --> 00:36:11,561 AND TAKE THE QUESTION SERIOUSLY. 918 00:36:11,561 --> 00:36:14,631 I ALSO FEEL LIKE IT'S WORTH 919 00:36:14,631 --> 00:36:18,135 EMPHASIZING AGAIN BOTH ANALYSES 920 00:36:18,135 --> 00:36:20,303 STARTED FROM THE HEALTHY 921 00:36:20,303 --> 00:36:21,705 RECOMMENDED NUTRIENT-DENSE FORMS 922 00:36:21,705 --> 00:36:26,209 OF THE FOODS AND BEVERAGES BEING 923 00:36:26,209 --> 00:36:26,443 MODELED. 924 00:36:26,443 --> 00:36:29,613 AND A LOT OF SORT OF LIKE THE 925 00:36:29,613 --> 00:36:32,249 LOW CARB ADVICE, THE PLANT-BASED 926 00:36:32,249 --> 00:36:34,985 ADVICE, IS CONSISTENT WITH WHAT 927 00:36:34,985 --> 00:36:37,220 IS ALREADY EXCLUDED FROM THAT 928 00:36:37,220 --> 00:36:38,488 HEALTHY PATTERN. 929 00:36:38,488 --> 00:36:41,124 WE'RE NOT MODELING SUGARY 930 00:36:41,124 --> 00:36:43,193 BEVERAGES AND POP TARTS AND 931 00:36:43,193 --> 00:36:43,527 DORITOS. 932 00:36:43,527 --> 00:36:45,929 THOSE ARE ALREADY NOT IN THE 933 00:36:45,929 --> 00:36:46,163 PATTERN. 934 00:36:46,163 --> 00:36:48,565 THE EXTENT TO WHICH THERE ARE 935 00:36:48,565 --> 00:36:51,434 BENEFITS WITHIN THIS HEALTHY 936 00:36:51,434 --> 00:36:53,303 PATTERN OF MANIPULATING THESE 937 00:36:53,303 --> 00:36:55,705 FOODS OR THESE TYPES OF MODELING 938 00:36:55,705 --> 00:36:57,340 ARE ALSO NOT KNOWN. 939 00:36:57,340 --> 00:36:59,843 LIKE WE KIND OF TOOK A LEAP AND 940 00:36:59,843 --> 00:37:01,645 LOOKED AT THE MODELING APPROACH 941 00:37:01,645 --> 00:37:02,913 BUT THE SYSTEMATIC REVIEW 942 00:37:02,913 --> 00:37:05,849 EVIDENCE AND OTHER LINES OF 943 00:37:05,849 --> 00:37:06,917 EVIDENCE WERE NOT MOTIVATED 944 00:37:06,917 --> 00:37:07,951 THAT, RIGHT? 945 00:37:07,951 --> 00:37:10,020 LIKE SOME OF THE OTHER ANALYSES 946 00:37:10,020 --> 00:37:12,556 THAT WE'LL LOOK AT MAY HAVE. 947 00:37:12,556 --> 00:37:15,959 SO, AGAIN, I THINK IN TERMS OF 948 00:37:15,959 --> 00:37:17,460 FUTURE DIRECTIONS FOR RESEARCH, 949 00:37:17,460 --> 00:37:25,602 DOES REMOVING REMOVING FRUIT HA 950 00:37:25,602 --> 00:37:25,835 BENEFIT? 951 00:37:25,835 --> 00:37:31,942 GRAINS, WHOLE GRAINS, GIVING AN 952 00:37:31,942 --> 00:37:33,343 ADDED BENEFIT, THAT I DON'T 953 00:37:33,343 --> 00:37:36,313 THINK IS WHERE, YOU KNOW, THERE 954 00:37:36,313 --> 00:37:40,150 IS AS MUCH RESEARCH AS MIGHT BE 955 00:37:40,150 --> 00:37:41,318 STATED. 956 00:37:41,318 --> 00:37:44,087 SO, AGAIN, JUST EMPHASIZING THAT 957 00:37:44,087 --> 00:37:45,589 PIECE IS ALSO REALLY IMPORTANT 958 00:37:45,589 --> 00:37:46,823 BECAUSE THERE'S A LOT OF 959 00:37:46,823 --> 00:37:49,559 ALIGNMENT ALREADY WITH WHAT 960 00:37:49,559 --> 00:37:57,434 WOULD NOT BE RECOMMENDED. 961 00:37:57,434 --> 00:37:57,867 >> GREAT. 962 00:37:57,867 --> 00:37:58,301 YES? 963 00:37:58,301 --> 00:38:00,170 >> I THINK CHRIS MENTIONED 964 00:38:00,170 --> 00:38:03,773 THERE'S A GAP BETWEEN HEALTHY 965 00:38:03,773 --> 00:38:06,610 PATTERNS AND ACTUAL INTAKE. 966 00:38:06,610 --> 00:38:08,545 SO DID THE COMMITTEE CONSIDER 967 00:38:08,545 --> 00:38:11,214 WHAT ARE THESE GAPS AND WHAT 968 00:38:11,214 --> 00:38:14,818 WOULD BE THE MOST IMPORTANT 969 00:38:14,818 --> 00:38:16,786 RECOMMENDATION TO BRIDGE THE 970 00:38:16,786 --> 00:38:19,956 IMPORTANT NUTRIENT GAPS AS WE 971 00:38:19,956 --> 00:38:20,390 MOVE FORWARD? 972 00:38:20,390 --> 00:38:22,025 >> YEAH, I THINK THAT WILL ALSO 973 00:38:22,025 --> 00:38:23,893 BE PART OF A LOT OF INTEGRATION 974 00:38:23,893 --> 00:38:25,562 DISCUSSION IS BECAUSE WITH THE 975 00:38:25,562 --> 00:38:28,498 HEALTHY U.S. STYLE PATTERN, 976 00:38:28,498 --> 00:38:30,767 WE'RE MODELING IT TO MEET THE 977 00:38:30,767 --> 00:38:34,871 NUTRIENT GOALS AND WE'RE SEEING 978 00:38:34,871 --> 00:38:37,507 FROM DATA ANALYSIS, I'LL STEAL 979 00:38:37,507 --> 00:38:41,278 HEATHER'S THUNDER HERE, THE U.S. 980 00:38:41,278 --> 00:38:43,980 ISN'T ALIGNED WELL WITH THE 981 00:38:43,980 --> 00:38:45,081 CURRENT RECOMMENDATIONS, SO YOU 982 00:38:45,081 --> 00:38:46,716 ALREADY HAVE A HURDLE TO GET 983 00:38:46,716 --> 00:38:50,787 THERE BUT OUR GOAL IS REALLY TO 984 00:38:50,787 --> 00:38:53,056 CREATE AN ACHIEVABLE PLAN TO 985 00:38:53,056 --> 00:38:55,592 MEET THOSE NUTRIENT GOALS. 986 00:38:55,592 --> 00:38:56,893 SO, THE IMPLEMENTATION SIDE HAS 987 00:38:56,893 --> 00:39:00,096 GOT TO BE IN CHANGING THAT TO 988 00:39:00,096 --> 00:39:00,964 GET THOSE, OUR FEDERAL PROGRAMS 989 00:39:00,964 --> 00:39:02,999 WITH DOING THAT AND HELPING USE 990 00:39:02,999 --> 00:39:08,305 WHAT WE'RE DEVELOPING FROM THE 991 00:39:08,305 --> 00:39:10,140 PATTERN TO GET IMPROVEMENTS IN 992 00:39:10,140 --> 00:39:12,676 THE PUBLIC'S INTAKE. 993 00:39:12,676 --> 00:39:14,110 SO, IT'S THIS JUXTAPOSITION, WE 994 00:39:14,110 --> 00:39:15,912 LOOK AT SYSTEM REVIEW EVIDENCE, 995 00:39:15,912 --> 00:39:18,148 THE EVIDENCE IS WHAT ARE PEOPLE 996 00:39:18,148 --> 00:39:20,250 CURRENTLY EATING AND MAKING 997 00:39:20,250 --> 00:39:20,650 CHANGES. 998 00:39:20,650 --> 00:39:23,186 WHICH IS DIFFERENT THAN THIS IS 999 00:39:23,186 --> 00:39:24,054 THE PATTERN THAT ACTUALLY HAS 1000 00:39:24,054 --> 00:39:25,488 DEVELOPED AND BEEN DEVELOPED 1001 00:39:25,488 --> 00:39:27,324 OVER TIME WITH PREVIOUS 1002 00:39:27,324 --> 00:39:29,426 COMMITTEES TO REALLY MEET 1003 00:39:29,426 --> 00:39:33,263 NUTRIENT GOALS AND REPRESENT THE 1004 00:39:33,263 --> 00:39:34,464 EVIDENCE SO BRIDGING THAT GAP 1005 00:39:34,464 --> 00:39:37,200 BETWEEN THE TWO AND WE'RE USING 1006 00:39:37,200 --> 00:39:40,403 CURRENT INTAKES FROM RECENT 1007 00:39:40,403 --> 00:39:43,006 INTAKES FROM NHANES TO DEVELOP 1008 00:39:43,006 --> 00:39:44,007 THOSE NUTRIENT PROFILES BUT 1009 00:39:44,007 --> 00:39:46,276 WE'RE PUTTING IT INTO THE MODEL 1010 00:39:46,276 --> 00:39:52,849 FOR MEETING ACTUAL NUTRIENT 1011 00:39:52,849 --> 00:39:53,483 GOALS. 1012 00:39:53,483 --> 00:39:55,151 >> CHRIS, ARE YOU READY TO 1013 00:39:55,151 --> 00:39:56,353 CONTINUE WITH FOOD PATTERN 1014 00:39:56,353 --> 00:39:56,886 MODELING? 1015 00:39:56,886 --> 00:40:00,090 THIS HAS BEEN A GREAT 1016 00:40:00,090 --> 00:40:00,390 DISCUSSION. 1017 00:40:00,390 --> 00:40:01,725 >> YES, THANKS FOR ALL OF YOUR 1018 00:40:01,725 --> 00:40:06,663 COMMENTS ALONG THE WAY, I'LL 1019 00:40:06,663 --> 00:40:08,965 PASS OVER TO HEATHER FOR RANGES 1020 00:40:08,965 --> 00:40:10,600 AND NUTRIENT DENSITY. 1021 00:40:10,600 --> 00:40:14,671 >> THIS IS OUR LAST SET OF 1022 00:40:14,671 --> 00:40:17,941 RESULTS TO SHARE. 1023 00:40:17,941 --> 00:40:19,943 FOR THIS SEGMENT WE ARE DOING 1024 00:40:19,943 --> 00:40:22,979 THIS AT THE END BECAUSE IT'S 1025 00:40:22,979 --> 00:40:26,049 REALLY A LOOK AT AFTER WE 1026 00:40:26,049 --> 00:40:28,785 FULFILL THE PATTERNS AND USE 1027 00:40:28,785 --> 00:40:32,188 ENERGY FOR THAT, IS THERE ANY 1028 00:40:32,188 --> 00:40:35,125 ENERGY LEFT FOR OTHER USES? 1029 00:40:35,125 --> 00:40:40,063 SO, SOMETIMES THIS HAS BEEN 1030 00:40:40,063 --> 00:40:47,737 CALLED LIKE DISCRETIONARY 1031 00:40:47,737 --> 00:40:50,774 CALORIES, RECREATIONAL CALORIES 1032 00:40:50,774 --> 00:40:53,176 YOU COULD USE IN OTHER WAYS. 1033 00:40:53,176 --> 00:40:54,978 OUR QUESTION HERE WHAT 1034 00:40:54,978 --> 00:40:57,046 QUANTITIES OF FOODS AND 1035 00:40:57,046 --> 00:40:58,581 BEVERAGES LOWER IN NUTRIENT 1036 00:40:58,581 --> 00:41:00,884 DENSITY CAN BE ACCOMMODATED IN 1037 00:41:00,884 --> 00:41:03,820 THE USDA DIETARY PATTERNS WHILE 1038 00:41:03,820 --> 00:41:05,455 MEETING NUTRITIONAL GOALS WITHIN 1039 00:41:05,455 --> 00:41:06,122 CALORIE LEVELS. 1040 00:41:06,122 --> 00:41:13,196 AND IF YOU REMEMBER, WE DO HAVE 1041 00:41:13,196 --> 00:41:17,400 OVER 10-CALORIE LEVELS THAT ARE 1042 00:41:17,400 --> 00:41:18,935 FOR RECOMMENDED FOR DIFFERENT 1043 00:41:18,935 --> 00:41:22,105 AGE/SEX GROUPS IN THE U.S. 1044 00:41:22,105 --> 00:41:26,142 MOVING TO OUR SYNTHESIS 1045 00:41:26,142 --> 00:41:28,778 STATEMENT HERE, WE MADE FOR A 1046 00:41:28,778 --> 00:41:30,947 POTENTIAL MODIFICATION TO ALL 1047 00:41:30,947 --> 00:41:33,917 DIETARY PATTERNS ACROSS ALL LIFE 1048 00:41:33,917 --> 00:41:36,886 STAGES STARTING AT AGE 2, AND 1049 00:41:36,886 --> 00:41:39,522 OUR STATEMENT IS THAT THE ENERGY 1050 00:41:39,522 --> 00:41:41,291 FROM NUTRIENT DENSE 1051 00:41:41,291 --> 00:41:42,358 REPRESENTATIVE FOODS AND 1052 00:41:42,358 --> 00:41:44,327 BEVERAGES UNDERLYING THE 1053 00:41:44,327 --> 00:41:45,862 NUTRIENT PROFILE CALCULATION FOR 1054 00:41:45,862 --> 00:41:49,599 EACH FOOD GROUP AND SUBGROUP ARE 1055 00:41:49,599 --> 00:41:50,066 VARIABLE. 1056 00:41:50,066 --> 00:41:52,435 SO JUST KIND OF REFERRING BACK 1057 00:41:52,435 --> 00:41:54,604 TO SOMETHING THAT DEE DEE SAID, 1058 00:41:54,604 --> 00:41:55,839 EVERYTHING IN THE PATTERN 1059 00:41:55,839 --> 00:42:00,243 ALREADY IS ALREADY VERY NUTRIENT 1060 00:42:00,243 --> 00:42:01,211 DENSE. 1061 00:42:01,211 --> 00:42:03,079 AND THAT'S MODELED AND WE HAVE 1062 00:42:03,079 --> 00:42:04,514 THAT, THE AMOUNT OF CALORIES 1063 00:42:04,514 --> 00:42:09,419 THAT ARE GOING WITH THAT, BUT 1064 00:42:09,419 --> 00:42:14,757 THAT AMOUNT OF CALORIES IS 1065 00:42:14,757 --> 00:42:15,158 SOMEWHAT VARIABLE. 1066 00:42:15,158 --> 00:42:16,960 THAT PRECLUDES OUR ABILITY TO 1067 00:42:16,960 --> 00:42:27,370 ESTIMATE THE QUANTITY OF 1068 00:42:34,210 --> 00:42:37,313 REMAINING CALORIES PER DAY. 1069 00:42:37,313 --> 00:42:38,848 THERE'S SUPPORT TO SUPPORT 1070 00:42:38,848 --> 00:42:40,149 EXPLORING MODIFICATION THAT DOES 1071 00:42:40,149 --> 00:42:41,584 NOT INCLUDE LISTING SPECIFIC 1072 00:42:41,584 --> 00:42:42,886 QUANTITIES OF REMAINING DAILY 1073 00:42:42,886 --> 00:42:44,320 CALORIES FOR OTHER USES IN 1074 00:42:44,320 --> 00:42:45,755 PRESENTATION OF PATTERNS. 1075 00:42:45,755 --> 00:42:49,792 HERE WHAT WE'RE REALLY SAYING IS 1076 00:42:49,792 --> 00:42:54,063 BECAUSE WHEN WE MODEL PATTERNS, 1077 00:42:54,063 --> 00:42:57,000 WE'RE USING UP A CERTAIN AMOUNT 1078 00:42:57,000 --> 00:42:57,767 OF CALORIES. 1079 00:42:57,767 --> 00:43:01,070 THAT AMOUNT IS AN ESTIMATE BUT 1080 00:43:01,070 --> 00:43:05,108 IT'S IN ACTUALITY VARIABLE. 1081 00:43:05,108 --> 00:43:08,044 BECAUSE OF THAT VARIABILITY, 1082 00:43:08,044 --> 00:43:09,612 IT'S REALLY DIFFICULT TO SAY 1083 00:43:09,612 --> 00:43:14,651 WITH CERTAINTY HOW MUCH ENERGY 1084 00:43:14,651 --> 00:43:17,353 WOULD BE LEFT OVER EVEN WHEN 1085 00:43:17,353 --> 00:43:18,488 MAKING NUTRIENT DENSE CHOICES 1086 00:43:18,488 --> 00:43:20,423 THERE'S NONE LEFT OVER. 1087 00:43:20,423 --> 00:43:23,927 SO WE'RE PROPOSING TO NOT LIST 1088 00:43:23,927 --> 00:43:26,663 WHAT MIGHT BE LEFT OVER BECAUSE 1089 00:43:26,663 --> 00:43:34,771 IT'S NOT A GOOD -- IT'S NOT VERY 1090 00:43:34,771 --> 00:43:35,638 IT'S VARIABLE, BEST WAY TO SAY 1091 00:43:35,638 --> 00:43:36,539 IT I GUESS. 1092 00:43:36,539 --> 00:43:42,579 YOU CAN SEE ON THE TABLE HERE 1093 00:43:42,579 --> 00:43:44,147 THAT WE'VE PROPOSED CROSSING OUT 1094 00:43:44,147 --> 00:43:47,150 LINES WHERE WE SHOW WHAT THESE 1095 00:43:47,150 --> 00:43:47,817 ESTIMATES WERE. 1096 00:43:47,817 --> 00:43:53,089 AND SO IT'S REALLY JUST A 1097 00:43:53,089 --> 00:43:56,025 MODIFICATION IN PRESENTATION OF 1098 00:43:56,025 --> 00:43:58,227 OUR RESULTS, OF OUR MODELING. 1099 00:43:58,227 --> 00:44:00,496 SO IF WE COULD GO TO THE NEXT 1100 00:44:00,496 --> 00:44:02,966 SLIDE, I WANT TO EXPLAIN THIS 1101 00:44:02,966 --> 00:44:04,567 RATIONALE A LITTLE BIT MORE. 1102 00:44:04,567 --> 00:44:07,971 REMEMBERING BACK TO HOW WE'RE 1103 00:44:07,971 --> 00:44:08,871 CREATING THESE NUTRIENT 1104 00:44:08,871 --> 00:44:11,307 PROFILES, WE'RE BASING THIS ON 1105 00:44:11,307 --> 00:44:14,110 WEIGHTED AVERAGE OF THE 1106 00:44:14,110 --> 00:44:15,545 PROPORTION OF CONSUMPTION WITHIN 1107 00:44:15,545 --> 00:44:20,316 EACH OF THOSE FOOD GROUPS AND 1108 00:44:20,316 --> 00:44:20,583 SUBGROUPS. 1109 00:44:20,583 --> 00:44:23,620 AND SO FOR EXAMPLE FOR THE RED 1110 00:44:23,620 --> 00:44:25,722 AND ORANGE VEGETABLE WE ESTIMATE 1111 00:44:25,722 --> 00:44:29,192 THAT ONE CUP EQUIVALENT HAS 1112 00:44:29,192 --> 00:44:32,061 ABOUT 53 CALORIES. 1113 00:44:32,061 --> 00:44:35,999 BUT WITHIN THAT SUBGROUP, YOU 1114 00:44:35,999 --> 00:44:38,201 HAVE RAW TOMATOES WHICH HAVE 31 1115 00:44:38,201 --> 00:44:41,904 CALORIES PER CUP EQUIVALENT, ALL 1116 00:44:41,904 --> 00:44:50,246 THE WAY UP TO COOKED SWEET 1117 00:44:50,246 --> 00:44:51,881 POTATOES, 180 CUP EQUIVALENT. 1118 00:44:51,881 --> 00:44:54,384 ON ANY ONE DAY, THERE COULD BE 1119 00:44:54,384 --> 00:44:56,586 OVER 100 CALORIES DIFFERENCE 1120 00:44:56,586 --> 00:44:59,422 JUST FOR THAT ONE SUBGROUP. 1121 00:44:59,422 --> 00:45:02,158 SO, WHEN YOU THINK ABOUT THAT 1122 00:45:02,158 --> 00:45:04,127 AND THEN ALL THE VARIABILITY 1123 00:45:04,127 --> 00:45:10,166 WENT IN ALL THE OTHER FOOD 1124 00:45:10,166 --> 00:45:12,235 GROUPS, IT'S JUST, IT MEANS 1125 00:45:12,235 --> 00:45:15,071 EVERY DAY YOU COULD BE MAYBE 1126 00:45:15,071 --> 00:45:17,707 HAVING NO EXTRA ENERGY LEFT TO 1127 00:45:17,707 --> 00:45:19,208 MAKE ANY OTHER CHOICES. 1128 00:45:19,208 --> 00:45:27,583 MOVING TO THE NEXT SLIDE. 1129 00:45:27,583 --> 00:45:31,287 WHEN WE ESTIMATE HOW MUCH MODEL 1130 00:45:31,287 --> 00:45:33,256 BASED ON NUTRIENT PROFILES TAKES 1131 00:45:33,256 --> 00:45:36,426 UP WE USE ABOUT 86% OF CALORIES 1132 00:45:36,426 --> 00:45:37,727 IN THE PATTERN. 1133 00:45:37,727 --> 00:45:40,930 AND THERE'S LESS THAN 2% OF 1134 00:45:40,930 --> 00:45:46,169 CALORIES FROM ADDED SUGARS, 6% 1135 00:45:46,169 --> 00:45:46,936 FROM SATURATED FATS. 1136 00:45:46,936 --> 00:45:49,439 THEN BUT WHEN WE'RE MAKING 1137 00:45:49,439 --> 00:45:51,074 CHOICES WITHIN HERE IT'S VERY 1138 00:45:51,074 --> 00:45:54,043 VARIABLE, AND SO IN OUR 1139 00:45:54,043 --> 00:45:56,012 MODIFICATION WE WANT TO PROPOSE 1140 00:45:56,012 --> 00:45:58,614 TO NOT PRESENT THIS ESTIMATE OF 1141 00:45:58,614 --> 00:46:04,654 LIMIT ON CALORIES FOR OTHER USES 1142 00:46:04,654 --> 00:46:06,522 FOR AGING 2 AND OLDER. 1143 00:46:06,522 --> 00:46:11,127 MOVING FORWARD WE HAVE A SECOND 1144 00:46:11,127 --> 00:46:12,962 SYNTHESIS STATEMENT, AND THIS IS 1145 00:46:12,962 --> 00:46:21,104 AN ASSESSMENT OF ENERGY 1146 00:46:21,104 --> 00:46:21,771 CONTRIBUTIONS LOWER, DEMONSTRATE 1147 00:46:21,771 --> 00:46:23,172 CHALLENGES WHILE STAYING IN 1148 00:46:23,172 --> 00:46:26,809 DAILY ALLOTMENT FOR CALORIES, 1149 00:46:26,809 --> 00:46:30,613 ADDED SUGARS, SATURATED FATS. 1150 00:46:30,613 --> 00:46:32,482 BECAUSE OF THAT WE'RE NOT 1151 00:46:32,482 --> 00:46:34,884 PROPOSING TO DO ANALYSIS TO 1152 00:46:34,884 --> 00:46:45,394 FURTHER SEE WHAT WOULD FIT, AS 1153 00:46:45,995 --> 00:46:48,431 AS DISCRETIONARY CALORIES 1154 00:46:48,431 --> 00:46:49,332 BECAUSE THEY COULD ALREADY BE 1155 00:46:49,332 --> 00:46:50,733 TAKEN UP. 1156 00:46:50,733 --> 00:46:51,734 IT'S NOT FEASIBLE TO PROVIDE 1157 00:46:51,734 --> 00:46:54,036 RELIABLE ESTIMATE OF A LIMIT ON 1158 00:46:54,036 --> 00:46:56,105 CALORIES FOR OTHER USES. 1159 00:46:56,105 --> 00:46:56,873 THEREFORE THE SUBSEQUENT 1160 00:46:56,873 --> 00:46:58,608 EVALUATION OF FOODS AND 1161 00:46:58,608 --> 00:47:00,476 BEVERAGES LOWER IN NUTRIENT 1162 00:47:00,476 --> 00:47:04,847 DENSITY FOR FEASIBLE INCLUSION 1163 00:47:04,847 --> 00:47:07,450 IS NOT WARRANTED. 1164 00:47:07,450 --> 00:47:11,220 AND WE'LL FOLLOW WITH 1165 00:47:11,220 --> 00:47:11,521 DISCUSSIONS. 1166 00:47:11,521 --> 00:47:12,188 >> THANK YOU, HEATHER. 1167 00:47:12,188 --> 00:47:20,530 I'M GOING TO HAND OVER TO 1168 00:47:20,530 --> 00:47:21,164 ANGELA. 1169 00:47:21,164 --> 00:47:24,233 >> THAT WAS VERY INTERESTING. 1170 00:47:24,233 --> 00:47:26,769 THINKING ABOUT THE MODELING, 1171 00:47:26,769 --> 00:47:31,240 JUST CLARIFICATION QUESTION, 1172 00:47:31,240 --> 00:47:33,876 IT'S AS PREPARED, THE FOOD, 1173 00:47:33,876 --> 00:47:34,877 NUTRIENT PROFILES PUT TOGETHER, 1174 00:47:34,877 --> 00:47:37,280 WHEN YOU TALKED ABOUT RAW 1175 00:47:37,280 --> 00:47:41,317 TOMATOES AND SWEET POTATOES, IS 1176 00:47:41,317 --> 00:47:42,618 THAT WITHOUT ANY ADDITIONS? 1177 00:47:42,618 --> 00:47:43,519 >> YEAH, THAT'S A GREAT 1178 00:47:43,519 --> 00:47:44,487 QUESTION. 1179 00:47:44,487 --> 00:47:46,856 SO THEY ARE IN THEIR MOST 1180 00:47:46,856 --> 00:47:49,158 NUTRIENT DENSE FORMS. 1181 00:47:49,158 --> 00:47:50,893 SO, PROBABLY FOR THE SWEET 1182 00:47:50,893 --> 00:47:52,862 POTATO IT'S NOT LIKE WITH BUTTER 1183 00:47:52,862 --> 00:47:54,497 AND, YOU KNOW, BROWN SUGAR OR 1184 00:47:54,497 --> 00:47:57,333 ANY OTHER THING THAT YOU WOULD 1185 00:47:57,333 --> 00:47:58,668 ADD. 1186 00:47:58,668 --> 00:48:06,075 AND THEY ARE ALSO IN THE VERSION 1187 00:48:06,075 --> 00:48:09,712 OF THE FOOD THAT'S MOST 1188 00:48:09,712 --> 00:48:12,448 PREVALENTLY CONSUMED BUT ALSO 1189 00:48:12,448 --> 00:48:17,353 MOST NUTRIENT DENSE. 1190 00:48:17,353 --> 00:48:18,955 SO WHAT COULD BE PREPARED. 1191 00:48:18,955 --> 00:48:21,090 >> THAT'S HELPFUL. 1192 00:48:21,090 --> 00:48:22,058 THANK YOU. 1193 00:48:22,058 --> 00:48:23,626 >> SO, DO I UNDERSTAND THAT WHAT 1194 00:48:23,626 --> 00:48:26,662 WE'RE SAYING IS WE'RE GETTING 1195 00:48:26,662 --> 00:48:29,498 RID OF THE CONCEPT DISCRETIONARY 1196 00:48:29,498 --> 00:48:30,766 CALORIES? 1197 00:48:30,766 --> 00:48:32,001 OKAY, YOU DIDN'T SAY THOSE WORDS 1198 00:48:32,001 --> 00:48:34,103 BUT THAT'S WHAT I TOOK. 1199 00:48:34,103 --> 00:48:36,706 FAMILIES USE THAT IDEA, YOU CAN 1200 00:48:36,706 --> 00:48:40,376 HAVE ONE TREAT A DAY, IT STILL 1201 00:48:40,376 --> 00:48:41,177 FITS. 1202 00:48:41,177 --> 00:48:42,345 WHETHER OR NOT THAT'S A GOOD 1203 00:48:42,345 --> 00:48:45,848 IDEA IS A DIFFERENT DISCUSSION. 1204 00:48:45,848 --> 00:48:47,149 HOW DO WE REFRAME THAT IN THE BE 1205 00:48:47,149 --> 00:48:50,987 A SENSE OF THE CONCEPT OF 1206 00:48:50,987 --> 00:48:51,988 DISCRETIONARY CALORIES, IF WE 1207 00:48:51,988 --> 00:48:54,257 GET RID OF THAT, OKAY ONE TREAT 1208 00:48:54,257 --> 00:48:57,860 A 1209 00:48:57,860 --> 00:48:59,896 A DAY STILL FITS, HOW DO WE FIT 1210 00:48:59,896 --> 00:49:03,232 IN THE CONCEPT OF A KNACK OR 1211 00:49:03,232 --> 00:49:04,767 TREAT THAT'S OUTSIDE BOUNDARIES 1212 00:49:04,767 --> 00:49:06,936 OF CLEAR MEALS THAT ARE 1213 00:49:06,936 --> 00:49:07,203 PREPARED. 1214 00:49:07,203 --> 00:49:09,238 >> I MAY NOT HAVE THE BEST 1215 00:49:09,238 --> 00:49:13,976 ANSWER BUT I THINK JUST THINKING 1216 00:49:13,976 --> 00:49:15,311 ABOUT EVERY DAY'S CHOICES 1217 00:49:15,311 --> 00:49:17,813 TOGETHER, KIND OF LIKE ARE 1218 00:49:17,813 --> 00:49:21,250 YOU -- HOW ARE YOU MAKING 1219 00:49:21,250 --> 00:49:23,619 CHOICES THROUGHOUT THE DAY, NOT 1220 00:49:23,619 --> 00:49:25,821 KIND OF CONSIDERING THOSE 1221 00:49:25,821 --> 00:49:27,356 DISCRETIONARY CALORIES IN 1222 00:49:27,356 --> 00:49:29,225 ISOLATION, LIKE I ATE HEALTHY SO 1223 00:49:29,225 --> 00:49:32,862 NOW I CAN HAVE THIS EXTRA THING. 1224 00:49:32,862 --> 00:49:35,564 JUST THINKING MORE HOLISTICALLY 1225 00:49:35,564 --> 00:49:41,070 ABOUT ALL OF THE CHOICES 1226 00:49:41,070 --> 00:49:43,339 THROUGHOUT THE DAY, AND THAT 1227 00:49:43,339 --> 00:49:44,974 MIGHT BE A STARTING POINT BUT 1228 00:49:44,974 --> 00:49:49,578 MAYBE OTHER PEOPLE HAVE IDEAS 1229 00:49:49,578 --> 00:49:49,979 TOO. 1230 00:49:49,979 --> 00:49:54,850 >> I MEAN, THAT'S A REALLY BIG 1231 00:49:54,850 --> 00:49:55,618 QUESTION. 1232 00:49:55,618 --> 00:49:57,053 THE DIETARY GUIDELINES DON'T 1233 00:49:57,053 --> 00:50:03,626 ALLOW LIKE BIRTHDAY CAKE, HOT 1234 00:50:03,626 --> 00:50:05,361 COCOA IN THE WINTER, THE CONCEPT 1235 00:50:05,361 --> 00:50:07,196 OF TAKING IT OUT OF DAILY 1236 00:50:07,196 --> 00:50:09,065 ALLOWANCE IS WHAT'S BEING 1237 00:50:09,065 --> 00:50:10,833 PROPOSED, MORE ALONG THE LINES 1238 00:50:10,833 --> 00:50:12,335 OF RECREATIONAL FOODS AND 1239 00:50:12,335 --> 00:50:14,437 BEVERAGES YOU ENJOY ONCE IN A 1240 00:50:14,437 --> 00:50:14,670 WHILE. 1241 00:50:14,670 --> 00:50:16,639 AND MAYBE THAT'S NOT DAILY, 1242 00:50:16,639 --> 00:50:18,708 MAYBE THAT IS SOMETHING LIKE 1243 00:50:18,708 --> 00:50:20,343 WEEKLY OR MONTHLY BUT I DON'T 1244 00:50:20,343 --> 00:50:20,576 KNOW. 1245 00:50:20,576 --> 00:50:24,747 ALSO, EARLIER I WAS MENTIONING 1246 00:50:24,747 --> 00:50:26,282 THAT THIS ISN'T EVEN MODELING IN 1247 00:50:26,282 --> 00:50:31,420 THE FORMS THEY ARE CONSUMED SO 1248 00:50:31,420 --> 00:50:33,723 WITH THAT, NUTRIENT DENSE 1249 00:50:33,723 --> 00:50:35,124 VERSION, ALREADY IN SOME 1250 00:50:35,124 --> 00:50:37,660 COMBINATIONS OF THESE FOODS AND 1251 00:50:37,660 --> 00:50:40,062 BEVERAGES BEING AT OR OVER THE 1252 00:50:40,062 --> 00:50:43,766 CALORIE LIMIT FOR MANY OF THESE 1253 00:50:43,766 --> 00:50:45,468 CALORIE LEVELS, IT'S UNLIKELY 1254 00:50:45,468 --> 00:50:48,637 THAT IN THE REAL WORLD GIVEN OUR 1255 00:50:48,637 --> 00:50:50,806 FOOD ENVIRONMENT THAT WOULD BE, 1256 00:50:50,806 --> 00:50:54,510 YOU KNOW, EVEN LESS ACHIEVABLE. 1257 00:50:54,510 --> 00:50:57,013 SO, I DON'T KNOW, I THINK IT'S 1258 00:50:57,013 --> 00:50:58,447 SOMETHING THAT WE COULD PROBABLY 1259 00:50:58,447 --> 00:51:00,950 DESCRIBE AND MENTION BUT IT'S 1260 00:51:00,950 --> 00:51:03,152 THE REMOVAL FROM THE LINE ITEM 1261 00:51:03,152 --> 00:51:06,422 AND THE TABLE THAT'S WHAT'S 1262 00:51:06,422 --> 00:51:10,059 BEING DRIVEN BY THESE. 1263 00:51:10,059 --> 00:51:10,393 >> THERESA? 1264 00:51:10,393 --> 00:51:12,028 >> I THINK WHEN IT COMES TO 1265 00:51:12,028 --> 00:51:17,066 MESSAGING WE NEED TO BE CLEAR TO 1266 00:51:17,066 --> 00:51:20,770 DESCRIBE THAT HERE ARE THE FOOD 1267 00:51:20,770 --> 00:51:22,104 GROUPS AND PROPORTIONS THAT IS 1268 00:51:22,104 --> 00:51:26,942 NEEDED TO MEET NUTRIENT NEEDS 1269 00:51:26,942 --> 00:51:28,344 FOR THAT ENERGY LEVEL. 1270 00:51:28,344 --> 00:51:29,712 HOWEVER DEPENDING ON FOOD 1271 00:51:29,712 --> 00:51:31,714 CHOICES THERE MIGHT BE ROOM OR 1272 00:51:31,714 --> 00:51:34,383 MIGHT NOT BE ROOM FOR ADDITIONAL 1273 00:51:34,383 --> 00:51:36,452 FOODS THAT COULD BE HEALTHY, 1274 00:51:36,452 --> 00:51:38,354 NUTRIENT DENSE, OR LESS NUTRIENT 1275 00:51:38,354 --> 00:51:38,721 DENSE. 1276 00:51:38,721 --> 00:51:40,389 AS LONG AS THERE'S DESCRIPTION 1277 00:51:40,389 --> 00:51:43,359 THERE THAT PEOPLE ARE AWARE AND 1278 00:51:43,359 --> 00:51:46,062 THEN BECAUSE HEATHER, AS YOU 1279 00:51:46,062 --> 00:51:49,799 SAID, IT'S SO VARIABLE THAT IF 1280 00:51:49,799 --> 00:51:52,635 THERE'S ANY LEFTOVER CALORIES, 1281 00:51:52,635 --> 00:51:53,736 SO VARIABLE, THAT FOR SOME 1282 00:51:53,736 --> 00:51:56,472 PEOPLE IT MIGHT BE BENEFICIAL TO 1283 00:51:56,472 --> 00:51:58,007 WORK WITH A PROFESSIONAL 1284 00:51:58,007 --> 00:52:03,045 REGISTERED DIETITIAN TO FIND OUT 1285 00:52:03,045 --> 00:52:04,046 FOR THEIR USUAL INTAKE HOW MUCH 1286 00:52:04,046 --> 00:52:05,915 ROOM THERE ARE AND WHAT WOULD BE 1287 00:52:05,915 --> 00:52:07,249 SUITABLE FOR THAT. 1288 00:52:07,249 --> 00:52:08,551 >> THANK YOU. 1289 00:52:08,551 --> 00:52:10,252 DEANNA AND THEN CHRIS. 1290 00:52:10,252 --> 00:52:13,122 >> YES, I KIND OF SEE WE CAN 1291 00:52:13,122 --> 00:52:15,191 SPIN THIS IN A POSITIVE LIGHT 1292 00:52:15,191 --> 00:52:15,357 TOO. 1293 00:52:15,357 --> 00:52:17,593 FOR INSTANCE IF YOU HAVE A SNACK 1294 00:52:17,593 --> 00:52:19,328 RATHER THAN SAYING I WANT A 1295 00:52:19,328 --> 00:52:20,763 TREAT OR SOMETHING FROM THOSE 1296 00:52:20,763 --> 00:52:23,365 EXTRA CALORIES YOU MIGHT SAY, 1297 00:52:23,365 --> 00:52:32,241 WELL, MAYBE I WANT CARROTS AND 1298 00:52:32,241 --> 00:52:35,978 HUMMUS OR APPLE AND PEANUT 1299 00:52:35,978 --> 00:52:38,280 BUTTER OR YOGURT, DRAWING FROM 1300 00:52:38,280 --> 00:52:41,317 THOSE CALORIES RATHER THAN GOING 1301 00:52:41,317 --> 00:52:42,318 OUTSIDE OF THEM. 1302 00:52:42,318 --> 00:52:45,488 >> IT'S GREAT FOR INTEGRATION 1303 00:52:45,488 --> 00:52:47,790 DISCUSSION, HOW THOSE PIECES 1304 00:52:47,790 --> 00:52:48,657 COME TOGETHER, FORESHADOWING FOR 1305 00:52:48,657 --> 00:52:53,028 TOMORROW AT THE LOWER CALORIE 1306 00:52:53,028 --> 00:52:56,265 LEVELS IT BECOMES MORE IMPORTANT 1307 00:52:56,265 --> 00:53:00,136 FOR NUTRIENT DENSITY WITHIN THE 1308 00:53:00,136 --> 00:53:02,872 CALORIES, FOR OUR YOUNGER 1309 00:53:02,872 --> 00:53:05,307 CHILDREN WE'VE MODELED BASED ON 1310 00:53:05,307 --> 00:53:07,276 NEW EER CALCULATIONS WITHOUT 1311 00:53:07,276 --> 00:53:12,848 HIGH LEVEL OF PHYSICAL ACTIVITY, 1312 00:53:12,848 --> 00:53:14,183 LOWEST CALORIE LEVELS YOU MIGHT 1313 00:53:14,183 --> 00:53:17,987 NEED FOR AGE SEX GROUPS. 1314 00:53:17,987 --> 00:53:19,855 IT ALSO MEANS THAT THERE'S VERY 1315 00:53:19,855 --> 00:53:22,591 LITTLE WIGGLE ROOM TO MEET 1316 00:53:22,591 --> 00:53:24,493 NUTRIENT NEEDS AS LOWER CALORIES 1317 00:53:24,493 --> 00:53:25,761 BECAUSE CALORIE LEVELS NEED TO 1318 00:53:25,761 --> 00:53:29,165 BE SO NUTRIENT DENSE IT GIVES 1319 00:53:29,165 --> 00:53:35,838 LESS WIGGLE ROOM, OUR PLUG FOR 1320 00:53:35,838 --> 00:53:37,239 PHYSICAL ACTIVITY, MORE FOOD 1321 00:53:37,239 --> 00:53:39,708 GIVES MORE POE TENGE TO GET 1322 00:53:39,708 --> 00:53:42,211 NUTRIENTS PACKED WITHIN, SO 1323 00:53:42,211 --> 00:53:43,979 WE'RE LOOKING AT THESE WITHIN 1324 00:53:43,979 --> 00:53:44,980 TIGHT CALORIC RESTRICTIONS AND 1325 00:53:44,980 --> 00:53:48,984 UNTIL YOU GET UP SO FAR THE 1326 00:53:48,984 --> 00:53:57,426 DENSITY NEEDS TO BE PACKED IN. 1327 00:53:57,426 --> 00:54:01,564 >> OTHER QUESTIONS? 1328 00:54:01,564 --> 00:54:01,897 ANGELA? 1329 00:54:01,897 --> 00:54:07,269 >> I'M CURIOUS, SINCE THE 1330 00:54:07,269 --> 00:54:14,476 CALORIE CAP IS ALSO KIND OF 1331 00:54:14,476 --> 00:54:16,345 TIGHT, DO YOU HAVE THOUGHTS 1332 00:54:16,345 --> 00:54:18,113 ABOUT THINGS ADDED TO FOODS, YOU 1333 00:54:18,113 --> 00:54:20,849 KNOW, THE PERCENTAGE OF 1334 00:54:20,849 --> 00:54:25,421 SATURATED FAT AND SUGARS, THAT'S 1335 00:54:25,421 --> 00:54:27,089 EXTREMELY LOW COMPARED TO WHAT 1336 00:54:27,089 --> 00:54:28,057 PEOPLE ARE CONSUMING. 1337 00:54:28,057 --> 00:54:34,196 I'M WONDERING IF YOU HAD 1338 00:54:34,196 --> 00:54:35,497 RECOMMENDATIONS IN RELATION TO 1339 00:54:35,497 --> 00:54:37,099 THAT HOW MESSAGING SHOULD GO. 1340 00:54:37,099 --> 00:54:39,001 ESSENTIALLY I DON'T THINK IT'S 1341 00:54:39,001 --> 00:54:42,404 THE TREAT BUT IT'S WITHIN THE 1342 00:54:42,404 --> 00:54:45,341 PREPARATION OF THAT ADDED FAT 1343 00:54:45,341 --> 00:54:50,479 AND POTENTIALLY ADDED SUGAR THAT 1344 00:54:50,479 --> 00:54:54,516 WOULD MAKE IT MAYBE DIFFICULT 1345 00:54:54,516 --> 00:54:55,951 BECAUSE EVEN WITHIN COOKING, FOR 1346 00:54:55,951 --> 00:54:56,719 EXAMPLE, THAT A CERTAIN 1347 00:54:56,719 --> 00:55:00,656 PERCENTAGE OF SOMETHING MAY BE 1348 00:55:00,656 --> 00:55:04,260 ADDED THAT'S OUTSIDE OF WATER, 1349 00:55:04,260 --> 00:55:06,462 SO I'M JUST CURIOUS, WHAT WOULD 1350 00:55:06,462 --> 00:55:08,864 RECOMMENDATION BE OR DISCUSSION 1351 00:55:08,864 --> 00:55:11,400 PARTICULARLY IF SOMEBODY WAS A 1352 00:55:11,400 --> 00:55:14,670 NUTRITION EDUCATOR, PLAYING A 1353 00:55:14,670 --> 00:55:24,280 ROLE OR A DIETITIAN THAT'S 1354 00:55:24,280 --> 00:55:25,281 COUNSELING. 1355 00:55:25,281 --> 00:55:27,249 >> WE'LL LET HEATHER TAKE THAT. 1356 00:55:27,249 --> 00:55:29,785 >> THAT'S A HARD QUESTION TO 1357 00:55:29,785 --> 00:55:30,519 GRAPPLE WITH. 1358 00:55:30,519 --> 00:55:35,491 SOME ITS ARE -- IDEAS THINKING 1359 00:55:35,491 --> 00:55:36,325 ABOUT PORTION SIZE, MAYBE 1360 00:55:36,325 --> 00:55:42,364 PORTION SIZE IN THE BAG IS MORE 1361 00:55:42,364 --> 00:55:43,899 THAN YOU SHOULD THINK ABOUT 1362 00:55:43,899 --> 00:55:47,503 EATING AT ONE OCCASION OR THERE 1363 00:55:47,503 --> 00:55:52,074 COULD BE MORE WORK THAT COULD BE 1364 00:55:52,074 --> 00:55:53,175 DONE WITH MOTIVATION TOWARDS 1365 00:55:53,175 --> 00:55:54,943 INDUSTRY TO LOWER FORMULATION OF 1366 00:55:54,943 --> 00:56:00,349 SOME THINGS WITHIN THE PRODUCTS, 1367 00:56:00,349 --> 00:56:05,120 FOR INDIVIDUALS TRYING TO DO 1368 00:56:05,120 --> 00:56:05,788 THIS, ESPECIALLY WITHIN 1369 00:56:05,788 --> 00:56:08,624 FAMILIES, I LIKE THE IDEA OF 1370 00:56:08,624 --> 00:56:12,428 TRYING TO MOVE FOR TOWARDS 1371 00:56:12,428 --> 00:56:16,332 NUTRIENT DENSE SNACKS THAT ARE 1372 00:56:16,332 --> 00:56:21,070 WITHIN THE -- IN THE NUTRIENT 1373 00:56:21,070 --> 00:56:24,807 DENSE CHOICES ALREADY, IT'S A 1374 00:56:24,807 --> 00:56:25,341 CHALLENGE. 1375 00:56:25,341 --> 00:56:28,210 >> I THINK CHRISTINA. 1376 00:56:28,210 --> 00:56:31,046 >> BASED ON FOOD MODELING THERE 1377 00:56:31,046 --> 00:56:33,115 ARE SOME GRAMS FOR OIL. 1378 00:56:33,115 --> 00:56:36,185 YOU CAN STILL -- WHILE YOU'RE 1379 00:56:36,185 --> 00:56:37,920 LOOKING, A SWEET POTATO IS 1380 00:56:37,920 --> 00:56:41,490 COOKED WITHOUT ANYTHING, THERE 1381 00:56:41,490 --> 00:56:42,991 ARE SOME GRAMS ON OIL, I GUESS 1382 00:56:42,991 --> 00:56:45,394 NOT BUTTER BUT AT LEAST OIL TO 1383 00:56:45,394 --> 00:56:48,364 ADD TO THE FOOD PREPARATION, 1384 00:56:48,364 --> 00:56:49,665 THERE'S SOME. 1385 00:56:49,665 --> 00:56:59,641 HOWEVER MY QUESTION WAS THOSE 1386 00:56:59,641 --> 00:57:01,610 GRAMS OF OIL, WERE THEY BASED ON 1387 00:57:01,610 --> 00:57:03,112 WHAT'S ADDED TO THE PREPARATION 1388 00:57:03,112 --> 00:57:10,452 OR WHATEVER CALORIES ARE LEFT, 1389 00:57:10,452 --> 00:57:17,126 HOW WAS THAT CALCULATED? 1390 00:57:17,126 --> 00:57:19,194 >> OILS WERE INTRODUCED AS 1391 00:57:19,194 --> 00:57:21,463 COMMITTEES WERE BRINGING FORWARD 1392 00:57:21,463 --> 00:57:24,700 EVIDENCE PROMOTING INTAKE OF 1393 00:57:24,700 --> 00:57:28,303 UNSATURATED FATS OVER SOLID FATS 1394 00:57:28,303 --> 00:57:29,138 WITH MORE SATURATED FAT AND 1395 00:57:29,138 --> 00:57:33,142 PROVIDES THAT QUANTITY IN THE 1396 00:57:33,142 --> 00:57:34,209 PATTERN. 1397 00:57:34,209 --> 00:57:35,310 FOR 12-23 MONTHS PATTERN FOR 1398 00:57:35,310 --> 00:57:38,714 EXAMPLE THE OILS WERE 1399 00:57:38,714 --> 00:57:39,415 ESSENTIALLY THE REMAINING 1400 00:57:39,415 --> 00:57:41,316 CALORIES, BECAUSE AS CHRIS NOTED 1401 00:57:41,316 --> 00:57:45,053 AT THOSE VERY LOW CALORIE 1402 00:57:45,053 --> 00:57:47,656 LEVELS, AND RELATIVELY HIGH 1403 00:57:47,656 --> 00:57:51,293 NUTRIENT NEEDS, THE FOOD GROUPS 1404 00:57:51,293 --> 00:57:52,594 AND SUBGROUPS WERE NEEDED TO 1405 00:57:52,594 --> 00:57:55,264 MEET THOSE, STILL OILS 1406 00:57:55,264 --> 00:58:00,135 REMAINING. 1407 00:58:00,135 --> 00:58:05,207 >> DEE DEE AND CHERYL. 1408 00:58:05,207 --> 00:58:07,943 >> I LOVE HOW WE CAN HELP PEOPLE 1409 00:58:07,943 --> 00:58:09,912 FOLLOW GUIDELINES IN MORE CLEAR 1410 00:58:09,912 --> 00:58:20,422 AND I GUESS EASIER DAILY LIFE 1411 00:58:27,696 --> 00:58:28,464 WAY. 1412 00:58:28,464 --> 00:58:29,932 YOU MENTIONED FOOD PREPARATION, 1413 00:58:29,932 --> 00:58:31,467 ANGELA, AND THAT GOES INTO FOODS 1414 00:58:31,467 --> 00:58:34,536 THAT YOU BUY THAT ARE READY TO 1415 00:58:34,536 --> 00:58:37,606 EAT AND HEAT AS WELL, AGAIN, 1416 00:58:37,606 --> 00:58:41,109 AFTER YOU'VE COOKED ALL THESE 1417 00:58:41,109 --> 00:58:43,512 THINGS WHETHER IT'S A BEHAVIOR 1418 00:58:43,512 --> 00:58:46,014 CHOICE OR TREAT, YOU'RE 1419 00:58:46,014 --> 00:58:48,217 ALREADIED A SATURATED FAT, ADDED 1420 00:58:48,217 --> 00:58:51,920 SUGAR, SODIUM WHICH WE'VE NOT 1421 00:58:51,920 --> 00:58:57,426 TALKED ABOUT AND CAL CALORIES E 1422 00:58:57,426 --> 00:58:58,160 YOU'VE ADDED TREATS BASED ON 1423 00:58:58,160 --> 00:59:00,496 WHAT'S AVAILABLE IN OUR GROCERY 1424 00:59:00,496 --> 00:59:00,829 STORES. 1425 00:59:00,829 --> 00:59:03,398 TO CHECK ALL THE BOXES, STILL 1426 00:59:03,398 --> 00:59:06,168 NOT BE WHERE THE MOST NUTRIENT 1427 00:59:06,168 --> 00:59:08,904 DENSE FORMS AND FOODS AND 1428 00:59:08,904 --> 00:59:10,005 BEVERAGES ARE, BECAUSE THAT'S 1429 00:59:10,005 --> 00:59:11,106 AVAILABLE, IS ALSO A MAJOR 1430 00:59:11,106 --> 00:59:11,373 CHALLENGE. 1431 00:59:11,373 --> 00:59:16,678 A LOT OF THIS DOES COME DOWN TO 1432 00:59:16,678 --> 00:59:19,515 CHANGING THE FOODS THEMSELVES AS 1433 00:59:19,515 --> 00:59:30,025 WELL AS BEHAVIOR, BUT A LOT OF 1434 00:59:31,860 --> 00:59:32,895 IS THE FOODS. 1435 00:59:32,895 --> 00:59:37,699 >> I WANT TO ADD ONCE PIECE, IN 1436 00:59:37,699 --> 00:59:40,969 ADDITION TO OUR SHARED RESPONSE 1437 00:59:40,969 --> 00:59:42,638 ABILITY FOR ASSURING HEALTHY 1438 00:59:42,638 --> 00:59:43,639 PATTERNS WE OUTLINE BECOME 1439 00:59:43,639 --> 00:59:46,441 DEFAULT IN THE U.S. FOOD SYSTEM 1440 00:59:46,441 --> 00:59:48,810 SO PEOPLE CAN STAND A CHANCE OF 1441 00:59:48,810 --> 00:59:50,712 GETTING THERE. 1442 00:59:50,712 --> 00:59:54,016 IN THE GAP, BETWEEN HERE AND 1443 00:59:54,016 --> 00:59:56,485 THAT IDEAL IS SOME OPPORTUNITY 1444 00:59:56,485 --> 00:59:58,487 FOR TOOLS, AND SO IN ADDITION TO 1445 00:59:58,487 --> 00:59:59,588 THINKING THROUGH SOME 1446 00:59:59,588 --> 01:00:01,557 SUGGESTIONS THAT HAVE BEEN MADE 1447 01:00:01,557 --> 01:00:05,160 BY THE COMMITTEE AROUND R D 1448 01:00:05,160 --> 01:00:08,230 CONSULTATIONS, WE REALLY HAVE TO 1449 01:00:08,230 --> 01:00:09,798 CONSIDER COST AND AVAILABILITY. 1450 01:00:09,798 --> 01:00:13,468 YOU KNOW, WHEN WE LOOK AT THE 1451 01:00:13,468 --> 01:00:17,673 LEVEL OF ADHERENCE OR 1452 01:00:17,673 --> 01:00:18,907 NON-ADHERENCE TO DIETARY 1453 01:00:18,907 --> 01:00:21,510 GUIDELINES, WE KNOW A GOOD CHUNK 1454 01:00:21,510 --> 01:00:23,345 OF THE COUNTRY SITS IN NEED OF 1455 01:00:23,345 --> 01:00:25,247 ABILITY TO THINK THROUGH AM I 1456 01:00:25,247 --> 01:00:28,951 GOING TO REDUCE ANIMAL FAT, 1457 01:00:28,951 --> 01:00:30,052 CARBOHYDRATE FROM ALREADY 1458 01:00:30,052 --> 01:00:31,353 HEALTHY PATTERN, AM I GOING TO 1459 01:00:31,353 --> 01:00:33,522 HAVE ENERGY LEFT OVER FOR OTHER 1460 01:00:33,522 --> 01:00:36,058 USES AFTER I'VE MET A VERY 1461 01:00:36,058 --> 01:00:39,461 NUTRIENT DENSE PATTERN. 1462 01:00:39,461 --> 01:00:40,562 THESE AREN'T SIMPLE CALCULATIONS 1463 01:00:40,562 --> 01:00:42,197 FOR PEOPLE WITHIN OUR COUNTRY. 1464 01:00:42,197 --> 01:00:43,599 THEY ARE NOT SIMPLE CALCULATIONS 1465 01:00:43,599 --> 01:00:46,568 FOR THOSE AROUND THIS TABLE 1466 01:00:46,568 --> 01:00:46,768 TODAY. 1467 01:00:46,768 --> 01:00:50,839 AND SO I WANT TO ADD TO WHAT DEE 1468 01:00:50,839 --> 01:00:53,875 DEE SAID, THINKING ABOUT IN 1469 01:00:53,875 --> 01:00:55,444 ADDITION TO HUMAN TOOLS, OTHER 1470 01:00:55,444 --> 01:00:58,380 TOOLS THAT WHETHER IT'S DIGITAL 1471 01:00:58,380 --> 01:01:00,449 OR TECHNOLOGICAL ADVANCES THAT 1472 01:01:00,449 --> 01:01:02,884 WE CAN BE PROMOTING AND 1473 01:01:02,884 --> 01:01:06,588 RECOMMENDING TO HELP FILL THIS 1474 01:01:06,588 --> 01:01:08,290 GAP BECAUSE THERE'S A LOT OF 1475 01:01:08,290 --> 01:01:10,092 WORK THAT NEEDS TO BE PUT INTO 1476 01:01:10,092 --> 01:01:12,461 GETTING AMERICA TO WHERE THE 1477 01:01:12,461 --> 01:01:17,299 DATA SUGGESTS WE NEED TO GET TO. 1478 01:01:17,299 --> 01:01:19,034 >> THANK YOU. 1479 01:01:19,034 --> 01:01:20,035 YES, ANGELA? 1480 01:01:20,035 --> 01:01:21,903 >> I THINK THAT'S SUCH AN 1481 01:01:21,903 --> 01:01:24,072 IMPORTANT POINT, CHERYL, BECAUSE 1482 01:01:24,072 --> 01:01:26,174 NOT ONLY FOR INDIVIDUALS BUT 1483 01:01:26,174 --> 01:01:28,176 ALSO FOR OUR FOOD ASSISTANCE 1484 01:01:28,176 --> 01:01:34,316 PROGRAMS, THINKING ABOUT SCHOOL 1485 01:01:34,316 --> 01:01:36,251 LUNCH PLANNING, CACFP, SO A LOT 1486 01:01:36,251 --> 01:01:38,153 OF MODELED, WHEN YOU THINK ABOUT 1487 01:01:38,153 --> 01:01:39,321 DIETARY GUIDELINES TO BE 1488 01:01:39,321 --> 01:01:40,656 CONSISTENT AT THIS POINT, AND 1489 01:01:40,656 --> 01:01:44,359 THEY HAVE THEIR OWN CALORIE 1490 01:01:44,359 --> 01:01:46,328 RANGES. 1491 01:01:46,328 --> 01:01:48,296 SO I THINK THAT WHEN WE THINK 1492 01:01:48,296 --> 01:01:50,632 ABOUT TOOLS, MORE OF A COMMENT 1493 01:01:50,632 --> 01:01:51,366 THAN QUESTION, SOME 1494 01:01:51,366 --> 01:01:53,669 RECOMMENDATIONS, WE HAVE SOME 1495 01:01:53,669 --> 01:01:55,637 SECTIONS, WHEN WE HAVE 1496 01:01:55,637 --> 01:01:58,273 INTEGRATION CHAPTER, NOT 1497 01:01:58,273 --> 01:02:03,078 INTEGRATION CHAPTER, INTEGRATION 1498 01:02:03,078 --> 01:02:04,713 DISCUSSION TO THINK ABOUT 1499 01:02:04,713 --> 01:02:05,714 RESEARCH RECOMMENDATIONS, 1500 01:02:05,714 --> 01:02:12,387 RECOMMENDATIONS TO THE FEDERAL 1501 01:02:12,387 --> 01:02:13,689 PROGRAMS OR TO AGENCIES. 1502 01:02:13,689 --> 01:02:17,759 >> I WANT TO MAKE CERTAIN THAT 1503 01:02:17,759 --> 01:02:25,100 OUR TWO PARTICIPANTS ONLINE, 1504 01:02:25,100 --> 01:02:26,501 VALERIE OR HOLLIE, DO EITHER OF 1505 01:02:26,501 --> 01:02:29,471 YOU HAVE QUESTIONS YOU WANT TO 1506 01:02:29,471 --> 01:02:29,671 ASK? 1507 01:02:29,671 --> 01:02:31,106 >> THIS IS HOLLIE. 1508 01:02:31,106 --> 01:02:32,708 NO ADDITIONAL QUESTIONS FROM ME. 1509 01:02:32,708 --> 01:02:33,742 >> THANK YOU. 1510 01:02:33,742 --> 01:02:40,415 >> I HAVE NONE. 1511 01:02:40,415 --> 01:02:45,921 THANK YOU. 1512 01:02:45,921 --> 01:02:46,221 >> GREAT. 1513 01:02:46,221 --> 01:02:47,889 I'M ENCOURAGED THE COMMITTEE IS 1514 01:02:47,889 --> 01:02:57,299 TALKING ABOUT RANGES, WHEN WE'RE 1515 01:02:57,299 --> 01:02:58,166 TALKING ABOUT NUTRIENTS BECAUSE 1516 01:02:58,166 --> 01:03:03,305 THE DATA FOR FOODS IS WIDELY 1517 01:03:03,305 --> 01:03:04,172 VARIABLE, FOR INDIVIDUAL 1518 01:03:04,172 --> 01:03:07,309 NUTRIENTS, EVEN FOR INDIVIDUAL 1519 01:03:07,309 --> 01:03:09,010 FOODS, BUT LAYERING ONTO THIS 1520 01:03:09,010 --> 01:03:11,613 DISCUSSION WE ARE VIEWING THIS 1521 01:03:11,613 --> 01:03:14,249 THROUGH A HEALTH EQUITY LENS. 1522 01:03:14,249 --> 01:03:18,620 WHEN WE START TALKING ABOUT THE 1523 01:03:18,620 --> 01:03:21,690 RANGES, FOR EXAMPLE, YOUR 1524 01:03:21,690 --> 01:03:24,993 EXAMPLE, HEATHER, OF SWEET 1525 01:03:24,993 --> 01:03:30,465 POTATOES AND TOMATOES, YOU KNOW, 1526 01:03:30,465 --> 01:03:32,667 I HAVE POPULATION GROUPS 1527 01:03:32,667 --> 01:03:33,702 INDIVIDUALS CHOOSE DIFFERENT 1528 01:03:33,702 --> 01:03:35,170 FOODS FOR DIFFERENT REASONS. 1529 01:03:35,170 --> 01:03:39,007 I THINK BY STARTING TO TALK 1530 01:03:39,007 --> 01:03:42,711 ABOUT RANGES WE TAKE AWAY -- WE 1531 01:03:42,711 --> 01:03:44,813 START ACKNOWLEDGE THAT THERE -- 1532 01:03:44,813 --> 01:03:46,348 THE LEVEL OF PRECISION PEOPLE 1533 01:03:46,348 --> 01:03:49,618 WOULD LIKE TO HAVE IS JUST NOT 1534 01:03:49,618 --> 01:03:53,455 FACILITATED BY THE DATA. 1535 01:03:53,455 --> 01:03:55,423 AND I THINK OWNING AT THAT AND 1536 01:03:55,423 --> 01:03:59,127 WORKING WITH IT IS JUST A REAL 1537 01:03:59,127 --> 01:04:01,429 CONTRIBUTION, SO I REALLY 1538 01:04:01,429 --> 01:04:06,668 COMMEND YOU FOR THIS, THIS 1539 01:04:06,668 --> 01:04:07,102 DISCUSSION. 1540 01:04:07,102 --> 01:04:09,104 >> ANY OTHER COMMENTS? 1541 01:04:09,104 --> 01:04:13,341 >> SO, WE ARE AHEAD OF TIME. 1542 01:04:13,341 --> 01:04:15,110 SO DO YOU WANT TO JUST DISCUSS 1543 01:04:15,110 --> 01:04:24,085 WHAT WE'RE TALKING ABOUT 1544 01:04:24,085 --> 01:04:24,352 TOMORROW? 1545 01:04:24,352 --> 01:04:24,986 >> TOMORROW -- THIS CONCLUDES 1546 01:04:24,986 --> 01:04:26,087 OUR NEW DATA PORTION THAT GETS 1547 01:04:26,087 --> 01:04:28,456 US INTO OUR SYNTHESIS AND 1548 01:04:28,456 --> 01:04:28,757 INTEGRATION. 1549 01:04:28,757 --> 01:04:32,561 SO TOMORROW WE'RE GOING TO TALK 1550 01:04:32,561 --> 01:04:34,429 ABOUT WHAT ARE MODIFICATIONS TO 1551 01:04:34,429 --> 01:04:37,365 DIETARY PATTERNS THAT WE'RE 1552 01:04:37,365 --> 01:04:37,966 PROPOSING, SYNTHESIZING THOSE 1553 01:04:37,966 --> 01:04:39,801 RESULTS, KIND OF THE EVALUATION 1554 01:04:39,801 --> 01:04:41,636 REFINEMENT OF THE DIETARY 1555 01:04:41,636 --> 01:04:43,305 PATTERNS WE'RE DOING THROUGH 1556 01:04:43,305 --> 01:04:45,941 DIET SIMULATIONS, AND THEN 1557 01:04:45,941 --> 01:04:46,441 FINALLY TALKING ABOUT 1558 01:04:46,441 --> 01:04:50,846 FLEXIBILITIES WITHIN THE DIETARY 1559 01:04:50,846 --> 01:04:52,047 PATTERNS THEMSELVES. 1560 01:04:52,047 --> 01:04:52,414 SO -- 1561 01:04:52,414 --> 01:04:52,981 >> THANK YOU. 1562 01:04:52,981 --> 01:04:58,854 I THINK THAT WILL BE A VERY 1563 01:04:58,854 --> 01:04:59,421 EXCITING DISCUSSION. 1564 01:04:59,421 --> 01:05:01,256 WE'RE GOING TO HAVE A MEETING 1565 01:05:01,256 --> 01:05:01,489 BREAK. 1566 01:05:01,489 --> 01:05:02,691 WE'RE RUNNING AHEAD OF TIME. 1567 01:05:02,691 --> 01:05:04,659 BUT WE THOUGHT WE WOULD TAKE A 1568 01:05:04,659 --> 01:05:06,728 BREAK BECAUSE THE NEXT SESSION 1569 01:05:06,728 --> 01:05:10,332 WE'RE DOING IS DATA ANALYSIS, 1570 01:05:10,332 --> 01:05:11,566 WHICH I ANTICIPATE WILL GENERATE 1571 01:05:11,566 --> 01:05:13,935 QUITE A BIT OF COMMENTARY. 1572 01:05:13,935 --> 01:05:18,673 SO IT'S 10:07 NOW. 1573 01:05:18,673 --> 01:05:24,012 CAN WE MEET AT 10:25? 1574 01:05:24,012 --> 01:05:25,580 AND I JUST ASK THE PUBLIC THAT 1575 01:05:25,580 --> 01:05:26,882 YOU JOIN US AT 10:25. 1576 01:05:26,882 --> 01:05:26,990 THANK YOU VERY MUCH FOR GREAT 1577 01:05:26,990 --> 01:05:30,036 DISCUSSION. 1578 01:05:30,036 --> 01:05:31,370 >> WELCOME BACK. 1579 01:05:31,370 --> 01:05:35,408 LOOKING FORWARD TO A GREAT 1580 01:05:35,408 --> 01:05:36,742 DISCUSSION ON FOOD PATTERN 1581 01:05:36,742 --> 01:05:44,183 MODELING AND DATA ANALYSIS. 1582 01:05:44,183 --> 01:05:48,221 TAKE IT AWAY, HEATHER. 1583 01:05:48,221 --> 01:05:49,455 >> PART 2 HERE, NEXT SLIDE. 1584 01:05:49,455 --> 01:05:51,157 I WANT TO GO OVER WHAT WE'RE 1585 01:05:51,157 --> 01:05:58,965 GOING TO TALK ABOUT IN THIS 1586 01:05:58,965 --> 01:06:00,700 PORTION, FIRST I'M GOING TO 1587 01:06:00,700 --> 01:06:02,335 REVIEW PROCESS SINCE LAST 1588 01:06:02,335 --> 01:06:03,536 MEETING AND SHARE NEW ANALYSIS, 1589 01:06:03,536 --> 01:06:05,871 NEW RESULTS THAT WE HAVE THAT WE 1590 01:06:05,871 --> 01:06:09,242 DIDN'T HAVE A CHANCE TO SHARE 1591 01:06:09,242 --> 01:06:11,010 YET SINCE MEETING 5. 1592 01:06:11,010 --> 01:06:13,079 THEN WE'LL GO INTO YOUR DRAFT 1593 01:06:13,079 --> 01:06:15,815 CONCLUSION STATEMENTS AND IF YOU 1594 01:06:15,815 --> 01:06:17,016 REMEMBER WE ADDRESS FOUR 1595 01:06:17,016 --> 01:06:17,850 QUESTIONS. 1596 01:06:17,850 --> 01:06:19,652 WE'RE GOING TO GIVE CONCLUSION 1597 01:06:19,652 --> 01:06:30,196 STATEMENTS ON EACH OF THOSE FOUR 1598 01:06:32,632 --> 01:06:32,898 QUESTIONS. 1599 01:06:32,898 --> 01:06:33,799 I'LL EXPLAIN NEXT STEPS AND 1600 01:06:33,799 --> 01:06:35,968 WE'LL HAVE TIME FOR DISCUSSION. 1601 01:06:35,968 --> 01:06:40,006 I'D LIKE TO RECOGNIZE OUR 1602 01:06:40,006 --> 01:06:41,140 SUBCOMMITTEE MEMBERS FOR SC 3, 1603 01:06:41,140 --> 01:06:45,945 PART OF THIS WORK. 1604 01:06:45,945 --> 01:06:49,315 AND THEN AMAZING SUPPORT STAFF, 1605 01:06:49,315 --> 01:06:51,284 FOR THIS DATA ANALYSIS PORTION, 1606 01:06:51,284 --> 01:06:58,724 THEY DID A VERY HEAVY LIFT, SO 1607 01:06:58,724 --> 01:07:05,965 THANK YOU SO MUCH. 1608 01:07:05,965 --> 01:07:07,600 WE WANT TO RECOGNIZE THE DATA 1609 01:07:07,600 --> 01:07:12,204 ANALYSIS TEAM AND ALL OF OUR 1610 01:07:12,204 --> 01:07:12,805 INTERAGENCY COLLABORATIONS WHO 1611 01:07:12,805 --> 01:07:17,376 REALLY DID ALL OF THE ANALYSIS 1612 01:07:17,376 --> 01:07:24,784 FOR US, FROM ARS, CDC, AND THE 1613 01:07:24,784 --> 01:07:25,017 NIH. 1614 01:07:25,017 --> 01:07:28,087 THIS IS WHAT OUR FINDINGS RELY 1615 01:07:28,087 --> 01:07:28,621 ON. 1616 01:07:28,621 --> 01:07:31,157 MOVING FORWARD, WE CAN DIVIDE 1617 01:07:31,157 --> 01:07:32,892 OUR PROGRESS INTO TWO SETS. 1618 01:07:32,892 --> 01:07:35,294 WE HAVE THINGS THAT WERE LED BY 1619 01:07:35,294 --> 01:07:36,796 THE COMMITTEE AND THEN ALSO 1620 01:07:36,796 --> 01:07:40,466 THINGS LED BY THE STAFF. 1621 01:07:40,466 --> 01:07:41,867 SO, FOR THE COMMITTEE-LED 1622 01:07:41,867 --> 01:07:44,203 ACTIVITIES, FIRST WE WERE 1623 01:07:44,203 --> 01:07:50,209 REVIEWING AND SYNTHESIZING ALL 1624 01:07:50,209 --> 01:07:51,477 THE RESULTS TOGETHER. 1625 01:07:51,477 --> 01:07:52,945 IF YOU REMEMBER IN THE LAST 1626 01:07:52,945 --> 01:07:57,116 MEETINGS WE PRESENT WORK ON 1627 01:07:57,116 --> 01:07:57,883 EVIDENCE SCAN REGARDING DIETARY 1628 01:07:57,883 --> 01:08:01,087 INTAKES DURING THE COVID-19 1629 01:08:01,087 --> 01:08:10,029 PANDEMIC. 1630 01:08:10,029 --> 01:08:12,998 SO WE ALSO CONSIDERED THOSE 1631 01:08:12,998 --> 01:08:15,634 FINDINGS IN OUR SYNTHESIS, 1632 01:08:15,634 --> 01:08:17,503 CARING THE STATEMENTS FOR THE 1633 01:08:17,503 --> 01:08:18,137 SCIENTIFIC QUESTIONS AND WORKING 1634 01:08:18,137 --> 01:08:20,005 ON THE CHAPTERS FOR OUR 1635 01:08:20,005 --> 01:08:21,006 SCIENTIFIC REPORT. 1636 01:08:21,006 --> 01:08:23,376 FINALLY, WE'VE BEEN WORKING IN 1637 01:08:23,376 --> 01:08:25,378 COLLABORATION WITH THE HEALTH 1638 01:08:25,378 --> 01:08:30,182 EQUITY WORKING GROUP TO THINK 1639 01:08:30,182 --> 01:08:31,617 ABOUT OUR INTERPRETATIONS AND 1640 01:08:31,617 --> 01:08:34,553 HELP THOSE HEALTH EQUITY 1641 01:08:34,553 --> 01:08:36,956 CONSIDERATIONS IN OUR WORK. 1642 01:08:36,956 --> 01:08:40,793 THE STAFF ON THE OTHER HAND HAVE 1643 01:08:40,793 --> 01:08:45,531 BEEN WORKING WITH THOSE 1644 01:08:45,531 --> 01:08:47,166 INTERAGENCY PARTNERS TO COLLECT 1645 01:08:47,166 --> 01:08:48,267 ALL THOSE DATA ANALYSIS TOGETHER 1646 01:08:48,267 --> 01:08:50,970 AND THEN THEY HAVE BEEN DOING 1647 01:08:50,970 --> 01:08:53,706 THIS WORK TO DRAFT FIVE DATA 1648 01:08:53,706 --> 01:08:56,909 ANALYSIS REPORTS THAT ARE OVER 1649 01:08:56,909 --> 01:08:58,544 500 PAGES LONG THAT SUMMARIZE 1650 01:08:58,544 --> 01:08:59,779 ALL OF THE ANALYTIC RESULTS. 1651 01:08:59,779 --> 01:09:02,381 SO IF YOU CAN IMAGINE GOING 1652 01:09:02,381 --> 01:09:06,352 THROUGH PAGES AND PAGES OF THE 1653 01:09:06,352 --> 01:09:09,955 DATA ANALYSIS, AND THAT HAS BEEN 1654 01:09:09,955 --> 01:09:11,357 SUBMITTED FOR FEDERAL EXPERT 1655 01:09:11,357 --> 01:09:12,024 REVIEW ALREADY. 1656 01:09:12,024 --> 01:09:14,960 AND AS PART OF THAT, THEY HAVE 1657 01:09:14,960 --> 01:09:17,296 ALSO BEEN DRAFTING 41 FEDERAL 1658 01:09:17,296 --> 01:09:21,066 DATA ANALYSIS SUPPLEMENTS THAT 1659 01:09:21,066 --> 01:09:22,868 ARE OVER 4,700 PAGES LONG. 1660 01:09:22,868 --> 01:09:25,237 SO, IT'S A LOT OF RESULTS. 1661 01:09:25,237 --> 01:09:27,039 OF COURSE, IT'S SO MUCH MORE 1662 01:09:27,039 --> 01:09:31,277 THAN WE CAN HAVE TIME TO PRESENT 1663 01:09:31,277 --> 01:09:33,712 IN OUR -- YOU KNOW, IN THESE 1664 01:09:33,712 --> 01:09:35,281 MEETINGS, SO WE'VE SELECTED 1665 01:09:35,281 --> 01:09:37,783 HIGHLIGHTS THAT WE WANT TO 1666 01:09:37,783 --> 01:09:39,018 SHARE. 1667 01:09:39,018 --> 01:09:39,218 OKAY. 1668 01:09:39,218 --> 01:09:47,860 MOVING ON, NOW WE'LL GET TO 1669 01:09:47,860 --> 01:09:49,862 SHARING THIS UPDATED ANALYSIS 1670 01:09:49,862 --> 01:09:51,564 THAT WE -- THAT ARE GOING TO 1671 01:09:51,564 --> 01:09:52,665 ADDRESS TWO OF THE QUESTIONS. 1672 01:09:52,665 --> 01:09:54,733 SO WE'RE NOT GOING TO ADDRESS 1673 01:09:54,733 --> 01:09:57,470 ALL FOUR, JUST TWO OF THEM TODAY 1674 01:09:57,470 --> 01:10:00,239 BECAUSE WE'VE ALREADY ADDRESSED 1675 01:10:00,239 --> 01:10:02,408 THOSE OTHER TWO WITH COMPLETE 1676 01:10:02,408 --> 01:10:04,710 ANALYSIS THAT WE HAVE. 1677 01:10:04,710 --> 01:10:08,547 SO WE JUST WANT TO SHARE NEW 1678 01:10:08,547 --> 01:10:11,851 INFORMATION FOR THE QUESTION ON 1679 01:10:11,851 --> 01:10:13,052 CURRENT PATTERNS WHICH WE'LL 1680 01:10:13,052 --> 01:10:16,856 COVER FIRST AND ONE ON CURRENT 1681 01:10:16,856 --> 01:10:17,089 INTAKES. 1682 01:10:17,089 --> 01:10:18,958 SO, FOR THIS QUESTION WHAT ARE 1683 01:10:18,958 --> 01:10:20,960 THE CURRENT PATTERNS OF FOOD AND 1684 01:10:20,960 --> 01:10:23,028 BEVERAGE INTAIGS, WE'RE GOING TO 1685 01:10:23,028 --> 01:10:28,067 FOCUS MORE ON THE PATTERN PIECE, 1686 01:10:28,067 --> 01:10:33,639 SO WE HAVE THIS ANALYSIS THAT IS 1687 01:10:33,639 --> 01:10:34,306 SHOWING. 1688 01:10:34,306 --> 01:10:38,344 THESE ARE FASCINATING, SHOWING 1689 01:10:38,344 --> 01:10:39,979 DIFFERENT DEMOGRAPHIC GROUPS, IN 1690 01:10:39,979 --> 01:10:41,614 THE U.S., ALL TOGETHER WITH 1691 01:10:41,614 --> 01:10:46,452 RECORD TO THEIR HEALTHY EATING 1692 01:10:46,452 --> 01:10:48,654 INDEX 2020 SCORES. 1693 01:10:48,654 --> 01:10:52,458 AND AGAIN THIS, JUST TO REMIND 1694 01:10:52,458 --> 01:10:54,026 YOU, HEADING EATING INDEX SCORES 1695 01:10:54,026 --> 01:10:58,063 ARE EVALUATING DIET QUALITY AND 1696 01:10:58,063 --> 01:11:00,266 ALIGNMENT OF DIETS WITH THE 1697 01:11:00,266 --> 01:11:01,634 DIETARY GUIDELINES FOR 1698 01:11:01,634 --> 01:11:02,001 AMERICANS. 1699 01:11:02,001 --> 01:11:04,436 AND SO TO START OFF, WE -- I'M 1700 01:11:04,436 --> 01:11:08,040 GOING TO KIND OF WALK YOU 1701 01:11:08,040 --> 01:11:09,441 THROUGH GROUND VIEW ON THIS 1702 01:11:09,441 --> 01:11:11,343 SLIDE SO THE NEXT FOUR SLIDES 1703 01:11:11,343 --> 01:11:13,812 YOU'LL BE ABLE TO MORE EASILY 1704 01:11:13,812 --> 01:11:15,948 GET RIGHT AWAY. 1705 01:11:15,948 --> 01:11:18,017 SO, FIRST WE HAVE ON THE X-AXIS 1706 01:11:18,017 --> 01:11:21,620 HERE, WE HAVE ALL OF THE 1707 01:11:21,620 --> 01:11:23,055 DIFFERENT SOCIODEMOGRAPHIC 1708 01:11:23,055 --> 01:11:23,589 GROUPS. 1709 01:11:23,589 --> 01:11:25,791 WE'LL HAVE THE TOTAL POPULATION 1710 01:11:25,791 --> 01:11:32,264 ON THE FAR LEFT FOLLOWED BY 1711 01:11:32,264 --> 01:11:35,734 THESE TWO VERTICAL BLACK BARS 1712 01:11:35,734 --> 01:11:36,835 BOUNDING OUR RACE-ETHNIC GROUP 1713 01:11:36,835 --> 01:11:38,037 BREAKDOWNS IN THE U.S. FOR THE 1714 01:11:38,037 --> 01:11:39,905 DATA WE HAD AVAILABLE. 1715 01:11:39,905 --> 01:11:50,182 WE HAVE NON-HISPANIC WHITE, 1716 01:11:50,182 --> 01:11:51,483 NON-HISPANIC BLACK, 1717 01:11:51,483 --> 01:11:54,687 NON-HISPANIC, AND OTHER 1718 01:11:54,687 --> 01:11:55,554 RACE/ETHNICITY THERE. 1719 01:11:55,554 --> 01:11:56,655 FOOD SECURITY REFERS TO HAVING 1720 01:11:56,655 --> 01:11:58,624 ENOUGH FOOD FOR AN ACTIVE 1721 01:11:58,624 --> 01:12:00,926 HEALTHY LIFE, AND THAT WOULD BE 1722 01:12:00,926 --> 01:12:02,761 THE FOOD SECURE GROUP. 1723 01:12:02,761 --> 01:12:05,164 THE FOOD INSECURE GROUP ON THE 1724 01:12:05,164 --> 01:12:07,566 OTHER HAND HAS LIMITED 1725 01:12:07,566 --> 01:12:08,567 AVAILABILITY DUE TO RESOURCES 1726 01:12:08,567 --> 01:12:11,203 FOR GETTING ENOUGH FOOD FOR AN 1727 01:12:11,203 --> 01:12:12,071 ACTIVE HEALTHY LIFE. 1728 01:12:12,071 --> 01:12:13,706 SO THOSE ARE SHOWN THERE. 1729 01:12:13,706 --> 01:12:16,008 AND THEN FOLLOWED BY THE TWO 1730 01:12:16,008 --> 01:12:18,677 GROUPS ON THE FAR RIGHT SIDE, 1731 01:12:18,677 --> 01:12:22,381 WHICH ARE DIVIDED BY THEIR 1732 01:12:22,381 --> 01:12:23,582 POVERTY INCOME RATIO. 1733 01:12:23,582 --> 01:12:27,186 THIS IS A RATIO OF HOUSEHOLD 1734 01:12:27,186 --> 01:12:31,557 INCOME, DIVIDED BY THE POVERTY 1735 01:12:31,557 --> 01:12:33,425 THRESHOLD. 1736 01:12:33,425 --> 01:12:35,094 AND SO ESTIMATES THAT ARE -- 1737 01:12:35,094 --> 01:12:37,262 THAT WOULD BE, YOU KNOW, BELOW 1738 01:12:37,262 --> 01:12:40,099 THAT THRESHOLD WOULD BE IN 1739 01:12:40,099 --> 01:12:42,401 POVERTY, WHEREAS THOSE ABOVE 1740 01:12:42,401 --> 01:12:45,571 WOULD HAVE WHOLE NUMBERS AND 1741 01:12:45,571 --> 01:12:47,139 HERE WE HAVE FIRST GROUP, 1742 01:12:47,139 --> 01:12:48,974 POVERTY INCOME RATIO LESS THAN 1743 01:12:48,974 --> 01:12:51,744 OR EQUAL TO 1.5, ON THE FAR 1744 01:12:51,744 --> 01:12:54,813 RIGHT POVERTY INCOME RATIO OF 1745 01:12:54,813 --> 01:12:56,582 GREATER THAN 1.85. 1746 01:12:56,582 --> 01:12:59,084 SO, THOSE ARE OUR GROUPS. 1747 01:12:59,084 --> 01:13:02,254 ON THE Y-AXIS WE HAVE OUR 1748 01:13:02,254 --> 01:13:04,223 SCORING FOR THE HEALTHY EATING 1749 01:13:04,223 --> 01:13:06,425 INDEX WHICH GOES ALL THE WAY TO 1750 01:13:06,425 --> 01:13:08,694 100, THAT WOULD BE PERFECT 1751 01:13:08,694 --> 01:13:10,896 ALIGNMENT WITH THE DIETARY 1752 01:13:10,896 --> 01:13:11,964 GUIDELINES. 1753 01:13:11,964 --> 01:13:16,435 SO JUST LOOKING AT THIS, YOU CAN 1754 01:13:16,435 --> 01:13:18,370 SEE THAT UNFORTUNATELY WE'RE NOT 1755 01:13:18,370 --> 01:13:20,673 AS A POPULATION OR IN ANY 1756 01:13:20,673 --> 01:13:22,608 SUBGROUPS IN ALIGNMENT WITH THE 1757 01:13:22,608 --> 01:13:25,344 DIETARY GUIDELINES FOR 1758 01:13:25,344 --> 01:13:25,611 AMERICANS. 1759 01:13:25,611 --> 01:13:31,050 AND OUR SCORES TEND TO BE KIND 1760 01:13:31,050 --> 01:13:36,321 OF IN A PRETTY CLOSE BAND OF 1761 01:13:36,321 --> 01:13:37,856 RANGES TOGETHER, RIGHT AROUND 53 1762 01:13:37,856 --> 01:13:38,424 TO 63. 1763 01:13:38,424 --> 01:13:39,825 AND I WANT TO INTERPRET THIS 1764 01:13:39,825 --> 01:13:42,661 SCORE A LITTLE BIT MORE FOR YOU. 1765 01:13:42,661 --> 01:13:44,697 SO WE DIDN'T DO SIGNIFICANT 1766 01:13:44,697 --> 01:13:46,732 TESTING IN A LOT OF THESE 1767 01:13:46,732 --> 01:13:48,934 ANALYSES BUT WHAT WE CAN SAY 1768 01:13:48,934 --> 01:13:51,003 ABOUT THE HEALTHY EATING INDEX 1769 01:13:51,003 --> 01:13:52,971 SCORES IS THAT DIFFERENCES IN 1770 01:13:52,971 --> 01:13:54,707 ABOUT FIVE OR SIX POINTS HAVE 1771 01:13:54,707 --> 01:13:57,776 BEEN SHOWN TO BE MEANINGFUL WITH 1772 01:13:57,776 --> 01:14:01,714 REGARD TO HEALTH INDICATORS. 1773 01:14:01,714 --> 01:14:03,248 SO, THERE'S CERTAINLY 1774 01:14:03,248 --> 01:14:06,218 DISPARITIES THAT WE CAN SEE 1775 01:14:06,218 --> 01:14:07,853 BETWEEN THESE DIFFERENT 1776 01:14:07,853 --> 01:14:08,620 SOCIODEMOGRAPHIC GROUPS IN THE 1777 01:14:08,620 --> 01:14:10,489 POPULATION, BUT I THINK THE 1778 01:14:10,489 --> 01:14:14,760 TAKEHOME, YOU KNOW, HERE IS THAT 1779 01:14:14,760 --> 01:14:17,262 ALL DIETS ARE QUITE POOR. 1780 01:14:17,262 --> 01:14:19,431 SO, AND THIS SLIDE IS, AGAIN, 1781 01:14:19,431 --> 01:14:22,201 FOR AGES 2 AND OLDER. 1782 01:14:22,201 --> 01:14:24,937 SO LET'S MOVE TO THE NEXT SLIDE. 1783 01:14:24,937 --> 01:14:27,005 AND HERE WE'LL SEE THE SAME KIND 1784 01:14:27,005 --> 01:14:28,774 OF GRAPH, BUT THIS IS WITH 1785 01:14:28,774 --> 01:14:32,711 REGARD TO THE HEALTHY EATING 1786 01:14:32,711 --> 01:14:34,012 INDEX TODDLERS 2020 SCORES. 1787 01:14:34,012 --> 01:14:36,982 AND SO THESE ARE SPECIFICALLY 1788 01:14:36,982 --> 01:14:39,485 FOR TODDLERS, AND THIS AGE GROUP 1789 01:14:39,485 --> 01:14:42,354 IS 12 TO 23 MONTHS. 1790 01:14:42,354 --> 01:14:43,255 AGAIN, ACROSS OUR SIMILAR 1791 01:14:43,255 --> 01:14:45,424 GROUPS, BUT WE ALSO HAVE THESE 1792 01:14:45,424 --> 01:14:48,727 ESTIMATES DIVIDED BY MALES AND 1793 01:14:48,727 --> 01:14:49,061 FEMALES. 1794 01:14:49,061 --> 01:14:51,363 AND SO HERE JUST TO INTERPRET 1795 01:14:51,363 --> 01:14:55,067 THESE, YOU CAN SEE THE SCORES 1796 01:14:55,067 --> 01:14:57,069 ARE GENERALLY HIGHER THAN WE SAW 1797 01:14:57,069 --> 01:14:59,438 FOR ADULTS, MORE OF THE SCORES 1798 01:14:59,438 --> 01:15:03,575 ARE IN THE RANGE OF 60 TO 66. 1799 01:15:03,575 --> 01:15:07,846 PERHAPS KIND OF TIGHTER RANGE 1800 01:15:07,846 --> 01:15:08,080 THERE. 1801 01:15:08,080 --> 01:15:11,583 BUT STILL, YOU KNOW, POORLY 1802 01:15:11,583 --> 01:15:15,854 ALIGNING TO THE RECOMMENDATIONS 1803 01:15:15,854 --> 01:15:16,288 OVERALL. 1804 01:15:16,288 --> 01:15:18,690 MOVING FORWARD, IN THIS SLIDE 1805 01:15:18,690 --> 01:15:22,728 WE'RE MOVING UP TO OUR CHILD AGE 1806 01:15:22,728 --> 01:15:24,830 GROUPS OF AGES 2-18 YEARS, AND 1807 01:15:24,830 --> 01:15:27,533 YOU CAN SEE THAT OUR SCORES IN 1808 01:15:27,533 --> 01:15:30,836 GENERAL KIND OF DECREASE. 1809 01:15:30,836 --> 01:15:36,942 AND THE RANGE WE HAVE IS FROM 50 1810 01:15:36,942 --> 01:15:38,477 FOR MALES IN OTHER RACE OR 1811 01:15:38,477 --> 01:15:42,314 ETHNICITY GOING UP TO 57 IN 1812 01:15:42,314 --> 01:15:43,649 NON-HISPANIC ASIAN GROUP. 1813 01:15:43,649 --> 01:15:46,018 THERE'S SOME VARIATION THERE 1814 01:15:46,018 --> 01:15:49,555 WITHIN OUR GROUPS. 1815 01:15:49,555 --> 01:15:52,191 MOVING FORWARD TO OUR ADULTS 1816 01:15:52,191 --> 01:15:55,794 SLIDE HERE, THIS IS FOR AGES 19 1817 01:15:55,794 --> 01:15:58,297 YEARS AND OLDER. 1818 01:15:58,297 --> 01:16:00,065 AND YOU CAN SEE THAT RANGE WIDEN 1819 01:16:00,065 --> 01:16:01,033 A BIT. 1820 01:16:01,033 --> 01:16:04,870 WE HAVE THAT GOING NOW FROM 52 1821 01:16:04,870 --> 01:16:05,337 TO 64. 1822 01:16:05,337 --> 01:16:09,074 I WANT TO POINT OUT HERE WE DO 1823 01:16:09,074 --> 01:16:12,277 HAVE A LITTLE BIT MORE RANGE FOR 1824 01:16:12,277 --> 01:16:14,646 THE FOOD INSECURITY, AND FOR THE 1825 01:16:14,646 --> 01:16:17,950 POVERTY INCOME RATIO GROUPS AS 1826 01:16:17,950 --> 01:16:18,150 WELL. 1827 01:16:18,150 --> 01:16:19,518 THOSE WERE KIND OF CLOSER 1828 01:16:19,518 --> 01:16:21,253 PERHAPS THAN SOME OF THE OTHER 1829 01:16:21,253 --> 01:16:21,486 SLIDES. 1830 01:16:21,486 --> 01:16:24,690 AND THERE IS, YOU KNOW, A LOT OF 1831 01:16:24,690 --> 01:16:29,328 VARIATION IN THE RACE/ETHNIC 1832 01:16:29,328 --> 01:16:31,396 GROUP SCORES AS WELL, STILL IN 1833 01:16:31,396 --> 01:16:36,768 GENERAL STILL QUITE POOR. 1834 01:16:36,768 --> 01:16:37,202 OKAY. 1835 01:16:37,202 --> 01:16:39,838 SO, MOVING ON, SO THAT KIND OF 1836 01:16:39,838 --> 01:16:44,643 WRAPS UP THOSE NEW RESULTS TO 1837 01:16:44,643 --> 01:16:46,612 SHARE FOR CURRENT PATTERNS. 1838 01:16:46,612 --> 01:16:49,448 AND NOW WE'RE GOING TO ADDRESS 1839 01:16:49,448 --> 01:16:51,183 THIS SECOND QUESTION WITH SOME 1840 01:16:51,183 --> 01:16:52,417 NEW RESULTS WE HAVE. 1841 01:16:52,417 --> 01:16:54,386 THIS QUESTION IS WHAT ARE THE 1842 01:16:54,386 --> 01:16:57,656 CURRENT INTAKES OF FOOD GROUPS, 1843 01:16:57,656 --> 01:16:58,857 NUTRIENTS, AND DIETARY 1844 01:16:58,857 --> 01:16:59,758 COMPONENTS? 1845 01:16:59,758 --> 01:17:03,462 AND HERE WE'RE GOING TO FOCUS ON 1846 01:17:03,462 --> 01:17:03,795 FOOD GROUPS. 1847 01:17:03,795 --> 01:17:08,100 AND SO JUST TO GROUND YOU HERE 1848 01:17:08,100 --> 01:17:10,269 INSTEAD OF LOOKING AT AGI SCORES 1849 01:17:10,269 --> 01:17:12,571 WE'LL LOOK AT HOW WELL INTAKES 1850 01:17:12,571 --> 01:17:15,407 ARE MEETING RECOMMENDATIONS. 1851 01:17:15,407 --> 01:17:17,910 IN THESE GRAPHS WE'RE AGAIN 1852 01:17:17,910 --> 01:17:20,445 SHOWING THE SAME 1853 01:17:20,445 --> 01:17:22,514 SOCIODEMOGRAPHIC GROUPS, BUT OUR 1854 01:17:22,514 --> 01:17:24,283 GRAPH IS DIFFERENT BECAUSE WE'RE 1855 01:17:24,283 --> 01:17:29,755 LOOKING LIKE THE BARS YOU SEE 1856 01:17:29,755 --> 01:17:33,158 ADD UP TO 100% OF THE GROUP, AND 1857 01:17:33,158 --> 01:17:38,397 THEN ON THE TOP, ABOVE THE ZERO 1858 01:17:38,397 --> 01:17:40,399 AXIS WE'RE SEEING THE PERCENTAGE 1859 01:17:40,399 --> 01:17:44,303 OF THE GROUP THAT IS AT OR ABOVE 1860 01:17:44,303 --> 01:17:46,071 RECOMMENDATION, THAT'S IN GREEN. 1861 01:17:46,071 --> 01:17:49,007 AND THEN THE PORTION IN BLUE IS 1862 01:17:49,007 --> 01:17:50,876 GOING TO BE THE PERCENT OF THE 1863 01:17:50,876 --> 01:17:54,813 GROUP THAT IS BELOW THE 1864 01:17:54,813 --> 01:17:55,180 RECOMMENDATION. 1865 01:17:55,180 --> 01:17:56,882 AND WE'RE GOING TO START WITH 1866 01:17:56,882 --> 01:17:58,750 FRUIT AND THEN GOING THROUGH 1867 01:17:58,750 --> 01:18:01,153 VEGETABLES, AND THE OTHER FOOD 1868 01:18:01,153 --> 01:18:01,386 GROUPS. 1869 01:18:01,386 --> 01:18:02,821 AND SO AGAIN, YOU KNOW, I JUST 1870 01:18:02,821 --> 01:18:04,089 WANT TO HIGHLIGHT THIS. 1871 01:18:04,089 --> 01:18:06,625 IT'S REALLY INTERESTING TO LOOK 1872 01:18:06,625 --> 01:18:08,593 ACROSS THESE DIFFERENT 1873 01:18:08,593 --> 01:18:09,094 SOCIODEMOGRAPHIC GROUPS. 1874 01:18:09,094 --> 01:18:12,097 I THINK IT'S KIND OF FASCINATING 1875 01:18:12,097 --> 01:18:15,701 TO SEE JUST THAT RANGE THERE AND 1876 01:18:15,701 --> 01:18:17,569 THAT COMPARISON THAT WE HAVE 1877 01:18:17,569 --> 01:18:21,807 THIS RICH DATA FROM. 1878 01:18:21,807 --> 01:18:25,444 SO, TOTAL FRUITS THEN YOU CAN 1879 01:18:25,444 --> 01:18:27,713 SEE REALLY AS A WHOLE GROUP, AS 1880 01:18:27,713 --> 01:18:29,181 A POPULATION, WE'RE NOT DOING 1881 01:18:29,181 --> 01:18:33,585 WELL AT MEETING THE FRUIT GROUP 1882 01:18:33,585 --> 01:18:34,486 RECOMMENDATION. 1883 01:18:34,486 --> 01:18:37,155 WE HAVE SOME VARIABILITY FROM 1884 01:18:37,155 --> 01:18:43,395 ABOUT 18% GOING UP TO 29% IN 1885 01:18:43,395 --> 01:18:44,496 COMPLIANCE WITH THOSE 1886 01:18:44,496 --> 01:18:45,931 RECOMMENDATIONS, IN AGES 1 AND 1887 01:18:45,931 --> 01:18:46,264 OLDER. 1888 01:18:46,264 --> 01:18:48,200 AND ALSO ALL OF THESE SLIDES ARE 1889 01:18:48,200 --> 01:18:51,069 GOING TO BE FOR AGES 1 AND 1890 01:18:51,069 --> 01:18:51,503 OLDER. 1891 01:18:51,503 --> 01:18:56,875 SO MOVING FORWARD TO TOTAL 1892 01:18:56,875 --> 01:18:58,510 VEGETABLES, HERE A LITTLE BIT 1893 01:18:58,510 --> 01:19:01,580 WORSE COMPLIANCE I WOULD SAY 1894 01:19:01,580 --> 01:19:04,483 COMPARED WITH FRUITS, AND WE 1895 01:19:04,483 --> 01:19:07,152 ONLY HAVE RANGE OF ABOUT 5 GOING 1896 01:19:07,152 --> 01:19:12,290 UP TO 21% OF OUR GROUPS, 1897 01:19:12,290 --> 01:19:15,027 SOCIODEMOGRAPHIC GROUPS, MEETING 1898 01:19:15,027 --> 01:19:16,228 TOTAL VEGETABLES 1899 01:19:16,228 --> 01:19:16,795 RECOMMENDATIONS. 1900 01:19:16,795 --> 01:19:18,296 WITHIN TOTAL VEGETABLES THERE'S 1901 01:19:18,296 --> 01:19:20,732 SEVERAL SUBGROUPS. 1902 01:19:20,732 --> 01:19:22,467 AND WE HAVE SOME INTERESTING 1903 01:19:22,467 --> 01:19:24,569 VARIETY THERE THAT NOW WE'LL GO 1904 01:19:24,569 --> 01:19:24,870 INTO. 1905 01:19:24,870 --> 01:19:27,272 MOVING FORWARD WE'LL START WITH 1906 01:19:27,272 --> 01:19:28,974 THE DARK GREEN VEGETABLES. 1907 01:19:28,974 --> 01:19:32,778 AND HERE YOU CAN SEE THAT THE 1908 01:19:32,778 --> 01:19:36,715 NON-HISPANIC ASIAN GROUP HAS 42% 1909 01:19:36,715 --> 01:19:38,683 COMPLIANCE, WHICH IS NOT QUITE 1910 01:19:38,683 --> 01:19:40,018 MAJORITY BUT PRETTY GOOD. 1911 01:19:40,018 --> 01:19:44,823 AND THEN THAT WE HAVE A LOW OF 1912 01:19:44,823 --> 01:19:48,427 ABOUT 10% IN THE HISPANIC GROUP 1913 01:19:48,427 --> 01:19:50,595 FOR MEETING OR ABOVE THE 1914 01:19:50,595 --> 01:19:53,331 RECOMMENDATIONS FOR DARK GREEN 1915 01:19:53,331 --> 01:19:53,799 VEGETABLES. 1916 01:19:53,799 --> 01:19:57,836 MOVING FORWARD, WITH RED AND 1917 01:19:57,836 --> 01:19:58,603 ORANGE VEGETABLES, WORSE 1918 01:19:58,603 --> 01:20:00,272 COMPLIANCE OVERALL. 1919 01:20:00,272 --> 01:20:02,974 A SMALLER RANGE, ONLY FROM 1920 01:20:02,974 --> 01:20:05,177 ABOUT -- IT'S HARD TO READ FROM 1921 01:20:05,177 --> 01:20:07,712 HERE, BUT 3 TO 7%, I THINK. 1922 01:20:07,712 --> 01:20:10,315 MAYBE A LITTLE HIGHER THAN THAT. 1923 01:20:10,315 --> 01:20:13,085 SO IT'S PRETTY TIGHT THOUGH. 1924 01:20:13,085 --> 01:20:15,153 MOVING FORWARD TO BEANS, PEAS, 1925 01:20:15,153 --> 01:20:18,423 LENTILS, A LITTLE BIT MORE 1926 01:20:18,423 --> 01:20:20,092 VARIATIONS IN OUR SUBGROUPS, AND 1927 01:20:20,092 --> 01:20:24,329 HERE WE HAVE THE HISPANIC GROUP 1928 01:20:24,329 --> 01:20:26,731 DOING MUCH BETTER WITH 45% 1929 01:20:26,731 --> 01:20:31,002 COMPLIANCE OR ABOVE THAT 1930 01:20:31,002 --> 01:20:31,770 RECOMMENDATION. 1931 01:20:31,770 --> 01:20:35,907 GOING FORWARD, FOR STARCHY 1932 01:20:35,907 --> 01:20:38,443 VEGETABLES, KIND OF LOWER 1933 01:20:38,443 --> 01:20:39,978 OVERALL RANGES FOR COMPLIANCE, 1934 01:20:39,978 --> 01:20:42,247 AND WE'VE GOT ABOUT, YOU KNOW, 3 1935 01:20:42,247 --> 01:20:45,650 TO 15% THERE WHO ARE MEETING OR 1936 01:20:45,650 --> 01:20:48,086 ABOVE THOSE RECOMMENDATIONS FOR 1937 01:20:48,086 --> 01:20:49,387 STARCHY VEGETABLES. 1938 01:20:49,387 --> 01:20:51,456 AND FINALLY, WE HAVE OTHER 1939 01:20:51,456 --> 01:20:53,959 VEGETABLES, AND HERE WE ALSO SEE 1940 01:20:53,959 --> 01:20:57,796 QUITE A BIT OF VARIATION IN 1941 01:20:57,796 --> 01:20:59,331 ACROSS, YOU KNOW, THE GROUPS 1942 01:20:59,331 --> 01:21:01,533 BUT, YEAH, GENERALLY WE'RE 1943 01:21:01,533 --> 01:21:06,571 SEEING THE MOST VARIATION WITHIN 1944 01:21:06,571 --> 01:21:08,540 THE RACE/ETHNIC GROUPS AS FAR AS 1945 01:21:08,540 --> 01:21:09,875 VEGETABLES ARE CONCERNED. 1946 01:21:09,875 --> 01:21:11,610 NEXT SLIDE WE WANTED TO PUT 1947 01:21:11,610 --> 01:21:13,879 THESE ALL TOGETHER FOR YOU, JUST 1948 01:21:13,879 --> 01:21:16,615 VISUALLY TO SEE FOR ALL OF THESE 1949 01:21:16,615 --> 01:21:19,050 FOR TOTAL VEGETABLES IN ALL 1950 01:21:19,050 --> 01:21:22,988 THESE VEGETABLE GROUPS, THE 1951 01:21:22,988 --> 01:21:24,823 VARIATION IN THE RACE/ETHNIC 1952 01:21:24,823 --> 01:21:26,658 GROUPS THERE BECAUSE AS I 1953 01:21:26,658 --> 01:21:30,629 HIGHLIGHTED WE SEEM TOE HAVE THE 1954 01:21:30,629 --> 01:21:36,568 MOST VARIATION FOR THAT 1955 01:21:36,568 --> 01:21:36,935 SOCIODEMOGRAPHIC 1956 01:21:36,935 --> 01:21:37,302 CHARACTERISTICS. 1957 01:21:37,302 --> 01:21:39,371 YEAH, AND FOR CERTAIN SUBGROUPS 1958 01:21:39,371 --> 01:21:40,805 HERE THERE'S NOT AS MUCH, JUST 1959 01:21:40,805 --> 01:21:43,675 POINTING OUT RED AND ORANGE 1960 01:21:43,675 --> 01:21:44,776 VEGETABLES, STARCHY VEGETABLES, 1961 01:21:44,776 --> 01:21:48,446 BUT THEN FOR SEVERAL WE DO HAVE 1962 01:21:48,446 --> 01:21:50,315 QUITE A BIG RANGE. 1963 01:21:50,315 --> 01:21:50,882 OKAY. 1964 01:21:50,882 --> 01:21:53,618 NOW WE'LL MOVE FORWARD WITH SOME 1965 01:21:53,618 --> 01:21:58,423 OF OUR OTHER FOOD GROUPS. 1966 01:21:58,423 --> 01:22:00,192 WHOLE GRAINS, THIS GROUP IS 1967 01:22:00,192 --> 01:22:03,895 PERHAPS KIND OF OUR WORST AT 1968 01:22:03,895 --> 01:22:07,199 COMPLYING AS A POPULATION. 1969 01:22:07,199 --> 01:22:09,601 VERY SMALL PERCENTAGES IN OUR 1970 01:22:09,601 --> 01:22:11,670 SUBGROUPS ARE COMPLYING OR ABOVE 1971 01:22:11,670 --> 01:22:15,407 THIS RECOMMENDATION GOING FROM 1972 01:22:15,407 --> 01:22:18,376 ABOUT 1 TO 7%. 1973 01:22:18,376 --> 01:22:21,213 MOVING FORWARD, TO REFINED 1974 01:22:21,213 --> 01:22:22,314 GRAINS, WE'VE MADE THE -- THOSE 1975 01:22:22,314 --> 01:22:24,749 THAT ARE AT OR ABOVE THE 1976 01:22:24,749 --> 01:22:27,118 RECOMMENDATION BARS HERE IN 1977 01:22:27,118 --> 01:22:28,553 ORANGE, BECAUSE THIS 1978 01:22:28,553 --> 01:22:30,322 RECOMMENDATION ALSO HAS A LIMIT 1979 01:22:30,322 --> 01:22:33,158 THAT IT SHOULD ONLY BE 50% OF 1980 01:22:33,158 --> 01:22:36,027 GRAINS AS REFINED GRAINS. 1981 01:22:36,027 --> 01:22:37,429 AND SO EVEN THOUGH WE'RE -- YOU 1982 01:22:37,429 --> 01:22:38,630 KNOW, THERE'S A MAJORITY OF US 1983 01:22:38,630 --> 01:22:42,534 WHO ARE AT OR ABOVE THE 1984 01:22:42,534 --> 01:22:44,236 RECOMMENDATIONS, IT'S TOO MUCH 1985 01:22:44,236 --> 01:22:44,436 ABOVE. 1986 01:22:44,436 --> 01:22:47,072 WE NEED TO BALANCE THAT WITH 1987 01:22:47,072 --> 01:22:48,940 THOSE WHOLE GRAINS WHICH WE'RE 1988 01:22:48,940 --> 01:22:50,041 NOT DOING. 1989 01:22:50,041 --> 01:22:52,110 SO YOU CAN SEE THOSE PERCENTAGES 1990 01:22:52,110 --> 01:22:55,380 ARE QUITE HIGH. 1991 01:22:55,380 --> 01:22:57,582 MOVING FORWARD TO TOTAL PROTEIN 1992 01:22:57,582 --> 01:23:01,853 FOODS, THIS IS ONE OF THE FOOD 1993 01:23:01,853 --> 01:23:05,557 GROUPS THAT WE ARE ALSO AT OR 1994 01:23:05,557 --> 01:23:09,060 ABOVE THE RECOMMENDATIONS IN 1995 01:23:09,060 --> 01:23:10,495 MAJORITY ESTIMATES FOR AGES 1 1996 01:23:10,495 --> 01:23:13,665 AND OLDER AGAIN, AND YOU CAN SEE 1997 01:23:13,665 --> 01:23:16,268 WE'VE GOT PRETTY BIG MAJORITY 1998 01:23:16,268 --> 01:23:21,106 HERE, ABOUT 51 GOING TO 64% OF 1999 01:23:21,106 --> 01:23:24,609 US WHO ARE MEETING THE TOTAL 2000 01:23:24,609 --> 01:23:27,779 PROTEIN FOODS RECOMMENDATIONS. 2001 01:23:27,779 --> 01:23:28,980 MOVING FORWARD FOR SEAFOOD, A 2002 01:23:28,980 --> 01:23:32,183 LITTLE MORE VARIETY BUT 2003 01:23:32,183 --> 01:23:35,120 GENERALLY VERY LOW PERCENTAGES 2004 01:23:35,120 --> 01:23:38,323 WHO ARE AT OR ABOVE 2005 01:23:38,323 --> 01:23:39,624 RECOMMENDATION, WE HAVE ESTIMATE 2006 01:23:39,624 --> 01:23:43,461 OF TOP END OF 34% IN THE 2007 01:23:43,461 --> 01:23:46,498 NON-HISPANIC ASIAN GROUP. 2008 01:23:46,498 --> 01:23:48,133 MOVING FORWARD, FOR MEAT, 2009 01:23:48,133 --> 01:23:52,437 POULTRY, EGGS, ONE OF THE 2010 01:23:52,437 --> 01:23:53,672 RECOMMENDATIONS WE'RE MEETING, 2011 01:23:53,672 --> 01:23:55,840 IN A LARGE PART FOR, AND THIS IS 2012 01:23:55,840 --> 01:24:00,111 FOR JUST TO REMIND YOU, FOR AGES 2013 01:24:00,111 --> 01:24:01,746 2 AND OLDER. 2014 01:24:01,746 --> 01:24:05,483 AND HERE WE HAVE ESTIMATES OF 2015 01:24:05,483 --> 01:24:10,188 56% GOING UP TO ABOUT 76% WHO 2016 01:24:10,188 --> 01:24:12,590 ARE MEETING THIS. 2017 01:24:12,590 --> 01:24:15,660 GOING AHEAD, FOR OUR LAST 2018 01:24:15,660 --> 01:24:18,530 PROTEIN GROUP HERE, NUTS, SEEDS, 2019 01:24:18,530 --> 01:24:21,800 SOY PRODUCTS, A LOT OF VARIATION 2020 01:24:21,800 --> 01:24:27,038 IN THESE ESTIMATES WHO ARE AT OR 2021 01:24:27,038 --> 01:24:33,745 ABOVE GOING FROM ABOUT 26% OR 2022 01:24:33,745 --> 01:24:39,084 27, TO UP TO 47 OR 49%. 2023 01:24:39,084 --> 01:24:40,885 AND THAT'S ALSO VARIATION IN -- 2024 01:24:40,885 --> 01:24:44,823 BY FOOD SECURITY AND POVERTY 2025 01:24:44,823 --> 01:24:48,560 INCOME RATIO AS WELL AS ETHNIC 2026 01:24:48,560 --> 01:24:48,960 GROUPS. 2027 01:24:48,960 --> 01:24:51,930 MOVING FORWARD, NOW WE HAVE 2028 01:24:51,930 --> 01:24:55,300 TOTAL DAIRY AND FORTIFIED SOY 2029 01:24:55,300 --> 01:24:58,403 ALTERNATIVES FOOD GROUP. 2030 01:24:58,403 --> 01:25:01,139 MAJORITY ARE VERY PREVALENTLY 2031 01:25:01,139 --> 01:25:02,974 NOT MEETING THIS RECOMMENDATION. 2032 01:25:02,974 --> 01:25:06,144 IT'S QUITE LOW ACROSS ALL OF THE 2033 01:25:06,144 --> 01:25:07,245 SOCIODEMOGRAPHIC GROUPS THAT WE 2034 01:25:07,245 --> 01:25:09,981 LOOKED AT WITH OUR RANGE, ONLY 2035 01:25:09,981 --> 01:25:12,684 FROM 4 TO ABOUT 12% WHO ARE 2036 01:25:12,684 --> 01:25:16,221 MEETING THIS RECOMMENDATION. 2037 01:25:16,221 --> 01:25:18,990 AND MOVING FORWARD AGAIN, OUR 2038 01:25:18,990 --> 01:25:20,925 VERY LAST FOOD GROUP TO SHOW TO 2039 01:25:20,925 --> 01:25:25,196 YOU TODAY IS GOING TO BE OILS. 2040 01:25:25,196 --> 01:25:26,931 AND HERE WE'RE AGAIN DOING 2041 01:25:26,931 --> 01:25:28,700 PRETTY WELL. 2042 01:25:28,700 --> 01:25:30,902 ONE OF OUR GROUPS WHERE MAJORITY 2043 01:25:30,902 --> 01:25:35,273 OF US ARE AT OR ABOVE THE 2044 01:25:35,273 --> 01:25:37,942 RECOMMENDATION, AND THIS RANGES 2045 01:25:37,942 --> 01:25:46,217 FROM ABOUT 47 TO 59% OF US WHO 2046 01:25:46,217 --> 01:25:48,853 ARE MEETING THESE 2047 01:25:48,853 --> 01:25:49,320 RECOMMENDATIONS. 2048 01:25:49,320 --> 01:25:51,689 SO, THOSE ARE ALL OF THE NEW 2049 01:25:51,689 --> 01:25:53,324 RESULTS THAT WE WANTED TO SHARE 2050 01:25:53,324 --> 01:25:55,193 WITH YOU TODAY. 2051 01:25:55,193 --> 01:25:59,597 I JUST WANTED TO SAY A FEW 2052 01:25:59,597 --> 01:26:01,666 THINGS ABOUT THE CONSIDERATIONS 2053 01:26:01,666 --> 01:26:06,905 AND LIMITATIONS OF THIS DATA. 2054 01:26:06,905 --> 01:26:08,106 SO, AGAIN THIS IS THE FIRST TIME 2055 01:26:08,106 --> 01:26:10,975 WE SHARED THESE, ALSO THE FIRST 2056 01:26:10,975 --> 01:26:13,378 TIME DIETARY GUIDELINES ADVISORY 2057 01:26:13,378 --> 01:26:16,314 COMMITTEE HAS REALLY EXAMINED 2058 01:26:16,314 --> 01:26:17,649 ALL OF THESE INTAKES TOGETHER 2059 01:26:17,649 --> 01:26:19,150 AND ALL THIS EVIDENCE TOGETHER 2060 01:26:19,150 --> 01:26:21,686 WITH THE HEALTH EQUITY LENS AND 2061 01:26:21,686 --> 01:26:25,056 BY ALL OF THESE DIFFERENT GROUPS 2062 01:26:25,056 --> 01:26:27,025 THAT WE LOOKED AT. 2063 01:26:27,025 --> 01:26:28,460 THERE'S A LOT MORE DEMOGRAPHIC 2064 01:26:28,460 --> 01:26:30,528 GROUPS THAT WE LOOKED AT THAT WE 2065 01:26:30,528 --> 01:26:33,164 JUST DON'T HAVE THE TIME TO 2066 01:26:33,164 --> 01:26:34,265 PRESENT TODAY. 2067 01:26:34,265 --> 01:26:38,403 SO, COULD ONLY SHOW THESE MAJOR 2068 01:26:38,403 --> 01:26:38,636 GROUPS. 2069 01:26:38,636 --> 01:26:40,705 AND I ALSO WANTED TO REMIND 2070 01:26:40,705 --> 01:26:45,510 EVERYONE ALTHOUGH WE DO SEE THIS 2071 01:26:45,510 --> 01:26:46,744 VARIATION, AND WE SEE THAT MANY 2072 01:26:46,744 --> 01:26:51,349 OF THE GROUPS ARE NOT MEETING 2073 01:26:51,349 --> 01:26:52,650 THE RECOMMENDATIONS, IT'S -- YOU 2074 01:26:52,650 --> 01:26:55,053 KNOW, WE CAN'T REALLY SAY 2075 01:26:55,053 --> 01:26:55,920 THERE'S SIGNIFICANT DIFFERENCES 2076 01:26:55,920 --> 01:26:58,356 BETWEEN SOME OF THOSE, YOU KNOW, 2077 01:26:58,356 --> 01:27:00,124 RANGES OF ESTIMATES THAT WE SAW. 2078 01:27:00,124 --> 01:27:03,394 SO WE HAVE TO BE CAREFUL IN OUR 2079 01:27:03,394 --> 01:27:05,263 INTERPRETATION OF THAT. 2080 01:27:05,263 --> 01:27:07,665 WE CAN SAY, HOWEVER, THAT 2081 01:27:07,665 --> 01:27:10,869 THERE'S CERTAINLY A LOT OF 2082 01:27:10,869 --> 01:27:12,837 SHORTFALLS IN OUR POPULATION 2083 01:27:12,837 --> 01:27:16,407 DIETARY INTAKES AS FAR AS THEY 2084 01:27:16,407 --> 01:27:18,276 MEET THOSE RECOMMENDATIONS. 2085 01:27:18,276 --> 01:27:19,377 THERE'S MANY COMPLEX FACTORS AT 2086 01:27:19,377 --> 01:27:21,679 PLAY HERE THAT ARE ALSO NOT 2087 01:27:21,679 --> 01:27:24,415 CAPTURED WHEN WE JUST LOOK AT 2088 01:27:24,415 --> 01:27:26,084 INTAKES FOR CERTAIN GROUPS. 2089 01:27:26,084 --> 01:27:29,053 WE DON'T KNOW WHY THAT'S 2090 01:27:29,053 --> 01:27:29,320 HAPPENING. 2091 01:27:29,320 --> 01:27:33,558 AND WE NEED TO DIG A LOT DEEPER 2092 01:27:33,558 --> 01:27:36,127 TO TRY TO UNDERSTAND THAT. 2093 01:27:36,127 --> 01:27:38,563 ALL OF US, I JUST WANT TO 2094 01:27:38,563 --> 01:27:40,532 MENTION TOO, THAT ALL OF US ARE 2095 01:27:40,532 --> 01:27:43,067 REALLY REPRESENTED IN MULTIPLE 2096 01:27:43,067 --> 01:27:45,603 OF THESE CATEGORIES, AND JUST 2097 01:27:45,603 --> 01:27:49,407 LOOKING AT ONE ASPECT, ONE 2098 01:27:49,407 --> 01:27:51,376 CHARACTERISTIC, IS NOT GIVING US 2099 01:27:51,376 --> 01:27:54,879 A FULL PICTURE OF HOW ALL OF 2100 01:27:54,879 --> 01:27:57,949 THOSE, YOU KNOW, FACTORS AND 2101 01:27:57,949 --> 01:28:02,220 INFLUENCES AROUND US MAY BE 2102 01:28:02,220 --> 01:28:04,455 CONTRIBUTING TO DIETARY INTAKES. 2103 01:28:04,455 --> 01:28:06,057 ALL OF US ARE SHAPED BY THE 2104 01:28:06,057 --> 01:28:06,925 ENVIRONMENT AND SOCIAL SYSTEMS 2105 01:28:06,925 --> 01:28:10,528 AROUND US, SO THAT'S A BIG PIECE 2106 01:28:10,528 --> 01:28:11,062 OF THIS. 2107 01:28:11,062 --> 01:28:12,931 AND THEN I WANT TO REMIND 2108 01:28:12,931 --> 01:28:15,033 EVERYONE THESE DATA ARE 2109 01:28:15,033 --> 01:28:16,434 CROSS-SECTIONAL, AND WE 2110 01:28:16,434 --> 01:28:20,271 CERTAINLY CAN'T USE THEM TO 2111 01:28:20,271 --> 01:28:21,906 DETERMINE CAUSE AND EFFECT. 2112 01:28:21,906 --> 01:28:25,310 SO FOR THE FUTURE, HOPEFULLY WE 2113 01:28:25,310 --> 01:28:29,247 COULD DO MORE TO, YOU KNOW -- 2114 01:28:29,247 --> 01:28:31,316 NOT JUST IN THIS COMMITTEE, ALSO 2115 01:28:31,316 --> 01:28:33,084 FOR OTHER RESEARCHERS, WE COULD 2116 01:28:33,084 --> 01:28:36,154 DO MORE TO CAPTURE MORE, YOU 2117 01:28:36,154 --> 01:28:38,122 KNOW, OF THESE FACTORS, DIG 2118 01:28:38,122 --> 01:28:39,023 DEEPER, AND UNDERSTAND THIS DATA 2119 01:28:39,023 --> 01:28:43,595 FURTHER WITH THE HEALTH EQUITY 2120 01:28:43,595 --> 01:28:43,795 LENS. 2121 01:28:43,795 --> 01:28:45,029 MOVING AHEAD, SO NOW WE GET TO 2122 01:28:45,029 --> 01:28:49,534 THE TIME WHERE WE CAN SHARE OUR 2123 01:28:49,534 --> 01:28:50,635 DRAFT CONCLUSION STATEMENT FOR 2124 01:28:50,635 --> 01:28:54,138 EACH OF THE FOUR QUESTIONS THAT 2125 01:28:54,138 --> 01:28:54,572 WE ADDRESSED. 2126 01:28:54,572 --> 01:28:59,177 AND GOING TO THE NEXT SLIDE, 2127 01:28:59,177 --> 01:29:01,679 JUST TO PROVIDE A BACKGROUND ON 2128 01:29:01,679 --> 01:29:03,748 THAT, I'M GOING TO HIGHLIGHT A 2129 01:29:03,748 --> 01:29:04,983 FEW THINGS. 2130 01:29:04,983 --> 01:29:08,620 WE'RE GOING TO GIVE SUMMARY 2131 01:29:08,620 --> 01:29:09,821 STATEMENTS OF THE EVIDENCE WE 2132 01:29:09,821 --> 01:29:11,389 REVIEWED TO ANSWER EACH OF OUR 2133 01:29:11,389 --> 01:29:12,590 QUESTIONS, FOR SOME OF THE 2134 01:29:12,590 --> 01:29:16,361 QUESTIONS WE HAVE A FEW 2135 01:29:16,361 --> 01:29:17,362 STATEMENTS. 2136 01:29:17,362 --> 01:29:19,097 AND IN THESE SUMMARIES WE DID 2137 01:29:19,097 --> 01:29:21,966 CONSIDER ALL OF THE NATIONALLY 2138 01:29:21,966 --> 01:29:23,401 REPRESENTED FEDERAL DATA ON 2139 01:29:23,401 --> 01:29:25,870 DIETARY INTAKES AND PREVALENCE 2140 01:29:25,870 --> 01:29:27,972 OF NUTRITION-RELATED CHRONIC 2141 01:29:27,972 --> 01:29:30,341 HEALTH CONDITIONS THAT WE 2142 01:29:30,341 --> 01:29:31,809 REQUESTED, EVEN THOUGH WE 2143 01:29:31,809 --> 01:29:34,345 HAVEN'T SHARED, YOU KNOW, ALL OF 2144 01:29:34,345 --> 01:29:36,080 THAT PUBLICLY, BUT IT ALL IS 2145 01:29:36,080 --> 01:29:37,815 GOING TO BE PUBLISHED OUT THERE 2146 01:29:37,815 --> 01:29:40,885 FOR EVERYONE TO LOOK AT. 2147 01:29:40,885 --> 01:29:44,555 AND ALSO JUST -- WE JUST WANT TO 2148 01:29:44,555 --> 01:29:46,591 MENTION THAT THE DATA ANALYSIS 2149 01:29:46,591 --> 01:29:49,727 IS DIFFERENT THAN THE SYSTEMATIC 2150 01:29:49,727 --> 01:29:51,429 REVIEWS IN THAT WE'RE NOT 2151 01:29:51,429 --> 01:29:54,932 APPLYING LIKE A GRADING RUBRIC 2152 01:29:54,932 --> 01:29:56,334 OF STRONG, MODERATE, LIMITED, TO 2153 01:29:56,334 --> 01:30:00,004 LOOK AT THIS EVIDENCE. 2154 01:30:00,004 --> 01:30:02,907 BUT WE DO -- YOU KNOW, WE DID 2155 01:30:02,907 --> 01:30:05,209 TAKE ON CERTAIN METHODS IN OUR 2156 01:30:05,209 --> 01:30:08,813 ANALYSIS TO TRY TO PROVIDE THE 2157 01:30:08,813 --> 01:30:10,248 HIGHEST QUALITY OF ESTIMATES 2158 01:30:10,248 --> 01:30:17,155 THAT WE COULD FOR THESE RESULTS. 2159 01:30:17,155 --> 01:30:18,589 SO, MOVING FORWARD TO JUST SHARE 2160 01:30:18,589 --> 01:30:22,894 A LITTLE BIT MORE ABOUT THAT, WE 2161 01:30:22,894 --> 01:30:25,363 DO HAVE LIMITATIONS IN THE DATA 2162 01:30:25,363 --> 01:30:29,067 THAT ARE WORTH MENTIONING HERE. 2163 01:30:29,067 --> 01:30:31,135 SO, DUE TO THE SAMPLE SIZES WE 2164 01:30:31,135 --> 01:30:33,337 HAD TO WORK WITH AND DATA 2165 01:30:33,337 --> 01:30:34,539 AVAILABILITY, THERE IS SOME 2166 01:30:34,539 --> 01:30:35,740 VARIATION WHEN YOU'RE GOING 2167 01:30:35,740 --> 01:30:38,810 TO -- IF YOU LOOK AT THOSE 2168 01:30:38,810 --> 01:30:41,212 REPORTS, AND DIG INTO THE 2169 01:30:41,212 --> 01:30:42,980 RESULTS THAT WE HAVE, THERE'S 2170 01:30:42,980 --> 01:30:45,483 GOING TO BE SOME VARIATION IN 2171 01:30:45,483 --> 01:30:48,019 THE ANALYSIS WITH REGARD TO 2172 01:30:48,019 --> 01:30:50,321 STANDARD ERRORS AND ESTIMATES 2173 01:30:50,321 --> 01:30:51,289 FOR THE DIFFERENT DEMOGRAPHIC 2174 01:30:51,289 --> 01:30:54,992 GROUPS FOR THAT DATA THAT WE HAD 2175 01:30:54,992 --> 01:30:55,993 AVAILABLE TO US. 2176 01:30:55,993 --> 01:30:59,497 AND ALSO WITH REGARD TO CUTOFFS 2177 01:30:59,497 --> 01:31:02,500 THAT WERE APPLIED FOR CERTAIN 2178 01:31:02,500 --> 01:31:04,035 SOCIODEMOGRAPHIC GROUPS, SO, YOU 2179 01:31:04,035 --> 01:31:06,204 KNOW, JUST TO MENTION, FOR 2180 01:31:06,204 --> 01:31:11,242 EXAMPLE, FOR WIC, WHEN WE LOOKED 2181 01:31:11,242 --> 01:31:12,910 AT WIC, NOT ALL SEX AGE GROUPS 2182 01:31:12,910 --> 01:31:14,545 ARE PART OF THAT DATA SO THAT'S 2183 01:31:14,545 --> 01:31:17,281 AN IMPORTANT CONSIDERATION WHEN 2184 01:31:17,281 --> 01:31:18,583 YOU LOOK AT THAT. 2185 01:31:18,583 --> 01:31:22,720 FOR THE DATA YEARS ANALYZED, WE 2186 01:31:22,720 --> 01:31:25,723 INCLUDED MULTIPLE CYCLES OF DATA 2187 01:31:25,723 --> 01:31:27,024 OVER LONGER TIMEFRAMES FOR 2188 01:31:27,024 --> 01:31:28,893 CERTAIN DEMOGRAPHIC GROUPS SO WE 2189 01:31:28,893 --> 01:31:29,961 COULD GET BETTER ESTIMATES. 2190 01:31:29,961 --> 01:31:32,830 AND WE ALSO USED A VARIETY OF 2191 01:31:32,830 --> 01:31:33,598 DATA SOURCES. 2192 01:31:33,598 --> 01:31:37,869 BUT THIS IS ALL OUTLINED IN 2193 01:31:37,869 --> 01:31:39,403 THOSE REPORTS. 2194 01:31:39,403 --> 01:31:40,905 AND IN OUR PROTOCOLS. 2195 01:31:40,905 --> 01:31:42,807 THEN WE DIDN'T -- JUST A 2196 01:31:42,807 --> 01:31:44,108 REMINDER, WE DIDN'T DO 2197 01:31:44,108 --> 01:31:46,711 STATISTICAL TESTING FOR MOST OF 2198 01:31:46,711 --> 01:31:49,280 THE ANALYSIS, AND OUR DIETARY 2199 01:31:49,280 --> 01:31:51,549 INTAKE DATA IS OF COURSE SUBJECT 2200 01:31:51,549 --> 01:31:53,417 TO MEASUREMENT ERROR. 2201 01:31:53,417 --> 01:31:56,254 AND THAT'S INHERENT TO 2202 01:31:56,254 --> 01:31:58,356 SELF-REPORTED INTAKE, FOR SOME 2203 01:31:58,356 --> 01:32:01,492 OF THE INTAKES WE HAD PROXY 2204 01:32:01,492 --> 01:32:03,161 REPORTERS, FOR EXAMPLE, PARENTS 2205 01:32:03,161 --> 01:32:04,896 REPORTING ON CHILDREN, AND 2206 01:32:04,896 --> 01:32:06,964 THERE'S GOING TO BE VARIATION IN 2207 01:32:06,964 --> 01:32:08,733 OUR FOOD COMPOSITION DATABASE AS 2208 01:32:08,733 --> 01:32:10,034 WELL. 2209 01:32:10,034 --> 01:32:14,305 SO THOSE COULD ALL BE SOURCES OF 2210 01:32:14,305 --> 01:32:14,539 ERRORS. 2211 01:32:14,539 --> 01:32:16,274 AND THEN WE HAVE INTERPRETATION 2212 01:32:16,274 --> 01:32:18,709 CHALLENGES, SEVERAL OF WHICH 2213 01:32:18,709 --> 01:32:20,778 I'VE ALREADY MENTIONED. 2214 01:32:20,778 --> 01:32:22,780 SO COMPLEX FACTORS CONTRIBUTING 2215 01:32:22,780 --> 01:32:24,315 TO THE RESULTS THAT WE CAN'T 2216 01:32:24,315 --> 01:32:26,951 CAPTURE IN JUST LOOKING AT THESE 2217 01:32:26,951 --> 01:32:28,085 ESTIMATES. 2218 01:32:28,085 --> 01:32:30,454 THE DATA IS CROSS-SECTIONAL. 2219 01:32:30,454 --> 01:32:31,022 AND, AGAIN, THAT 2220 01:32:31,022 --> 01:32:32,957 INTERSECTIONALITY THAT I ALREADY 2221 01:32:32,957 --> 01:32:35,293 MENTIONED BEFORE, WE DIDN'T 2222 01:32:35,293 --> 01:32:35,827 CAPTURE. 2223 01:32:35,827 --> 01:32:40,431 BUT WE DO HAVE SOME STRENGTHS. 2224 01:32:40,431 --> 01:32:41,732 SO, MOVING AHEAD, THE STRENGTHS 2225 01:32:41,732 --> 01:32:45,102 ARE THAT OUR DATA CAN BE MADE 2226 01:32:45,102 --> 01:32:47,438 REPRESENTATIVE OF THE U.S. 2227 01:32:47,438 --> 01:32:50,374 POPULATION, SO THAT'S REALLY 2228 01:32:50,374 --> 01:32:50,641 IMPORTANT. 2229 01:32:50,641 --> 01:32:53,010 IT MEANS THAT WE -- YOU KNOW, WE 2230 01:32:53,010 --> 01:32:54,979 CAN BE PRETTY CONFIDENT IN 2231 01:32:54,979 --> 01:32:57,081 THIS -- THE DATA THAT WE HAVE. 2232 01:32:57,081 --> 01:33:00,918 AND WE CAN USE IT TO CREATE 2233 01:33:00,918 --> 01:33:02,553 PRACTICAL RELEVANT AND 2234 01:33:02,553 --> 01:33:03,421 ACHIEVABLE RECOMMENDATIONS. 2235 01:33:03,421 --> 01:33:06,490 AND THEN, YOU KNOW, WE HAVE DONE 2236 01:33:06,490 --> 01:33:09,560 A LOT OF ANALYSIS. 2237 01:33:09,560 --> 01:33:10,962 WE'VE LOOKED AT THE POPULATION 2238 01:33:10,962 --> 01:33:16,100 MANY DIFFERENT WAYS AND JUST 2239 01:33:16,100 --> 01:33:18,502 HAVE THIS MASSIVE GREAT SET OF 2240 01:33:18,502 --> 01:33:23,341 DATA OVER 4,000 PAGES OF NEW 2241 01:33:23,341 --> 01:33:24,108 DATA TABLES THAT'S RELATIVELY 2242 01:33:24,108 --> 01:33:27,712 CURRENT TO MAKE OUR SUMMARY 2243 01:33:27,712 --> 01:33:27,912 FROM. 2244 01:33:27,912 --> 01:33:30,781 AND WE HAVE APPLIED, AS I 2245 01:33:30,781 --> 01:33:32,283 MENTIONED, SOME METHODS TO TRY 2246 01:33:32,283 --> 01:33:35,052 TO OVERCOME SOME OF THE 2247 01:33:35,052 --> 01:33:36,687 SHORTFALLS IN THE MEASUREMENT 2248 01:33:36,687 --> 01:33:37,455 ERROR. 2249 01:33:37,455 --> 01:33:39,924 FOR EXAMPLE, WE USED FIVE-STEP 2250 01:33:39,924 --> 01:33:42,059 MULTIPLE PASS METHOD, WHICH IS A 2251 01:33:42,059 --> 01:33:43,461 REALLY -- IT'S A MORE GOLD 2252 01:33:43,461 --> 01:33:46,764 STANDARD WAY OF COLLECTING 2253 01:33:46,764 --> 01:33:50,601 DIETARY RECALLS. 2254 01:33:50,601 --> 01:33:51,435 WE'VE ALSO USED STATISTICAL 2255 01:33:51,435 --> 01:33:52,670 ADJUSTMENTS TO HELP MITIGATE 2256 01:33:52,670 --> 01:33:54,972 SOME OF THAT MEASUREMENT ERROR 2257 01:33:54,972 --> 01:33:57,608 IN THE DIETARY INTAKES. 2258 01:33:57,608 --> 01:33:58,809 FOR EXAMPLE, THE NATIONAL CANCER 2259 01:33:58,809 --> 01:34:02,747 INSTITUTE METHOD WAS APPLIED. 2260 01:34:02,747 --> 01:34:05,917 AND THEN WE HAVE ENHANCED 2261 01:34:05,917 --> 01:34:07,318 ESTIMATES FOR DISEASE AND 2262 01:34:07,318 --> 01:34:08,019 BIOMARKER PREVALENCE FROM 2263 01:34:08,019 --> 01:34:08,986 PHYSICAL EXAM AND LABORATORY 2264 01:34:08,986 --> 01:34:11,289 DATA THAT ARE ALL COLLECTED. 2265 01:34:11,289 --> 01:34:13,024 AS PART OF NHANES. 2266 01:34:13,024 --> 01:34:21,465 SO THIS IS AN AMAZING DATASET O 2267 01:34:21,465 --> 01:34:23,134 USE AND WE SHOULD CELEBRATE THAT 2268 01:34:23,134 --> 01:34:25,303 STRENGTH WE HAVE. 2269 01:34:25,303 --> 01:34:27,171 WE ALSO INTEGRATED OR CONSIDERED 2270 01:34:27,171 --> 01:34:32,076 THOSE RESULTS FROM THE EVIDENCE 2271 01:34:32,076 --> 01:34:34,278 SCAN THAT WE'VE ALREADY SHARED 2272 01:34:34,278 --> 01:34:36,380 REGARDING THE DIETARY PATTERNS 2273 01:34:36,380 --> 01:34:40,418 DURING THE COVID-19 PANDEMIC. 2274 01:34:40,418 --> 01:34:42,820 AND IN THIS TIME TOO I WANT TO 2275 01:34:42,820 --> 01:34:44,922 HIGHLIGHT WE DID APPLY A HEALTH 2276 01:34:44,922 --> 01:34:48,326 EQUITY LENS TO EXAMINE DATA FOR 2277 01:34:48,326 --> 01:34:50,728 THIS WIDE VARIETY OF 2278 01:34:50,728 --> 01:34:52,029 SOCIODEMOGRAPHIC GROUPS, A MUCH 2279 01:34:52,029 --> 01:34:53,564 WIDER THAN WE COULD SHARE TODAY, 2280 01:34:53,564 --> 01:34:55,766 BUT JUST TO MENTION THOSE WE 2281 01:34:55,766 --> 01:35:01,806 LOOKED AT THE DATA BY AGE LIFE 2282 01:35:01,806 --> 01:35:10,114 STAGE, SEX, RACE, ETHNICITY, 2283 01:35:10,114 --> 01:35:11,315 POVERTY TO INCOME, SUPPLEMENTAL 2284 01:35:11,315 --> 01:35:17,555 PROGRAM FOR NUTRITION, WIC, BY 2285 01:35:17,555 --> 01:35:18,856 EDUCATIONAL LEVEL, FAMILY 2286 01:35:18,856 --> 01:35:21,726 INCOME, COUNTRY OF BIRTH, HEALTH 2287 01:35:21,726 --> 01:35:24,028 INSURANCE STATUS, DISABILITY 2288 01:35:24,028 --> 01:35:25,896 STATUS, GEOGRAPHIC AND 2289 01:35:25,896 --> 01:35:29,834 METROPOLITAN LOCATION, BMI 2290 01:35:29,834 --> 01:35:31,469 STATUS AND DIABETES STATUS. 2291 01:35:31,469 --> 01:35:34,638 MOVING AHEAD, NOW I'M GOING TO 2292 01:35:34,638 --> 01:35:37,375 FINALLY GET TO SHARE OUR SUMMARY 2293 01:35:37,375 --> 01:35:39,343 STATEMENTS FOR OUR FOUR 2294 01:35:39,343 --> 01:35:39,744 QUESTIONS. 2295 01:35:39,744 --> 01:35:41,545 SO, WHAT ARE THE CURRENT 2296 01:35:41,545 --> 01:35:42,847 PATTERNS OF FOOD AND BEVERAGE 2297 01:35:42,847 --> 01:35:45,049 INTAKE, WE HAVE TWO SUMMARIES. 2298 01:35:45,049 --> 01:35:47,051 ONE WILL FOCUS ON DIETARY 2299 01:35:47,051 --> 01:35:47,685 PATTERNS. 2300 01:35:47,685 --> 01:35:52,156 AND THE OTHER IS ON BEVERAGES. 2301 01:35:52,156 --> 01:35:53,491 SO FOR DIETARY PATTERNS, FOR 2302 01:35:53,491 --> 01:35:57,762 THOSE AGES 1 AND OLDER, DIETARY 2303 01:35:57,762 --> 01:36:00,064 INTAKE PATTERNS AS EVALUATED BY 2304 01:36:00,064 --> 01:36:02,133 THE HEALTHY EATING INDEX 2020 2305 01:36:02,133 --> 01:36:05,770 AND HEALTHY EATING INDEX 2306 01:36:05,770 --> 01:36:07,605 TODDLERS 2020, WE FAILED TO 2307 01:36:07,605 --> 01:36:09,807 ALIGN WITH DIETARY GUIDELINES 2308 01:36:09,807 --> 01:36:12,009 FOR AMERICANS 2020 TO 2025, IN 2309 01:36:12,009 --> 01:36:13,944 THE LIFE STAGES OR 2310 01:36:13,944 --> 01:36:16,480 SOCIODEMOGRAPHIC GROUPS THAT WE 2311 01:36:16,480 --> 01:36:16,747 EXAMINED. 2312 01:36:16,747 --> 01:36:18,949 THE MEAN SCORES FOR THE TOTAL 2313 01:36:18,949 --> 01:36:21,152 POPULATION AGES 2 AND OLDER WAS 2314 01:36:21,152 --> 01:36:24,255 58 OUT OF 100. 2315 01:36:24,255 --> 01:36:27,124 AND FOR TODDLERS, AGES 12 TO 23 2316 01:36:27,124 --> 01:36:34,432 MONTHS, THE MEAN WAS 63 OUT OF 2317 01:36:34,432 --> 01:36:34,598 100. 2318 01:36:34,598 --> 01:36:36,300 FOR BEVERAGES HERE WE HAVE 2319 01:36:36,300 --> 01:36:37,835 INTERESTING RESULTS TO 2320 01:36:37,835 --> 01:36:39,136 HIGHLIGHT. 2321 01:36:39,136 --> 01:36:42,773 AMONG ADULTS AND OLDER ADULTS, 2322 01:36:42,773 --> 01:36:44,642 BEVERAGES, THEY DO CONTRIBUTE TO 2323 01:36:44,642 --> 01:36:47,578 DAILY ENERGY NUTRIENT AND 2324 01:36:47,578 --> 01:36:49,380 DIETARY COMPONENT INTAKES. 2325 01:36:49,380 --> 01:36:51,582 AND THE TOP FIVE FOOD COMPONENTS 2326 01:36:51,582 --> 01:36:54,185 THAT ARE GOING TO BE PROVIDED BY 2327 01:36:54,185 --> 01:36:57,588 ALL BEVERAGES CONSUMED ARE ADDED 2328 01:36:57,588 --> 01:37:02,493 SUGARS, VITAMIN C, D, CALCIUM, 2329 01:37:02,493 --> 01:37:03,027 MAGNESIUM. 2330 01:37:03,027 --> 01:37:04,795 SO, THEN JUST TO SHARE WHAT ARE 2331 01:37:04,795 --> 01:37:09,033 SOME OF THESE TOP BEVERAGES, 2332 01:37:09,033 --> 01:37:11,001 AMONG INDIVIDUALS AGES 2 AND 2333 01:37:11,001 --> 01:37:13,337 OLDER, WATER IS THE MOST 2334 01:37:13,337 --> 01:37:15,639 CONSUMED BEVERAGES, BOTH IN MEAN 2335 01:37:15,639 --> 01:37:17,308 VOLUME AND PERCENT REPORTING 2336 01:37:17,308 --> 01:37:20,010 INTAKE AT LEAST ONCE A DAY. 2337 01:37:20,010 --> 01:37:22,413 SO THAT'S GOOD. 2338 01:37:22,413 --> 01:37:31,522 INTAKES ARE SIGNIFICANTLY HIGHER 2339 01:37:31,522 --> 01:37:33,791 COMPARED WITH THE 2007-2008 2340 01:37:33,791 --> 01:37:38,195 DATA, THAT'S A POSITIVE, WATER 2341 01:37:38,195 --> 01:37:40,264 INTAKE IN THESE GROUPS IS HIGHER 2342 01:37:40,264 --> 01:37:41,632 THAN OLDER YEARS. 2343 01:37:41,632 --> 01:37:44,768 AND THEN FOR OLDER CHILDREN AND 2344 01:37:44,768 --> 01:37:48,506 ADOLESCENTS AGES 6-11 YEARS AND 2345 01:37:48,506 --> 01:37:50,374 12-19 YEARS, THEY CONSUME 2346 01:37:50,374 --> 01:37:51,809 SIGNIFICANTLY HIGHER VOLUME 2347 01:37:51,809 --> 01:37:55,446 COMPARED WITH YOUNGER CHILDREN, 2348 01:37:55,446 --> 01:37:59,683 AGES 2-5, AND OLDER ADULTS 60 2349 01:37:59,683 --> 01:38:00,784 AND OLDER CONSUMED SIGNIFICANTLY 2350 01:38:00,784 --> 01:38:05,289 LOWER VOLUME COMPARED WITH 2351 01:38:05,289 --> 01:38:09,326 YOUNGER ADULTS AGES 20-39, 40-59 2352 01:38:09,326 --> 01:38:09,760 YEARS. 2353 01:38:09,760 --> 01:38:13,264 BASED ON MEAN VOLUME CONSUMES 2354 01:38:13,264 --> 01:38:14,465 SUGAR-SWEETENED BEVERAGES, MILK, 2355 01:38:14,465 --> 01:38:16,333 100% JUICE ARE OTHER TOP 2356 01:38:16,333 --> 01:38:19,069 BEVERAGES FOR CHILDREN AND 2357 01:38:19,069 --> 01:38:19,403 ADOLESCENTS. 2358 01:38:19,403 --> 01:38:21,805 FOR ADULTS, WE HAVE ALCOHOLIC 2359 01:38:21,805 --> 01:38:24,975 BEVERAGES, COFFEE AND TEA, AND 2360 01:38:24,975 --> 01:38:25,843 SUGAR-SWEETENED BEVERAGES BEING 2361 01:38:25,843 --> 01:38:30,881 SOME OF THE OTHER TOP BEVERAGES. 2362 01:38:30,881 --> 01:38:41,392 COMPARED WITH OUR OLDER DATA, 2363 01:38:44,628 --> 01:38:48,299 2007-2008, A LOWER PERCENTAGE 2364 01:38:48,299 --> 01:38:49,066 CONSUMING SUGAR SWEETENED 2365 01:38:49,066 --> 01:38:51,268 BEVERAGES, ALSO A WIN, BUT IT'S 2366 01:38:51,268 --> 01:38:53,571 ALSO A LOWER PERCENTAGE 2367 01:38:53,571 --> 01:38:56,840 CONSUMING MILK AND 100% JUICE IN 2368 01:38:56,840 --> 01:38:57,608 A DAY. 2369 01:38:57,608 --> 01:39:01,545 SO NOT AS GOOD THERE. 2370 01:39:01,545 --> 01:39:02,947 NONETHELESS SUGAR-SWEETENED 2371 01:39:02,947 --> 01:39:07,418 BEVERAGES ARE THE TOP FOOD 2372 01:39:07,418 --> 01:39:08,552 CATEGORY CONTRIBUTOR TO ADD 2373 01:39:08,552 --> 01:39:09,520 SUGAR INTAKES. 2374 01:39:09,520 --> 01:39:11,055 MOVING ON TO CONCLUSION 2375 01:39:11,055 --> 01:39:12,489 STATEMENTS FOR OUR NEXT 2376 01:39:12,489 --> 01:39:14,892 QUESTION, WHAT ARE THE CURRENT 2377 01:39:14,892 --> 01:39:17,861 INTAKES OF FOOD GROUPS, 2378 01:39:17,861 --> 01:39:18,329 NUTRIENTS, AND DIETARY 2379 01:39:18,329 --> 01:39:20,798 COMPONENTS, AND SO THESE ARE 2380 01:39:20,798 --> 01:39:23,334 REFLECTING BACK ON SOME OF THE 2381 01:39:23,334 --> 01:39:25,069 RESULTS WE SHARED TODAY. 2382 01:39:25,069 --> 01:39:26,604 FIRST WE'LL TALK ABOUT FOOD 2383 01:39:26,604 --> 01:39:29,907 GROUP AND SUBGROUPS, THEN 2384 01:39:29,907 --> 01:39:30,307 NUTRIENTS. 2385 01:39:30,307 --> 01:39:32,509 SO, IN GENERAL FOR FOOD GROUP 2386 01:39:32,509 --> 01:39:34,478 AND SUBGROUP INTAKES FOR AGES 1 2387 01:39:34,478 --> 01:39:36,780 AND OLDER WE'RE NOT ALIGNING 2388 01:39:36,780 --> 01:39:39,083 WITH THE DIETARY GUIDELINES FOR 2389 01:39:39,083 --> 01:39:41,518 AMERICANS, AND FOR THE MAJORITY 2390 01:39:41,518 --> 01:39:44,888 OF THOSE AGES 1 AND OLDER THE 2391 01:39:44,888 --> 01:39:46,390 INTAKES OF THE FOLLOWING FOOD 2392 01:39:46,390 --> 01:39:50,427 GROUPS AND SUBGROUPS ARE BELOW 2393 01:39:50,427 --> 01:39:51,528 DIETARY GUIDELINES 2394 01:39:51,528 --> 01:39:51,895 RECOMMENDATIONS. 2395 01:39:51,895 --> 01:39:56,033 THAT INCLUDES FRUITS, AS WE SAW, 2396 01:39:56,033 --> 01:39:57,368 TOTAL VEGETABLES, ALL THOSE 2397 01:39:57,368 --> 01:39:59,670 SUBGROUPS, BEANS, PEAS AND 2398 01:39:59,670 --> 01:40:01,639 LENTILS, STARCHY VEGETABLES, RED 2399 01:40:01,639 --> 01:40:04,041 AND ORANGE VEGETABLES, DARK 2400 01:40:04,041 --> 01:40:05,809 GREEN VEGETABLES, AND THEN ALSO 2401 01:40:05,809 --> 01:40:10,080 LOWER FOR DAIRY AND FORTIFIED 2402 01:40:10,080 --> 01:40:11,815 SOY ALTERNATIVES, SEAFOOD, NUTS, 2403 01:40:11,815 --> 01:40:15,019 SEEDS AND SOY PRODUCTS, AND 2404 01:40:15,019 --> 01:40:15,786 WHOLE GRAINS. 2405 01:40:15,786 --> 01:40:18,188 BUT ALSO FOR THE MAJORITY OF 2406 01:40:18,188 --> 01:40:20,591 INDIVIDUALS AGES 1 AND OLDER, 2407 01:40:20,591 --> 01:40:22,026 INTAKES OF THE FOLLOWING FOOD 2408 01:40:22,026 --> 01:40:25,296 GROUPS AND SUBGROUPS ARE AT OR 2409 01:40:25,296 --> 01:40:27,298 ABOVE DIETARY GUIDELINES 2410 01:40:27,298 --> 01:40:28,832 RECOMMENDATIONS, AND THOSE 2411 01:40:28,832 --> 01:40:31,335 INCLUDE TOTAL GRAINS, REFINED 2412 01:40:31,335 --> 01:40:32,970 GRAINS, TOTAL PROTEIN FOODS, 2413 01:40:32,970 --> 01:40:36,707 MEAT, POULTRY AND EGGS FOR AGES 2414 01:40:36,707 --> 01:40:38,242 2 AND OLDER. 2415 01:40:38,242 --> 01:40:40,210 AND UNFORTUNATELY THOUGH MANY OF 2416 01:40:40,210 --> 01:40:42,479 OUR TOP SOURCES OF FOOD GROUPS 2417 01:40:42,479 --> 01:40:45,449 ARE CONSUMED IN FORMS THAT ARE 2418 01:40:45,449 --> 01:40:49,953 HIGH IN NUTRIENTS TO LIMIT, 2419 01:40:49,953 --> 01:40:53,023 SATURATED FAT, SODIUM, ADDED 2420 01:40:53,023 --> 01:40:53,257 SUGARS. 2421 01:40:53,257 --> 01:40:54,992 MOVING ON TO OUR ANSWER TO THIS 2422 01:40:54,992 --> 01:40:58,262 QUESTION WITH REGARD TO 2423 01:40:58,262 --> 01:41:00,030 NUTRIENTS, OUR NUTRIENT INTAKES 2424 01:41:00,030 --> 01:41:03,434 DON'T ALIGN WITH THE 2425 01:41:03,434 --> 01:41:06,136 RECOMMENDATIONS, AND MANY OF 2426 01:41:06,136 --> 01:41:06,870 THOSE NUTRIENTS ARE 2427 01:41:06,870 --> 01:41:09,540 UNDERCONSUMED FOR AGES 1 AND 2428 01:41:09,540 --> 01:41:13,811 OLDER, AND THOSE INCLUDE DIETARY 2429 01:41:13,811 --> 01:41:15,145 PROTEIN, FIBER, CALCIUM, 2430 01:41:15,145 --> 01:41:22,019 POTASSIUM, MAGNESIUM, IRON, SINK 2431 01:41:22,019 --> 01:41:23,821 ZINC, COPPER, PHOSPHORUS, 2432 01:41:23,821 --> 01:41:26,990 VITAMIN B-12, C, D, E, AND K, A 2433 01:41:26,990 --> 01:41:31,729 BIG PROFILE THERE THAT WE'RE 2434 01:41:31,729 --> 01:41:33,030 UNDERCONSUMING. 2435 01:41:33,030 --> 01:41:34,431 HOWEVER, WE ARE OVERCONSUMING, 2436 01:41:34,431 --> 01:41:37,735 AS I ALREADY MENTIONED, SODIUM, 2437 01:41:37,735 --> 01:41:40,471 ADDED SUGARS, SATURATED FATS. 2438 01:41:40,471 --> 01:41:42,773 AND THE PROPORTIONS HERE WHO ARE 2439 01:41:42,773 --> 01:41:45,409 MEETING OR EXCEEDING THESE 2440 01:41:45,409 --> 01:41:47,578 INTAKE VARIES WITHIN OUR 2441 01:41:47,578 --> 01:41:49,346 POPULATION GROUPS BY AGE, SEX, 2442 01:41:49,346 --> 01:41:53,717 RACE, AND/OR ETHNICITY, AND 2443 01:41:53,717 --> 01:41:54,618 SOCIOECONOMIC POSITION. 2444 01:41:54,618 --> 01:41:57,788 AND THEN MANY OF OUR TOP FOOD 2445 01:41:57,788 --> 01:41:59,356 SOURCES AGAIN OF NUTRIENTS ARE 2446 01:41:59,356 --> 01:42:02,726 NOT CONSUMED IN THE MOST 2447 01:42:02,726 --> 01:42:04,895 NUTRIENT DENSE FORMS. 2448 01:42:04,895 --> 01:42:05,462 OKAY. 2449 01:42:05,462 --> 01:42:07,965 SO MOVING AHEAD TO OUR THIRD 2450 01:42:07,965 --> 01:42:11,468 QUESTION, WHICH WAS WHAT IS THE 2451 01:42:11,468 --> 01:42:13,203 CURRENT PREVALENCE OF 2452 01:42:13,203 --> 01:42:17,374 NUTRITION-RELATED CHRONIC HEALTH 2453 01:42:17,374 --> 01:42:18,108 CONDITIONS? 2454 01:42:18,108 --> 01:42:20,110 AND THESE RESULTS WERE REALLY 2455 01:42:20,110 --> 01:42:20,411 INTERESTING. 2456 01:42:20,411 --> 01:42:23,514 WE PRESENTED A LOT OF THESE IN 2457 01:42:23,514 --> 01:42:26,049 OUR LAST MEETING. 2458 01:42:26,049 --> 01:42:29,853 HERE WE HAVE WIDESPREAD 2459 01:42:29,853 --> 01:42:31,522 PREVALENCE OF NUTRITION-RELATED 2460 01:42:31,522 --> 01:42:34,525 CHRONIC HEALTH CONDITIONS. 2461 01:42:34,525 --> 01:42:37,561 AND THIS CONTINUES TO BE A BIG 2462 01:42:37,561 --> 01:42:38,762 PROBLEM FOR OUR POPULATION. 2463 01:42:38,762 --> 01:42:40,931 FOR EXAMPLE, WE HAVE A REALLY 2464 01:42:40,931 --> 01:42:46,103 HIGH PREVALENCE OF RISK FACTORS 2465 01:42:46,103 --> 01:42:47,938 AMONG ADOLESCENTS, HAVING ABOUT 2466 01:42:47,938 --> 01:42:50,774 38% OF 12-19 YEAR OLD WAS 2467 01:42:50,774 --> 01:42:51,875 PREDIABETES. 2468 01:42:51,875 --> 01:42:52,976 AND THIS IS PARTICULARLY 2469 01:42:52,976 --> 01:42:55,479 CONCERNING BECAUSE IT'S IN OUR 2470 01:42:55,479 --> 01:42:56,046 CHILD AGE GROUPS. 2471 01:42:56,046 --> 01:42:59,783 AND, YOU KNOW, HOW DOES THAT 2472 01:42:59,783 --> 01:43:01,819 BODE FOR FUTURE HEALTH THROUGH 2473 01:43:01,819 --> 01:43:04,688 THE ADULT LIFESPAN? AND THEN WE 2474 01:43:04,688 --> 01:43:08,559 ALSO SEE THAT OUR CHRONIC 2475 01:43:08,559 --> 01:43:10,494 DISEASE RATES ARE EVEN HIGH 2476 01:43:10,494 --> 01:43:12,563 AMONG MIDDLE AGED ADULTS, BEFORE 2477 01:43:12,563 --> 01:43:13,997 WE'RE GETTING TO OLDER 2478 01:43:13,997 --> 01:43:14,264 ADULTHOOD. 2479 01:43:14,264 --> 01:43:16,533 OF COURSE, THEY CONTINUE TO BE 2480 01:43:16,533 --> 01:43:20,904 QUITE HIGH FOR OLDER ADULTS. 2481 01:43:20,904 --> 01:43:22,906 JUST AS WE DID FOR INTAKES WE DO 2482 01:43:22,906 --> 01:43:26,477 HAVE A VARIATION IN THE 2483 01:43:26,477 --> 01:43:28,879 PREVALENCE, INCIDENCE, AND 2484 01:43:28,879 --> 01:43:33,383 MORTALITY RATES FOR OUR 2485 01:43:33,383 --> 01:43:34,751 DIFFERENT SOCIOECONOMIC, 2486 01:43:34,751 --> 01:43:38,322 SOCIODEMOGRAPHIC GROUPS THAT WE 2487 01:43:38,322 --> 01:43:39,756 HAVE YOU ALREADY HIGHLIGHTED 2488 01:43:39,756 --> 01:43:40,858 BEFORE BUT CERTAINLY DISPARITIES 2489 01:43:40,858 --> 01:43:44,027 IN PREVALENCE OF OBESITY AND 2490 01:43:44,027 --> 01:43:48,699 DIABETES AMONG THOSE OF LOWER 2491 01:43:48,699 --> 01:43:50,801 SOCIOECONOMIC POSITION. 2492 01:43:50,801 --> 01:43:54,972 THEN WE HAVE SOME CHRONIC HEALTH 2493 01:43:54,972 --> 01:43:56,507 CONDITIONS INCLUDING OBESITY, 2494 01:43:56,507 --> 01:43:57,608 DIABETES, OSTEOPOROSIS FOR 2495 01:43:57,608 --> 01:44:00,544 FEMALES THAT HAVE BECOME MORE 2496 01:44:00,544 --> 01:44:02,079 PREVALENT COMPARED TO 10 OR 20 2497 01:44:02,079 --> 01:44:08,085 YEARS AGO. 2498 01:44:08,085 --> 01:44:09,720 SO THESE ARE ESTIMATES WE NEED 2499 01:44:09,720 --> 01:44:12,155 TO KEEP A PULSE ON IN OUR 2500 01:44:12,155 --> 01:44:18,161 POPULATION AND UNDERSTAND WHY 2501 01:44:18,161 --> 01:44:18,996 THOSE ARE HAPPENING, AND THINK 2502 01:44:18,996 --> 01:44:20,697 ABOUT DIET AS PART OF THAT. 2503 01:44:20,697 --> 01:44:25,836 MOVING TO OUR LAST QUESTION, 2504 01:44:25,836 --> 01:44:27,905 WHICH NUTRIENTS AND/OR DIETARY 2505 01:44:27,905 --> 01:44:29,339 COMPONENTS PRESENT A SUBSTANTIAL 2506 01:44:29,339 --> 01:44:32,509 PUBLIC HEALTH CONCERN BECAUSE OF 2507 01:44:32,509 --> 01:44:33,176 UNDERCONSUMPTION OR 2508 01:44:33,176 --> 01:44:34,044 OVERCONSUMPTION. 2509 01:44:34,044 --> 01:44:41,919 AND SO HERE WE'RE JUST TRYING TO 2510 01:44:41,919 --> 01:44:43,587 HIGHLIGHT THESE NUTRIENTS WHERE 2511 01:44:43,587 --> 01:44:48,292 THEY ARE SIGNIFICANTLY 2512 01:44:48,292 --> 01:44:49,660 UNDERCONSUMED IN THE POPULATION, 2513 01:44:49,660 --> 01:44:51,128 AND THAT'S BASED ON AT LEAST 2514 01:44:51,128 --> 01:44:53,430 THREE SOURCES OF DATA WE LOOKED 2515 01:44:53,430 --> 01:44:53,931 AT. 2516 01:44:53,931 --> 01:44:57,267 AND SO FOR THOSE AGES 1 AND 2517 01:44:57,267 --> 01:45:00,203 OLDER, BASED ON DIETARY INTAKE 2518 01:45:00,203 --> 01:45:01,972 DATA, BIOMARKER DATA, AND 2519 01:45:01,972 --> 01:45:04,141 RELEVANCE TO HEALTH, FOR THOSE 1 2520 01:45:04,141 --> 01:45:08,345 AND OLDER, WE HAVE CONTINUED TO 2521 01:45:08,345 --> 01:45:10,314 IDENTIFY VITAMIN D, CALCIUM, 2522 01:45:10,314 --> 01:45:12,049 POTASSIUM, FIBER AS NUTRIENTS OF 2523 01:45:12,049 --> 01:45:14,985 PUBLIC HEALTH CONCERN DUE TO 2524 01:45:14,985 --> 01:45:16,653 UNDERCONSUMPTION. 2525 01:45:16,653 --> 01:45:18,055 AND I SAID CONTINUE BECAUSE 2526 01:45:18,055 --> 01:45:20,657 THESE WERE HIGHLIGHTED IN THE 2527 01:45:20,657 --> 01:45:25,195 LAST REPORT OF THE DIETARY 2528 01:45:25,195 --> 01:45:25,495 GUIDELINES. 2529 01:45:25,495 --> 01:45:31,001 WE ALSO CONTINUE TO OVERCONSUME 2530 01:45:31,001 --> 01:45:32,035 SODIUM, ADDED SUGARS, SATURATED 2531 01:45:32,035 --> 01:45:33,837 FAT FOR 2 AND OLDER, ALSO 2532 01:45:33,837 --> 01:45:35,806 NUTRIENTS OF PUBLIC HEALTH 2533 01:45:35,806 --> 01:45:38,008 CONCERN. 2534 01:45:38,008 --> 01:45:39,643 NOW WE HAVE SOME OTHER IMPORTANT 2535 01:45:39,643 --> 01:45:41,178 NUTRIENTS OF PUBLIC HEALTH 2536 01:45:41,178 --> 01:45:44,247 CONCERN FOR CERTAIN AGE GROUPS. 2537 01:45:44,247 --> 01:45:46,316 SO FOR INFANTS 6-11 MONTHS, 2538 01:45:46,316 --> 01:45:52,456 BASED ON DIETARY INTAKE DATA AND 2539 01:45:52,456 --> 01:45:53,757 PUBLIC HEALTH RELEVANCE, IRON IS 2540 01:45:53,757 --> 01:45:57,828 A NUTRIENT OF PUBLIC HEALTH 2541 01:45:57,828 --> 01:46:00,764 CONCERN FOR INFANTS 6-11 MONTHS 2542 01:46:00,764 --> 01:46:03,000 FED HUMAN MILK, FOR ADOLESCENT 2543 01:46:03,000 --> 01:46:07,137 FAMILIES WE'VE IDENTIFIED IRON 2544 01:46:07,137 --> 01:46:08,572 AS BEING OF PUBLIC HEALTH 2545 01:46:08,572 --> 01:46:12,175 CONCERN BASED ON DIETARY INTAKE 2546 01:46:12,175 --> 01:46:21,585 DATA FOR FEMALES 14-18, AND 2547 01:46:21,585 --> 01:46:24,521 BIOMARKER DATA FOR FEMALES 12. 2548 01:46:24,521 --> 01:46:25,856 FOR FEMALES 20-49 YEARS, BASED 2549 01:46:25,856 --> 01:46:29,026 ON THE DIETARY INTAKE DATA AND 2550 01:46:29,026 --> 01:46:31,294 BIOMARKER DATA, WE AGAIN 2551 01:46:31,294 --> 01:46:33,063 IDENTIFY IRON AS AN IMPORTANT 2552 01:46:33,063 --> 01:46:35,899 NUTRIENT OF PUBLIC HEALTH 2553 01:46:35,899 --> 01:46:36,566 CONCERN. 2554 01:46:36,566 --> 01:46:39,169 AND FOR PREGNANCY AND LACTATION, 2555 01:46:39,169 --> 01:46:43,573 BASED ON DIETARY INTAKE DATA, IN 2556 01:46:43,573 --> 01:46:45,542 FEMALES 20-44 YEARS, BIOMARKER 2557 01:46:45,542 --> 01:46:48,512 DATA IN PREGNANT FEMALES, WE 2558 01:46:48,512 --> 01:46:52,349 HAVE IRON IDENTIFIED AGAIN AS 2559 01:46:52,349 --> 01:46:53,984 BEING A PUBLIC HEALTH CONCERN 2560 01:46:53,984 --> 01:46:55,419 AMONG FEMALES WHO ARE PREGNANT. 2561 01:46:55,419 --> 01:46:58,522 AND THEN BASED ON DIETARY INTAKE 2562 01:46:58,522 --> 01:47:00,791 DATA AND RELEVANCE TO HEALTH, 2563 01:47:00,791 --> 01:47:02,859 FOLATE IS ALSO A PUBLIC HEALTH 2564 01:47:02,859 --> 01:47:05,228 CONCERN FOR FEMALES DURING THE 2565 01:47:05,228 --> 01:47:08,899 PRE-CONCEPTION PERIOD AND IN THE 2566 01:47:08,899 --> 01:47:10,534 FIRST TRIMESTER OF PREGNANCY. 2567 01:47:10,534 --> 01:47:12,836 BASED ON BIOMARKER DATA AND 2568 01:47:12,836 --> 01:47:16,540 RELEVANCE TO HEALTH, IN FEMALES 2569 01:47:16,540 --> 01:47:20,510 PREGNANT, IODINE IS OF PUBLIC 2570 01:47:20,510 --> 01:47:23,680 HEALTH CONCERN FOR THOSE WHO ARE 2571 01:47:23,680 --> 01:47:24,581 PREGNANT. 2572 01:47:24,581 --> 01:47:28,085 SO THAT CONCLUDES ALL OF OUR 2573 01:47:28,085 --> 01:47:31,254 SUMMARY STATEMENTS, AND NOW I'LL 2574 01:47:31,254 --> 01:47:31,788 SHARE NEXT STEPS. 2575 01:47:31,788 --> 01:47:35,726 SO, WE'RE GOING TO BE WORKING ON 2576 01:47:35,726 --> 01:47:38,028 FINALIZING OUR DATA ANALYSIS 2577 01:47:38,028 --> 01:47:41,431 CHAPTER OF THE SCIENTIFIC 2578 01:47:41,431 --> 01:47:42,165 REPORT. 2579 01:47:42,165 --> 01:47:44,601 AND THEN INTEGRATING OUR 2580 01:47:44,601 --> 01:47:48,205 EVIDENCE FROM THE DATA ANALYSIS 2581 01:47:48,205 --> 01:47:49,940 WITH THE OTHER EVIDENCE THAT 2582 01:47:49,940 --> 01:47:52,576 FROM THE SYSTEMATIC REVIEW AND 2583 01:47:52,576 --> 01:47:55,779 FROM FOOD PATTERN MODELING, AND 2584 01:47:55,779 --> 01:47:57,948 THEN CONSIDERING AND WRITING UP 2585 01:47:57,948 --> 01:48:00,584 OUR FUTURE DIRECTIONS AND ADVICE 2586 01:48:00,584 --> 01:48:03,220 TO THE DEPARTMENTS AND GETTING 2587 01:48:03,220 --> 01:48:04,955 OUR SCIENTIFIC REPORT OUT THERE 2588 01:48:04,955 --> 01:48:09,025 AND PUBLISHED FOR EVERYONE TO 2589 01:48:09,025 --> 01:48:10,427 LOOK AT. 2590 01:48:10,427 --> 01:48:12,629 FINALLY THE STAFF WILL PUBLISH, 2591 01:48:12,629 --> 01:48:15,465 MAKE SURE ALL OF THESE REPORT 2592 01:48:15,465 --> 01:48:16,533 DATA ANALYSIS REPORTS, 2593 01:48:16,533 --> 01:48:17,968 SUPPLEMENTS, AND THE PLAN ARE 2594 01:48:17,968 --> 01:48:24,641 ALSO OUT THERE FOR EVERYONE TO 2595 01:48:24,641 --> 01:48:27,144 HAVE SOME GREAT READING. 2596 01:48:27,144 --> 01:48:28,945 AND NOW WE'LL OPEN UP FOR 2597 01:48:28,945 --> 01:48:33,950 DISCUSSION IS OUR NEXT THING I 2598 01:48:33,950 --> 01:48:35,185 THINK. 2599 01:48:35,185 --> 01:48:35,385 YES. 2600 01:48:35,385 --> 01:48:37,220 >> YEAH, BEFORE WE OPEN UP FOR 2601 01:48:37,220 --> 01:48:38,889 QUESTIONS, HEATHER, I WANT TO 2602 01:48:38,889 --> 01:48:41,658 COMMEND YOU FOR A REALLY STRONG 2603 01:48:41,658 --> 01:48:44,060 PRESENTATION BECAUSE I REALLY 2604 01:48:44,060 --> 01:48:45,162 FEEL YOUR PRESENTATION IS 2605 01:48:45,162 --> 01:48:47,097 CONSISTENT WITH THE SPIRIT OF 2606 01:48:47,097 --> 01:48:47,764 THE COMMITTEE. 2607 01:48:47,764 --> 01:48:49,399 WE'RE GOING WHERE THE EVIDENCE 2608 01:48:49,399 --> 01:48:49,633 IS. 2609 01:48:49,633 --> 01:48:51,601 WE STOP WHERE THE EVIDENCE 2610 01:48:51,601 --> 01:48:52,135 STOPS. 2611 01:48:52,135 --> 01:48:54,971 AND YOU REALLY DID A BEAUTIFUL 2612 01:48:54,971 --> 01:48:56,640 JOB OF EXPLAINING THE GUARD 2613 01:48:56,640 --> 01:48:57,874 RAILS OF INTERPRETATION. 2614 01:48:57,874 --> 01:49:01,945 AND I THINK THAT'S SO CRITICAL. 2615 01:49:01,945 --> 01:49:06,516 SO, KUDOS TO YOU AND KUDOS TO 2616 01:49:06,516 --> 01:49:08,485 THE STAFF FOR GENERATING. 2617 01:49:08,485 --> 01:49:11,021 SO, WITH THAT, I'M GOING TO OPEN 2618 01:49:11,021 --> 01:49:13,190 UP FOR QUESTIONS. 2619 01:49:13,190 --> 01:49:13,423 FATIMA? 2620 01:49:13,423 --> 01:49:16,059 >> YES, THANK YOU FOR THAT 2621 01:49:16,059 --> 01:49:16,593 LOVELY PRESENTATION. 2622 01:49:16,593 --> 01:49:18,662 I WANT TO GO BACK TO YOUR 2623 01:49:18,662 --> 01:49:19,663 BEGINNING PORTION OF YOUR 2624 01:49:19,663 --> 01:49:21,531 PRESENTATION WHEN YOU WERE 2625 01:49:21,531 --> 01:49:24,134 BREAKING DOWN BY RACIAL/ETHNIC 2626 01:49:24,134 --> 01:49:24,334 GROUP. 2627 01:49:24,334 --> 01:49:26,870 WE SAW QUITE A BIT OF DATA 2628 01:49:26,870 --> 01:49:28,405 SPEAKING TO THOSE OF ASIAN 2629 01:49:28,405 --> 01:49:30,707 DESCENT WITH A HIGHER LIKELIHOOD 2630 01:49:30,707 --> 01:49:31,441 OF MEETING RECOMMENDATIONS. 2631 01:49:31,441 --> 01:49:32,776 WHAT I WANTED TO ASK, IF THIS 2632 01:49:32,776 --> 01:49:35,545 WAS ONE OF THE CONSIDERATIONS, 2633 01:49:35,545 --> 01:49:38,014 LOOKING AT IMMIGRANTS STATUS AND 2634 01:49:38,014 --> 01:49:39,349 TIME FROM IMMIGRATION, FOR 2635 01:49:39,349 --> 01:49:41,551 EXAMPLE, HAVING A HIGHER 2636 01:49:41,551 --> 01:49:44,187 LIKELIHOOD OF MAYBE MEETING THE 2637 01:49:44,187 --> 01:49:46,122 RECOMMENDATIONS, FOR EXAMPLE, 2638 01:49:46,122 --> 01:49:47,023 THERE'S ALWAYS A COMPARISON OF 2639 01:49:47,023 --> 01:49:49,192 THOSE OF US THAT HAVE LIVED HERE 2640 01:49:49,192 --> 01:49:51,494 IN THE UNITED STATES, NOT 2641 01:49:51,494 --> 01:49:52,495 MEETING RECOMMENDATIONS AND 2642 01:49:52,495 --> 01:49:53,997 MAYBE -- WHAT I HEAR FROM MY 2643 01:49:53,997 --> 01:49:55,565 PATIENTS, FOR EXAMPLE, IS THAT 2644 01:49:55,565 --> 01:49:56,967 THEY STATE THAT ONCE THEY HAVE 2645 01:49:56,967 --> 01:49:57,968 LIVED HERE FOR A LONGER PERIOD 2646 01:49:57,968 --> 01:50:01,671 OF TIME THEY ARE LESS LIKELY TO, 2647 01:50:01,671 --> 01:50:03,540 LET'S SAY, DEAL WITH THAT OR 2648 01:50:03,540 --> 01:50:05,175 LESS LIKELY TO MEET 2649 01:50:05,175 --> 01:50:06,243 RECOMMENDATIONS, FOR EXAMPLE. 2650 01:50:06,243 --> 01:50:07,777 I DON'T KNOW IF THIS HAS BEEN 2651 01:50:07,777 --> 01:50:08,879 SOMETHING OF CONSIDERATION. 2652 01:50:08,879 --> 01:50:10,213 IT'S NOT SOMETHING WE 2653 01:50:10,213 --> 01:50:11,081 SPECIFICALLY THOUGHT ABOUT BUT 2654 01:50:11,081 --> 01:50:14,050 AS WE THINK ABOUT IMMIGRANT 2655 01:50:14,050 --> 01:50:16,019 STATUS THE TIME THAT WE'VE SPENT 2656 01:50:16,019 --> 01:50:17,354 HERE IN THE COUNTRY, SOMEONE 2657 01:50:17,354 --> 01:50:18,421 HERE THAT HAS LIVED MY WHOLE 2658 01:50:18,421 --> 01:50:19,556 LIFE IN THE UNITED STATES, I 2659 01:50:19,556 --> 01:50:21,458 DON'T HAVE THAT AS A COMPARISON 2660 01:50:21,458 --> 01:50:23,126 POINT BUT I HEAR IT FROM 2661 01:50:23,126 --> 01:50:25,328 PATIENTS THAT COME FROM VARIOUS 2662 01:50:25,328 --> 01:50:27,397 COUNTRIES THAT THEY -- YOU KNOW 2663 01:50:27,397 --> 01:50:29,366 ASSIMILATE U.S. DIET SO CURIOUS 2664 01:50:29,366 --> 01:50:34,938 IF THIS IS A CONSIDERATION. 2665 01:50:34,938 --> 01:50:36,239 >> SURE, YEAH, THAT'S A REALLY 2666 01:50:36,239 --> 01:50:37,340 GREAT POINT. 2667 01:50:37,340 --> 01:50:40,543 AND WE WERE ABLE TO BREAK DOWN 2668 01:50:40,543 --> 01:50:42,946 OUR LOOK AT THOSE ATIs AND 2669 01:50:42,946 --> 01:50:43,380 INTAKE. 2670 01:50:43,380 --> 01:50:44,781 WELL, I'M NOT SURE EXACTLY WHAT 2671 01:50:44,781 --> 01:50:47,851 WE WERE ABLE TO APPLY THIS TO 2672 01:50:47,851 --> 01:50:51,354 BUT WE DID CONSIDER COUNTRY OF 2673 01:50:51,354 --> 01:50:53,456 BIRTH AS ONE OF THOSE FACTORS 2674 01:50:53,456 --> 01:50:58,261 THAT WE SPLIT OUR DATA BY. 2675 01:50:58,261 --> 01:51:01,197 AND, YOU KNOW, WE -- IF MY 2676 01:51:01,197 --> 01:51:04,734 MEMORY SERVES ME I THINK WE -- 2677 01:51:04,734 --> 01:51:08,905 THE VARIATION YOU SEE HERE IS 2678 01:51:08,905 --> 01:51:11,508 PROBABLY KIND OF LIKE ONE OF THE 2679 01:51:11,508 --> 01:51:14,444 HIGHLIGHTS IN COMPARISON TO SOME 2680 01:51:14,444 --> 01:51:17,213 OF THESE OTHER THINGS THAT WE 2681 01:51:17,213 --> 01:51:18,515 LOOKED AT. 2682 01:51:18,515 --> 01:51:20,717 SO, BUT, YEAH, I ALSO WANT TO 2683 01:51:20,717 --> 01:51:23,119 RECOGNIZE THAT OF COURSE WITHIN 2684 01:51:23,119 --> 01:51:25,388 EACH OF THESE RACE/ETHNIC GROUPS 2685 01:51:25,388 --> 01:51:27,490 THERE'S A TON OF VARIETY, 2686 01:51:27,490 --> 01:51:28,591 PERHAPS MORE, YOU KNOW, I DON'T 2687 01:51:28,591 --> 01:51:30,760 KNOW, BUT LIKE THERE COULD BE 2688 01:51:30,760 --> 01:51:34,698 MORE VARIATION THAN WE EVEN SEE 2689 01:51:34,698 --> 01:51:38,535 AMONG THESE MAJOR GROUPS. 2690 01:51:38,535 --> 01:51:40,070 SO THAT'S REALLY AN IMPORTANT 2691 01:51:40,070 --> 01:51:44,674 THING TO THINK ABOUT, I THINK. 2692 01:51:44,674 --> 01:51:46,076 >> THERESA? 2693 01:51:46,076 --> 01:51:49,245 >> QUICKLY ABOUT PROTEIN, YOU'VE 2694 01:51:49,245 --> 01:51:50,780 SHOWN TOTAL PROTEIN ADEQUACY, 2695 01:51:50,780 --> 01:52:00,190 THAT IS BASED ON PROTEIN FOOD 2696 01:52:00,190 --> 01:52:03,026 GROUPS, NOT BASED ON 8 GRAMS OF 2697 01:52:03,026 --> 01:52:05,862 PROTEIN PER KILOGRAM, WHAT IS IT 2698 01:52:05,862 --> 01:52:07,297 BASED ON? 2699 01:52:07,297 --> 01:52:09,466 THEREFORE HOW MANY SERVINGS A 2700 01:52:09,466 --> 01:52:11,134 DAY, HOW MANY SERVINGS A DAY. 2701 01:52:11,134 --> 01:52:12,002 ALL RIGHT. 2702 01:52:12,002 --> 01:52:16,272 I WANT TO CLARIFY THAT. 2703 01:52:16,272 --> 01:52:18,875 I SEE QUITE A PORTION OF THE 2704 01:52:18,875 --> 01:52:19,876 POPULATION REGARDLESS OF WHAT 2705 01:52:19,876 --> 01:52:21,411 SEGMENT OF THE POPULATION, 2706 01:52:21,411 --> 01:52:22,812 THERE'S QUITE A PORTION UNDER 2707 01:52:22,812 --> 01:52:25,115 THE RECOMMENDATION, I WANT TO 2708 01:52:25,115 --> 01:52:29,185 CLARIFY UNDER RECOMMENDATION 2709 01:52:29,185 --> 01:52:33,223 ISN'T NECESSARILY -- DOESN'T 2710 01:52:33,223 --> 01:52:34,758 MEAN PROTEIN INADEQUACY, MEANING 2711 01:52:34,758 --> 01:52:37,193 BELOW 8 GRAMS PER KILL OH GRAM 2712 01:52:37,193 --> 01:52:40,296 FOR ACULTS BECAUSE PROTEIN IS 2713 01:52:40,296 --> 01:52:42,632 BASED ON AMDRs RATHER THAN 2714 01:52:42,632 --> 01:52:42,966 RDA? 2715 01:52:42,966 --> 01:52:47,771 I WANT TO MAKE SURE, IT SAYS 2716 01:52:47,771 --> 01:52:48,004 INTAKE. 2717 01:52:48,004 --> 01:52:55,779 IS IT BOTH? 2718 01:52:55,779 --> 01:52:57,580 AND WITHIN VARIATION -- 2719 01:52:57,580 --> 01:52:59,716 >> POSSIBLY THE PROTEIN COMES 2720 01:52:59,716 --> 01:53:01,785 FROM NON-PROTEIN FOOD GROUPS 2721 01:53:01,785 --> 01:53:02,085 TOO. 2722 01:53:02,085 --> 01:53:04,421 THAT'S WHAT WE'RE GETTING AT. 2723 01:53:04,421 --> 01:53:05,355 >> THEREFORE IT'S NOT -- 2724 01:53:05,355 --> 01:53:09,025 >> CAN WE JUST ASK FOR 2725 01:53:09,025 --> 01:53:11,661 VERIFICATION FROM THE STAFF? 2726 01:53:11,661 --> 01:53:15,799 >> YEAH, SO WE LOOK AT BOTH AMDR 2727 01:53:15,799 --> 01:53:21,604 AND RDA FOR PROTEIN, YEAH. 2728 01:53:21,604 --> 01:53:21,838 SO BOTH. 2729 01:53:21,838 --> 01:53:24,974 BUT PROTEIN DOES COME FROM A LOT 2730 01:53:24,974 --> 01:53:26,409 OF FOOD GROUPS OUTSIDE PROTEIN 2731 01:53:26,409 --> 01:53:32,649 FOOD GROUPS AS DEE DEE AND 2732 01:53:32,649 --> 01:53:33,950 OTHERS DISCUSSED THIS MORNING. 2733 01:53:33,950 --> 01:53:40,090 >> THE NUMBER OF FOOD GROUPS NOT 2734 01:53:40,090 --> 01:53:40,957 NECESSARILY MEETING INADEQUATE 2735 01:53:40,957 --> 01:53:41,291 PROTEIN. 2736 01:53:41,291 --> 01:53:43,493 >> NOT NECESSARILY. 2737 01:53:43,493 --> 01:53:43,927 IT COULD. 2738 01:53:43,927 --> 01:53:46,429 >> THANK YOU. 2739 01:53:46,429 --> 01:53:46,963 THAT'S THE CLARIFICATION. 2740 01:53:46,963 --> 01:53:48,565 >> ONE MORE THING. 2741 01:53:48,565 --> 01:53:49,165 SORRY, THERESA. 2742 01:53:49,165 --> 01:53:52,268 WE DID LOOK AT ACTUALLY THE 2743 01:53:52,268 --> 01:53:56,272 NUTRIENT PROTEIN INTAKE BUT 2744 01:53:56,272 --> 01:53:57,841 DIDN'T SHOW THAT TODAY. 2745 01:53:57,841 --> 01:53:58,808 >> THERE'S SO MANY QUESTIONS. 2746 01:53:58,808 --> 01:54:01,010 WHAT I THINK WE'LL DO IS START 2747 01:54:01,010 --> 01:54:02,779 WITH CHERYL AND WE'LL JUST GO 2748 01:54:02,779 --> 01:54:04,547 DOWN THE TABLE AND IF PEOPLE 2749 01:54:04,547 --> 01:54:06,382 DON'T HAVE A QUESTION JUST SAY 2750 01:54:06,382 --> 01:54:08,585 NO COMMENT OR NO QUESTION. 2751 01:54:08,585 --> 01:54:09,786 AND THAT WAY EVERYBODY GETS 2752 01:54:09,786 --> 01:54:13,189 HEARD WHICH IS THE POINT OF THIS 2753 01:54:13,189 --> 01:54:13,656 DISCUSSION. 2754 01:54:13,656 --> 01:54:15,158 CHERYL, TAKE IT AWAY. 2755 01:54:15,158 --> 01:54:17,026 >> YOU PROMISED A LIVELY ENGAGED 2756 01:54:17,026 --> 01:54:18,228 DISCUSSION AND WE'RE DELIVERING 2757 01:54:18,228 --> 01:54:19,662 ON THAT. 2758 01:54:19,662 --> 01:54:21,397 I HAVE A COMMENT FIRST ABOUT THE 2759 01:54:21,397 --> 01:54:23,933 BEAUTIFUL SLIDES THAT YOU SHOWED 2760 01:54:23,933 --> 01:54:24,567 AROUND ATI. 2761 01:54:24,567 --> 01:54:26,769 I WANT TO LINK THAT TO WHAT WE 2762 01:54:26,769 --> 01:54:28,671 ALL KNOW FROM READING SCIENTIFIC 2763 01:54:28,671 --> 01:54:31,307 LITERATURE THAT THE ATI IS 2764 01:54:31,307 --> 01:54:32,942 LARGELY ASSOCIATED AND SOMETIMES 2765 01:54:32,942 --> 01:54:35,278 SHOWN TO BE CAUSAL WITH 2766 01:54:35,278 --> 01:54:36,579 OUTCOMES, HEALTH OUTCOMES. 2767 01:54:36,579 --> 01:54:37,747 AND SO LIKE THAT'S UNDERLYING 2768 01:54:37,747 --> 01:54:40,283 ALL OF THE THINGS THAT I'M 2769 01:54:40,283 --> 01:54:41,684 THINKING ABOUT, NOW THAT WE'VE 2770 01:54:41,684 --> 01:54:45,221 ACTUALLY SEEN IT IN FRONT OF US. 2771 01:54:45,221 --> 01:54:50,460 THE OTHER QUESTION THAT I HAVE 2772 01:54:50,460 --> 01:54:53,630 IS AROUND THE APPROACH TO DATA 2773 01:54:53,630 --> 01:54:55,265 ANALYSIS, WITH REGARDS TO 2774 01:54:55,265 --> 01:54:58,535 PROPORTION OF PEOPLE WHO ARE 2775 01:54:58,535 --> 01:54:59,536 MEETING GUIDELINES. 2776 01:54:59,536 --> 01:55:04,807 WE USE AT OR ABOVE AS THE CUT 2777 01:55:04,807 --> 01:55:06,242 POINT, FOR REFINED GRAINS IN 2778 01:55:06,242 --> 01:55:12,682 PARTICULAR THAT CAN BE A LITTLE 2779 01:55:12,682 --> 01:55:13,650 BIT TRICKY BECAUSE WE'RE NOT 2780 01:55:13,650 --> 01:55:15,185 SURE WHO IS AT OR ABOVE. 2781 01:55:15,185 --> 01:55:16,553 WHAT ARE CONSIDERATIONS LOOKING 2782 01:55:16,553 --> 01:55:22,525 ABOVE BECAUSE I THINK IT TELLS 2783 01:55:22,525 --> 01:55:23,393 US SOMETHING DIFFERENT THAN 2784 01:55:23,393 --> 01:55:31,167 LOOKING AT AT OR ABOVE TOGETHER. 2785 01:55:31,167 --> 01:55:32,602 >> YEAH, THAT'S A GREAT 2786 01:55:32,602 --> 01:55:32,869 QUESTION. 2787 01:55:32,869 --> 01:55:34,671 I WOULD SAY, YOU KNOW, THE GRAPH 2788 01:55:34,671 --> 01:55:36,206 THAT WE SHOWED TODAY, WE WANTED 2789 01:55:36,206 --> 01:55:39,142 TO KIND OF MAKE THEM ALL SIMILAR 2790 01:55:39,142 --> 01:55:45,481 TO JUST BE EASY TO CONVEY THOSE, 2791 01:55:45,481 --> 01:55:47,984 HOW WELL AS A PROPORTION OF 2792 01:55:47,984 --> 01:55:49,219 POPULATION IS DOING. 2793 01:55:49,219 --> 01:55:56,326 BUT WE DID ALSO LOOK AT THE 2794 01:55:56,326 --> 01:55:59,262 ACTUAL ESTIMATES OF WHERE THOSE 2795 01:55:59,262 --> 01:56:01,998 MARKERS ARE FOR, YOU KNOW, WHAT 2796 01:56:01,998 --> 01:56:04,534 THE MEAN INTAKE IS, AND THEN 2797 01:56:04,534 --> 01:56:07,237 WHAT THE DISTRIBUTION LOOKS LIKE 2798 01:56:07,237 --> 01:56:10,740 FOR, FOR EXAMPLE, FOR REFINED 2799 01:56:10,740 --> 01:56:11,207 GRAINS. 2800 01:56:11,207 --> 01:56:13,509 SO, I DON'T REMEMBER WHAT THOSE 2801 01:56:13,509 --> 01:56:16,446 ESTIMATES ARE RIGHT NOW, BUT, 2802 01:56:16,446 --> 01:56:19,415 YEAH, THERE CERTAINLY IS A 2803 01:56:19,415 --> 01:56:22,685 PROPORTION THAT IS EXCEEDING 2804 01:56:22,685 --> 01:56:25,521 WHAT WE SET AS MAKE HALF GRAINS, 2805 01:56:25,521 --> 01:56:26,723 WHOLE GRAINS, MAKE THE OTHER, 2806 01:56:26,723 --> 01:56:30,627 THE OTHER HALF CAN BE REFINED 2807 01:56:30,627 --> 01:56:30,860 GRAINS. 2808 01:56:30,860 --> 01:56:36,332 BUT, YEAH, IT IS IMPORTANT TO 2809 01:56:36,332 --> 01:56:39,402 CONSIDER THAT WHEN WE'RE THEN 2810 01:56:39,402 --> 01:56:40,169 INTEGRATING EVIDENCE ALL 2811 01:56:40,169 --> 01:56:43,139 TOGETHER AND WITH FOOD PATTERN 2812 01:56:43,139 --> 01:56:44,240 MODELING AND SYSTEMATIC REVIEWS 2813 01:56:44,240 --> 01:56:46,843 FOR WHERE WE NEED TO BE. 2814 01:56:46,843 --> 01:56:49,045 >> IT ALSO OCCURRED TO ME AS WE 2815 01:56:49,045 --> 01:56:51,347 WERE LOOKING AT NUTRIENTS OF 2816 01:56:51,347 --> 01:56:55,051 CONCERN FOR OVER AND 2817 01:56:55,051 --> 01:56:57,120 UNDERCONSUMPTION, AND MOST OF 2818 01:56:57,120 --> 01:56:58,554 THE FINDINGS RESONATE REALLY 2819 01:56:58,554 --> 01:56:58,788 WELL. 2820 01:56:58,788 --> 01:57:02,492 THE ONE THING THAT STUCK OUT FOR 2821 01:57:02,492 --> 01:57:04,494 ME WAS FOLATE IN PREGNANCY. 2822 01:57:04,494 --> 01:57:06,129 SO MY QUESTION -- IT LED ME TO 2823 01:57:06,129 --> 01:57:07,964 THE QUESTION WHAT ARE THE 2824 01:57:07,964 --> 01:57:12,468 SOURCES OF FOLATE FOR WOMEN, 2825 01:57:12,468 --> 01:57:15,505 BIRTHING PERSONS, PERSONS WHO 2826 01:57:15,505 --> 01:57:18,274 ARE PREGNANT, AND WHAT'S BEEN 2827 01:57:18,274 --> 01:57:19,676 THE IMPACT OF FORTIFICATION 2828 01:57:19,676 --> 01:57:21,411 BECAUSE I THINK FORTIFICATION IS 2829 01:57:21,411 --> 01:57:24,280 IN SOME OF THOSE PROBABLY 2830 01:57:24,280 --> 01:57:25,014 REFINED GRAIN PRODUCTS. 2831 01:57:25,014 --> 01:57:30,386 SO I'M HAVING THIS MENTAL 2832 01:57:30,386 --> 01:57:31,521 GYMNASTICS AROUND -- BECAUSE 2833 01:57:31,521 --> 01:57:34,691 FOLATE IN NATURAL SOURCE CAN 2834 01:57:34,691 --> 01:57:36,959 COME FROM DARK GREEN VEGGIES, 2835 01:57:36,959 --> 01:57:40,697 AND THEN WITH THE ATTEMPT TO 2836 01:57:40,697 --> 01:57:45,068 TAKE CARE OF BIRTH DEFECTS WITH 2837 01:57:45,068 --> 01:57:47,470 FORTIFIED FOODS WHAT ARE THE 2838 01:57:47,470 --> 01:57:48,338 CARRIERS OF FORTIFICATION AND 2839 01:57:48,338 --> 01:57:50,340 HOW DOES THAT LINK BACK TO THIS, 2840 01:57:50,340 --> 01:57:53,209 WHAT WE SEE AS PROPORTION OF 2841 01:57:53,209 --> 01:57:55,411 PEOPLE ABOVE CONSUMPTION FOR 2842 01:57:55,411 --> 01:57:57,046 REFINED GRAINS, I'D LIKE TO HEAR 2843 01:57:57,046 --> 01:57:58,448 MORE ABOUT WHAT'S HAPPENING IN 2844 01:57:58,448 --> 01:58:05,788 PREGNANT PEOPLE. 2845 01:58:05,788 --> 01:58:10,059 >> YEAH, I THINK PUTTING 2846 01:58:10,059 --> 01:58:11,361 TOGETHER THOSE TWO PIECES OF 2847 01:58:11,361 --> 01:58:12,795 DATA ARE IMPORTANT, AND I'M 2848 01:58:12,795 --> 01:58:15,965 PRETTY SURE WE DO HAVE 2849 01:58:15,965 --> 01:58:18,167 INFORMATION ON THE SOURCES OF 2850 01:58:18,167 --> 01:58:23,306 FOLATE IN THAT AGE GROUP. 2851 01:58:23,306 --> 01:58:26,142 AND SO IT HAS IMPORTANT, LIKE 2852 01:58:26,142 --> 01:58:29,412 YOU SAID, RAMIFICATIONS FOR ANY 2853 01:58:29,412 --> 01:58:33,149 KIND OF MODIFICATION WE MIGHT 2854 01:58:33,149 --> 01:58:37,220 THINK ABOUT FOR REFINED GRAINS, 2855 01:58:37,220 --> 01:58:40,156 FOR WHOLE GRAINS, AND I DON'T -- 2856 01:58:40,156 --> 01:58:40,923 YEAH, PLEASE DO. 2857 01:58:40,923 --> 01:58:43,192 >> I THINK IT'S A GREAT 2858 01:58:43,192 --> 01:58:44,894 QUESTION, CHERYL. 2859 01:58:44,894 --> 01:58:47,930 AND WE HAD A LOT OF DISCUSSION 2860 01:58:47,930 --> 01:58:51,100 WITHIN THE COMMITTEE ABOUT THE 2861 01:58:51,100 --> 01:58:53,302 PROPORTION OF THE WHOLE AND 2862 01:58:53,302 --> 01:58:55,605 REFINED GRAINS WITHIN THE TOTAL 2863 01:58:55,605 --> 01:58:58,674 GRAINS AND WHAT HAPPENS IF YOU 2864 01:58:58,674 --> 01:59:00,576 ALTER THAT PROPORTION. 2865 01:59:00,576 --> 01:59:02,812 AND ONE CAN'T GO TO WHOLE GRAINS 2866 01:59:02,812 --> 01:59:09,419 AND NOT MAKE THE FOLATE STORY 2867 01:59:09,419 --> 01:59:09,619 WORSE. 2868 01:59:09,619 --> 01:59:12,355 SO, THERE WAS QUITE EXTENSIVE 2869 01:59:12,355 --> 01:59:14,657 ANALYSIS IN THAT QUESTION, AND 2870 01:59:14,657 --> 01:59:16,058 SOME OF IT NOT PRESENTED HERE, 2871 01:59:16,058 --> 01:59:24,367 BUT I KNOW THAT IT'S GOING TO BE 2872 01:59:24,367 --> 01:59:26,669 IN THAT SCIENTIFIC REPORT. 2873 01:59:26,669 --> 01:59:27,770 >> GREAT JOB. 2874 01:59:27,770 --> 01:59:28,871 LOVE SEEING THE DATA. 2875 01:59:28,871 --> 01:59:30,740 SO, ONE OF THE THINGS I WANTED 2876 01:59:30,740 --> 01:59:32,141 TO BRING UP, IT'S ALREADY BEEN 2877 01:59:32,141 --> 01:59:34,777 BROUGHT UP BY DEE DEE AND 2878 01:59:34,777 --> 01:59:38,181 CHERYL, BUT WITH THE ATI BEING 2879 01:59:38,181 --> 01:59:40,349 RELATIVELY LOW, I DON'T THINK 2880 01:59:40,349 --> 01:59:44,320 IT'S -- THERE'S A LOT OF 2881 01:59:44,320 --> 01:59:44,821 CRITICISM ABOUT DIETARY 2882 01:59:44,821 --> 01:59:45,988 GUIDELINES, I THINK THE 2883 01:59:45,988 --> 01:59:47,690 GUIDELINES ARE GOOD AND BASED ON 2884 01:59:47,690 --> 01:59:49,692 THE SCIENCE, IT'S A LOT IN THE 2885 01:59:49,692 --> 01:59:51,561 IMPLEMENTATION. 2886 01:59:51,561 --> 01:59:53,863 THERE'S NOTHING WE CAN DO IF 2887 01:59:53,863 --> 01:59:54,931 INDIVIDUAL PREFERENCES AND 2888 01:59:54,931 --> 01:59:58,534 KNOWLEDGE OF FOOD PREP AND THEN 2889 01:59:58,534 --> 02:00:00,570 JUST ALL OF THE ENVIRONMENTAL, 2890 02:00:00,570 --> 02:00:04,040 AND YOU CAN SEE THAT IN THE 2891 02:00:04,040 --> 02:00:07,743 POVERTY INCOME RATIO AND FOOD 2892 02:00:07,743 --> 02:00:09,912 INSECURITY, SO ACCESSIBILITY TO 2893 02:00:09,912 --> 02:00:10,513 FOODS, MESSAGING ENVIRONMENT, 2894 02:00:10,513 --> 02:00:11,347 ALL OF THAT. 2895 02:00:11,347 --> 02:00:14,650 SO I THINK THAT'S SOMETHING FOR 2896 02:00:14,650 --> 02:00:16,819 US TO CONTINUE TO KEEP TOP OF 2897 02:00:16,819 --> 02:00:18,688 MIND AND TALK ABOUT 2898 02:00:18,688 --> 02:00:20,323 IMPLEMENTING, HOW DO WE DO A 2899 02:00:20,323 --> 02:00:21,424 BETTER JOB ABOUT IMPLEMENTING 2900 02:00:21,424 --> 02:00:23,493 ALL THIS GOOD SCIENCE THAT WE 2901 02:00:23,493 --> 02:00:24,827 HAVE ACCESS TO. 2902 02:00:24,827 --> 02:00:27,330 THE SECOND COMMENT REAL QUICKLY, 2903 02:00:27,330 --> 02:00:29,198 I REALLY LOVE SEEING THE 2904 02:00:29,198 --> 02:00:31,701 BREAKDOWN OF THE DIFFERENT 2905 02:00:31,701 --> 02:00:34,337 CULTURAL PATTERNS AND WHERE THEY 2906 02:00:34,337 --> 02:00:36,706 MET THE GUIDELINES OR NOT FOR 2907 02:00:36,706 --> 02:00:37,807 THE DIFFERENT FOOD GROUPS. 2908 02:00:37,807 --> 02:00:40,076 AND SO I THINK WE HAVE A LOT TO 2909 02:00:40,076 --> 02:00:42,345 LEARN ABOUT HOW CAN WE 2910 02:00:42,345 --> 02:00:44,814 INCORPORATE THOSE FOODS THAT ARE 2911 02:00:44,814 --> 02:00:47,216 ALREADY IN THE ENVIRONMENT, AND 2912 02:00:47,216 --> 02:00:50,286 USE THAT TO OUR ADVANTAGE WHEN 2913 02:00:50,286 --> 02:00:52,355 WE'RE PLANNING MEALS AND LOOKING 2914 02:00:52,355 --> 02:00:56,826 AT FOOD PATTERNS GOING FORWARD. 2915 02:00:56,826 --> 02:00:58,794 SO KEEPING ALL OF THE GOOD KIND 2916 02:00:58,794 --> 02:01:03,633 OF ADHERENCE TO THE DIETARY 2917 02:01:03,633 --> 02:01:04,934 GUIDELINES AND THOSE DIFFERENT 2918 02:01:04,934 --> 02:01:07,136 CULTURAL GROUPS AND BUILDING ON 2919 02:01:07,136 --> 02:01:07,336 THAT. 2920 02:01:07,336 --> 02:01:08,337 ANYWAY, I THOUGHT THAT WAS 2921 02:01:08,337 --> 02:01:15,044 REALLY GREAT TO SEE AND KIND OF 2922 02:01:15,044 --> 02:01:15,444 FUN. 2923 02:01:15,444 --> 02:01:19,148 >> I ECHO THAT. 2924 02:01:19,148 --> 02:01:24,520 WE CAN HAVE A GOOD DISCUSSION 2925 02:01:24,520 --> 02:01:24,754 LATER. 2926 02:01:24,754 --> 02:01:25,421 TWO QUESTIONS. 2927 02:01:25,421 --> 02:01:26,956 SEEMS LIKE WE HAVE A SHORTFALL 2928 02:01:26,956 --> 02:01:28,157 OF KEY NUTRIENTS. 2929 02:01:28,157 --> 02:01:32,528 ONE IS ARE WE CONSIDERING OTHER 2930 02:01:32,528 --> 02:01:33,629 SOURCES LIKE SUPPLEMENTS, AND IF 2931 02:01:33,629 --> 02:01:39,201 WE'RE NOT THEN ARE WE SEEING AN 2932 02:01:39,201 --> 02:01:41,737 INCREASE IN NEURAL TUBAL 2933 02:01:41,737 --> 02:01:42,872 DEFECTS, ANEMIA, IN NUTRIENTS OF 2934 02:01:42,872 --> 02:01:44,373 CONCERN BECAUSE THEY ARE LOW AND 2935 02:01:44,373 --> 02:01:45,875 THEY HAVE BEEN LOW FOR A LONG 2936 02:01:45,875 --> 02:01:49,512 TIME SO ARE WE SEEING MORE 2937 02:01:49,512 --> 02:01:55,718 RICKETS AND ALL THESE NUTRIENTS? 2938 02:01:55,718 --> 02:01:57,687 >> SO DATA WE'RE BASING THESE 2939 02:01:57,687 --> 02:01:59,455 STATEMENTS ON IS JUST FROM 2940 02:01:59,455 --> 02:02:03,292 DIETARY SOURCES. 2941 02:02:03,292 --> 02:02:03,759 BUT, YEAH, RECOGNIZING 2942 02:02:03,759 --> 02:02:05,027 SUPPLEMENTS IS OF COURSE GOING 2943 02:02:05,027 --> 02:02:08,097 TO MAKE A DIFFERENCE, AND IT'S 2944 02:02:08,097 --> 02:02:10,833 GOING TO BE DIFFERENTIAL ACROSS 2945 02:02:10,833 --> 02:02:12,234 THOSE DIFFERENT SOCIOECONOMIC 2946 02:02:12,234 --> 02:02:13,436 GROUPS TOO. 2947 02:02:13,436 --> 02:02:15,304 LIKE THERE'S A DIFFERENT 2948 02:02:15,304 --> 02:02:16,505 PROPORTION THAT TAKES 2949 02:02:16,505 --> 02:02:18,808 SUPPLEMENTS BY INCOME LEVEL, FOR 2950 02:02:18,808 --> 02:02:19,141 EXAMPLE. 2951 02:02:19,141 --> 02:02:20,643 SO I THINK THAT'S AN IMPORTANT 2952 02:02:20,643 --> 02:02:24,814 PIECE TO KEEP IN MIND, BUT HERE 2953 02:02:24,814 --> 02:02:30,286 WE'RE FOCUSED ON THE DIET, AND 2954 02:02:30,286 --> 02:02:32,021 -- BUT, YEAH, AND THINKING HOW 2955 02:02:32,021 --> 02:02:37,193 THAT WILL RELATE TO HOW THE DATA 2956 02:02:37,193 --> 02:02:39,161 ANALYSIS WILL RELATE TO THOSE 2957 02:02:39,161 --> 02:02:40,262 OUTCOMES IS IMPORTANT. 2958 02:02:40,262 --> 02:02:44,066 AND I THINK THAT'S WHERE THE 2959 02:02:44,066 --> 02:02:46,702 SYSTEMATIC REVIEWS CAN COME IN 2960 02:02:46,702 --> 02:02:49,672 AND HELP US WITH MORE -- MAKING 2961 02:02:49,672 --> 02:02:52,942 THAT LEAP, LIKE EVIDENCE BEHIND 2962 02:02:52,942 --> 02:02:53,609 THAT. 2963 02:02:53,609 --> 02:02:58,414 BUT IF SOMEONE WANTS TO HELP 2964 02:02:58,414 --> 02:02:59,081 WITH CHRISTINA'S QUESTION. 2965 02:02:59,081 --> 02:03:01,283 >> WE LOVE THE FACT YOU TOOK ON 2966 02:03:01,283 --> 02:03:01,884 THE HARDEST QUESTION. 2967 02:03:01,884 --> 02:03:05,321 I DON'T THINK A DISCUSSION OF 2968 02:03:05,321 --> 02:03:06,856 DIETARY SUPPLEMENTS IS 2969 02:03:06,856 --> 02:03:07,523 APPROPRIATE HERE. 2970 02:03:07,523 --> 02:03:09,258 WE'RE TALKING ABOUT DIETARY 2971 02:03:09,258 --> 02:03:09,525 GUIDANCE. 2972 02:03:09,525 --> 02:03:10,159 GOOD POINT. 2973 02:03:10,159 --> 02:03:12,328 WE CAN PUT IT IN THE DISCUSSION, 2974 02:03:12,328 --> 02:03:17,833 BUT I DON'T THINK THIS IS A 2975 02:03:17,833 --> 02:03:21,537 CONVERSATION OR TOPIC THAT 2976 02:03:21,537 --> 02:03:25,474 WE'RE -- APPROPRIATE TO DISCUSS 2977 02:03:25,474 --> 02:03:26,008 HERE. 2978 02:03:26,008 --> 02:03:30,179 >> A QUICK ONE, YOU IN THE 2979 02:03:30,179 --> 02:03:31,280 NUTRIENT CONCERNS 6 TO 11 MONTHS 2980 02:03:31,280 --> 02:03:34,383 YOU INDICATE IRON. 2981 02:03:34,383 --> 02:03:37,219 IS VITAMIN D LISTED SEPARATELY, 2982 02:03:37,219 --> 02:03:39,622 ALL AGES, BIRTH ONWARD? 2983 02:03:39,622 --> 02:03:40,589 WE'VE HAD SOME DISCUSSIONS WITH 2984 02:03:40,589 --> 02:03:41,891 STAFF ABOUT THAT. 2985 02:03:41,891 --> 02:03:44,760 I JUST SAW 6 TO 11 MONTH 2986 02:03:44,760 --> 02:03:51,200 NUTRIENT CONCERN IRON, THE MORE 2987 02:03:51,200 --> 02:03:52,001 COMMONLY CONCERNED IS VITAMIN D, 2988 02:03:52,001 --> 02:03:57,239 IS IT LISTED SOMEWHERE? 2989 02:03:57,239 --> 02:04:00,309 >> THE FOUR NUTRIENTS WE NEED 2990 02:04:00,309 --> 02:04:04,680 MORE OF, D, CALCIUM, FIBER, 2991 02:04:04,680 --> 02:04:06,315 POTASSIUM, THOSE ARE NUTRIENTS 2992 02:04:06,315 --> 02:04:11,020 OF CONCERN FOR AGES 1 AND OLDER. 2993 02:04:11,020 --> 02:04:13,089 YEAH, WITH REGARD TO YOUR 2994 02:04:13,089 --> 02:04:15,224 QUESTION ABOUT VITAMIN D FOR 2995 02:04:15,224 --> 02:04:20,096 AGES 6 TO 12 -- 2996 02:04:20,096 --> 02:04:24,166 >> ACTUALLY 0 TO 12. 2997 02:04:24,166 --> 02:04:25,668 >> 0 TO 12, WONDER, DANA, IF YOU 2998 02:04:25,668 --> 02:04:26,535 MIGHT BE ABLE TO HELP US 2999 02:04:26,535 --> 02:04:28,671 >> WE HAVE A SECTION ON VITAMIN 3000 02:04:28,671 --> 02:04:30,973 D FOR 6 TO 11 MONTHS, A SPECIAL 3001 02:04:30,973 --> 02:04:32,742 CHALLENGE, NOT A NUTRIENT OF 3002 02:04:32,742 --> 02:04:33,743 PUBLIC HEALTH CONCERN. 3003 02:04:33,743 --> 02:04:35,144 >> I JUST DON'T WANT ANYTHING TO 3004 02:04:35,144 --> 02:04:37,012 MAKE IT SOUND LIKE WE'RE GOING 3005 02:04:37,012 --> 02:04:39,515 AGAINST EVERY RECOMMENDATION FOR 3006 02:04:39,515 --> 02:04:41,851 PROVIDING VITAMIN D TO BABIES 3007 02:04:41,851 --> 02:04:44,687 BECAUSE YOU CANNOT GET IT FROM 3008 02:04:44,687 --> 02:04:46,155 BREAST MILK IN THE FIRST 12 3009 02:04:46,155 --> 02:04:48,924 MONTHS OF LIFE, CAN'T BE DONE. 3010 02:04:48,924 --> 02:04:50,459 THAT RECOMMENDATION ACTUALLY IS 3011 02:04:50,459 --> 02:04:51,994 FROM BIRTH ON WARD, THOUGH I 3012 02:04:51,994 --> 02:04:53,863 REALIZE WE DON'T DO DATA FROM 3013 02:04:53,863 --> 02:04:55,598 BIRTH TO 6 MONTHS BUT WE'LL LOOK 3014 02:04:55,598 --> 02:04:57,666 AT NUTRIENTS OF CONCERN AND IF 3015 02:04:57,666 --> 02:05:03,372 YOU LEAVE VITAMIN D OUT THAT MAY 3016 02:05:03,372 --> 02:05:04,740 BE MISLEADING OR CONFUSING. 3017 02:05:04,740 --> 02:05:06,776 >> MAZE 3018 02:05:06,776 --> 02:05:08,611 >> MAY I PROPOSE THIS IS A VERY 3019 02:05:08,611 --> 02:05:10,246 IMPORTANT POINT BECAUSE WE'RE 3020 02:05:10,246 --> 02:05:11,480 CONSIDERING ACROSS THE ENTIRE 3021 02:05:11,480 --> 02:05:12,815 LIFE CYCLE, I THINK THIS IS A 3022 02:05:12,815 --> 02:05:20,790 POINT THAT WOULD BE GREAT IN 3023 02:05:20,790 --> 02:05:21,991 DISCUSSION AND RECOMMENDATIONS 3024 02:05:21,991 --> 02:05:23,292 TO RECOMMENDATIONS. 3025 02:05:23,292 --> 02:05:24,593 >> YEAH, TO HIGHLIGHT WHAT DANA 3026 02:05:24,593 --> 02:05:26,362 SAID, WE HAVE THESE OTHER -- 3027 02:05:26,362 --> 02:05:28,330 WHAT WE'VE SHOWN HERE ARE 3028 02:05:28,330 --> 02:05:28,798 HIGHLIGHTS. 3029 02:05:28,798 --> 02:05:31,300 SO THERE ARE NUTRIENTS OF PUBLIC 3030 02:05:31,300 --> 02:05:35,237 HEALTH CONCERN BUT WE ALSO HAVE 3031 02:05:35,237 --> 02:05:38,174 A LIST THAT'S SOMEWHAT LENGTHY 3032 02:05:38,174 --> 02:05:40,910 OF NUTRIENTS OF SPECIAL 3033 02:05:40,910 --> 02:05:42,978 CONSIDERATION, AND IT'S NOT JUST 3034 02:05:42,978 --> 02:05:46,148 FOR INFANTS BUT THERE'S SOME 3035 02:05:46,148 --> 02:05:48,484 OTHERS, AGE, SEX GROUPS, 3036 02:05:48,484 --> 02:05:50,319 NUTRIENTS OF SPECIAL 3037 02:05:50,319 --> 02:05:52,421 CONSIDERATION FOR. 3038 02:05:52,421 --> 02:05:55,724 SO, THAT IS ALL, YOU KNOW, 3039 02:05:55,724 --> 02:06:00,529 AVAILABLE AND WE'LL SHARE IT. 3040 02:06:00,529 --> 02:06:04,266 >> WE HAVE TIME FOR ONE MORE 3041 02:06:04,266 --> 02:06:04,533 QUESTION. 3042 02:06:04,533 --> 02:06:04,934 >> OKAY. 3043 02:06:04,934 --> 02:06:06,902 I'M GOING TO HAND IT OVER TO 3044 02:06:06,902 --> 02:06:07,203 CHRISTOPHER. 3045 02:06:07,203 --> 02:06:08,537 IT'S BECAUSE I OFFERED THE WHOLE 3046 02:06:08,537 --> 02:06:11,707 SIDE OF THE TABLE AN OPTION. 3047 02:06:11,707 --> 02:06:12,975 I'M TRYING TO FOLLOW -- 3048 02:06:12,975 --> 02:06:14,343 >> WE NEED BALANCE HERE 3049 02:06:14,343 --> 02:06:16,078 >> OKAY, YOU'VE GOT THE FLOOR. 3050 02:06:16,078 --> 02:06:18,948 YOU'RE THE LAST QUESTION BECAUSE 3051 02:06:18,948 --> 02:06:22,117 WE'VE GOT ANOTHER SESSION. 3052 02:06:22,117 --> 02:06:23,319 >> AMAZING PRESENTATION. 3053 02:06:23,319 --> 02:06:24,753 IT'S JUST INCREDIBLE WE HAVE 3054 02:06:24,753 --> 02:06:26,689 THIS KIND OF DATA. 3055 02:06:26,689 --> 02:06:30,960 WHAT STRUCK ME IS FOOD 3056 02:06:30,960 --> 02:06:32,261 SECURE/INSECURE AND 3057 02:06:32,261 --> 02:06:36,999 POVERTY/INCOME RATIO, I EXPECTED 3058 02:06:36,999 --> 02:06:41,570 A BIGGER DIFFERENCE IS ATI 3059 02:06:41,570 --> 02:06:41,904 SCORES. 3060 02:06:41,904 --> 02:06:44,874 IS IT BECAUSE U.S. SAFETY NET 3061 02:06:44,874 --> 02:06:46,709 PROGRAMS ARE SO EFFECTIVE ARE 3062 02:06:46,709 --> 02:06:48,043 PEOPLE ARE ABLE TO ACHIEVE 3063 02:06:48,043 --> 02:06:56,585 ALMOST THE THE ATI SCORE BECAUF 3064 02:06:56,585 --> 02:06:57,887 RESOURCES, A SHOUT OUT TO 3065 02:06:57,887 --> 02:06:59,955 PROGRAM OR A DAMNING CASE OF 3066 02:06:59,955 --> 02:07:00,956 PEOPLE WITH RESOURCES ARE NOT 3067 02:07:00,956 --> 02:07:02,791 EATING VERY WELL AND IS THAT 3068 02:07:02,791 --> 02:07:09,398 BECAUSE OF EDUCATION AND CHOICE? 3069 02:07:09,398 --> 02:07:11,233 TODAY'S FOOD AVAILABILITY. 3070 02:07:11,233 --> 02:07:12,234 DEFAULT, FOOD AVAILABILITY, THAT 3071 02:07:12,234 --> 02:07:15,170 WE HAVE, EVEN FOR THOSE WITH 3072 02:07:15,170 --> 02:07:18,574 RESOURCES, DOESN'T ALLOW PEOPLE 3073 02:07:18,574 --> 02:07:19,475 TO EAT WELL. 3074 02:07:19,475 --> 02:07:21,210 I DON'T KNOW THAT THERE'S AN 3075 02:07:21,210 --> 02:07:26,415 ANSWER BUT THAT'S LOOKING AT THE 3076 02:07:26,415 --> 02:07:28,150 POVERTY/INCOME RATIO AND FOOD 3077 02:07:28,150 --> 02:07:29,051 INSECURITY DIFFERENTIALS BEING 3078 02:07:29,051 --> 02:07:31,754 SO SMALL REALLY MAKES ME THINK. 3079 02:07:31,754 --> 02:07:34,290 >> CAN I -- THAT'S A GREAT WAY 3080 02:07:34,290 --> 02:07:36,158 TO END THIS SESSION. 3081 02:07:36,158 --> 02:07:43,265 I WANT EVERYONE TO HOLD THAT FOR 3082 02:07:43,265 --> 02:07:45,134 THE INTEGRATION PIECE, AND LET'S 3083 02:07:45,134 --> 02:07:46,769 GO TO OUR NEXT SESSION BECAUSE 3084 02:07:46,769 --> 02:07:49,805 YOU FRAMED IT VERY NICELY, 3085 02:07:49,805 --> 02:07:51,006 CHRISTOPHER, OF COURSE, RIGHT? 3086 02:07:51,006 --> 02:08:00,149 SO I'M GOING TO HAND IT OVER TO 3087 02:08:00,149 --> 02:08:03,319 YOU NOW, CRISTINA. 3088 02:08:03,319 --> 02:08:05,487 >> NOW WE MOVE TO THE STRATEGIES 3089 02:08:05,487 --> 02:08:07,690 FOR INDIVIDUALS AND FAMILIES 3090 02:08:07,690 --> 02:08:09,458 RELATED TO DIET QUALITY AND 3091 02:08:09,458 --> 02:08:10,559 WEIGHT MANAGEMENT. 3092 02:08:10,559 --> 02:08:12,828 WE WILL DISCUSS SOME STRATEGIES 3093 02:08:12,828 --> 02:08:14,797 THAT WE'RE TALKING ABOUT 3094 02:08:14,797 --> 02:08:19,601 PREVIOUSLY, AND HOW TO IMPLEMENT 3095 02:08:19,601 --> 02:08:22,371 THIS HEALTHY DIETARY PATTERN AND 3096 02:08:22,371 --> 02:08:24,440 STAY IN CALORIE LIMITS. 3097 02:08:24,440 --> 02:08:25,841 WE HAVE SOME EXCITING STATEMENTS 3098 02:08:25,841 --> 02:08:28,677 TO SHOW AND CAN DISCUSS MORE IN 3099 02:08:28,677 --> 02:08:34,550 OUR INTRODUCTION. 3100 02:08:34,550 --> 02:08:35,184 INTEGRATION, SORRY. 3101 02:08:35,184 --> 02:08:35,918 NEXT SLIDE. 3102 02:08:35,918 --> 02:08:38,253 YOU PROBABLY KNOW US BY NOW. 3103 02:08:38,253 --> 02:08:40,422 AND NEXT, IN ADDITION TO WHAT 3104 02:08:40,422 --> 02:08:43,192 OTHERS HAVE SAID ABOUT THE 3105 02:08:43,192 --> 02:08:45,627 AMAZING WORK THE STAFF DOES FOR 3106 02:08:45,627 --> 02:08:47,997 US, I WANT TO HIGHLIGHT THAT 3107 02:08:47,997 --> 02:08:49,965 THEY KEEP TRACK OF ALL OF OUR 3108 02:08:49,965 --> 02:08:51,600 NOTES IN OUR DISCUSSIONS, TO 3109 02:08:51,600 --> 02:08:53,168 MAKE SURE WE CAN INTEGRATE 3110 02:08:53,168 --> 02:08:55,104 EVERYTHING SO I WOULD LIKE TO 3111 02:08:55,104 --> 02:08:59,708 REALLY THANK YOU FOR ALL THE 3112 02:08:59,708 --> 02:09:04,413 DETAILED DISCUSSIONS AND NOTES 3113 02:09:04,413 --> 02:09:06,382 YOU DO FOR US. 3114 02:09:06,382 --> 02:09:07,683 NEXT SLIDE. 3115 02:09:07,683 --> 02:09:09,018 WE HAD SOME PROGRESS MADE SINCE 3116 02:09:09,018 --> 02:09:10,853 LAST MEETING. 3117 02:09:10,853 --> 02:09:14,490 WE HAVE A FEW SYSTEMATIC REVIEWS 3118 02:09:14,490 --> 02:09:16,558 SENT TO PEER REVIEW. 3119 02:09:16,558 --> 02:09:18,527 THEY WERE DISCUSSED IN PREVIOUS 3120 02:09:18,527 --> 02:09:18,794 MEETINGS. 3121 02:09:18,794 --> 02:09:22,564 AND YOU CAN SEE WHEN THEY WERE 3122 02:09:22,564 --> 02:09:26,435 DISCUSSED, IN MEETING 4, MEETING 3123 02:09:26,435 --> 02:09:29,171 5, AND WE DID REVISE A 3124 02:09:29,171 --> 02:09:31,240 CONCLUSION STATEMENT BASED ON 3125 02:09:31,240 --> 02:09:33,108 PEER REVIEW AND ED WILL PRESENT 3126 02:09:33,108 --> 02:09:34,309 ON THAT. 3127 02:09:34,309 --> 02:09:37,279 SO TODAY WE'LL BE PRESENTING ON 3128 02:09:37,279 --> 02:09:39,615 THAT SMALL CHANGE AND ALSO 3129 02:09:39,615 --> 02:09:42,117 AILEEN WILL BE PRESENTING ON THE 3130 02:09:42,117 --> 02:09:43,085 EXCITING CONCLUSION STATEMENTS 3131 02:09:43,085 --> 02:09:45,087 ON PORTION SIZE AND ENERGY 3132 02:09:45,087 --> 02:09:51,060 INTAKE AND THEN FATIMA AND 3133 02:09:51,060 --> 02:09:55,798 ANGELA WILL PRESENT ON EVIDENCE 3134 02:09:55,798 --> 02:09:55,998 SCAN. 3135 02:09:55,998 --> 02:09:58,200 >> THANKS, YES, SO WE HAD ONE 3136 02:09:58,200 --> 02:09:58,634 UPDATE. 3137 02:09:58,634 --> 02:10:03,338 SO JUST AS A REMINDER, THE FULL 3138 02:10:03,338 --> 02:10:04,440 SYSTEMATIC REVIEW QUESTION, 3139 02:10:04,440 --> 02:10:06,475 INCLUDED MULTIPLE CATEGORIES OF 3140 02:10:06,475 --> 02:10:08,844 FREQUENCY OF MEALS, AND/OR 3141 02:10:08,844 --> 02:10:10,712 SNACKING SUCH AS BREAKFAST, 3142 02:10:10,712 --> 02:10:14,750 SNACKING, NUMBER OF EATING 3143 02:10:14,750 --> 02:10:16,718 OCCASIONS, YOU CAN SEE THE 3144 02:10:16,718 --> 02:10:17,920 SYNTHESIS AT THE BOTTOM OF THE 3145 02:10:17,920 --> 02:10:18,921 SLIDE THERE. 3146 02:10:18,921 --> 02:10:20,789 SO ALL OF THE CONCLUSION 3147 02:10:20,789 --> 02:10:23,192 STATEMENTS THAT ADDRESSED THIS 3148 02:10:23,192 --> 02:10:25,060 QUESTION WERE PRESENTED AT THE 3149 02:10:25,060 --> 02:10:34,937 FOURTH PUBLIC MEETING, SEEMS SO 3150 02:10:34,937 --> 02:10:40,943 LONG AGO. 3151 02:10:40,943 --> 02:10:44,546 SYSTEMATIC REVIEW UNDERWENT PEER 3152 02:10:44,546 --> 02:10:46,148 REVIEW, CON WAS ON THE 3153 02:10:46,148 --> 02:10:46,982 RELATIONSHIP BETWEEN BREAKFAST 3154 02:10:46,982 --> 02:10:49,918 CON SUMMINGS IN ADULTS AND TOTAL 3155 02:10:49,918 --> 02:10:50,619 ENERGY TAKE. 3156 02:10:50,619 --> 02:10:52,621 PREVIOUSLY, THIS SHOWS PREVIOUS 3157 02:10:52,621 --> 02:10:53,755 AND UPDATED. 3158 02:10:53,755 --> 02:10:56,091 PREVIOUSLY WE HAD CONCLUDED 3159 02:10:56,091 --> 02:10:59,027 BREAKFAST CONSUMPTION COMPARED 3160 02:10:59,027 --> 02:11:00,662 TO NO BREAKFAST CONSUMPTION IN 3161 02:11:00,662 --> 02:11:03,098 ADULT DOES NOT DECREASE TOTAL 3162 02:11:03,098 --> 02:11:04,199 ENERGY INTAKE. 3163 02:11:04,199 --> 02:11:06,368 THIS CONCLUSION STATEMENT IS 3164 02:11:06,368 --> 02:11:08,770 BASED ON EVIDENCE GRADED AS 3165 02:11:08,770 --> 02:11:09,004 LIMITED. 3166 02:11:09,004 --> 02:11:14,676 YOU CAN SEE THE BODY OF EVIDENCE 3167 02:11:14,676 --> 02:11:17,079 WAS MOSTLY RANDOMIZED TRIALS, 19 3168 02:11:17,079 --> 02:11:19,915 ARTICLES OVERALL, 18 RANDOMIZED 3169 02:11:19,915 --> 02:11:22,217 TRIALS, ONE PROSPECTIVE COHORT 3170 02:11:22,217 --> 02:11:22,684 STUDY. 3171 02:11:22,684 --> 02:11:24,887 NOW, AFTER PEER REVIEW AND 3172 02:11:24,887 --> 02:11:27,189 REVISITING THE EVIDENCE, AND 3173 02:11:27,189 --> 02:11:30,025 MANY DISCUSSIONS, THE CONCLUSION 3174 02:11:30,025 --> 02:11:33,962 WAS CHANGED, A NEW STATEMENT AS 3175 02:11:33,962 --> 02:11:34,830 YOU CAN SEE, CONCLUSION 3176 02:11:34,830 --> 02:11:37,266 STATEMENT COULD NOT BE DRAWN 3177 02:11:37,266 --> 02:11:39,134 ABOUT RELATIONSHIP BETWEEN 3178 02:11:39,134 --> 02:11:41,303 BREAKFAST CONSUMPTION AND TOTAL 3179 02:11:41,303 --> 02:11:43,739 ENERGY INTAKE BECAUSE OF 3180 02:11:43,739 --> 02:11:45,140 STANDING CONCERNS, CONSISTENCY 3181 02:11:45,140 --> 02:11:48,210 AND GENERALIZABILITY IN THE BODY 3182 02:11:48,210 --> 02:11:49,845 OF EVIDENCE. 3183 02:11:49,845 --> 02:11:51,713 THE AVAILABLE EVIDENCE 3184 02:11:51,713 --> 02:11:54,016 CONTRIBUTED MIXED RESULTS, AND 3185 02:11:54,016 --> 02:11:56,318 HAD MANY LIMITATIONS, INCLUDING 3186 02:11:56,318 --> 02:11:59,488 LACK OF DIVERSITY OF 3187 02:11:59,488 --> 02:12:01,557 POPULATIONS, DIFFERENT STUDY 3188 02:12:01,557 --> 02:12:05,928 DESIGNS, INTERVENTIONS, 3189 02:12:05,928 --> 02:12:09,097 DURATIONS, AS WELL AS DIVERSITY 3190 02:12:09,097 --> 02:12:10,199 AND ENERGY INTAKE ASSESSMENTS. 3191 02:12:10,199 --> 02:12:13,335 SO, JUST TO GIVE A LITTLE BIT 3192 02:12:13,335 --> 02:12:16,138 MORE BACKGROUND, REMEMBER THERE 3193 02:12:16,138 --> 02:12:17,973 WERE ABOUT 18 TRIALS. 3194 02:12:17,973 --> 02:12:21,577 NOW, THERE WAS A LOT OF 3195 02:12:21,577 --> 02:12:25,414 VARIATION IN THE METHODOLOGY, 3196 02:12:25,414 --> 02:12:27,015 BRIEFLY NINE TRIALS WERE 3197 02:12:27,015 --> 02:12:28,217 CONSIDERED SHORT, LESS THAN SIX 3198 02:12:28,217 --> 02:12:28,684 WEEKS. 3199 02:12:28,684 --> 02:12:35,224 SOME WERE MUCH LESS THAN SIX 3200 02:12:35,224 --> 02:12:35,424 WEEKS. 3201 02:12:35,424 --> 02:12:38,994 THESE GENERALLY -- I'M SORRY, 3202 02:12:38,994 --> 02:12:40,929 YEAH, NINE TRIALS REPORTED OF 3203 02:12:40,929 --> 02:12:41,797 THE SHORTER TRIALS, ACTUALLY 3204 02:12:41,797 --> 02:12:43,899 MOST OF THE TRIALS, EXCUSE ME, 3205 02:12:43,899 --> 02:12:46,101 WERE SHORT. 3206 02:12:46,101 --> 02:12:47,836 SO ALMOST ALL BUT TWO WERE 3207 02:12:47,836 --> 02:12:51,240 CONSIDERED SHORT. 3208 02:12:51,240 --> 02:12:53,875 AMONG SHORT TRIALS THERE'S A LOT 3209 02:12:53,875 --> 02:12:56,578 OF INCONSISTENCY BUT ROUGHLY 3210 02:12:56,578 --> 02:12:59,147 HALF REPORTED THOSE WHO CONSUMED 3211 02:12:59,147 --> 02:13:01,016 BREAKFAST CONSUMED MORE ENERGY 3212 02:13:01,016 --> 02:13:03,719 INTAKE SO BREAKFAST, MORE ENERGY 3213 02:13:03,719 --> 02:13:04,620 INTAKE. 3214 02:13:04,620 --> 02:13:06,788 BUT ABOUT HALF THE TRIALS ALSO 3215 02:13:06,788 --> 02:13:10,959 REPORTED NO DIFFERENCE IN ENERGY 3216 02:13:10,959 --> 02:13:11,560 INTAKE. 3217 02:13:11,560 --> 02:13:13,595 INCONSISTENCY BECAUSE THERE WERE 3218 02:13:13,595 --> 02:13:16,331 TWO LONGER TRIALS, THESE WERE 12 3219 02:13:16,331 --> 02:13:18,166 AND 14 WEEKS. 3220 02:13:18,166 --> 02:13:21,136 AND IN THOSE TRIALS THE RESULTS 3221 02:13:21,136 --> 02:13:22,671 WERE QUITE DIFFERENT. 3222 02:13:22,671 --> 02:13:25,407 THOSE WHO CONSUMED BREAKFAST HAD 3223 02:13:25,407 --> 02:13:27,709 LOWER ENERGY INTAKE. 3224 02:13:27,709 --> 02:13:31,780 SO BECAUSE OF THE INCONSISTENCY 3225 02:13:31,780 --> 02:13:33,849 OF THE TRIALS, ESPECIALLY BY -- 3226 02:13:33,849 --> 02:13:36,485 AN DIRECTION AND DIFFERENCES BY 3227 02:13:36,485 --> 02:13:39,321 DURATION, ONLY TWO TRIALS OF 3228 02:13:39,321 --> 02:13:42,391 LONG DURATION, THE COMMITTEE, 3229 02:13:42,391 --> 02:13:42,858 SUBCOMMITTEE CONCLUDED 3230 02:13:42,858 --> 02:13:44,226 ADDITIONAL STANDARDIZED STUDIES 3231 02:13:44,226 --> 02:13:48,163 ARE NEEDED IN LARGER AND 3232 02:13:48,163 --> 02:13:49,031 PARTICULARLY LONGER-TERM TRIALS 3233 02:13:49,031 --> 02:13:50,365 IN ORDER TO ESTABLISH A 3234 02:13:50,365 --> 02:13:52,968 CONCLUSION STATEMENT FOR THIS 3235 02:13:52,968 --> 02:13:54,303 TOPIC. 3236 02:13:54,303 --> 02:13:57,272 SO THAT'S A SUMMARY. 3237 02:13:57,272 --> 02:14:02,978 HAPPY TO TAKE QUESTIONS. 3238 02:14:02,978 --> 02:14:07,582 >> FIRST OF ALL, I THINK THIS 3239 02:14:07,582 --> 02:14:09,484 EXAMPLE REALLY SPEAKS OUT -- 3240 02:14:09,484 --> 02:14:12,888 SPEAKS TO THE VALUE OF PEER 3241 02:14:12,888 --> 02:14:14,089 REVIEW. 3242 02:14:14,089 --> 02:14:17,559 AND I JUST WANT TO THANK ON 3243 02:14:17,559 --> 02:14:19,961 BEHALF OF THE COMMITTEE THE 3244 02:14:19,961 --> 02:14:22,064 INDIVIDUALS WHO ARE CONDUCTING 3245 02:14:22,064 --> 02:14:24,800 PEER REVIEW OF OUR CONCLUSION 3246 02:14:24,800 --> 02:14:25,467 STATEMENTS. 3247 02:14:25,467 --> 02:14:28,103 THE QUALITY OF YOUR FEEDBACK IS 3248 02:14:28,103 --> 02:14:28,670 AMAZING. 3249 02:14:28,670 --> 02:14:30,939 AND WE KNOW IT TAKES TIME SO 3250 02:14:30,939 --> 02:14:32,240 THANK YOU. 3251 02:14:32,240 --> 02:14:35,977 I ALSO REALLY WANT TO COMMEND 3252 02:14:35,977 --> 02:14:41,016 THE WORKING GROUP FOR TAKING THE 3253 02:14:41,016 --> 02:14:41,550 FEEDBACK, GOING BACK, 3254 02:14:41,550 --> 02:14:44,486 RECONSIDERING, LOOKING AT IT IN 3255 02:14:44,486 --> 02:14:47,456 A DIFFERENT PERSPECTIVE, AND I 3256 02:14:47,456 --> 02:14:49,758 SEE THIS AS COURAGE TO SAY, YOU 3257 02:14:49,758 --> 02:14:52,160 KNOW, BASED ON PEER REVIEW, 3258 02:14:52,160 --> 02:14:54,896 REEVALUATION OF THE LITERATURE, 3259 02:14:54,896 --> 02:14:56,965 THE DATA, WE'RE GOING TO UPDATE 3260 02:14:56,965 --> 02:14:58,266 OUR CONCLUSION STATEMENT. 3261 02:14:58,266 --> 02:15:01,236 SO TO ME THIS IS JUST A 3262 02:15:01,236 --> 02:15:03,405 BEAUTIFUL EXAMPLE OF HOW THE 3263 02:15:03,405 --> 02:15:06,708 PROCESS IS WORKING. 3264 02:15:06,708 --> 02:15:10,212 SO THANK YOU. 3265 02:15:10,212 --> 02:15:13,448 >> WHAT WAS THE CRITERIA OF 3266 02:15:13,448 --> 02:15:20,622 INCLUSION FOR DURATION OF THE 3267 02:15:20,622 --> 02:15:24,459 RCT? 3268 02:15:24,459 --> 02:15:24,993 HOW MANY WEEKS MINIMUM? 3269 02:15:24,993 --> 02:15:27,129 >> I DON'T REMEMBER OFFHAND. 3270 02:15:27,129 --> 02:15:28,497 >> WE INCLUDED ANYTHING IN A HAD 3271 02:15:28,497 --> 02:15:30,465 AT LEAST 24 HOURS, ENERGY INTAKE 3272 02:15:30,465 --> 02:15:33,635 IN THE 24 HOURS, IF I'M NOT 3273 02:15:33,635 --> 02:15:33,902 MISTAKEN. 3274 02:15:33,902 --> 02:15:38,140 >> WE CAN HAVE STAFF RESPOND. 3275 02:15:38,140 --> 02:15:39,441 >> IS THERE ANY MORE CLARITY IF 3276 02:15:39,441 --> 02:15:42,711 YOU DROP OUT THE VERY SHORT-TERM 3277 02:15:42,711 --> 02:15:44,813 ONES OR WAS IT ONLY AT THE TWO 3278 02:15:44,813 --> 02:15:48,617 LONGER TERMS OR JUST A MIXED 3279 02:15:48,617 --> 02:15:48,817 BAG? 3280 02:15:48,817 --> 02:15:50,252 >> YEAH, SO CHRISTINA WAS 3281 02:15:50,252 --> 02:15:51,686 CORRECT, WE DIDN'T -- WE WERE 3282 02:15:51,686 --> 02:15:53,555 JUST LOOKING AT TOTAL DAILY SO 3283 02:15:53,555 --> 02:15:59,995 THEY DID HAVE TO HAVE A 24-HOUR 3284 02:15:59,995 --> 02:16:02,864 PERIOD BUT DIDN'T EXCLUDE FOOD 3285 02:16:02,864 --> 02:16:03,598 FOR DURATION. 3286 02:16:03,598 --> 02:16:05,133 THE NEXT QUESTION, REALLY ONLY 3287 02:16:05,133 --> 02:16:07,769 THOSE TWO THAT WERE OF LONGER 3288 02:16:07,769 --> 02:16:08,870 DURATION FOUND THAT, THAT 3289 02:16:08,870 --> 02:16:10,672 RELATIONSHIP IN THE OPPOSITE 3290 02:16:10,672 --> 02:16:10,939 DIRECTION. 3291 02:16:10,939 --> 02:16:12,307 AND SO IF YOU WERE TO DROP OUT 3292 02:16:12,307 --> 02:16:14,109 SHORTER TRIALS YOU WOULD HAVE 3293 02:16:14,109 --> 02:16:20,549 ONLY HAD THOSE TWO, THOSE TWO 3294 02:16:20,549 --> 02:16:23,952 TRIALS. 3295 02:16:23,952 --> 02:16:24,953 >> OTHER QUESTIONS? 3296 02:16:24,953 --> 02:16:25,821 TAKE IT AWAY. 3297 02:16:25,821 --> 02:16:28,557 WE CAN MOVE ON THEN TO THE NEXT. 3298 02:16:28,557 --> 02:16:30,792 SO I WANTED TO REMIND EVERYONE, 3299 02:16:30,792 --> 02:16:32,594 NOW WE'RE GOING TO TALK ABOUT 3300 02:16:32,594 --> 02:16:34,996 PORTION SIZE AND ENERGY INTAKE. 3301 02:16:34,996 --> 02:16:37,499 LAST MEETING WE REPORTED ON 3302 02:16:37,499 --> 02:16:41,002 PORTION SIZE AND GROWTH BODY 3303 02:16:41,002 --> 02:16:41,903 COMPOSITION AND OBESITY 3304 02:16:41,903 --> 02:16:43,872 OUTCOMES, AND IN SUMMARY WE 3305 02:16:43,872 --> 02:16:45,474 COULD NOT MAKE ANY CONCLUSION 3306 02:16:45,474 --> 02:16:47,676 STATEMENTS IN ANY OF THE LIFE 3307 02:16:47,676 --> 02:16:50,312 STAGES BECAUSE OF EITHER LACK OF 3308 02:16:50,312 --> 02:16:53,281 EVIDENCE, MOSTLY IN CHILDREN, 3309 02:16:53,281 --> 02:16:56,218 PREGNANCY AND POSTPARTUM, OR 3310 02:16:56,218 --> 02:16:57,552 INCONSISTENCY IN INTERVENTIONS, 3311 02:16:57,552 --> 02:17:01,256 COMPETITORS, OUTCOMES IN ADULTS. 3312 02:17:01,256 --> 02:17:05,327 NOW WE'LL SHIFT FROM GBCO, 3313 02:17:05,327 --> 02:17:08,396 GROWTH BODY COMPOSITION OBESITY 3314 02:17:08,396 --> 02:17:10,799 TO ENERGY INTAKE IN A LEAN ROLE, 3315 02:17:10,799 --> 02:17:12,133 REPORT ON THAT. 3316 02:17:12,133 --> 02:17:15,971 >> LET'S GET STARTED. 3317 02:17:15,971 --> 02:17:18,640 A QUICK REMINDER ABOUT US ON THE 3318 02:17:18,640 --> 02:17:20,008 ANALYTICAL FRAMEWORK FOR THE 3319 02:17:20,008 --> 02:17:20,976 QUESTION, RELATIONSHIP BETWEEN 3320 02:17:20,976 --> 02:17:24,145 PORTION SIZE AND ENERGY INTAKE, 3321 02:17:24,145 --> 02:17:26,348 SO WE EVALUATED EVIDENCE FOR ALL 3322 02:17:26,348 --> 02:17:29,417 AGE GROUPS FROM AGE 1 UP TO 3323 02:17:29,417 --> 02:17:31,720 OLDER ADULTS INCLUDING 3324 02:17:31,720 --> 02:17:33,922 INDIVIDUALS DURING PREGNANCY AND 3325 02:17:33,922 --> 02:17:34,222 POSTPARTUM. 3326 02:17:34,222 --> 02:17:37,192 THE INTERVENTION EXPOSURE WAS 3327 02:17:37,192 --> 02:17:41,229 DEFINED AS PORTION SIZE THAT 3328 02:17:41,229 --> 02:17:43,031 CONSIDERED ENERGY DENSITY, 3329 02:17:43,031 --> 02:17:45,066 NUTRIENT DENSITY, AND/OR THE 3330 02:17:45,066 --> 02:17:48,436 QUALITY OR TYPE OF FOOD SERVED 3331 02:17:48,436 --> 02:17:51,973 AS WELL AS PRE-PORTIONED FOODS. 3332 02:17:51,973 --> 02:17:54,042 THE OUTCOME WAS SAID TO BE 3333 02:17:54,042 --> 02:17:55,777 ENERGY INTAKE AND EACH STUDY 3334 02:17:55,777 --> 02:17:58,647 DEFINED IT WHICH COULD BE FOR 3335 02:17:58,647 --> 02:18:04,586 MEALS, SEVERAL MEALS, OR A DAY. 3336 02:18:04,586 --> 02:18:07,689 SO MOVING ON, WE DEVELOPED TWO 3337 02:18:07,689 --> 02:18:08,390 CONCLUSION STATEMENTS FOR 3338 02:18:08,390 --> 02:18:10,091 PORTION SIZE AND ENERGY INTAKE 3339 02:18:10,091 --> 02:18:12,627 IN CHILDREN. 3340 02:18:12,627 --> 02:18:15,463 THE FIRST CONCLUSION STATEMENT 3341 02:18:15,463 --> 02:18:17,766 IS SERVING LARGER PORTIONS OF 3342 02:18:17,766 --> 02:18:19,634 ENERGY DENSE FOODS INCREASES 3343 02:18:19,634 --> 02:18:21,836 ENERGY INTAKE IN CHILDREN. 3344 02:18:21,836 --> 02:18:24,539 THIS CONCLUSION STATEMENT IS 3345 02:18:24,539 --> 02:18:29,311 BASED ON EVIDENCE GRADED AT 3346 02:18:29,311 --> 02:18:31,346 STRONG, INCLUDING 27 ARTICLES 3347 02:18:31,346 --> 02:18:33,315 REPRESENTING 28 ESTIMATES. 3348 02:18:33,315 --> 02:18:35,183 SECOND CONCLUSION STATEMENT THAT 3349 02:18:35,183 --> 02:18:36,918 WE DEVELOPED IS SEARCHING LARGER 3350 02:18:36,918 --> 02:18:40,322 PORTIONS OF FRUITS AND 3351 02:18:40,322 --> 02:18:42,057 VEGETABLES INCREASES INTAKE OF 3352 02:18:42,057 --> 02:18:44,793 THOSE FOODS WITHOUT INCREASING 3353 02:18:44,793 --> 02:18:46,528 ENERGY INTAKE IN CHILDREN. 3354 02:18:46,528 --> 02:18:49,297 THIS CONCLUSION STATEMENT IS 3355 02:18:49,297 --> 02:18:53,668 BASED ON EVIDENCE GRADED AS 3356 02:18:53,668 --> 02:18:54,102 MODERATE. 3357 02:18:54,102 --> 02:18:56,504 AND INCLUDED SIX STUDIES. 3358 02:18:56,504 --> 02:18:59,608 THE BODY OF EVIDENCE FOR BOTH 3359 02:18:59,608 --> 02:19:01,676 CONCLUSION STATEMENTS WAS MOSTLY 3360 02:19:01,676 --> 02:19:05,180 FROM WITHIN SUBJECTIVE DESIGN 3361 02:19:05,180 --> 02:19:07,782 WITH CROSSOVER RANDOMIZED 3362 02:19:07,782 --> 02:19:08,183 CONTROLLED TRIALS. 3363 02:19:08,183 --> 02:19:09,884 EVIDENCE SUGGESTS LARGER PORTION 3364 02:19:09,884 --> 02:19:11,853 SIDE OF ENERGY DENSE FOOD 3365 02:19:11,853 --> 02:19:14,155 PROMOTES ENERGY INTAKE AS MEALS 3366 02:19:14,155 --> 02:19:16,658 AS WELL ADAILY ENERGY INTAKE 3367 02:19:16,658 --> 02:19:20,195 SEARCHING LARGER PROPORTION OF 3368 02:19:20,195 --> 02:19:25,233 VEGETABLES AND FRUIT MAY INTAKE 3369 02:19:25,233 --> 02:19:26,234 INTAKE WITHOUT EXERTING 3370 02:19:26,234 --> 02:19:31,006 APPRECIABLE EFFECT ON ENERGY 3371 02:19:31,006 --> 02:19:31,573 INTAKE. 3372 02:19:31,573 --> 02:19:34,075 GRATING ELEMENTS WERE GENERAL 3373 02:19:34,075 --> 02:19:35,644 SIMILAR, STUDIES DIRECT, 3374 02:19:35,644 --> 02:19:38,480 FINDINGS CONSISTENT, MINOR 3375 02:19:38,480 --> 02:19:40,115 CONCERNS WITH PRECISION AND RISK 3376 02:19:40,115 --> 02:19:42,183 ADVISED GENERALLY LOW BECAUSE OF 3377 02:19:42,183 --> 02:19:46,621 USE OF RANDOMIZED CONTROLLED 3378 02:19:46,621 --> 02:19:47,322 TRIAL DESIGN. 3379 02:19:47,322 --> 02:19:49,624 THERE WAS CONCERN ABOUT 3380 02:19:49,624 --> 02:19:50,825 GENERALIZABILITY TO LACK OF 3381 02:19:50,825 --> 02:19:51,926 DIVERSITY FOR STUDY PARTICIPANTS 3382 02:19:51,926 --> 02:19:58,166 WITH REGARDS TO RACE AND 3383 02:19:58,166 --> 02:20:00,802 ETHNICITY AND SOCIOECONOMIC 3384 02:20:00,802 --> 02:20:01,102 POSITION. 3385 02:20:01,102 --> 02:20:04,406 AND MOVING TO YOUNG CHILDREN AND 3386 02:20:04,406 --> 02:20:07,575 ADULTS, FOR THEM CONCLUSION 3387 02:20:07,575 --> 02:20:08,977 STATEMENT COULD NOT BE DRAWN 3388 02:20:08,977 --> 02:20:09,844 ABOUT RELATIONSHIP BETWEEN 3389 02:20:09,844 --> 02:20:11,680 PORTION SIZE AND ENERGY INTAKE 3390 02:20:11,680 --> 02:20:18,520 BECAUSE THERE WAS NO STUDY 3391 02:20:18,520 --> 02:20:18,787 AVAILABLE. 3392 02:20:18,787 --> 02:20:22,891 SO FOR ADULTS AND OLDER ADULTS 3393 02:20:22,891 --> 02:20:26,628 THE COMMITTEE WAS ABLE TO DRAW 3394 02:20:26,628 --> 02:20:28,129 TWO STATEMENTS REGARDING PORTION 3395 02:20:28,129 --> 02:20:32,967 SIZE AND ENERGY INTAKE, FIRST IS 3396 02:20:32,967 --> 02:20:34,135 SEARCHING LARGER PORTIONS OF 3397 02:20:34,135 --> 02:20:36,571 FOOD INCREASES ENERGY AND FOOD 3398 02:20:36,571 --> 02:20:38,740 INTAKE IN ADULTS, OLDER ADULT, 3399 02:20:38,740 --> 02:20:42,243 THIS CONCLUSION STATEMENT IS 3400 02:20:42,243 --> 02:20:47,048 BASED ON EVIDENCE GRADED AS 3401 02:20:47,048 --> 02:20:51,853 STRONG, INCLUDINGELED 44 3402 02:20:51,853 --> 02:20:52,487 ARTICLES. 3403 02:20:52,487 --> 02:20:56,357 PORTION SIZE ANDS ENERGY DENSITY 3404 02:20:56,357 --> 02:20:57,926 ARE INDEPENDENT AND ADDITIVE IN 3405 02:20:57,926 --> 02:21:00,228 EFFECTS ON ENERGY INTAKE IN 3406 02:21:00,228 --> 02:21:02,197 ADULTS AND OLDER ADULTS. 3407 02:21:02,197 --> 02:21:04,599 AND THIS CONCLUSION STATEMENT IS 3408 02:21:04,599 --> 02:21:08,536 BASED ON EVIDENCE CREATED AS 3409 02:21:08,536 --> 02:21:11,940 MODERATE, INCLUDED FIVE ARTICLES 3410 02:21:11,940 --> 02:21:12,607 COMPRISING SIX INTERVENTIONS. 3411 02:21:12,607 --> 02:21:16,544 THERE WERE A FEW CONCERNS WITH 3412 02:21:16,544 --> 02:21:17,979 CONSISTENCY, PRECISION, 3413 02:21:17,979 --> 02:21:20,381 DIRECTNESS FOR BOTH. 3414 02:21:20,381 --> 02:21:21,483 BECAUSE THEY USED SIMILAR 3415 02:21:21,483 --> 02:21:25,520 DESIGNS AND METHODS AS WELL AS 3416 02:21:25,520 --> 02:21:26,855 DEMONSTRATING CONSISTENT 3417 02:21:26,855 --> 02:21:28,690 DIRECTION AND MAGNITUDE OF 3418 02:21:28,690 --> 02:21:30,024 EFFECT. 3419 02:21:30,024 --> 02:21:31,126 STUDIES WERE SUFFICIENTLY 3420 02:21:31,126 --> 02:21:32,761 POWERED, AND DIRECTLY DESIGNED 3421 02:21:32,761 --> 02:21:34,963 TO EXAMINE EFFECT OF PORTION 3422 02:21:34,963 --> 02:21:38,399 SIZE AND ENERGY DENSITY OR 3423 02:21:38,399 --> 02:21:39,434 ENERGY INTAKE. 3424 02:21:39,434 --> 02:21:40,869 THERE WERE SOME CONCERNS WITH 3425 02:21:40,869 --> 02:21:45,573 RISK OF BIAS DUE TO A LACK OF 3426 02:21:45,573 --> 02:21:46,341 INFORMATION ABOUT RANDOMIZATION 3427 02:21:46,341 --> 02:21:48,877 METHODS AND POTENTIAL FOR 3428 02:21:48,877 --> 02:21:50,912 SELECTIVE REPORTING OF ARESULTS, 3429 02:21:50,912 --> 02:21:51,713 SEVERAL CONCERNS WITH 3430 02:21:51,713 --> 02:21:53,982 GENERALIZABILITY DUE TO LACK OF 3431 02:21:53,982 --> 02:21:58,720 DIVERSITY OF STUDY PARTICIPANTS 3432 02:21:58,720 --> 02:22:00,488 AS MENTIONED, ON THE OTHER 3433 02:22:00,488 --> 02:22:05,093 STATEMENTS AS WELL. 3434 02:22:05,093 --> 02:22:08,129 MOVING ON TO THE INDIVIDUAL 3435 02:22:08,129 --> 02:22:10,198 DURING PREGNANCY AND POSTPARTUM 3436 02:22:10,198 --> 02:22:11,866 CONCLUSION STATEMENT COULD NOT 3437 02:22:11,866 --> 02:22:13,067 BE DRAWN ABOUT RELATIONSHIP 3438 02:22:13,067 --> 02:22:14,903 BETWEEN PORTION SIZE AND ENERGY 3439 02:22:14,903 --> 02:22:18,540 INTAKE BECAUSE THERE'S NO 3440 02:22:18,540 --> 02:22:19,007 EVIDENCE AVAILABLE. 3441 02:22:19,007 --> 02:22:23,278 THERE WAS NO ARTICLES FOUND FOR 3442 02:22:23,278 --> 02:22:25,814 THESE LIFE STAGES. 3443 02:22:25,814 --> 02:22:28,316 SO, LET'S MOVE ON TO THE OTHER 3444 02:22:28,316 --> 02:22:30,285 PART OF THE PORTION SIZE 3445 02:22:30,285 --> 02:22:31,386 INTERVENTION AND EXPOSURE THAT 3446 02:22:31,386 --> 02:22:34,756 WE LOOKED AT SO WE EXAMINED THE 3447 02:22:34,756 --> 02:22:37,625 PRE-PORTIONED FOODS AND ENERGY 3448 02:22:37,625 --> 02:22:40,562 INTAKE IN YOUNG CHILDREN, 3449 02:22:40,562 --> 02:22:41,996 CHILDREN AND ADULTS. 3450 02:22:41,996 --> 02:22:42,964 HERE CONCLUSION STATEMENT COULD 3451 02:22:42,964 --> 02:22:46,267 NOT BE DRAWN BECAUSE THERE'S NOT 3452 02:22:46,267 --> 02:22:47,669 ENOUGH EVIDENCE AVAILABLE. 3453 02:22:47,669 --> 02:22:51,072 WE FOUND ONLY ONE STUDY THAT WAS 3454 02:22:51,072 --> 02:22:52,574 PARALLEL RANDOMIZED CONTROLLED 3455 02:22:52,574 --> 02:22:56,511 TRIAL AND SO WE COULDN'T ANSWER 3456 02:22:56,511 --> 02:22:57,612 THIS QUESTION. 3457 02:22:57,612 --> 02:22:58,713 HOWEVER, IN ADULTS AND OLDER 3458 02:22:58,713 --> 02:23:02,884 ADULTS WE WERE ABLE TO DRAW A 3459 02:23:02,884 --> 02:23:04,085 CONCLUSION STATEMENT THAT STATES 3460 02:23:04,085 --> 02:23:12,527 THAT SEARCHING FOODS AS SMALLER 3461 02:23:12,527 --> 02:23:14,729 DEPREESED AMOUNTS MAY DECREASE 3462 02:23:14,729 --> 02:23:16,898 ENERGY INTAKE, INCLUDED EIGHT 3463 02:23:16,898 --> 02:23:17,232 ARTICLES. 3464 02:23:17,232 --> 02:23:20,835 THERE WERE A FEW CONCERNS WITH 3465 02:23:20,835 --> 02:23:21,135 DIRECTNESS. 3466 02:23:21,135 --> 02:23:23,571 THERE WERE SOME CONCERNS RELATED 3467 02:23:23,571 --> 02:23:27,075 TO CONSISTENCY FOR VARIED EFFECT 3468 02:23:27,075 --> 02:23:28,476 SIZE, FOR PRECISION WITH SMALL 3469 02:23:28,476 --> 02:23:31,880 SIZE OF STUDY GROUPS AND 3470 02:23:31,880 --> 02:23:32,981 VARIANTS IN EFFECT ESTIMATE, 3471 02:23:32,981 --> 02:23:35,717 RISK OF BIAS BECAUSE OF LACK OF 3472 02:23:35,717 --> 02:23:37,485 INFORMATION ABOUT RANDOMIZATION 3473 02:23:37,485 --> 02:23:44,792 METHOD AND POTENTIAL FOR 3474 02:23:44,792 --> 02:23:48,329 SELECTIVE REPORTING OF RESULTS. 3475 02:23:48,329 --> 02:23:50,832 SEVERAL CONCERNS RELATED TO 3476 02:23:50,832 --> 02:23:52,700 GENERALIZABLE THAT WE'VE NOTED. 3477 02:23:52,700 --> 02:23:55,103 MOVING TO THE INDIVIDUALS DURING 3478 02:23:55,103 --> 02:23:58,039 PREGNANCY AND POSTPARTUM, WE 3479 02:23:58,039 --> 02:24:00,375 DIDN'T FIND ANY STUDIES THAT 3480 02:24:00,375 --> 02:24:03,745 LOOKED AT PRE-PORTIONED FOODS 3481 02:24:03,745 --> 02:24:05,947 AND ENERGY INTAKE AND MET 3482 02:24:05,947 --> 02:24:08,216 INCLUSION CRITERIA SO WE 3483 02:24:08,216 --> 02:24:09,651 COULDN'T DRAW CONCLUSION 3484 02:24:09,651 --> 02:24:09,984 STATEMENT. 3485 02:24:09,984 --> 02:24:14,923 AND WITH THAT I'LL PASS IT TO 3486 02:24:14,923 --> 02:24:15,290 CRISTINA. 3487 02:24:15,290 --> 02:24:16,357 >> CAN WE GO BACK? 3488 02:24:16,357 --> 02:24:18,626 LET'S HAVE QUESTIONS BEFORE WE 3489 02:24:18,626 --> 02:24:21,930 MOVE TO THE NEXT VERY DIFFERENT. 3490 02:24:21,930 --> 02:24:23,231 DEE DEE? 3491 02:24:23,231 --> 02:24:26,634 >> YEAH, I WAS CURIOUS ABOUT THE 3492 02:24:26,634 --> 02:24:31,239 CONCLUSION STATEMENT THAT WAS 3493 02:24:31,239 --> 02:24:32,874 GRADED STRONG FOR ENERGY DENSE 3494 02:24:32,874 --> 02:24:36,511 FOODS BEING AVAILABLE IN LARGER 3495 02:24:36,511 --> 02:24:37,345 PORTIONS AND CALORIE INTAKE. 3496 02:24:37,345 --> 02:24:39,314 I BELIEVE THAT WAS AMONG KIDS. 3497 02:24:39,314 --> 02:24:42,951 LIKE A THIRD OF THE WAY THROUGH 3498 02:24:42,951 --> 02:24:43,952 THE SLIDES MAYBE. 3499 02:24:43,952 --> 02:24:45,687 >> CAN YOU GO BACK? 3500 02:24:45,687 --> 02:24:49,290 >> LET US KNOW WHICH ONE. 3501 02:24:49,290 --> 02:24:49,624 >> NOPE. 3502 02:24:49,624 --> 02:24:50,725 ONE MORE BACK. 3503 02:24:50,725 --> 02:24:53,361 THERE YOU GO. 3504 02:24:53,361 --> 02:24:53,628 >> HERE. 3505 02:24:53,628 --> 02:24:54,329 >> OKAY. 3506 02:24:54,329 --> 02:24:59,033 THAT'S A LOT OF RCTs AND 3507 02:24:59,033 --> 02:25:00,234 EXPERIMENTAL EVIDENCE, I'M 3508 02:25:00,234 --> 02:25:02,337 CURIOUS WHAT ENERGY-DENSE FOODS 3509 02:25:02,337 --> 02:25:05,106 MEANT OR INCLUDED? 3510 02:25:05,106 --> 02:25:06,808 TYPICALLY THOSE ARE YOUR ULTRA 3511 02:25:06,808 --> 02:25:07,709 PROCESSED FOODS BUT I DON'T KNOW 3512 02:25:07,709 --> 02:25:12,847 IF THAT WAS TERMINOLOGY OR THEY 3513 02:25:12,847 --> 02:25:13,715 DESCRIBED WHAT ENERGY-DENSE 3514 02:25:13,715 --> 02:25:21,189 FOODS MEANT, DO YOU REMEMBER? 3515 02:25:21,189 --> 02:25:22,390 >> I CAN JUMP IN. 3516 02:25:22,390 --> 02:25:27,095 I ALSO WANT TO ACKNOWLEDGE DR. 3517 02:25:27,095 --> 02:25:29,864 REENER ON THE ZOOM HAS EXPERTISE 3518 02:25:29,864 --> 02:25:32,033 AND CAN JUMP IN AS WELL. 3519 02:25:32,033 --> 02:25:34,402 IT STEMMED FROM THE FACT THAT 3520 02:25:34,402 --> 02:25:35,737 INITIALLY EVALUATING THE BODY OF 3521 02:25:35,737 --> 02:25:39,007 EVIDENCE IT WAS QUITE CLEAR THE 3522 02:25:39,007 --> 02:25:41,542 EARLY STUDIES WERE FOCUSED ON 3523 02:25:41,542 --> 02:25:43,644 ASPECTS OF OUR DIETARY 3524 02:25:43,644 --> 02:25:45,813 ENVIRONMENTS THAT MIGHT PROMOTE 3525 02:25:45,813 --> 02:25:47,248 EXCESSIVE INTAKES SO THEY WERE 3526 02:25:47,248 --> 02:25:50,651 DESIGNED SPECIFICALLY FROM A 3527 02:25:50,651 --> 02:25:54,389 FRAMEWORK OF, YOU KNOW, LOOKING 3528 02:25:54,389 --> 02:25:56,858 AT EXCESSIVE INTAKES, AS WORK 3529 02:25:56,858 --> 02:26:00,261 EVOLVED THEY BEGAN TO SUGGEST 3530 02:26:00,261 --> 02:26:03,197 STRATEGIES COULD BE USE FOR 3531 02:26:03,197 --> 02:26:05,166 INTAKES OF OTHER HEALTHFUL FOODS 3532 02:26:05,166 --> 02:26:07,168 AND SO WITHOUT SPECIFIC 3533 02:26:07,168 --> 02:26:10,671 DEFINITIONS OF ENERGY DENSITY IN 3534 02:26:10,671 --> 02:26:12,206 THESE STUDIES YOU COULD SEE THE 3535 02:26:12,206 --> 02:26:14,842 WORK BROADLY FELL INTO THOSE 3536 02:26:14,842 --> 02:26:16,344 AREAS, AND SO WE I THINK, 3537 02:26:16,344 --> 02:26:18,913 CORRECT ME IF YOU REMEMBER IT 3538 02:26:18,913 --> 02:26:26,854 DIFFERENTLY, SO WE CHOSE TO 3539 02:26:26,854 --> 02:26:27,655 SYNTHESIZE THE EVIDENCE 3540 02:26:27,655 --> 02:26:28,956 REFLECTING DESIGNS OF THOSE 3541 02:26:28,956 --> 02:26:29,724 STUDIES BUT NOT WITH SPECIFIC 3542 02:26:29,724 --> 02:26:31,259 DEFINITION IN MIND. 3543 02:26:31,259 --> 02:26:32,994 INITIAL STUDIES LOOKED AT THINGS 3544 02:26:32,994 --> 02:26:35,530 LIKE A PASTA ENTREE OR MAC AND 3545 02:26:35,530 --> 02:26:36,731 CHEESE, RIGHT? 3546 02:26:36,731 --> 02:26:39,367 IN YOUNG KIDS, MANY STUDIES DID, 3547 02:26:39,367 --> 02:26:41,669 WHEREAS LATER STUDIES WOULD LOOK 3548 02:26:41,669 --> 02:26:43,671 AT MANIPULATING THE PORTION 3549 02:26:43,671 --> 02:26:46,974 SIZES OF THINGS LIKE BROCCOLI 3550 02:26:46,974 --> 02:26:47,842 AND CARROTS. 3551 02:26:47,842 --> 02:26:51,012 >> SO THAT'S THE DECISION HERE. 3552 02:26:51,012 --> 02:26:51,279 >> YES. 3553 02:26:51,279 --> 02:26:53,014 >> SO ENERGY DENSE FOODS WAS 3554 02:26:53,014 --> 02:26:55,016 THINGS LIKE MAC AND CHEESE, NOT 3555 02:26:55,016 --> 02:26:55,149 -- 3556 02:26:55,149 --> 02:26:56,584 >> WELL, I THINK THERE WAS A 3557 02:26:56,584 --> 02:26:56,818 VARIETY. 3558 02:26:56,818 --> 02:26:59,320 WE TOOK ALL THE FOODS THAT WERE 3559 02:26:59,320 --> 02:27:01,489 PART OF THE INTERVENTION, SO I 3560 02:27:01,489 --> 02:27:03,057 DON'T THINK -- AND THE 3561 02:27:03,057 --> 02:27:05,359 PREPARATION OF THE FOODS WERE 3562 02:27:05,359 --> 02:27:06,461 NOT AVAILABLE SO I DON'T THINK 3563 02:27:06,461 --> 02:27:07,995 WE CAN MAKE THE ASSUMPTION THAT 3564 02:27:07,995 --> 02:27:10,731 YOU MADE EARLIER. 3565 02:27:10,731 --> 02:27:13,801 IT'S TRULY MORE ENERGY DENSE 3566 02:27:13,801 --> 02:27:18,940 VERSUS NUTRIENT DENSE FOODS. 3567 02:27:18,940 --> 02:27:19,707 IT'S DIFFERENT. 3568 02:27:19,707 --> 02:27:21,676 >> INDIVIDUAL TRIALS VARIED IN 3569 02:27:21,676 --> 02:27:24,512 WHAT ENERGY DENSE FOOD WERE, 3570 02:27:24,512 --> 02:27:26,714 LARGER PORTION, MORE CALLY 3571 02:27:26,714 --> 02:27:31,319 INTAKES, FRUITS AND VEGETABLES, 3572 02:27:31,319 --> 02:27:33,588 DID NOT EQUAL MORE CALORIE 3573 02:27:33,588 --> 02:27:33,821 INTAKE. 3574 02:27:33,821 --> 02:27:36,557 >> THEY DID NOT INCREASE CALORIC 3575 02:27:36,557 --> 02:27:37,859 INTAKE BUT DID INCREASE AMOUNT 3576 02:27:37,859 --> 02:27:40,828 OF FOOD EATEN SO WE FEEL LIKE 3577 02:27:40,828 --> 02:27:43,431 THAT'S A REALLY IMPORTANT 3578 02:27:43,431 --> 02:27:46,968 STRATEGY TO DIFFERENTIATE ENERGY 3579 02:27:46,968 --> 02:27:49,103 DENSE FOODS, VEGETABLES AND 3580 02:27:49,103 --> 02:27:51,339 FRUITS, ONE MAY WANT TO REDUCE 3581 02:27:51,339 --> 02:27:54,075 PORTION SIDE, IN THE OTHER WE 3582 02:27:54,075 --> 02:27:56,911 MAY USE PORTION SIZE TO INCREASE 3583 02:27:56,911 --> 02:27:57,145 INTAKE. 3584 02:27:57,145 --> 02:28:04,919 >> EXACTLY, THANK YOU. 3585 02:28:04,919 --> 02:28:07,421 >> WE THINK IT'S A GREAT 3586 02:28:07,421 --> 02:28:10,057 STRATEGY FOR THE COMMITTEE TO 3587 02:28:10,057 --> 02:28:11,025 GIVE AND INTEGRATE WITH 3588 02:28:11,025 --> 02:28:12,560 EVERYTHING ELSE WE'LL BE 3589 02:28:12,560 --> 02:28:13,995 DISCUSSING NEXT DAY, TOMORROW. 3590 02:28:13,995 --> 02:28:16,063 SO WE'RE VERY EXCITED ABOUT 3591 02:28:16,063 --> 02:28:19,133 THAT. 3592 02:28:19,133 --> 02:28:19,333 OKAY. 3593 02:28:19,333 --> 02:28:21,002 MOVING ON TO -- GREAT, HERE. 3594 02:28:21,002 --> 02:28:24,038 SO WE'RE GOING TO MOVE TO THE 3595 02:28:24,038 --> 02:28:25,072 EVIDENCE SCAN, WE'VE BEEN 3596 02:28:25,072 --> 02:28:26,240 TALKING ABOUT THIS THROUGH THE 3597 02:28:26,240 --> 02:28:28,609 BEGINNING, WE COULD NOT DO A 3598 02:28:28,609 --> 02:28:30,344 SYSTEMATIC REVIEW BECAUSE WE 3599 02:28:30,344 --> 02:28:32,413 WERE NOT CLEAR ABOUT THE 3600 02:28:32,413 --> 02:28:38,419 OUTCOMES, AND YOU'LL SEE WHY. 3601 02:28:38,419 --> 02:28:39,854 FATIMA AND ANGELA ARE THE 3602 02:28:39,854 --> 02:28:40,321 PRESENTERS. 3603 02:28:40,321 --> 02:28:43,357 WE'LL POINT THIS OUT AGAIN. 3604 02:28:43,357 --> 02:28:45,760 I'LL REPEAT HERE. 3605 02:28:45,760 --> 02:28:47,962 THIS MAY NOT REPRESENT THE 3606 02:28:47,962 --> 02:28:52,200 ENTIRE ABSOLUTE NUMBER OF 3607 02:28:52,200 --> 02:28:53,734 PUBLISHED STUDIES. 3608 02:28:53,734 --> 02:28:57,572 WE -- THERE WERE SHOWERS OF 3609 02:28:57,572 --> 02:28:59,574 RECORDS IN THE PRE-SCREENING, 3610 02:28:59,574 --> 02:29:06,113 AND A LARGE AMOUNT MADE IT TO 3611 02:29:06,113 --> 02:29:07,648 THE EVIDENCE SCAN BUT WE WE WILL 3612 02:29:07,648 --> 02:29:10,718 DESCRIBE THIS MORE BUT WE WANT 3613 02:29:10,718 --> 02:29:12,253 TO BE CAUTIOUS, THERE COULD BE 3614 02:29:12,253 --> 02:29:13,788 OTHER STUDIES OUT THERE THEY 3615 02:29:13,788 --> 02:29:15,756 WERE NOT CAPTURED IN OUR SEARCH 3616 02:29:15,756 --> 02:29:17,825 THAT DID NOT MEET EXACTLY OUR 3617 02:29:17,825 --> 02:29:18,593 SEARCH CRITERIA. 3618 02:29:18,593 --> 02:29:21,996 SO WITH THAT IN MIND PLEASE, 3619 02:29:21,996 --> 02:29:24,265 FATIMA. 3620 02:29:24,265 --> 02:29:24,932 >> ABSOLUTELY. 3621 02:29:24,932 --> 02:29:25,700 NEXT SLIDE PLEASE. 3622 02:29:25,700 --> 02:29:28,202 >> LET'S LOOK AT ROLE OF 3623 02:29:28,202 --> 02:29:29,971 EVIDENCE SCAN IN DIETARY 3624 02:29:29,971 --> 02:29:30,338 GUIDELINES WORK. 3625 02:29:30,338 --> 02:29:34,642 WE HEARD THIS IDEA OF EVIDENCE 3626 02:29:34,642 --> 02:29:37,511 SCAN, EXPLORATORY EVIDENCE 3627 02:29:37,511 --> 02:29:38,312 DESCRIPTION PROJECT, SYSTEMATIC 3628 02:29:38,312 --> 02:29:39,947 METHODS DESCRIBE THE FOLLOW AND 3629 02:29:39,947 --> 02:29:41,048 CHARACTERISTICS OF EVIDENCE 3630 02:29:41,048 --> 02:29:43,217 AVAILABLE ON NUTRITION QUESTION 3631 02:29:43,217 --> 02:29:46,821 OR TOPIC OF PUBLIC HEALTH 3632 02:29:46,821 --> 02:29:47,121 IMPORTANCE. 3633 02:29:47,121 --> 02:29:48,122 DR. EICHER-MILLER REFERRED TO 3634 02:29:48,122 --> 02:29:49,790 THE SCAN EARLIER TODAY AND WE 3635 02:29:49,790 --> 02:29:57,331 KNOW THIS CAN PLAY AN IMPORTANT 3636 02:29:57,331 --> 02:29:57,965 SUPPLEMENTARY ROLE ALONGSIDE 3637 02:29:57,965 --> 02:29:58,633 SYSTEMATIC REVIEWS. 3638 02:29:58,633 --> 02:30:02,470 LET'S LOOK AT THE RATIONALE FOR 3639 02:30:02,470 --> 02:30:03,037 CULTURALLY TAILORED DIETARY 3640 02:30:03,037 --> 02:30:03,904 INTERVENTIONS IN TERMS OF 3641 02:30:03,904 --> 02:30:06,841 LOOKING AT THIS WITH EVIDENCE 3642 02:30:06,841 --> 02:30:07,174 SCAN. 3643 02:30:07,174 --> 02:30:09,043 INTERVENTION STUDIES DO 3644 02:30:09,043 --> 02:30:10,678 DEMONSTRATE APPROACHES FOR 3645 02:30:10,678 --> 02:30:12,113 TAILORING RECOMMENDATIONS FOR 3646 02:30:12,113 --> 02:30:13,514 CULTURAL GROUPS AND COMMUNITIES, 3647 02:30:13,514 --> 02:30:14,615 PARTICULARLY HERE IN THE UNITED 3648 02:30:14,615 --> 02:30:17,351 STATES WHETHER WE HAVE A VERY 3649 02:30:17,351 --> 02:30:18,319 HETEROGENEOUS POPULATION. 3650 02:30:18,319 --> 02:30:21,055 THIS INFORMATION IS IMPORTANT 3651 02:30:21,055 --> 02:30:22,156 FOR UNDERSTANDING IMPLEMENTATION 3652 02:30:22,156 --> 02:30:24,125 STRATEGIES ALIGNED WITH DIETARY 3653 02:30:24,125 --> 02:30:25,660 GUIDELINES FOR AMERICANS. 3654 02:30:25,660 --> 02:30:28,863 WHEN WE LOOK AT 2020 TO 2025 3655 02:30:28,863 --> 02:30:31,265 DIETARY GUIDELINE 3656 02:30:31,265 --> 02:30:31,899 RECOMMENDATIONS FOR AMERICANS, 3657 02:30:31,899 --> 02:30:34,101 SPECIFIC QUOTE THAT COMES OUT IS 3658 02:30:34,101 --> 02:30:35,403 CUSTOMIZE AND ENJOY NUTRIENT 3659 02:30:35,403 --> 02:30:37,838 DENSE FOOD AND BEVERAGE CHOICES 3660 02:30:37,838 --> 02:30:41,208 TO REFLECT PERSONAL PREFERENCES, 3661 02:30:41,208 --> 02:30:42,310 CULTURAL TRADITION AND BUDGETARY 3662 02:30:42,310 --> 02:30:42,777 CONSIDERATIONS. 3663 02:30:42,777 --> 02:30:45,379 WHEN WE LOOK AT THIS DEFINITION 3664 02:30:45,379 --> 02:30:47,315 OF CULTURE IT'S DEFINED HERE AS 3665 02:30:47,315 --> 02:30:48,582 SHARED VALUES, NORMS, CODES, 3666 02:30:48,582 --> 02:30:51,686 THAT COLLECTIVELY SHAPE A 3667 02:30:51,686 --> 02:30:53,154 GROUP'S BELIEFS, ATTITUDES, 3668 02:30:53,154 --> 02:30:55,022 BEHAVIOR THROUGH INTERACTION IN 3669 02:30:55,022 --> 02:30:56,991 AND WITH THEIR ENVIRONMENT. 3670 02:30:56,991 --> 02:30:57,992 NEXT SLIDE PLEASE. 3671 02:30:57,992 --> 02:31:01,495 NOW WHEN WE LOOK AT THIS 3672 02:31:01,495 --> 02:31:03,130 ANALYTIC FRAMEWORK THIS QUESTION 3673 02:31:03,130 --> 02:31:04,999 WAS POSED, WHAT EVIDENCE HAS 3674 02:31:04,999 --> 02:31:06,534 BEEN PUBLISHED ON THE 3675 02:31:06,534 --> 02:31:09,804 RELATIONSHIP BETWEEN 3676 02:31:09,804 --> 02:31:12,640 INTERVENTIONS AND DIET-RELATED 3677 02:31:12,640 --> 02:31:13,641 PSYCHOASSOCIATE FACTORS, INTAKE, 3678 02:31:13,641 --> 02:31:17,011 QUALITY AND HEALTH OUTCOMES. 3679 02:31:17,011 --> 02:31:19,313 WE'RE LOOKING ACROSS THE AGE 3680 02:31:19,313 --> 02:31:22,049 SPECTRUM FROM 2 TO 19 YEARS OF 3681 02:31:22,049 --> 02:31:24,452 AGE, ADULTS AND OLDER ADULTS, 3682 02:31:24,452 --> 02:31:25,619 INDIVIDUALS DURING THE PREGNANCY 3683 02:31:25,619 --> 02:31:27,388 AND POSTPARTUM YEARS. 3684 02:31:27,388 --> 02:31:31,025 YOU CAN SEE INTERVENTIONS HERE 3685 02:31:31,025 --> 02:31:31,826 LOOKING AT CULTURALLY TAILORED, 3686 02:31:31,826 --> 02:31:37,598 MODIFIED, ADAPTED TO AT ALTERED 3687 02:31:37,598 --> 02:31:39,233 INTAKE, OUTCOMES, DIET RELATED 3688 02:31:39,233 --> 02:31:41,302 PSYCHOSOCIAL FACTORS INCLUDING 3689 02:31:41,302 --> 02:31:42,603 NORMS, ATTITUDES, VALUES, 3690 02:31:42,603 --> 02:31:43,170 SELF-EFFICACY. 3691 02:31:43,170 --> 02:31:45,573 LOOKING AT DIETARY INTAKE 3692 02:31:45,573 --> 02:31:48,075 QUALITY, ENERGY INTAKE, RISK OF 3693 02:31:48,075 --> 02:31:52,580 CARDIOVASCULAR DISEASE, RISK OF 3694 02:31:52,580 --> 02:31:57,618 TYPE 2 DIABETES, BODY COMP 3695 02:31:57,618 --> 02:31:58,853 SITUATION AND OBESITY, INTAKE, 3696 02:31:58,853 --> 02:32:03,224 QUALITY INTAKE AS DESCRIBED 3697 02:32:03,224 --> 02:32:04,225 ABOVE, PREGNANCY AND 3698 02:32:04,225 --> 02:32:06,193 POSTPARTUM-RELATED WEIGHT 3699 02:32:06,193 --> 02:32:06,627 CHANGE. 3700 02:32:06,627 --> 02:32:07,495 NEXT SLIDE. 3701 02:32:07,495 --> 02:32:09,897 NOW WHEN WE LOOK AT, THIS GETS 3702 02:32:09,897 --> 02:32:13,401 TO WHAT WAS PREVIOUSLY DESCRIBED 3703 02:32:13,401 --> 02:32:15,503 BY DR. PALACIOS, TALKED ABOUT 3704 02:32:15,503 --> 02:32:18,205 THE FULL SCAN, WE HAD A LOT OF 3705 02:32:18,205 --> 02:32:19,006 ARTICLES INITIALLY PULLED OUT 3706 02:32:19,006 --> 02:32:20,841 BUT WHEN WE GOT DOWN TO WHAT 3707 02:32:20,841 --> 02:32:24,211 REALLY CAME OUT IN THE SCAN IT 3708 02:32:24,211 --> 02:32:28,149 CAME OUT TO 178 TOTAL ARTICLES, 3709 02:32:28,149 --> 02:32:29,917 COUNTRY OF ORIGIN, PREDOMINANTLY 3710 02:32:29,917 --> 02:32:31,886 FOR THE UNITED STATES, 6 FROM 3711 02:32:31,886 --> 02:32:32,286 CANADA. 3712 02:32:32,286 --> 02:32:33,988 WITH REGARDS TO INTERVENTION 3713 02:32:33,988 --> 02:32:37,792 DURATION, SINGLE SESSION TO FIVE 3714 02:32:37,792 --> 02:32:38,459 YEARS, ANALYTIC SAMPLE SHOWING 3715 02:32:38,459 --> 02:32:43,597 FROM N OF 20 PEOPLE BUT TO OVER 3716 02:32:43,597 --> 02:32:43,998 4,000 INDIVIDUALS. 3717 02:32:43,998 --> 02:32:44,698 WITH REGARDS TO RANDOMIZED 3718 02:32:44,698 --> 02:32:47,334 CONTROLLED TRIALS TO CLUSTER 3719 02:32:47,334 --> 02:32:49,537 STUDIES, 52 ARTICLES 3720 02:32:49,537 --> 02:32:52,940 REPRESENTING 29% OF THOSE 178 3721 02:32:52,940 --> 02:32:53,908 ARTICLES, NON-RANDOMIZED CONTROL 3722 02:32:53,908 --> 02:32:56,143 TRIALS, 22%, AND IF YOU LOOK AT 3723 02:32:56,143 --> 02:32:59,046 THAT ABOUT HALF OF THE STUDIES 3724 02:32:59,046 --> 02:33:00,648 ARE RCT PARALLEL STUDIES 3725 02:33:00,648 --> 02:33:03,751 REPRESENTING 87 OF THE ARTICLES 3726 02:33:03,751 --> 02:33:04,185 OF THAT 178. 3727 02:33:04,185 --> 02:33:05,386 NEXT SLIDE PLEASE. 3728 02:33:05,386 --> 02:33:07,354 NOW WHEN WE LOOK AT ARTICLES 3729 02:33:07,354 --> 02:33:10,324 PUBLISHED BY YEAR WE'RE TAKING 3730 02:33:10,324 --> 02:33:12,860 BACK TO 1985, BACK TO THE 3731 02:33:12,860 --> 02:33:14,728 '80s, AND BRING US BACK TO 3732 02:33:14,728 --> 02:33:16,897 2023, YOU CAN SEE VERY FEW WERE 3733 02:33:16,897 --> 02:33:19,200 PUBLISHED IN THE EARLIER YEARS, 3734 02:33:19,200 --> 02:33:21,302 VERY FEW, ONE, THREE, AND THREE, 3735 02:33:21,302 --> 02:33:23,471 MOVING INTO THE 2000s WE GET 3736 02:33:23,471 --> 02:33:28,609 INTO 13, 29, A LARGE BULK 3737 02:33:28,609 --> 02:33:29,376 PRESENTED OR PUBLISHED BETWEEN 3738 02:33:29,376 --> 02:33:30,044 2011 AND 2023. 3739 02:33:30,044 --> 02:33:33,547 LOOK AS WE'RE MOVING INTO THE 3740 02:33:33,547 --> 02:33:36,350 PANDEMIC YEARS, 2016 TO 2020, 3741 02:33:36,350 --> 02:33:38,786 53, AND 28 BEING PUBLISHED IN 3742 02:33:38,786 --> 02:33:40,921 THOSE PANDEMIC YEARS. 3743 02:33:40,921 --> 02:33:43,424 ARTICLES BY GENDER BREAK DOWN, 3744 02:33:43,424 --> 02:33:44,725 NOT REPORTED, ONLY ONE. 3745 02:33:44,725 --> 02:33:47,795 MALES THAT ARE CHILDREN, ONE. 3746 02:33:47,795 --> 02:33:49,763 MALES BY ITSELF, ONE. 3747 02:33:49,763 --> 02:33:51,398 SORRY, YOU GUYS, WE DON'T JUST 3748 02:33:51,398 --> 02:33:55,569 LIKE THIS, THOSE REPORTS. 3749 02:33:55,569 --> 02:33:57,304 FEMALES 3, BY ITSELF 45, MALE 3750 02:33:57,304 --> 02:33:59,073 AND FEMALE STUDIES YOU CAN SEE 3751 02:33:59,073 --> 02:34:01,375 LARGE MAJORITY OF THOSE BEING 3752 02:34:01,375 --> 02:34:03,177 REPORTED WITH BOTH GENDERS IN 3753 02:34:03,177 --> 02:34:04,411 THE STUDIES. 3754 02:34:04,411 --> 02:34:05,312 NEXT SLIDE PLEASE. 3755 02:34:05,312 --> 02:34:07,381 NOW LET'S LOOK AT THE EVIDENCE 3756 02:34:07,381 --> 02:34:08,916 SCAN BY OUTCOMES OF INTEREST. 3757 02:34:08,916 --> 02:34:12,086 YOU'LL NOTICE A LARGE MAJORITY 3758 02:34:12,086 --> 02:34:13,954 OF THESE ARE GROWTH BODY 3759 02:34:13,954 --> 02:34:15,756 COMPOSITION AND RISK OF OBESITY. 3760 02:34:15,756 --> 02:34:18,792 THIS IS WHAT REPRESENT A LARGE 3761 02:34:18,792 --> 02:34:20,628 MAJORITY OF THOSE, 178 ARTICLES 3762 02:34:20,628 --> 02:34:23,063 THAT WE TALKED ABOUT. 3763 02:34:23,063 --> 02:34:26,300 THE NEXT MOST FAVORED IS DIETARY 3764 02:34:26,300 --> 02:34:36,610 INTAKE, FOLLOWED BY RISK OF 3765 02:34:36,610 --> 02:34:37,811 CARDIOVASCULAR DISEASE, 3766 02:34:37,811 --> 02:34:38,812 PSYCHOSOCIAL FACTORS, DIABETES, 3767 02:34:38,812 --> 02:34:41,649 POSTPARTUM WEIGHT CHANGE, TERMS 3768 02:34:41,649 --> 02:34:46,053 OF OUTCOMES OF INTEREST. 3769 02:34:46,053 --> 02:34:54,695 ARTICLES BY RACIAL AND/OR ETHNC 3770 02:34:54,695 --> 02:34:58,265 GROUPS, LOOK AT THE LARGE 3771 02:34:58,265 --> 02:34:59,600 NUMBER, BLACK, AFRICAN AMERICAN, 3772 02:34:59,600 --> 02:35:00,801 AFRICAN DESCENT REPRESENTING THE 3773 02:35:00,801 --> 02:35:01,902 LARGEST NUMBER OF ARTICLES. 3774 02:35:01,902 --> 02:35:03,871 WHEN YOU LOOK HERE AT OUR 3775 02:35:03,871 --> 02:35:05,272 FURTHEST PORTION ON THE SLIDE IF 3776 02:35:05,272 --> 02:35:06,607 WE GO TO THE LEFT SIDE OF THE 3777 02:35:06,607 --> 02:35:09,243 SLIDE YOU CAN SEE MORE THAN 90% 3778 02:35:09,243 --> 02:35:14,148 OF PARTICIPANTS ARE FROM THAT 3779 02:35:14,148 --> 02:35:16,450 RACIAL/ETHNIC GROUP, 64 ARTICLES 3780 02:35:16,450 --> 02:35:16,750 REPRESENTED. 3781 02:35:16,750 --> 02:35:19,119 GETTING INTO THE LIGHT BLUE, 20 3782 02:35:19,119 --> 02:35:21,689 TO 49, FOR EXAMPLE, NINE OF 3783 02:35:21,689 --> 02:35:23,757 THOSE ARE IN THAT SUBSET. 3784 02:35:23,757 --> 02:35:26,393 WE COME FURTHER TO THE RIGHT, 3785 02:35:26,393 --> 02:35:27,828 HISPANIC OR LATINO, REPRESENTING 3786 02:35:27,828 --> 02:35:30,230 THAT NEXT MOST COMMON GROUP. 3787 02:35:30,230 --> 02:35:36,236 GETTING INTO OUR NATIVE GROUPS, 3788 02:35:36,236 --> 02:35:38,005 AMERICAN INDIAN, ALASKA NATIVE 3789 02:35:38,005 --> 02:35:45,112 OR INDIGENOUS, AND WHITE, ASIAN, 3790 02:35:45,112 --> 02:35:49,817 OTHER, SMALLEST BEING NATIVE 3791 02:35:49,817 --> 02:35:50,818 HAWAIIANS, PACIFIC ISLANDERS. 3792 02:35:50,818 --> 02:35:53,754 WE THOUGHT THIS WAS AN IMPORTANT 3793 02:35:53,754 --> 02:35:55,189 CONCEPT TO GET INTO, I WANT YOU 3794 02:35:55,189 --> 02:35:57,591 TO NOTICE THE PURPLE RECOMMENDS 3795 02:35:57,591 --> 02:35:58,692 HIGH COMMUNITY INVOLVEMENT. 3796 02:35:58,692 --> 02:36:00,661 HOW INVOLVED WAS THE COMMUNITY 3797 02:36:00,661 --> 02:36:02,863 IN THE INTERVENTION DESIGN? 3798 02:36:02,863 --> 02:36:05,666 WE'LL MOVE FROM 1985 AGAIN OVER 3799 02:36:05,666 --> 02:36:07,968 TO 2023, RECOGNIZING THAT THE 3800 02:36:07,968 --> 02:36:12,906 LARGEST SUBSET OF GROUP WAS 3801 02:36:12,906 --> 02:36:14,308 REPRESENTED BY 2016 TO 2020. 3802 02:36:14,308 --> 02:36:16,610 IN THE 2020 GROUP NOTICING THERE 3803 02:36:16,610 --> 02:36:20,014 WAS HIGH COMMUNITY INVOLVEMENT, 3804 02:36:20,014 --> 02:36:21,882 PARTICULARLY 29 STUDIES, 29 3805 02:36:21,882 --> 02:36:23,951 ARTICLES BEING REPRESENTED, HIGH 3806 02:36:23,951 --> 02:36:25,052 COMMUNITY INVOLVEMENT, LESSER AS 3807 02:36:25,052 --> 02:36:27,788 WE GO DOWN INTO THAT ORANGE, 3808 02:36:27,788 --> 02:36:30,090 ORANGE BEING REPRESENTED BY SOME 3809 02:36:30,090 --> 02:36:30,624 COMMUNITY INVOLVEMENT BUT 3810 02:36:30,624 --> 02:36:31,925 NOTICING THEY WERE TRYING TO 3811 02:36:31,925 --> 02:36:34,228 INVOLVE THE COMMUNITY IN THE 3812 02:36:34,228 --> 02:36:34,662 INTERVENTION DESIGN. 3813 02:36:34,662 --> 02:36:37,197 IF WE GO TO THE LAST SLIDE I'LL 3814 02:36:37,197 --> 02:36:39,166 PRESENT BEFORE HANDING IT OVER 3815 02:36:39,166 --> 02:36:43,570 TO MY PARTNER IN CRIME, I WANT 3816 02:36:43,570 --> 02:36:45,005 TO TALK ABOUT ARTICLES BY 3817 02:36:45,005 --> 02:36:46,740 OUTCOME AND LEVEL OF COMMUNITY 3818 02:36:46,740 --> 02:36:49,043 INVOLVEMENT AND WE'LL LOOK AT 3819 02:36:49,043 --> 02:36:52,446 THOSE MAJOR GROUPS THAT ARE 3820 02:36:52,446 --> 02:36:56,150 PRESENTED HERE, THE LARGEST 3821 02:36:56,150 --> 02:37:00,587 GROUP IS GROWTH BODY 3822 02:37:00,587 --> 02:37:03,824 COMPOSITION, HIGH 3823 02:37:03,824 --> 02:37:06,527 SOME, NOT REPORTED, LARGER 3824 02:37:06,527 --> 02:37:07,561 BLOCKS REPRESENT HIGHEST LEVEL 3825 02:37:07,561 --> 02:37:08,729 OF COMMUNITY INVOLVEMENT, DOWN 3826 02:37:08,729 --> 02:37:11,365 TO THE SMALLEST GROUP, WHICH IS 3827 02:37:11,365 --> 02:37:12,566 THAT POSTPARTUM WEIGHT CHANGE. 3828 02:37:12,566 --> 02:37:14,635 THIS IS A GREAT VISUAL SLIDE SO 3829 02:37:14,635 --> 02:37:16,503 YOU CAN SEE THAT AS WE GO 3830 02:37:16,503 --> 02:37:18,472 FURTHER TO THE RIGHT WE HAVE 3831 02:37:18,472 --> 02:37:19,807 LESS OUTCOME AND LEVEL OF 3832 02:37:19,807 --> 02:37:21,008 COMMUNITY INVOLVEMENT AS WE GO 3833 02:37:21,008 --> 02:37:21,875 TO THE RIGHT. 3834 02:37:21,875 --> 02:37:27,014 AND THEN I WANT TO TURN IT OVER 3835 02:37:27,014 --> 02:37:35,656 TO MY CO-LEAD HERE. 3836 02:37:35,656 --> 02:37:36,657 >> NEXT SLIDE. 3837 02:37:36,657 --> 02:37:38,592 THANK YOU, FOR THE EVIDENCE SCAN 3838 02:37:38,592 --> 02:37:40,127 IT WAS REALLY IMPORTANT THAT WE 3839 02:37:40,127 --> 02:37:43,697 USE SOME TYPE OF FRAMEWORK SO WE 3840 02:37:43,697 --> 02:37:46,266 WOULD HAVE CONSISTENCY ACROSS 3841 02:37:46,266 --> 02:37:48,902 THE WAY THAT WE CATEGORIZE THE 3842 02:37:48,902 --> 02:37:50,771 CULTURAL TAILORING, SO PART OF 3843 02:37:50,771 --> 02:37:54,041 THIS IS REALLY THINKING MORE 3844 02:37:54,041 --> 02:37:56,243 ABOUT CULTURAL RESPONSIVE 3845 02:37:56,243 --> 02:37:56,910 INTERVENTIONS, WHETHER THEY BE 3846 02:37:56,910 --> 02:37:58,545 MORE TARGETED, AND WE'LL TALK 3847 02:37:58,545 --> 02:38:01,582 MORE ABOUT THAT LATER, VERSUS 3848 02:38:01,582 --> 02:38:03,350 INDIVIDUALLY TAILORED. 3849 02:38:03,350 --> 02:38:05,652 SO LIKE COMMUNITY TARGETED, 3850 02:38:05,652 --> 02:38:07,087 THINKING ABOUT MAYBE TAILORED AT 3851 02:38:07,087 --> 02:38:12,192 THE INDIVIDUAL LEVEL, SO WE DREW 3852 02:38:12,192 --> 02:38:14,061 ON TWO APPROACHES AND 3853 02:38:14,061 --> 02:38:15,162 CLASSIFICATION SIS TESSMENTS 3854 02:38:15,162 --> 02:38:18,031 FIRST FROM KRUEGER AND 3855 02:38:18,031 --> 02:38:19,566 COLLEAGUES, THAT PROVIDES 3856 02:38:19,566 --> 02:38:22,402 OVERVIEW OF FIVE STRATEGIES AND 3857 02:38:22,402 --> 02:38:22,736 APPROACHES. 3858 02:38:22,736 --> 02:38:25,005 FIRST IS PERIPHERAL. 3859 02:38:25,005 --> 02:38:27,207 SO WHERE INTERVENTIONS SEEK TO 3860 02:38:27,207 --> 02:38:31,578 GIVE PROGRAMS OR MATERIALS 3861 02:38:31,578 --> 02:38:32,412 APPEARANCE OF CULTURAL 3862 02:38:32,412 --> 02:38:33,680 APPROPRIATENESS PACKAGING IN A 3863 02:38:33,680 --> 02:38:36,150 WAY THAT IS PERCEIVED THAT IT 3864 02:38:36,150 --> 02:38:38,152 WILL APPEAL TO CERTAIN GROUPS, 3865 02:38:38,152 --> 02:38:39,920 THE GROUPS THAT ARE BEING 3866 02:38:39,920 --> 02:38:50,430 INVOLVED IN THE INTERVENTION. 3867 02:39:04,478 --> 02:39:10,751 THERE'S EVIDENTIAL, LINGUISTIC 3868 02:39:10,751 --> 02:39:16,156 IS COMMON, SEEKING TO MAKE 3869 02:39:16,156 --> 02:39:16,924 MATERIALS ACCESSIBLE, MAKING 3870 02:39:16,924 --> 02:39:18,892 SURE INFORMATION WAS PROVIDED IN 3871 02:39:18,892 --> 02:39:20,961 DOMINANT OR NATIVE LANGUAGE OF 3872 02:39:20,961 --> 02:39:22,496 THAT GROUP. 3873 02:39:22,496 --> 02:39:25,465 THIS COULD INCLUDE LANGUAGE IN 3874 02:39:25,465 --> 02:39:26,867 TRADITIONAL SENSE OR TERMINOLOGY 3875 02:39:26,867 --> 02:39:32,339 THAT MIGHT BE COMMON IN A 3876 02:39:32,339 --> 02:39:36,510 SPECIFIC CULTURAL GROUP. 3877 02:39:36,510 --> 02:39:38,378 AND CONSTITUENT INVOLVING, SO 3878 02:39:38,378 --> 02:39:41,014 INCLUDING MEMBERS, AS WE TALKED 3879 02:39:41,014 --> 02:39:44,585 ABOUT, TARGET COMMUNITY OR 3880 02:39:44,585 --> 02:39:45,719 TARGET GROUP. 3881 02:39:45,719 --> 02:39:46,920 AND SOCIOCULTURAL, HEALTH ISSUES 3882 02:39:46,920 --> 02:39:49,223 DISCUSSED IN CONTEXT OF BROADER 3883 02:39:49,223 --> 02:39:51,158 SOCIAL AND CULTURAL VALUES OF 3884 02:39:51,158 --> 02:39:54,228 THAT INTENDED AUDIENCE. 3885 02:39:54,228 --> 02:39:55,662 NEXT SLIDE. 3886 02:39:55,662 --> 02:39:59,066 SO, SOME EXAMPLES OF PERIPHERAL 3887 02:39:59,066 --> 02:40:01,568 THINGS LIKE COLORS, IMAGES, 3888 02:40:01,568 --> 02:40:05,305 FONTS, PHOTOS, MUSIC, WE KNOW 3889 02:40:05,305 --> 02:40:07,274 THOSE INTERVENTIONS THAT REALLY 3890 02:40:07,274 --> 02:40:09,676 ARE DESIGNED TO RESONATE WITH 3891 02:40:09,676 --> 02:40:13,513 SOME OF THOSE PERIPHERAL FACTORS 3892 02:40:13,513 --> 02:40:16,583 OF THE TARGET GROUPS, OR 3893 02:40:16,583 --> 02:40:21,688 INCLUDING EPIDEMIOLOGIC EVIDENCE 3894 02:40:21,688 --> 02:40:23,223 OF A DIFFERENT POPULATION. 3895 02:40:23,223 --> 02:40:27,694 KEY FOCUS ON TRANSLATION OF 3896 02:40:27,694 --> 02:40:28,595 INTERVENTION MATERIALS, 3897 02:40:28,595 --> 02:40:29,463 INCLUDING BILINGUAL RESEARCH 3898 02:40:29,463 --> 02:40:32,299 STAFF OR THOSE THAT ARE 3899 02:40:32,299 --> 02:40:33,066 DELIVERING THE INTERVENTION, 3900 02:40:33,066 --> 02:40:35,168 INCLUDING COMMUNITY MEMBERS, 3901 02:40:35,168 --> 02:40:38,672 EITHER THROUGH FORMATIVE DATA OR 3902 02:40:38,672 --> 02:40:39,506 PART OF INTERVENTION TEAMS 3903 02:40:39,506 --> 02:40:41,942 INVOLVED IN THE PLANNING OR 3904 02:40:41,942 --> 02:40:43,710 IMPLEMENTATION OF THE 3905 02:40:43,710 --> 02:40:44,344 INTERVENTION. 3906 02:40:44,344 --> 02:40:46,546 AND THEN SOCIOCULTURAL FACTORS 3907 02:40:46,546 --> 02:40:52,853 LIKE COOKING METHODS, 3908 02:40:52,853 --> 02:40:54,955 TRADITIONAL FOODS, SPIRITUAL 3909 02:40:54,955 --> 02:40:57,557 MESSAGES, RELIGIOSITY, SOCIAL 3910 02:40:57,557 --> 02:41:00,627 SUPPORT, SOCIAL CIRCLES, AND 3911 02:41:00,627 --> 02:41:01,228 FAMILY-CENTERED INTERVENTIONS 3912 02:41:01,228 --> 02:41:03,931 THAT MAY EMPHASIZE A CERTAIN 3913 02:41:03,931 --> 02:41:07,534 TYPE OF FAMILY STRUCTURE OR 3914 02:41:07,534 --> 02:41:09,403 STRUCTURAL HIERARCHY WITHIN 3915 02:41:09,403 --> 02:41:12,673 FAMILIES OR FAMILY ROLES. 3916 02:41:12,673 --> 02:41:14,675 NEXT SLIDE. 3917 02:41:14,675 --> 02:41:18,879 SO WE COMBINED THIS WITH ANOTHER 3918 02:41:18,879 --> 02:41:20,881 TYPE OF FRAMING AROUND 3919 02:41:20,881 --> 02:41:25,118 DIMENSIONS OF CULTURAL 3920 02:41:25,118 --> 02:41:27,955 SENSITIVITY USING REFERENCE FROM 3921 02:41:27,955 --> 02:41:30,257 RESNICOW AND COLLEAGUES, DRAWING 3922 02:41:30,257 --> 02:41:32,359 ON HISTORY FROM CULTURAL STUDIES 3923 02:41:32,359 --> 02:41:36,863 AS WELL AS LINGUISTIC STUDIES TO 3924 02:41:36,863 --> 02:41:38,832 THINK ABOUT SURFACE STRUCTURE 3925 02:41:38,832 --> 02:41:41,668 VERSUS DEEP STRUCTURE, SURFACE 3926 02:41:41,668 --> 02:41:42,235 STRUCTURE, OBSERVABLE OR 3927 02:41:42,235 --> 02:41:44,304 SUPERFICIAL LIKE AS WE MENTIONED 3928 02:41:44,304 --> 02:41:46,907 KIND OF SIMILAR TO PERIPHERAL 3929 02:41:46,907 --> 02:41:49,977 STRATEGY, LIKE AUDIO AND VISUAL 3930 02:41:49,977 --> 02:41:51,511 MATERIALS, CHANNEL SETTINGS, 3931 02:41:51,511 --> 02:41:52,946 THAT ARE PERCEIVED TO BE 3932 02:41:52,946 --> 02:41:55,115 CULTURALLY APPROPRIATE WHEN IT 3933 02:41:55,115 --> 02:41:56,550 COMES TO INTERVENTION DELIVERY. 3934 02:41:56,550 --> 02:41:58,285 AND THEN ALSO DEEP STRUCTURE. 3935 02:41:58,285 --> 02:42:01,254 SO THOSE THINGS THAT ARE LINKED 3936 02:42:01,254 --> 02:42:05,058 TO MORE UNDERSTANDING OF A 3937 02:42:05,058 --> 02:42:07,394 CULTURE, HISTORY, ENVIRONMENTAL 3938 02:42:07,394 --> 02:42:09,496 AND PSYCHOSOCIAL FORCES, THAT 3939 02:42:09,496 --> 02:42:10,697 INFLUENCE A TARGET HEALTH 3940 02:42:10,697 --> 02:42:13,433 BEHAVIOR, IN THIS CASE DIET IN A 3941 02:42:13,433 --> 02:42:14,835 TARGET POPULATION. 3942 02:42:14,835 --> 02:42:16,803 SO, THINGS LIKE RELIGION, AGAIN 3943 02:42:16,803 --> 02:42:19,639 THERE'S SOME OVERLAP BETWEEN THE 3944 02:42:19,639 --> 02:42:22,376 TWO RUBRICS, FAMILY AND SOCIETY, 3945 02:42:22,376 --> 02:42:25,545 ECONOMICS, THAT MAY INFLUENCE 3946 02:42:25,545 --> 02:42:25,979 BEHAVIORS. 3947 02:42:25,979 --> 02:42:26,446 NEXT SLIDE. 3948 02:42:26,446 --> 02:42:33,887 SO I'M GOING TO TURN IT BACK 3949 02:42:33,887 --> 02:42:35,522 OVER TO MY COLLEAGUE. 3950 02:42:35,522 --> 02:42:36,023 >> ABSOLUTELY. 3951 02:42:36,023 --> 02:42:39,126 SO AS YOU CAN SEE HERE WHEN WE 3952 02:42:39,126 --> 02:42:40,227 LOOKED ACROSS OUR EVIDENCE SCAN, 3953 02:42:40,227 --> 02:42:42,396 WHEN WE LOOKED AT THOSE STUDIES 3954 02:42:42,396 --> 02:42:43,830 THAT WE TALKED ABOUT, WHEN WE 3955 02:42:43,830 --> 02:42:46,133 LOOKED AT THE THINGS THAT WE 3956 02:42:46,133 --> 02:42:47,634 JUST PRESENTED, WE CAN SEE 3957 02:42:47,634 --> 02:42:48,869 THERE'S A SPREAD OF THESE 3958 02:42:48,869 --> 02:42:50,504 PARTICULAR THINGS WHEN WE LOOKED 3959 02:42:50,504 --> 02:42:53,340 AT PERIPHERAL, YOU CAN SEE 3960 02:42:53,340 --> 02:42:54,541 THERE'S SOME PERIPHERAL STUDIES, 3961 02:42:54,541 --> 02:43:04,951 A VERY SMALL NUMBER OF THESE 3962 02:43:04,951 --> 02:43:06,153 WERE EVIDENTIAL, SOME 3963 02:43:06,153 --> 02:43:06,920 LINGUISTIC, CONSTITUENT 3964 02:43:06,920 --> 02:43:08,055 INVOLVING, AND SOCIAL CULTURAL. 3965 02:43:08,055 --> 02:43:11,825 YOU CAN SEE WHETHER THESE ARE 3966 02:43:11,825 --> 02:43:12,926 SURFACE STRUCTURE, DEEP, OR 3967 02:43:12,926 --> 02:43:14,161 SURFACE AND DEEP STRUCTURE. 3968 02:43:14,161 --> 02:43:15,762 WHEN YOU SEE THE LAYERING 3969 02:43:15,762 --> 02:43:22,135 BETWEEN THOSE, YOU CAN SEE THAT. 3970 02:43:22,135 --> 02:43:24,104 NEXT SLIDE PLEASE. 3971 02:43:24,104 --> 02:43:25,906 THESE LAYERS AND BUBBLED, WE 3972 02:43:25,906 --> 02:43:33,613 TALKED ABOUT WHETHER THEY ARE 3973 02:43:33,613 --> 02:43:34,948 GBCO, OR POSTPARTUM WEIGHT, AND 3974 02:43:34,948 --> 02:43:36,783 YOU CAN SEE HOW THESE FALL OUT 3975 02:43:36,783 --> 02:43:42,389 BY WHETHER OR NOT THESE ARE 3976 02:43:42,389 --> 02:43:42,989 SOCIAL, CULTURAL, CONSTITUENT 3977 02:43:42,989 --> 02:43:49,729 STROVING, -- INVOLVING, THOSE E 3978 02:43:49,729 --> 02:43:51,698 LARGER, PERIPHERAL NOTICING THEY 3979 02:43:51,698 --> 02:43:55,302 ARE LARGER AT THE BOTTOM, 3980 02:43:55,302 --> 02:43:57,270 EVIDENTIAL ARE NOT AS PROMINENT 3981 02:43:57,270 --> 02:43:58,905 IN THIS SLIDE, THINGS THAT WE 3982 02:43:58,905 --> 02:44:01,308 CAN TAKE NOTES OF AS WE THINK 3983 02:44:01,308 --> 02:44:03,477 ABOUT THESE FURTHER. 3984 02:44:03,477 --> 02:44:05,145 NEXT SLIDE PLEASE. 3985 02:44:05,145 --> 02:44:07,647 HERE'S AN EVIDENCE SCAN EXAMPLE, 3986 02:44:07,647 --> 02:44:09,616 JUST ONE OF THE PARTICULAR 3987 02:44:09,616 --> 02:44:10,550 ARTICLES, I WON'T SPEND A LOT OF 3988 02:44:10,550 --> 02:44:12,252 TIME HERE. 3989 02:44:12,252 --> 02:44:14,121 THIS IS A VERY -- YOU CAN SEE 3990 02:44:14,121 --> 02:44:21,795 IT'S A DENSE SLIDE, A PARTICULAR 3991 02:44:21,795 --> 02:44:24,731 ARTICLE FROM KWON 2022, A KOREAN 3992 02:44:24,731 --> 02:44:26,366 AMERICAN ARTICLE LOOKING AT 3993 02:44:26,366 --> 02:44:28,034 ADULTS IDENTIFIED AS RISK FOR 3994 02:44:28,034 --> 02:44:30,203 DIABETES IN THE METROPOLITAN NEW 3995 02:44:30,203 --> 02:44:31,404 YORK CITY AREA, INTERVENTION 3996 02:44:31,404 --> 02:44:31,671 STRATEGY. 3997 02:44:31,671 --> 02:44:37,611 IF YOU LOOK AT THIS FROM 3998 02:44:37,611 --> 02:44:38,845 PERIPHERAL PERSPECTIVE, USING 3999 02:44:38,845 --> 02:44:39,613 TYPICALLY KOREAN FOODS, THAT'S 4000 02:44:39,613 --> 02:44:42,482 THE SURFACE STRUCTURE. 4001 02:44:42,482 --> 02:44:45,952 FROM THE EVIDENTIAL, DIABETES 4002 02:44:45,952 --> 02:44:47,721 PREVENTION SESSIONS, CONCLUDED 4003 02:44:47,721 --> 02:44:48,588 DISCUSSION OF DIABETES 4004 02:44:48,588 --> 02:44:50,790 PREVALENCE, INCREASED RISK OF 4005 02:44:50,790 --> 02:44:52,559 DIABETES IN ASIAN AMERICAN 4006 02:44:52,559 --> 02:44:56,163 COMMUNITIES, LOOKS AT 4007 02:44:56,163 --> 02:45:03,170 EXPLANATION OF BMI, AT-RISK BMI, 4008 02:45:03,170 --> 02:45:08,575 DISPELLING MISCONCEPTION, 4009 02:45:08,575 --> 02:45:12,712 DEVELOPED IN ENGLISH, TRANSLATED 4010 02:45:12,712 --> 02:45:13,513 AND REVIEWS. 4011 02:45:13,513 --> 02:45:18,952 TOPICS TRANSLATED INTO KOREAN, 4012 02:45:18,952 --> 02:45:25,592 CLIP -- WHAT ABOUT DEEP 4013 02:45:25,592 --> 02:45:25,859 STRUCTURE? 4014 02:45:25,859 --> 02:45:27,794 COALITION OF COMMUNITY PARTNERS, 4015 02:45:27,794 --> 02:45:28,762 RESEARCHERS, HEALTHCARE, WE 4016 02:45:28,762 --> 02:45:30,330 DON'T LIKE PROVIDERS SOMETIMES 4017 02:45:30,330 --> 02:45:32,499 BUT CLINICIANS, COMMUNITY HEALTH 4018 02:45:32,499 --> 02:45:34,034 WORKES, ENGAGED AS ACTIVE AND 4019 02:45:34,034 --> 02:45:35,669 EQUAL PARTNERS IN RESEARCH 4020 02:45:35,669 --> 02:45:37,103 PROCESS, THAT'S A DEEPER 4021 02:45:37,103 --> 02:45:37,671 STRUCTURE. 4022 02:45:37,671 --> 02:45:39,739 COMMUNITY HEALTH WORKERS AND 4023 02:45:39,739 --> 02:45:43,009 STAFF, KOREAN AMERICANS SERVE ON 4024 02:45:43,009 --> 02:45:44,110 COMMUNITY-BASED ORGANIZATIONS, 4025 02:45:44,110 --> 02:45:45,078 ACTIVE MEMBERS AT COALITION, 4026 02:45:45,078 --> 02:45:47,514 SOURCE OF COMMUNITY KNOWLEDGE, 4027 02:45:47,514 --> 02:45:49,149 PROVIDING INPUT AND GUIDANCE, 4028 02:45:49,149 --> 02:45:50,350 AGAIN DEEP STRUCTURE. 4029 02:45:50,350 --> 02:45:54,187 INTERVENTION WAS LED BY THE 4030 02:45:54,187 --> 02:45:56,256 BILINGUAL KOREAN AMERICAN 4031 02:45:56,256 --> 02:45:57,591 COMMUNITY HEALTH WORKER. 4032 02:45:57,591 --> 02:45:59,593 FINDINGS WERE USED TO ADD 4033 02:45:59,593 --> 02:46:00,894 CULTURALLY RELEVANT TOPICS AND 4034 02:46:00,894 --> 02:46:02,629 STRATEGIES TO THE CURRICULUM, 4035 02:46:02,629 --> 02:46:06,366 AGAIN A DEEP STRUCTURE. 4036 02:46:06,366 --> 02:46:07,901 DISCUSSIONS INVOLVED SOCIAL 4037 02:46:07,901 --> 02:46:08,768 CULTURAL LEVEL, TRADITIONAL 4038 02:46:08,768 --> 02:46:12,572 KOREAN PRACTICE TO EAT FRUITS AS 4039 02:46:12,572 --> 02:46:15,775 AL 4040 02:46:15,775 --> 02:46:19,279 ALTERNATIVES TO HIGH FAT 4041 02:46:19,279 --> 02:46:20,647 DESSERTS, POTENTIAL DIABETES 4042 02:46:20,647 --> 02:46:21,982 TRIGGERS, SMALL PLATES IN 4043 02:46:21,982 --> 02:46:25,385 RELATION TO PLATE METHOD, 4044 02:46:25,385 --> 02:46:27,254 MANAGING CULTURAL EXPECTATIONS 4045 02:46:27,254 --> 02:46:35,495 WHEN INVITED IN HOMES AT -- ASA 4046 02:46:35,495 --> 02:46:36,029 GUEST. 4047 02:46:36,029 --> 02:46:36,796 YOU CAN SEE INTERVENTIONAL 4048 02:46:36,796 --> 02:46:39,666 STRATEGIES ON THE LEFT SIDE. 4049 02:46:39,666 --> 02:46:40,533 NEXT SLIDE PLEASE. 4050 02:46:40,533 --> 02:46:43,270 WHEN WE LOOK AT EVIDENCE SCAN 4051 02:46:43,270 --> 02:46:45,338 AND FUNDING SOURCES OF 178 4052 02:46:45,338 --> 02:46:46,339 ARTICLING CAN SEE LARGELY FUNDED 4053 02:46:46,339 --> 02:46:49,075 BY U.S. OR CANADIAN GOVERNMENT 4054 02:46:49,075 --> 02:46:52,012 FOLLOWED BY NON-PROFIT, ACADEMIC 4055 02:46:52,012 --> 02:46:52,245 SOURCES. 4056 02:46:52,245 --> 02:46:54,848 YOU CAN SEE THERE'S OTHER AN 4057 02:46:54,848 --> 02:46:57,584 NON-REPORTED, STATE GOVERNMENTS 4058 02:46:57,584 --> 02:46:57,917 AND INDUSTRY. 4059 02:46:57,917 --> 02:46:59,452 NEXT SLIDE PLEASE. 4060 02:46:59,452 --> 02:47:00,954 WITH REGARDS TO CONSIDERATIONS 4061 02:47:00,954 --> 02:47:01,621 AND LIMITATIONS THERE'S SOME 4062 02:47:01,621 --> 02:47:04,157 CHALLENGES IN THE NATURE OF THIS 4063 02:47:04,157 --> 02:47:06,893 WORK, THIS IS EXPLORATORY, 4064 02:47:06,893 --> 02:47:07,560 UNFORTUNATELY NO CONCLUSION 4065 02:47:07,560 --> 02:47:08,962 STATEMENTS OR GRADES UNLIKE WHAT 4066 02:47:08,962 --> 02:47:12,265 YOU HEARD PREVIOUSLY TODAY AND 4067 02:47:12,265 --> 02:47:13,800 WILL HEAR TOMORROW, RELIANCE ON 4068 02:47:13,800 --> 02:47:14,968 WHAT'S PRINTED VERSUS WHAT 4069 02:47:14,968 --> 02:47:16,503 HAPPENS IN PRACTICE. 4070 02:47:16,503 --> 02:47:19,472 AND THEN OUR SEARCH CRITERIA 4071 02:47:19,472 --> 02:47:20,674 CONSIDERATIONS, TIGHT SCOPE ON 4072 02:47:20,674 --> 02:47:21,241 SEARCH. 4073 02:47:21,241 --> 02:47:24,077 WE DID LIMIT TO PubMed AS 4074 02:47:24,077 --> 02:47:26,179 OUR DATABASE. 4075 02:47:26,179 --> 02:47:27,580 CITATION SEARCH INCLUDED 4076 02:47:27,580 --> 02:47:29,015 ARTICLES WAS NOT CONDUCTED. 4077 02:47:29,015 --> 02:47:30,550 NEXT SLIDE PLEASE. 4078 02:47:30,550 --> 02:47:31,951 WITH REGARDS TO RESEARCH 4079 02:47:31,951 --> 02:47:32,719 RECOMMENDATIONS AND FUTURE 4080 02:47:32,719 --> 02:47:34,921 DIRECTIONS THERE'S A NEED FOR 4081 02:47:34,921 --> 02:47:37,557 TAILORING TO COMMUNITIES IN 4082 02:47:37,557 --> 02:47:38,925 THEIR UNIQUE CHARACTERISTICS, 4083 02:47:38,925 --> 02:47:40,727 NOT SOLELY RACIAL AND ETHNIC 4084 02:47:40,727 --> 02:47:42,796 GROUP, EXAMPLE BY TIME AND U.S. 4085 02:47:42,796 --> 02:47:44,664 NATIVITY, WE TALKED ABOUT THIS 4086 02:47:44,664 --> 02:47:46,099 EARLIER TODAY. 4087 02:47:46,099 --> 02:47:47,600 THERE'S IMPORTANCE OF TAILORING 4088 02:47:47,600 --> 02:47:49,035 ACROSS HIERARCHY OF RESEARCH, 4089 02:47:49,035 --> 02:47:50,303 LIVED EXPERIENCE OF LEADERSHIP 4090 02:47:50,303 --> 02:47:51,538 AND STAFF. 4091 02:47:51,538 --> 02:47:52,305 COMMUNITY INVOLVEMENT AT ALL 4092 02:47:52,305 --> 02:47:53,840 STAGES OF THE WORK. 4093 02:47:53,840 --> 02:47:57,243 THAT'S REALLY IMPORTANT. 4094 02:47:57,243 --> 02:47:57,877 COMMUNITY INVOLVEMENT 4095 02:47:57,877 --> 02:47:58,545 INTERVENTIONS SUSTAINABILITY 4096 02:47:58,545 --> 02:47:59,746 PLAN SHOULD BE COMMUNICATED 4097 02:47:59,746 --> 02:48:00,947 WITHIN THE PUBLICATION, THAT'S 4098 02:48:00,947 --> 02:48:04,017 AN IMPORTANT POINT. 4099 02:48:04,017 --> 02:48:05,985 AND FOR FUTURE SYSTEMATIC 4100 02:48:05,985 --> 02:48:09,723 REVIEWS WE NEED TO DIVERSIFY 4101 02:48:09,723 --> 02:48:11,691 SEARCH TERMS, YOURS ITERATIVE 4102 02:48:11,691 --> 02:48:13,326 PROCESS FOR COMMON TERMINOLOGY, 4103 02:48:13,326 --> 02:48:14,861 EXPAND SEARCH DATABASES OF 4104 02:48:14,861 --> 02:48:16,363 COURSE, AND FOR SPECIFIC 4105 02:48:16,363 --> 02:48:18,131 POPULATIONS OF INTEREST TO 4106 02:48:18,131 --> 02:48:20,867 CONSIDER RELEVANT OUTCOMES WHICH 4107 02:48:20,867 --> 02:48:22,302 INCLUDE NUTRITIONAL ADEQUACY, 4108 02:48:22,302 --> 02:48:23,703 FOR EXAMPLE, IN BIRTHING 4109 02:48:23,703 --> 02:48:24,003 POPULATIONS. 4110 02:48:24,003 --> 02:48:25,772 I THINK THIS IS THE CONCLUSION 4111 02:48:25,772 --> 02:48:26,239 OF OUR SLIDES. 4112 02:48:26,239 --> 02:48:27,774 NEXT SLIDE PLEASE. 4113 02:48:27,774 --> 02:48:28,074 ABSOLUTELY. 4114 02:48:28,074 --> 02:48:29,142 THANK YOU SO MUCH FOR LISTENING 4115 02:48:29,142 --> 02:48:31,511 TO THIS. 4116 02:48:31,511 --> 02:48:33,580 THIS IS A NEW ADDITION TO THE 4117 02:48:33,580 --> 02:48:34,881 DIETARY GUIDELINES AND I'M 4118 02:48:34,881 --> 02:48:36,516 THANKFUL FOR ALL THOSE INVOLVED 4119 02:48:36,516 --> 02:48:36,950 IN OUR COMMITTEE. 4120 02:48:36,950 --> 02:48:45,592 THANKS SO MUCH. 4121 02:48:45,592 --> 02:48:48,695 >> SO WE'RE OPEN FOR DISCUSSION 4122 02:48:48,695 --> 02:48:49,062 QUESTIONS. 4123 02:48:49,062 --> 02:48:49,229 YES. 4124 02:48:49,229 --> 02:48:50,430 >> I HAVE A QUESTION. 4125 02:48:50,430 --> 02:48:52,031 AND A COMMENT. 4126 02:48:52,031 --> 02:48:52,565 SO, EXCELLENT. 4127 02:48:52,565 --> 02:48:54,367 THANK YOU FOR DOING THIS. 4128 02:48:54,367 --> 02:48:56,569 WE NEED IT SO DESPERATELY TO 4129 02:48:56,569 --> 02:48:57,971 HAVE THIS INFORMATION. 4130 02:48:57,971 --> 02:49:01,374 ON YOUR SLIDE WHERE YOU HAVE THE 4131 02:49:01,374 --> 02:49:03,042 KWON EXAMPLE ABOUT YOU EXTRACT 4132 02:49:03,042 --> 02:49:04,544 THAT INFORMATION BECAUSE THAT'S 4133 02:49:04,544 --> 02:49:08,615 RATHER UNUSUAL TO SEE THAT 4134 02:49:08,615 --> 02:49:12,118 FORMAT IN ARTICLES, THAT OFTEN 4135 02:49:12,118 --> 02:49:13,319 GIVE LIMITED INFORMATION ON 4136 02:49:13,319 --> 02:49:14,287 DEVELOPMENT BECAUSE OF THE 4137 02:49:14,287 --> 02:49:15,922 LENGTH OF THE ARTICLE. 4138 02:49:15,922 --> 02:49:17,357 I HAVE A FOLLOW-UP QUESTION THAT 4139 02:49:17,357 --> 02:49:19,793 I'LL ASK NOW. 4140 02:49:19,793 --> 02:49:24,364 AND THAT IS DID YOU ALSO LOOK 4141 02:49:24,364 --> 02:49:25,598 FOR ARTICLES BY THE SAME GROUP 4142 02:49:25,598 --> 02:49:27,967 FOR THE SAME PROJECT TO SEE IF 4143 02:49:27,967 --> 02:49:34,607 THEY HAD A DEVELOPMENT ARTICLE? 4144 02:49:34,607 --> 02:49:38,711 >> WE WERE DISCUSSING, THERE 4145 02:49:38,711 --> 02:49:41,214 WERE SEVERAL STUDIES ON KWAN. 4146 02:49:41,214 --> 02:49:43,283 >> YES, ALL THE INFORMATION ON 4147 02:49:43,283 --> 02:49:45,185 THAT EXAMPLE SLIDE WAS EXTRACTED 4148 02:49:45,185 --> 02:49:46,820 FROM THE ARTICLES WE COULD ONLY 4149 02:49:46,820 --> 02:49:50,290 RELY ON WHAT WAS PRINTED IN THE 4150 02:49:50,290 --> 02:49:50,523 TEXT. 4151 02:49:50,523 --> 02:49:52,392 SO WE UNDERSTAND THERE MAY BE 4152 02:49:52,392 --> 02:49:54,694 SOME UNSPOKEN THINGS THAT WERE 4153 02:49:54,694 --> 02:49:56,196 TAILORED THAT COULD HAVE BEEN 4154 02:49:56,196 --> 02:49:57,063 CONDUCTED DURING THE 4155 02:49:57,063 --> 02:50:00,467 INTERVENTION BUT AGAIN WE COULD 4156 02:50:00,467 --> 02:50:02,535 RELY ON PUBLISHED WORD. 4157 02:50:02,535 --> 02:50:05,939 IN SOME CASES WE WERE REFERRED 4158 02:50:05,939 --> 02:50:08,575 BACK TO FORMATIVE RESEARCH 4159 02:50:08,575 --> 02:50:10,510 ARTICLES OR, YOU KNOW, FOCUS 4160 02:50:10,510 --> 02:50:14,581 GROUPS, THERE COULD HAVE BEEN 4161 02:50:14,581 --> 02:50:15,782 MORE INFORMATION ON A GIVEN 4162 02:50:15,782 --> 02:50:17,217 INTERVENTION INCLUDED IN OUR 4163 02:50:17,217 --> 02:50:20,153 EVIDENCE SCAN SO IF WE FELT LIKE 4164 02:50:20,153 --> 02:50:21,821 WE NEEDED ADDITIONAL DETAILS 4165 02:50:21,821 --> 02:50:23,590 THERE WAS PROBABLY SOMETHING 4166 02:50:23,590 --> 02:50:26,292 WORTH LOOKING FOR IN SOME OF 4167 02:50:26,292 --> 02:50:26,960 THOSE FORMATIVE RESEARCH PAPERS, 4168 02:50:26,960 --> 02:50:29,796 WE DID TAKE A LOOK AT THEM AS 4169 02:50:29,796 --> 02:50:29,996 WELL. 4170 02:50:29,996 --> 02:50:31,764 >> BUT I WANT TO EMPHASIZE THAT 4171 02:50:31,764 --> 02:50:36,569 A PERSON DOING THIS TYPE OF 4172 02:50:36,569 --> 02:50:37,704 RESEARCH, DEANNA CAN TELL YOU, 4173 02:50:37,704 --> 02:50:39,973 THERE'S SO MUCH WE CAN PUT IN 4174 02:50:39,973 --> 02:50:42,942 THE PUBLICATION SO YOU'RE RIGHT, 4175 02:50:42,942 --> 02:50:44,811 THAT WAS ONE OF OUR CHALLENGES, 4176 02:50:44,811 --> 02:50:46,880 MANY THINGS ARE DONE IN THE BACK 4177 02:50:46,880 --> 02:50:49,516 END, AND NOT PUBLISHED. 4178 02:50:49,516 --> 02:50:51,484 LIKE EVIDENTIAL COMPONENT, THERE 4179 02:50:51,484 --> 02:50:56,155 WAS VERY SMALL NUMBER OF STUDIES 4180 02:50:56,155 --> 02:50:57,190 IN THE EVIDENTIAL COMPONENT, 4181 02:50:57,190 --> 02:50:59,726 MOST LIKELY USED THAT BUT DIDN'T 4182 02:50:59,726 --> 02:51:01,561 SPECIFICALLY SAY SO IN THE 4183 02:51:01,561 --> 02:51:03,496 PUBLICATION SO WE'RE LIMITED TO 4184 02:51:03,496 --> 02:51:07,567 WHAT'S WRITTEN THERE. 4185 02:51:07,567 --> 02:51:08,334 >> A RECOMMENDATION FOR 4186 02:51:08,334 --> 02:51:09,369 EXPANDING THIS AREA AND 4187 02:51:09,369 --> 02:51:11,404 UNDERSTANDING BETTER WOULD BE TO 4188 02:51:11,404 --> 02:51:14,874 ASK FOR JOURNALS TO BE MORE 4189 02:51:14,874 --> 02:51:16,543 ACCEPTING OF THESE DEVELOPMENTAL 4190 02:51:16,543 --> 02:51:17,844 PAPERS BECAUSE THERE'S NOT MANY 4191 02:51:17,844 --> 02:51:20,280 PLACES YOU CAN GO WITH THAT KIND 4192 02:51:20,280 --> 02:51:29,255 OF BACKGROUND INFORMATION ON 4193 02:51:29,255 --> 02:51:29,789 DEVELOPMENT. 4194 02:51:29,789 --> 02:51:31,457 >> GREAT RECOMMENDATION, THANKS. 4195 02:51:31,457 --> 02:51:32,058 >> REPORTING GUIDELINES IN 4196 02:51:32,058 --> 02:51:33,593 SPACE, WHAT NEEDS TO BE 4197 02:51:33,593 --> 02:51:36,462 REPORTED, WHAT DOESN'T HAVE TO 4198 02:51:36,462 --> 02:51:38,531 BE REPORTED, AND THAT 4199 02:51:38,531 --> 02:51:40,833 VARIABILITY, BECAUSE WE USE THIS 4200 02:51:40,833 --> 02:51:43,069 RUBRIC, BUT THERE IS NO STANDARD 4201 02:51:43,069 --> 02:51:48,274 TO SAY YOU NEED TO REPORT THIS, 4202 02:51:48,274 --> 02:51:51,477 THINGS NEED TO BE CATEGORIZED. 4203 02:51:51,477 --> 02:51:53,313 WHAT YOUR RECOMMENDATION IS, IS 4204 02:51:53,313 --> 02:51:53,613 REALLY KEY. 4205 02:51:53,613 --> 02:51:55,248 YOU CAN'T DO THAT IN THE 4206 02:51:55,248 --> 02:51:55,715 OUTCOMES PAPER. 4207 02:51:55,715 --> 02:51:59,118 A LOT OF THOSE THINGS HAVE TO BE 4208 02:51:59,118 --> 02:51:59,719 REPORTED. 4209 02:51:59,719 --> 02:52:00,687 >> A FOLLOW-UP, MAYBE WE CAN 4210 02:52:00,687 --> 02:52:02,522 PROVIDE JUST LIKE A TEMPLATE OF 4211 02:52:02,522 --> 02:52:09,429 THIS WOULD BE NICE TO INCLUDE 4212 02:52:09,429 --> 02:52:10,096 PARTICULARLY DOING INTERVENTION, 4213 02:52:10,096 --> 02:52:13,366 IF WE HAVE THIS FRAMEWORK WHICH 4214 02:52:13,366 --> 02:52:15,234 INCLUDES THESE ELEMENTS, IF YOU 4215 02:52:15,234 --> 02:52:16,669 HAVE THIS AVAILABLE PLEASE 4216 02:52:16,669 --> 02:52:18,871 INCLUDE THESE ELEMENTS. 4217 02:52:18,871 --> 02:52:22,041 AND THAT BECOMES BASELINE 4218 02:52:22,041 --> 02:52:24,210 FRAMEWORK FOR THIS LIKE A 4219 02:52:24,210 --> 02:52:24,477 CHECKLIST. 4220 02:52:24,477 --> 02:52:27,847 >> THAT'S WHY WE INCLUDED 4221 02:52:27,847 --> 02:52:29,582 EXAMPLE ARTICLE, BECAUSE ALLLI 4222 02:52:29,582 --> 02:52:32,218 AND TEAM MADE GREAT JOB OF 4223 02:52:32,218 --> 02:52:33,019 IDENTIFYING A STUDY, WELL 4224 02:52:33,019 --> 02:52:36,723 SEVERAL STUDIES, WE PICKED THIS 4225 02:52:36,723 --> 02:52:40,860 ONE TO SHOW THIS WILL BE GREAT, 4226 02:52:40,860 --> 02:52:44,163 INTERVENTION IS OUT THERE, 4227 02:52:44,163 --> 02:52:46,099 SOMETHING SIMILAR TO WHAT THIS 4228 02:52:46,099 --> 02:52:46,766 STUDY DID. 4229 02:52:46,766 --> 02:52:50,937 THEY WERE THOROUGH, THEY HAD IT 4230 02:52:50,937 --> 02:52:51,938 IN THEIR PUBLICATION. 4231 02:52:51,938 --> 02:52:54,874 SO WE'LL PUT IT AS PART OF THE 4232 02:52:54,874 --> 02:52:59,912 REPORT TO SHOW THESE ARE GREAT 4233 02:52:59,912 --> 02:53:00,380 EXAMPLES. 4234 02:53:00,380 --> 02:53:01,547 >> I WANT TO CONGRATULATE THE 4235 02:53:01,547 --> 02:53:03,850 SUBCOMMITTEE ON THIS WORK, IT'S 4236 02:53:03,850 --> 02:53:07,453 REALLY SHOWING MORE THAN JUST 4237 02:53:07,453 --> 02:53:09,622 CULTURALLY PLACED INTERVENTIONS. 4238 02:53:09,622 --> 02:53:10,690 IT'S CULTURALLY BASED 4239 02:53:10,690 --> 02:53:13,893 INTERVENTIONS WHICH I THINK 4240 02:53:13,893 --> 02:53:17,830 BECOMES A VERY DIFFERENT PIECE 4241 02:53:17,830 --> 02:53:19,465 OF LITERATURE. 4242 02:53:19,465 --> 02:53:21,901 I THINK IT HIGHLIGHTS THE EFFORT 4243 02:53:21,901 --> 02:53:24,303 GOING INTO THE WORK, AND HOW IT 4244 02:53:24,303 --> 02:53:26,139 TRANSLATES AS OPPOSED TO JUST 4245 02:53:26,139 --> 02:53:27,674 TRANSLATE IT AND IT WILL BE 4246 02:53:27,674 --> 02:53:29,876 FINE, SAME THING, SAME MESSAGE, 4247 02:53:29,876 --> 02:53:31,277 AND THAT SORT. 4248 02:53:31,277 --> 02:53:34,047 THE ABILITY TO USE SUPPLEMENTAL 4249 02:53:34,047 --> 02:53:37,750 MATERIALS WITHIN JOURNALS, TO 4250 02:53:37,750 --> 02:53:40,820 PROVIDE THOSE, SO WAS THERE 4251 02:53:40,820 --> 02:53:43,423 ANYTHING FROM THAT LEVEL OF 4252 02:53:43,423 --> 02:53:44,757 DISSECTION THAT RAISED IN YOUR 4253 02:53:44,757 --> 02:53:46,292 ASSESSMENT OF WHAT THE EVIDENCE 4254 02:53:46,292 --> 02:53:48,061 SCAN IS WHERE SOME MORE 4255 02:53:48,061 --> 02:53:51,364 SUCCESSFUL STRATEGIES AND THAT 4256 02:53:51,364 --> 02:53:54,400 KIND OF CULTURALLY BASED 4257 02:53:54,400 --> 02:53:55,835 INTERVENTIONS SEEMED TO SWING 4258 02:53:55,835 --> 02:53:56,169 FORWARD? 4259 02:53:56,169 --> 02:53:57,603 >> WE DIDN'T LOOK AT OUTCOMES. 4260 02:53:57,603 --> 02:53:59,105 SO THAT'S THE CHALLENGE. 4261 02:53:59,105 --> 02:54:00,640 WE DON'T KNOW WHICH ONE WAS 4262 02:54:00,640 --> 02:54:01,841 BETTER THAN ANOTHER ONE. 4263 02:54:01,841 --> 02:54:05,778 WE JUST LOOKED AT WHAT'S OUT 4264 02:54:05,778 --> 02:54:08,748 THERE. 4265 02:54:08,748 --> 02:54:10,483 BUT ONE THING THAT REALLY 4266 02:54:10,483 --> 02:54:12,785 STRUCK, WHEN I WAS REVEALING 4267 02:54:12,785 --> 02:54:15,088 THIS, I THINK IT WOULD BE FUTURE 4268 02:54:15,088 --> 02:54:17,290 COMMITTEES MAY HAVE TO SEE THE 4269 02:54:17,290 --> 02:54:20,226 EVIDENCE DIFFERENTLY DEPENDING 4270 02:54:20,226 --> 02:54:22,195 IF YOU'RE WORKING WITH 4271 02:54:22,195 --> 02:54:23,396 IMMIGRANTS VERSUS COMMUNITIES 4272 02:54:23,396 --> 02:54:24,497 THAT ARE ALREADY ESTABLISHED 4273 02:54:24,497 --> 02:54:27,133 HERE BECAUSE THE RESULT MAY BE 4274 02:54:27,133 --> 02:54:29,869 DIFFERENT LIKE FOR HISPANIC TYPE 4275 02:54:29,869 --> 02:54:31,637 OF INTERVENTIONS WE'RE LOOKING 4276 02:54:31,637 --> 02:54:33,806 FROM THEIR ASSIMILATING TO THE 4277 02:54:33,806 --> 02:54:35,875 CULTURE HERE, BUT FOR OTHER, 4278 02:54:35,875 --> 02:54:36,976 ANGELA DID MENTION SOMETHING 4279 02:54:36,976 --> 02:54:39,378 ABOUT THAT, BUT FOR OTHER NATIVE 4280 02:54:39,378 --> 02:54:40,913 AMERICANS THERE MAY BE MORE LIKE 4281 02:54:40,913 --> 02:54:43,116 A COMMUNITY TYPE OF INTERVENTION 4282 02:54:43,116 --> 02:54:45,485 DEPENDING WHERE THEY ARE, AND 4283 02:54:45,485 --> 02:54:48,688 NOT AN IMMIGRATION THING VERSUS 4284 02:54:48,688 --> 02:54:50,890 ASIANS OR HISPANICS, SO THEY MAY 4285 02:54:50,890 --> 02:54:56,028 HAVE TO BE DEALT INTO THE FUTURE 4286 02:54:56,028 --> 02:55:00,967 SEPARATELY, BECAUSE THERE COULD 4287 02:55:00,967 --> 02:55:01,734 BE IMPORTANT DIFFERENCES. 4288 02:55:01,734 --> 02:55:03,469 >> THAT'S THE OTHER THING NOT 4289 02:55:03,469 --> 02:55:07,306 REPORTED IN THIS ARTICLE, SOME 4290 02:55:07,306 --> 02:55:15,081 OF THE JUSTIFICATION FOR THE 4291 02:55:15,081 --> 02:55:15,381 APPROACHES. 4292 02:55:15,381 --> 02:55:19,652 TO CRISTINA'S POINT, THIS IS A 4293 02:55:19,652 --> 02:55:20,753 CULTURAL FOCUSED INTERVENTIONS, 4294 02:55:20,753 --> 02:55:22,321 AND THEY INDICATED WE HAD TO 4295 02:55:22,321 --> 02:55:25,224 HAVE SOME KIND OF CRITERIA FOR 4296 02:55:25,224 --> 02:55:27,693 THAT, BUT THINGS THAT ARE AROUND 4297 02:55:27,693 --> 02:55:29,729 SOCIAL DETERMINANTS, YOU KNOW, 4298 02:55:29,729 --> 02:55:30,630 THINKING HOW THESE 4299 02:55:30,630 --> 02:55:31,697 INTERVENTIONS, SO JUSTIFICATION 4300 02:55:31,697 --> 02:55:33,366 AND COMPONENTS IS REALLY 4301 02:55:33,366 --> 02:55:36,536 DIFFICULT TO GLEAN FROM THE 4302 02:55:36,536 --> 02:55:36,969 ARTICLES. 4303 02:55:36,969 --> 02:55:40,439 >> YEAH, BUT THAT POINT I THINK 4304 02:55:40,439 --> 02:55:45,945 IS REALLY WHEN THE BACKGROUND 4305 02:55:45,945 --> 02:55:52,618 FOR WHY MAY DIFFER ACROSS 4306 02:55:52,618 --> 02:55:53,386 SUBGROUPS. 4307 02:55:53,386 --> 02:55:56,556 >> JUST THINKING ABOUT WHAT 4308 02:55:56,556 --> 02:55:58,524 YOU'RE SAYING REGARDING THE 4309 02:55:58,524 --> 02:55:59,625 LIMITED AVAILABLE INFORMATION, I 4310 02:55:59,625 --> 02:56:03,129 DON'T THINK IT IS UNIQUE TO THIS 4311 02:56:03,129 --> 02:56:03,729 TOPIC. 4312 02:56:03,729 --> 02:56:05,431 I THINK EVERY DISCIPLINE IN 4313 02:56:05,431 --> 02:56:07,600 RESEARCH STRUGGLES WITH THIS. 4314 02:56:07,600 --> 02:56:16,709 BUT I NOTICED IN YOUR BREAKDOWN, 4315 02:56:16,709 --> 02:56:18,578 A MAJORITY FEDERALLY FUNDED, I 4316 02:56:18,578 --> 02:56:21,314 WOULD PROPOSE IN THE 4317 02:56:21,314 --> 02:56:23,649 RECOMMENDATION TO FEDERAL 4318 02:56:23,649 --> 02:56:26,719 AGENCIES THAT WE SHOULD BE 4319 02:56:26,719 --> 02:56:28,688 ASKING FOR SOME KIND OF 4320 02:56:28,688 --> 02:56:32,091 REPOSITORY WHERE YOU ASK THE KEY 4321 02:56:32,091 --> 02:56:33,492 QUESTIONS. 4322 02:56:33,492 --> 02:56:39,498 I'M THINKING AS A PARALLEL 4323 02:56:39,498 --> 02:56:40,299 clinicaltrials.gov, MANDATORY 4324 02:56:40,299 --> 02:56:41,934 TO PUBLISH ANY CLINICAL TRIAL, 4325 02:56:41,934 --> 02:56:47,940 IT'S A POWERFUL TOOL FOR 4326 02:56:47,940 --> 02:56:49,041 REVIEWERS, EDITORS, PEERS, 4327 02:56:49,041 --> 02:56:51,677 POLICYMAKERS, SO THE WEALTH OF 4328 02:56:51,677 --> 02:56:53,646 DATA HERE AND THIS REALLY DOES 4329 02:56:53,646 --> 02:56:55,715 SEEM AS YOU PRESENTED A 4330 02:56:55,715 --> 02:56:57,917 COMPELLING CASE, THIS IS THE 4331 02:56:57,917 --> 02:56:58,251 FUTURE. 4332 02:56:58,251 --> 02:57:00,653 SO WHY DON'T WE RECOMMEND THAT 4333 02:57:00,653 --> 02:57:02,054 TO A FEDERAL AGENCY? 4334 02:57:02,054 --> 02:57:03,723 AND START GETTING THE DATA 4335 02:57:03,723 --> 02:57:03,923 THERE. 4336 02:57:03,923 --> 02:57:04,357 THANK YOU. 4337 02:57:04,357 --> 02:57:06,225 THANK YOU AGAIN FOR A GREAT 4338 02:57:06,225 --> 02:57:06,759 PRESENTATION. 4339 02:57:06,759 --> 02:57:08,461 AND THANK YOU FOR BREAKING IT 4340 02:57:08,461 --> 02:57:11,697 DOWN BECAUSE SOMETIMES I THINK 4341 02:57:11,697 --> 02:57:13,232 WE OMIT THE BASICS AND THEN 4342 02:57:13,232 --> 02:57:15,201 WE'RE COMING AT IT OUT OF 4343 02:57:15,201 --> 02:57:19,906 CONTEXT. 4344 02:57:19,906 --> 02:57:22,208 SO THANK YOU, GREAT. 4345 02:57:22,208 --> 02:57:27,914 >> CAN I JUST ASK, VALERIE AND 4346 02:57:27,914 --> 02:57:29,248 HOLLIE DON'T WANT TO FORGET THAT 4347 02:57:29,248 --> 02:57:30,016 YOU'RE THERE. 4348 02:57:30,016 --> 02:57:32,518 I WONDERED IF EITHER OF YOU HAD 4349 02:57:32,518 --> 02:57:35,354 ANY QUESTIONS YOU WANTED TO ASK 4350 02:57:35,354 --> 02:57:42,461 OF THIS WORKING GROUP? 4351 02:57:42,461 --> 02:57:43,796 4352 02:57:43,796 --> 02:57:45,197 >> THIS IS HOLLIE. 4353 02:57:45,197 --> 02:57:46,532 NO ADDITIONAL QUESTIONS BUT I 4354 02:57:46,532 --> 02:57:49,902 APPRECIATE YOU REACHING OUT TO 4355 02:57:49,902 --> 02:57:50,770 US ONLINE. 4356 02:57:50,770 --> 02:57:52,104 >> HI. 4357 02:57:52,104 --> 02:57:53,940 I DON'T HAVE ANY ADDITIONAL 4358 02:57:53,940 --> 02:57:54,206 QUESTIONS. 4359 02:57:54,206 --> 02:57:55,875 I JUST WANT TO THANK EVERYONE ON 4360 02:57:55,875 --> 02:57:57,677 THE COMMITTEE. 4361 02:57:57,677 --> 02:58:01,948 THIS IS SUCH AN EXCITING STEP 4362 02:58:01,948 --> 02:58:05,451 FORWARD, AND REALLY GREAT 4363 02:58:05,451 --> 02:58:05,785 PRESENTATIONS. 4364 02:58:05,785 --> 02:58:06,319 THANK YOU. 4365 02:58:06,319 --> 02:58:09,722 >> THANK YOU BOTH. 4366 02:58:09,722 --> 02:58:12,458 WE REALLY APPRECIATE YOU WERE 4367 02:58:12,458 --> 02:58:14,827 ABLE TO JOIN US ALBEIT REMOTELY. 4368 02:58:14,827 --> 02:58:18,531 ANY OTHER QUESTIONS? 4369 02:58:18,531 --> 02:58:18,731 OKAY. 4370 02:58:18,731 --> 02:58:24,737 SO IF YOU DON'T -- IF THERE -- 4371 02:58:24,737 --> 02:58:24,971 OKAY. 4372 02:58:24,971 --> 02:58:28,040 >> YES, NEXT STEPS. 4373 02:58:28,040 --> 02:58:28,674 >> RIGHT. 4374 02:58:28,674 --> 02:58:30,609 NEXT STEPS WE'RE GOING COMPLETE 4375 02:58:30,609 --> 02:58:32,511 THE PEER REVIEW, WAIT FOR THE 4376 02:58:32,511 --> 02:58:34,914 PEER REVIEW PROCESS TO COME BACK 4377 02:58:34,914 --> 02:58:38,084 AND IF WE NEED TO MAKE CHANGES 4378 02:58:38,084 --> 02:58:39,518 WE'LL INCORPORATE THOSE. 4379 02:58:39,518 --> 02:58:41,253 WE'LL COMPLETE THE SCIENTIFIC 4380 02:58:41,253 --> 02:58:45,424 REPORT CHAPTERS WHICH WE'VE BEEN 4381 02:58:45,424 --> 02:58:47,593 WORKING VERY HARD. 4382 02:58:47,593 --> 02:58:51,130 WE HAVE THE PORTION SIZE ALREADY 4383 02:58:51,130 --> 02:58:52,765 OUT TO OUR SCIENTIFIC WRITER AND 4384 02:58:52,765 --> 02:58:54,367 WE ARE ALMOST DONE WITH THE 4385 02:58:54,367 --> 02:58:56,569 FREQUENCY OF MEALS AND/OR 4386 02:58:56,569 --> 02:58:58,537 SNACKING. 4387 02:58:58,537 --> 02:59:00,873 AND NOW WE'RE STARTING WITH 4388 02:59:00,873 --> 02:59:01,540 CULTURALLY TAILORED DIETARY 4389 02:59:01,540 --> 02:59:03,709 INTERVENTIONS SO WE'VE BEEN VERY 4390 02:59:03,709 --> 02:59:05,478 BUSY AND WE'LL PRESENT THOSE 4391 02:59:05,478 --> 02:59:11,283 FINDINGS IN OUR NEXT MEETING. 4392 02:59:11,283 --> 02:59:11,517 THANKS. 4393 02:59:11,517 --> 02:59:11,984 >> WONDERFUL. 4394 02:59:11,984 --> 02:59:14,787 I THINK WE'LL TAKE A BREAK 4395 02:59:14,787 --> 02:59:14,987 THERE. 4396 02:59:14,987 --> 02:59:20,126 WE'RE GOING TO COME BACK AT 4397 02:59:20,126 --> 02:59:20,559 1:30. 4398 02:59:20,559 --> 02:59:23,963 AND WE WILL START WITH THE 4399 02:59:23,963 --> 02:59:26,265 REVIEW ON THE -- UPDATES ON DIE 4400 02:59:26,265 --> 02:59:27,366 APPEAR PATTERNS. 4401 02:59:27,366 --> 02:59:28,934 SO TO THE PUBLIC, ENJOY YOUR 4402 02:59:28,934 --> 02:59:29,268 BREAK. 4403 02:59:29,268 --> 02:59:31,003 WE'LL SEE YOU AT 1:30. 4404 02:59:31,003 --> 02:59:31,771 TAKE CARE. 4405 02:59:31,771 --> 02:59:36,058 THANK YOU, EVERYBODY. 4406 02:59:36,058 --> 02:59:37,793 SO WITHOUT FURTHER ADO, I'M 4407 02:59:37,793 --> 02:59:43,498 GOING TO HAND THE PODIUM OVER TO 4408 02:59:43,498 --> 02:59:45,133 MY COLLEAGUE, DEANNA. 4409 02:59:45,133 --> 02:59:47,102 >> THANK YOU. 4410 02:59:47,102 --> 02:59:49,271 I'M HAPPY TO PRESENT OUR 4411 02:59:49,271 --> 02:59:51,273 COMMITTEE'S FINDINGS ON DIETARY 4412 02:59:51,273 --> 02:59:55,210 PATTERNS AND SPECIFIC DIETARY 4413 02:59:55,210 --> 02:59:56,745 PATTERN COMPONENTS ACROSS LIFE 4414 02:59:56,745 --> 02:59:57,279 STAGES. 4415 02:59:57,279 --> 02:59:59,681 AND TODAY WE'LL HAVE SEVERAL 4416 02:59:59,681 --> 03:00:01,316 PRESENTERS FROM THE COMMITTEE, 4417 03:00:01,316 --> 03:00:09,558 SO DR. SARAH BOOTH, DR. ED 4418 03:00:09,558 --> 03:00:14,796 JIOVANUCCI, DR. FUNG, DR. 4419 03:00:14,796 --> 03:00:17,532 ANDERSON, DR. DEIRLEIN, DR. 4420 03:00:17,532 --> 03:00:19,067 TOBIAS, DR. GARDNER WILL JOIN ME 4421 03:00:19,067 --> 03:00:23,005 IN PRESENTING OUR RESULTS TODAY. 4422 03:00:23,005 --> 03:00:23,372 NEXT SLIDE. 4423 03:00:23,372 --> 03:00:27,175 SO, HERE YOU CAN SEE THE MEMBERS 4424 03:00:27,175 --> 03:00:28,043 OF OUR COMMITTEE. 4425 03:00:28,043 --> 03:00:30,245 I DID WANT TO POINT OUT SEVERAL 4426 03:00:30,245 --> 03:00:34,383 OF US SERVE ON THE HEALTH EQUITY 4427 03:00:34,383 --> 03:00:36,251 WORKING GROUP, SO THERE IS 4428 03:00:36,251 --> 03:00:44,026 CROSS-CONVERSATION GOING ON WITH 4429 03:00:44,026 --> 03:00:44,393 BOTH. 4430 03:00:44,393 --> 03:00:45,560 GREAT COMMITTEE, AND THE LAST 4431 03:00:45,560 --> 03:00:49,631 FEW WEEKS A SPRINT TOWARD THE 4432 03:00:49,631 --> 03:00:49,831 ENDS. 4433 03:00:49,831 --> 03:00:54,770 AS BEFORE, I'D LIKE TO GIVE A 4434 03:00:54,770 --> 03:00:59,207 SHOUT OUT TO OUR NESR AND 4435 03:00:59,207 --> 03:00:59,808 SUPPORT GROUP. 4436 03:00:59,808 --> 03:01:01,443 THEY HAVE BEEN A SUPPORT GROUP 4437 03:01:01,443 --> 03:01:03,845 DURING THE LAST FEW WEEKS, AS I 4438 03:01:03,845 --> 03:01:06,782 MENTIONED IT HAS BEEN A PRINT. 4439 03:01:06,782 --> 03:01:11,553 WE HAVE DONE -- ENGAGED IN A LOT 4440 03:01:11,553 --> 03:01:14,956 OF EXTRA MEETINGS ESPECIALLY 4441 03:01:14,956 --> 03:01:15,924 SATURATED FAT CONCLUSION 4442 03:01:15,924 --> 03:01:16,692 STATEMENTS DONE TODAY, WE 4443 03:01:16,692 --> 03:01:17,893 APPRECIATE YOUR HARD WORK IN 4444 03:01:17,893 --> 03:01:26,335 WORKING WITH US AND THE 4445 03:01:26,335 --> 03:01:27,636 COMMITTEE AS WELL. 4446 03:01:27,636 --> 03:01:30,605 AN UPDATE ON PROGRESS, SINCE 4447 03:01:30,605 --> 03:01:32,808 MEETING 5 SEVERAL SYSTEMATIC 4448 03:01:32,808 --> 03:01:34,443 REVIEWS HAVE UNDERGONE PEER 4449 03:01:34,443 --> 03:01:35,544 REVIEW INCLUDING DIETARY 4450 03:01:35,544 --> 03:01:36,745 PATTERNS AND GROWTH, BODY 4451 03:01:36,745 --> 03:01:44,086 COMPOSITION AND RISK OF OBESITY. 4452 03:01:44,086 --> 03:01:46,888 TYPE 2 DIABETES, RISK OF 4453 03:01:46,888 --> 03:01:47,589 CARDIOVASCULAR DISEASE, AND 4454 03:01:47,589 --> 03:01:50,325 PATTERNS WITH VARYING AMOUNTS OF 4455 03:01:50,325 --> 03:01:56,665 ULTRA PROCESSED FOOD AND GROWTH, 4456 03:01:56,665 --> 03:01:58,200 BODY COMPOSITION AND RISK OF 4457 03:01:58,200 --> 03:01:58,567 OBESITY. 4458 03:01:58,567 --> 03:02:00,936 THERE'S ACTUALLY FOUR THAT WE'VE 4459 03:02:00,936 --> 03:02:02,904 GONE THROUGH PEER REVIEW WITH. 4460 03:02:02,904 --> 03:02:04,539 WE HAVE SEVERAL SYSTEMATIC 4461 03:02:04,539 --> 03:02:06,074 REVIEWS WITH DRAFT CONCLUSION 4462 03:02:06,074 --> 03:02:08,043 STATEMENTS THAT WE WILL PRESENT 4463 03:02:08,043 --> 03:02:09,778 TODAY, AND THEY INCLUDE DIETARY 4464 03:02:09,778 --> 03:02:15,951 PATTERNS AND RISK OF COGNITIVE 4465 03:02:15,951 --> 03:02:20,088 DECLINE, DEMENTIA, ALZHEIMER'S 4466 03:02:20,088 --> 03:02:22,824 DISEASE, MILD COGNITIVE 4467 03:02:22,824 --> 03:02:24,259 IMPAIRMENT, AND RISK OF 4468 03:02:24,259 --> 03:02:29,698 COLORECTAL OR BREAST CANCER. 4469 03:02:29,698 --> 03:02:30,599 THESE ARE UPDATES. 4470 03:02:30,599 --> 03:02:32,801 SINCE MEETING 5 WE LOOKED AT 4471 03:02:32,801 --> 03:02:37,606 SEVERAL DIETARY PATTERN 4472 03:02:37,606 --> 03:02:37,906 COMPONENTS. 4473 03:02:37,906 --> 03:02:43,278 SO HERE WE HAVE SIX SYSTEMATIC 4474 03:02:43,278 --> 03:02:45,680 REVIEWS, THESE HAD TO DO WITH 4475 03:02:45,680 --> 03:02:47,582 OUTCOMES OF GROWTH, BODY 4476 03:02:47,582 --> 03:02:52,053 COMPOSITION, RISK OF OBESITY OR 4477 03:02:52,053 --> 03:02:54,356 TYPE 2 DIABETES, INCLUDING 4478 03:02:54,356 --> 03:02:56,625 BEVERAGE PATTERNS, DAIRY MILK 4479 03:02:56,625 --> 03:03:00,128 AND MILK ALTERNATIVES, LOW AND 4480 03:03:00,128 --> 03:03:05,066 NO CALORIE SWEETENED, 100% JUICE 4481 03:03:05,066 --> 03:03:13,809 AND RISK OF TYPE 2 DIABETES AND 4482 03:03:13,809 --> 03:03:24,252 SUGAR SWEETENED BEVERAGES. 4483 03:03:26,121 --> 03:03:32,194 WE'LL COVER ADULT, OLDER ADULTS, 4484 03:03:32,194 --> 03:03:34,696 PREGNANCY AND POSTPARTUM, WE 4485 03:03:34,696 --> 03:03:36,031 PRESENTED FOR CHILDREN AND 4486 03:03:36,031 --> 03:03:36,798 ADOLESCENTS AT MEETING 5. 4487 03:03:36,798 --> 03:03:39,067 THIS IS AN UPDATE BUT WE DO HAVE 4488 03:03:39,067 --> 03:03:40,669 A META-ANALYSIS, A NEW COMPONENT 4489 03:03:40,669 --> 03:03:41,937 TO THAT. 4490 03:03:41,937 --> 03:03:45,974 AND THEN THE LAST SET OF 4491 03:03:45,974 --> 03:03:53,448 SYSTEMATIC -- LAST SYSTEMATIC 4492 03:03:53,448 --> 03:03:55,851 REVIEW, FOOD SOURCES OF 4493 03:03:55,851 --> 03:03:57,719 SATURATED FAT, RISK OF 4494 03:03:57,719 --> 03:03:58,220 CARDIOVASCULAR DISEASE. 4495 03:03:58,220 --> 03:03:59,688 WE'LL HAVE 31 CONCLUSION 4496 03:03:59,688 --> 03:04:02,524 STATEMENTS, AFTER THE BREAK 4497 03:04:02,524 --> 03:04:02,858 TODAY. 4498 03:04:02,858 --> 03:04:06,261 BUT WE KNOW THAT YOU'LL FIND IT 4499 03:04:06,261 --> 03:04:14,369 WILL BE A RIVETTING CONVERSATION 4500 03:04:14,369 --> 03:04:16,204 AND DISCUSSION. 4501 03:04:16,204 --> 03:04:17,873 I WANT TO REMIND THOSE WHO CAME 4502 03:04:17,873 --> 03:04:19,407 IN DURING THE BREAK THAT MISSED 4503 03:04:19,407 --> 03:04:21,009 THIS MORNING AND THOSE OF YOU 4504 03:04:21,009 --> 03:04:22,444 HERE JUST TO REMIND YOU AGAIN 4505 03:04:22,444 --> 03:04:24,179 WE'RE GOING TO PRESENT A LOT OF 4506 03:04:24,179 --> 03:04:25,280 CONCLUSION STATEMENTS WITH A LOT 4507 03:04:25,280 --> 03:04:28,149 OF GRADES SO I WANTED TO 4508 03:04:28,149 --> 03:04:29,818 EMPHASIZE WHAT THEY MEAN. 4509 03:04:29,818 --> 03:04:31,786 AND FOR STRONG, REMEMBER THE 4510 03:04:31,786 --> 03:04:33,655 LEVEL OF CERTAINTY IS STRONG AND 4511 03:04:33,655 --> 03:04:37,125 THAT IF NEW EVIDENCE EMERGES, 4512 03:04:37,125 --> 03:04:38,760 MODIFICATIONS TO THE CONCLUSION 4513 03:04:38,760 --> 03:04:41,096 STATEMENT ARE UNLIKELY TO BE 4514 03:04:41,096 --> 03:04:41,429 REQUIRED. 4515 03:04:41,429 --> 03:04:44,299 WITH MODERATE, IF NEW EVIDENCE 4516 03:04:44,299 --> 03:04:46,401 EMERGES, MODIFICATIONS TO THE 4517 03:04:46,401 --> 03:04:47,702 CONCLUSION STATEMENT MAY BE 4518 03:04:47,702 --> 03:04:49,004 REQUIRED. 4519 03:04:49,004 --> 03:04:51,706 AND THEN FOR LIMITED, IF NEW 4520 03:04:51,706 --> 03:04:53,074 EVIDENCE EMERGES, MODIFICATIONS 4521 03:04:53,074 --> 03:04:55,577 TO THE CONCLUSION ARE LIKELY TO 4522 03:04:55,577 --> 03:04:56,344 BE REQUIRED. 4523 03:04:56,344 --> 03:04:58,747 SO, IT'S GOOD FOR EVERYBODY TO 4524 03:04:58,747 --> 03:05:01,249 KEEP THAT IN MIND. 4525 03:05:01,249 --> 03:05:02,684 AND THEN GRADE NOT ASSIGNABLE 4526 03:05:02,684 --> 03:05:04,686 THAT MEANS WE CAN'T GIVE A 4527 03:05:04,686 --> 03:05:05,320 CONCLUSION STATEMENT, EITHER 4528 03:05:05,320 --> 03:05:07,956 BECAUSE WE HAVE A LACK OF 4529 03:05:07,956 --> 03:05:09,824 EVIDENCE OR THE EVIDENCE HAS 4530 03:05:09,824 --> 03:05:10,625 SEVERE LIMITATIONS. 4531 03:05:10,625 --> 03:05:12,627 AND WE CAN TALK ABOUT THOSE AS 4532 03:05:12,627 --> 03:05:15,964 WE GO THROUGH THE CONCLUSION 4533 03:05:15,964 --> 03:05:17,699 STATEMENTS THIS AFTERNOON. 4534 03:05:17,699 --> 03:05:20,001 AND SO WITH THAT, I'D LIKE TO 4535 03:05:20,001 --> 03:05:27,309 TURN TO THE DIETARY PATTERNS 4536 03:05:27,309 --> 03:05:28,743 WITH THE NEXT SLIDE. 4537 03:05:28,743 --> 03:05:30,612 I'LL TURN IT OVER TO DR. BOOTH. 4538 03:05:30,612 --> 03:05:33,048 >> NEXT SLIDE PLEASE. 4539 03:05:33,048 --> 03:05:37,552 SO, THIS REPRESENTS AN UPDATE TO 4540 03:05:37,552 --> 03:05:40,288 A PREVIOUS REVIEW EVALUATING 4541 03:05:40,288 --> 03:05:41,356 RELATIONSHIP BETWEEN DIETARY 4542 03:05:41,356 --> 03:05:43,625 PATTERNS, CONSUMED, RISK OF 4543 03:05:43,625 --> 03:05:44,759 COGNITIVE DECLINE, DEMENTIA, 4544 03:05:44,759 --> 03:05:47,362 ALZHEIMER'S DISEASE AND MILD 4545 03:05:47,362 --> 03:05:48,797 COGNITIVE IMPAIRMENT. 4546 03:05:48,797 --> 03:05:52,534 AS A REMINDER, HERE IS THE 4547 03:05:52,534 --> 03:05:54,169 ANALYTICAL FRAMEWORK. 4548 03:05:54,169 --> 03:05:56,671 ALTHOUGH THE OUTCOMES ARE 4549 03:05:56,671 --> 03:05:59,207 DEFINED IN ADULTS AND OLDER 4550 03:05:59,207 --> 03:06:04,012 ADULTS, WE DID INCLUDE SEVERAL 4551 03:06:04,012 --> 03:06:06,548 STUDIES THAT MET CRITERIA AND 4552 03:06:06,548 --> 03:06:11,119 ASSESSED DIETARY PATTERNS DURING 4553 03:06:11,119 --> 03:06:14,623 CHILDHOOD AND ADOLESCENCE. 4554 03:06:14,623 --> 03:06:18,560 WE PLANNED TO SYNTHESIZE DATA BY 4555 03:06:18,560 --> 03:06:19,561 ADULTS, OLDER ADULTS SEPARATELY, 4556 03:06:19,561 --> 03:06:22,197 IF SUFFICIENT DATA WERE 4557 03:06:22,197 --> 03:06:23,498 AVAILABLE. 4558 03:06:23,498 --> 03:06:24,833 THE GROUP HAD EXTENSIVE 4559 03:06:24,833 --> 03:06:28,937 DISCUSSION ABOUT WHAT ARE THE 4560 03:06:28,937 --> 03:06:29,971 CRITICAL TIME POINTS OVER THE 4561 03:06:29,971 --> 03:06:39,481 COURSE OF LIE LIFE AFFECTING 4562 03:06:39,481 --> 03:06:40,281 AGE-RELATED DECLINE OR DEMENTIA. 4563 03:06:40,281 --> 03:06:45,186 WE FELT IT WAS IMPORTANT TO 4564 03:06:45,186 --> 03:06:47,889 COMBINED ADULTS AND ORDINARY 4565 03:06:47,889 --> 03:06:49,591 ADULTS GIVEN WE DON'T KNOW 4566 03:06:49,591 --> 03:06:51,226 CRITICAL WINDOWS WHERE DIETARY 4567 03:06:51,226 --> 03:07:01,403 PATTERNS CAN HAVE AN IMPACT ON 4568 03:07:01,403 --> 03:07:02,404 BRAIN HEALTH. 4569 03:07:02,404 --> 03:07:05,640 I'LL START WITH CONCLUSION 4570 03:07:05,640 --> 03:07:06,207 STATEMENT. 4571 03:07:06,207 --> 03:07:07,842 WE CONCLUDED DIETARY PATTERNS 4572 03:07:07,842 --> 03:07:12,547 CONSUMED BY ADULTS AND OLDER 4573 03:07:12,547 --> 03:07:15,216 ADULTS WITH HIGHER INTAKES OF 4574 03:07:15,216 --> 03:07:20,889 VEGETABLES, FRUITS, LEGUMES OR 4575 03:07:20,889 --> 03:07:24,092 BEANS, NUTS, FISH, SEAFOOD, 4576 03:07:24,092 --> 03:07:24,759 UNSATURATED VEGETABLE OILS/FATS, 4577 03:07:24,759 --> 03:07:27,162 LOWER INTAKES OF RED AND 4578 03:07:27,162 --> 03:07:32,400 PROCESSED MEATS AND SUGAR 4579 03:07:32,400 --> 03:07:32,901 SWEETENED BEVER YADGESZ 4580 03:07:32,901 --> 03:07:39,941 ASSOCIATED WITH LOWER RISK OF 4581 03:07:39,941 --> 03:07:42,043 AGE RELATED COGNITIVE DECLINE, 4582 03:07:42,043 --> 03:07:47,749 BASED ON EVIDENCE GRADED AS 4583 03:07:47,749 --> 03:07:48,183 MODERATE. 4584 03:07:48,183 --> 03:07:52,587 THIS CONCLUSION STATEMENT CAME 4585 03:07:52,587 --> 03:07:55,857 AFTER REVIEWING 83 ARTICLES THAT 4586 03:07:55,857 --> 03:07:57,525 WERE PUBLISHED BETWEEN MARCH 4587 03:07:57,525 --> 03:08:00,562 2020 AND JANUARY 24, AS WELL AS 4588 03:08:00,562 --> 03:08:02,330 EVIDENCE THAT WAS EXCLUDED FROM 4589 03:08:02,330 --> 03:08:06,334 PREVIOUS REVIEWS THAT MET THE 4590 03:08:06,334 --> 03:08:10,638 NEW EXCLUSION CRITERIA OF THE 4591 03:08:10,638 --> 03:08:12,173 THE PRIOR REVIEW EVALUATE THE 4592 03:08:12,173 --> 03:08:13,608 STRENGTH OF EVIDENCE AS 4593 03:08:13,608 --> 03:08:14,576 MODERATE, WE DETERMINED THE 4594 03:08:14,576 --> 03:08:19,948 STRENGTH OF THAT EVIDENCE WAS 4595 03:08:19,948 --> 03:08:22,117 STILL MODERATE BASED ON 4596 03:08:22,117 --> 03:08:23,885 ASSESSMENT OF GRADING ELEMENT. 4597 03:08:23,885 --> 03:08:25,854 THERE WERE SOME CONCERNS OF 4598 03:08:25,854 --> 03:08:28,389 MINIMAL VARIABILITY IN DIRECTION 4599 03:08:28,389 --> 03:08:29,691 OF RESULTS. 4600 03:08:29,691 --> 03:08:32,427 HOWEVER, THERE WAS MINIMAL TO 4601 03:08:32,427 --> 03:08:34,295 MODERATE VARIABILITY IN THE 4602 03:08:34,295 --> 03:08:36,931 MAGNITUDE OF THESE RESULTS. 4603 03:08:36,931 --> 03:08:42,170 MOST OF THE ARTICLES, 54 OUT OF 4604 03:08:42,170 --> 03:08:44,038 83, REPORTED STATISTICALLY 4605 03:08:44,038 --> 03:08:45,607 SIGNIFICANT ASSOCIATIONS BETWEEN 4606 03:08:45,607 --> 03:08:50,945 DIETARY PATTERNS AND LOWER RISK. 4607 03:08:50,945 --> 03:08:53,348 ADVERSE COGNITIVE OUTCOMES. 4608 03:08:53,348 --> 03:08:55,416 THERE WERE SOME SERIOUS CONCERNS 4609 03:08:55,416 --> 03:08:58,753 NOTED REGARDING THE ONLY 4610 03:08:58,753 --> 03:09:00,555 ELIGIBLE ONE, RANDOMIZED 4611 03:09:00,555 --> 03:09:02,090 CONTROLLED TRIAL, AND CONFIDENCE 4612 03:09:02,090 --> 03:09:06,227 INTERVALS RANGED FROM NARROW TO 4613 03:09:06,227 --> 03:09:07,896 WIDE ACROSS REPORTED RESULTS IN 4614 03:09:07,896 --> 03:09:10,398 THE OBSERVATIONAL STUDY. 4615 03:09:10,398 --> 03:09:15,103 WE ALSO HAD EXTENSION OF 4616 03:09:15,103 --> 03:09:16,771 DISCUSSION ABOUT THE 4617 03:09:16,771 --> 03:09:19,741 MEASUREMENTS USED FOR THE 4618 03:09:19,741 --> 03:09:22,477 OUTCOMES, THERE IS A WIDE RANGE 4619 03:09:22,477 --> 03:09:24,879 OF TOOLS THAT PEOPLE -- THAT 4620 03:09:24,879 --> 03:09:27,415 INVESTIGATORS USE TO ASSESS 4621 03:09:27,415 --> 03:09:30,885 THESE OUTCOMES, AND THEY ARE NOT 4622 03:09:30,885 --> 03:09:31,553 HARMONIZED. 4623 03:09:31,553 --> 03:09:32,987 THEY ARE NOT STANDARDIZED. 4624 03:09:32,987 --> 03:09:35,824 AND THERE WAS A LOT OF CONCERN 4625 03:09:35,824 --> 03:09:39,027 ABOUT WHAT ACTUALLY WAS BEING 4626 03:09:39,027 --> 03:09:39,360 MEASURED. 4627 03:09:39,360 --> 03:09:42,630 AND THIS I THINK REALLY WEIGHED 4628 03:09:42,630 --> 03:09:45,033 INTO THE RISK OF BIAS, THE 4629 03:09:45,033 --> 03:09:47,902 OUTCOME MEASUREMENT ERROR. 4630 03:09:47,902 --> 03:09:52,774 SO, WE, AS I SAY, CONCLUDED A 4631 03:09:52,774 --> 03:09:54,042 MODERATE, YEAH, GRADE. 4632 03:09:54,042 --> 03:09:58,580 AND I DO BELIEVE THAT'S IT. 4633 03:09:58,580 --> 03:10:00,181 >> THANK YOU. 4634 03:10:00,181 --> 03:10:01,816 AND SO WE'LL DISCUSS ALL OF 4635 03:10:01,816 --> 03:10:07,088 THESE ONCE WE FINISH THE 4636 03:10:07,088 --> 03:10:09,490 COLORECTAL AND BREAST CANCERS, 4637 03:10:09,490 --> 03:10:09,657 ED? 4638 03:10:09,657 --> 03:10:10,358 >> THANK YOU. 4639 03:10:10,358 --> 03:10:13,761 YES, THIS IS AN UPDATE ON 4640 03:10:13,761 --> 03:10:15,930 RELATIONSHIP BETWEEN DIETARY 4641 03:10:15,930 --> 03:10:17,999 PATTERNS AND COLORECTAL CANCER 4642 03:10:17,999 --> 03:10:18,333 RISK. 4643 03:10:18,333 --> 03:10:25,340 YOU CAN SEE OUR OLD FRIEND THE 4644 03:10:25,340 --> 03:10:26,207 ANALYTIC FRAMEWORK. 4645 03:10:26,207 --> 03:10:28,743 I'LL POINT OUT WE'RE LOOKING AT 4646 03:10:28,743 --> 03:10:31,713 A RANGE OF POPULATIONS, ALTHOUGH 4647 03:10:31,713 --> 03:10:33,548 OUR CONCLUSIONS WILL BE BASED ON 4648 03:10:33,548 --> 03:10:36,618 ADULTS, THAT'S WHERE THE DATA 4649 03:10:36,618 --> 03:10:38,052 ARE. 4650 03:10:38,052 --> 03:10:40,121 IN TERMS OF THE OUTCOME, I'LL 4651 03:10:40,121 --> 03:10:44,459 JUST NOTE THAT WE DID LOOK AT 4652 03:10:44,459 --> 03:10:46,461 TUMOR SUBSITE, PARTS OF THE 4653 03:10:46,461 --> 03:10:47,662 COLON AND RECTUM. 4654 03:10:47,662 --> 03:10:50,431 THERE'S A LIST OF CONFOUNDERS 4655 03:10:50,431 --> 03:10:52,734 THAT'S VERY SIMILAR TO LIST OF 4656 03:10:52,734 --> 03:10:56,337 CONFOUNDERS, I WILL NOTE THAT WE 4657 03:10:56,337 --> 03:10:58,206 HAVE SCREENING FOR COLORECTAL 4658 03:10:58,206 --> 03:11:02,043 CANCER AS POTENTIALLY IMPORTANT 4659 03:11:02,043 --> 03:11:02,644 CONFOUNDER. 4660 03:11:02,644 --> 03:11:05,647 NEXT SLIDE PLEASE. 4661 03:11:05,647 --> 03:11:07,181 RIGHT. 4662 03:11:07,181 --> 03:11:09,918 SO, THIS IS THE MAIN CONCLUSION 4663 03:11:09,918 --> 03:11:11,319 STATEMENT IN GRAY. 4664 03:11:11,319 --> 03:11:13,588 SO AGAIN WE'RE LOOKING AT 4665 03:11:13,588 --> 03:11:16,658 DIETARY PATTERNS IN COLORECTAL 4666 03:11:16,658 --> 03:11:18,426 CANCER, AND I'LL JUST READ THE 4667 03:11:18,426 --> 03:11:20,962 SLIDE FOR THE CONCLUSION. 4668 03:11:20,962 --> 03:11:22,163 DIETARY PATTERNS CONSUMED BY 4669 03:11:22,163 --> 03:11:25,233 ADULT IT'S AND OLDER ADULTS THAT 4670 03:11:25,233 --> 03:11:27,535 ARE CHARACTERIZED BY HIGHER 4671 03:11:27,535 --> 03:11:29,270 INTAKES OF VEGETABLES, FRUITS, 4672 03:11:29,270 --> 03:11:31,239 LEGUMES AND NUTS, WHOLE GRAINS, 4673 03:11:31,239 --> 03:11:34,309 LOWER INTAKES OF RED AND 4674 03:11:34,309 --> 03:11:37,178 PROCESSED MEATS, REFINED GRAINS, 4675 03:11:37,178 --> 03:11:40,581 FRIED POTATOES, SATURATED FAT, 4676 03:11:40,581 --> 03:11:41,449 SUGAR-SWEETENED FOODS AND 4677 03:11:41,449 --> 03:11:43,217 BEVERAGES ARE ASSOCIATED WITH 4678 03:11:43,217 --> 03:11:47,488 LOWER RISK OF COLON AND RECTAL 4679 03:11:47,488 --> 03:11:47,722 CANCER. 4680 03:11:47,722 --> 03:11:50,658 SOME OF THESE DIETARY PATTERNS 4681 03:11:50,658 --> 03:11:52,527 ALSO INCLUDED FISH, LOW-FAT 4682 03:11:52,527 --> 03:11:56,798 DAIRY, TEA AND COFFEE. 4683 03:11:56,798 --> 03:11:57,799 THIS CONCLUSION STATEMENT IS 4684 03:11:57,799 --> 03:12:08,276 BASED ON EVIDENCE GRADED AS 4685 03:12:11,245 --> 03:12:11,446 MODERATE. 4686 03:12:11,446 --> 03:12:14,716 YOU CAN SEE THE BODY OF EVIDENCE 4687 03:12:14,716 --> 03:12:20,688 IS BASED ON 29 STUDIES, MOSTLY 4688 03:12:20,688 --> 03:12:21,990 PROSPECTIVE COHORT STUDIES. 4689 03:12:21,990 --> 03:12:24,959 SUMMARIZING BRIEFLY THE CRITERIA 4690 03:12:24,959 --> 03:12:27,595 THAT WE RELIED ON, CONSISTENCY, 4691 03:12:27,595 --> 03:12:30,565 THERE WERE VERY FEW CONCERNS 4692 03:12:30,565 --> 03:12:32,033 ACTUALLY WITH VARIABILITY IN 4693 03:12:32,033 --> 03:12:33,768 MAGNITUDE OF THE RESULTS. 4694 03:12:33,768 --> 03:12:40,208 MOST OF THE RESULTS WERE IN THE 4695 03:12:40,208 --> 03:12:43,044 RIGHT DIRECTION, PROTECTIVE 4696 03:12:43,044 --> 03:12:44,145 DIRECTION. 4697 03:12:44,145 --> 03:12:45,780 FOR PRECISION, DEPENDING ON SIZE 4698 03:12:45,780 --> 03:12:48,016 OF THE STUDY, CONFIDENCE 4699 03:12:48,016 --> 03:12:49,851 INTERVALS VARIED, SOME DID HAVE 4700 03:12:49,851 --> 03:12:50,952 WIDE CONFIDENCE INTERVALS BUT 4701 03:12:50,952 --> 03:12:53,921 AGAIN MOST OF THE STUDIES WERE 4702 03:12:53,921 --> 03:12:56,958 IN THE SAME DIRECTION. 4703 03:12:56,958 --> 03:13:00,895 FOR RISK OF BIAS, THERE WAS SOME 4704 03:13:00,895 --> 03:13:03,631 CONCERNS AND THE MAIN CONCERN 4705 03:13:03,631 --> 03:13:04,866 WAS DUE TO CONFOUNDING. 4706 03:13:04,866 --> 03:13:09,337 ONE OF THE KEY CONFOUNDERS THAT 4707 03:13:09,337 --> 03:13:11,139 WAS MISSING IN A NUMBER OF 4708 03:13:11,139 --> 03:13:16,010 STUDIES WAS SCREENING FOR 4709 03:13:16,010 --> 03:13:18,413 COLONOSCOPY WHICH COULD ACT AS 4710 03:13:18,413 --> 03:13:18,880 CONFOUNDER. 4711 03:13:18,880 --> 03:13:24,552 THERE WAS SOME CONCERN ABOUT THE 4712 03:13:24,552 --> 03:13:26,621 EXPOSURES ONLY MEASURED AT ONE 4713 03:13:26,621 --> 03:13:28,956 TIME AND COLORECTAL CANCER IS A 4714 03:13:28,956 --> 03:13:32,226 DISEASE THAT TAKES MANY YEARS 4715 03:13:32,226 --> 03:13:32,994 OTHER DECADES. 4716 03:13:32,994 --> 03:13:37,932 THERE WAS CONCERN ABOUT 4717 03:13:37,932 --> 03:13:40,234 SELECTION OF REPORTED RESULTS. 4718 03:13:40,234 --> 03:13:42,303 DIRECTNESS, THERE WERE A FEW 4719 03:13:42,303 --> 03:13:45,473 CONCERNS OF EXPOSURE COMPARATORS 4720 03:13:45,473 --> 03:13:47,208 AND OUTCOMES BEING EXAMINED THAT 4721 03:13:47,208 --> 03:13:51,179 WERE DIRECTLY RELATED TO THE 4722 03:13:51,179 --> 03:13:53,915 SYSTEMATIC REVIEW QUESTION. 4723 03:13:53,915 --> 03:13:55,116 GENERALIZABILITY, THERE WAS SOME 4724 03:13:55,116 --> 03:14:00,154 CONCERNS, THERE WAS A LACK OF 4725 03:14:00,154 --> 03:14:01,556 DIVERSITY IN THE STUDIES, AND 4726 03:14:01,556 --> 03:14:03,191 THE ONLY OTHER NOTE I'LL MAKE IS 4727 03:14:03,191 --> 03:14:07,628 I MENTIONED WE DID LOOK AT TUMOR 4728 03:14:07,628 --> 03:14:08,996 LOCATION, BUT AT THE END WE 4729 03:14:08,996 --> 03:14:17,438 DIDN'T FEEL THERE WAS ENOUGH 4730 03:14:17,438 --> 03:14:19,507 EVIDENCE FOR A SEPARATE 4731 03:14:19,507 --> 03:14:20,942 CONCLUSION STATEMENT SO OTHER 4732 03:14:20,942 --> 03:14:23,578 CONCLUSION IS FOR COLORECTAL 4733 03:14:23,578 --> 03:14:26,214 CANCER. 4734 03:14:26,214 --> 03:14:28,182 >> THANK YOU. 4735 03:14:28,182 --> 03:14:28,716 THERESA? 4736 03:14:28,716 --> 03:14:30,151 >> I WILL PRESENT DRAFT 4737 03:14:30,151 --> 03:14:31,152 CONCLUSION STATEMENT ON 4738 03:14:31,152 --> 03:14:31,886 RELATIONSHIP BETWEEN DIETARY 4739 03:14:31,886 --> 03:14:35,089 PATTERNS AND RISK OF BREAST 4740 03:14:35,089 --> 03:14:35,323 CANCER. 4741 03:14:35,323 --> 03:14:40,428 THIS IS AN UPDATE BECAUSE WE'VE 4742 03:14:40,428 --> 03:14:41,863 COME UPON CONCLUSION STATEMENT 4743 03:14:41,863 --> 03:14:47,768 ALREADY, SO OUR DATA IS BASED ON 4744 03:14:47,768 --> 03:14:49,504 MOSTLY 2014 AND 2023, AND 4745 03:14:49,504 --> 03:14:51,272 COMPARED WITH THE CONCLUSION 4746 03:14:51,272 --> 03:14:53,441 STATEMENTS AND EVIDENCE FROM THE 4747 03:14:53,441 --> 03:14:55,209 PAST COMMITTEES AS WELL. 4748 03:14:55,209 --> 03:14:59,747 HERE IS REMINDER OF ANALYTIC 4749 03:14:59,747 --> 03:15:01,782 FRAMEWORK, ORIGINAL INTENTION TO 4750 03:15:01,782 --> 03:15:02,850 INCLUDE ALL LIFE STAGES, 4751 03:15:02,850 --> 03:15:04,652 CONCLUSION STATEMENT NOW THAT WE 4752 03:15:04,652 --> 03:15:08,122 HAVE IS ONLY BASED ON ADULT DATA 4753 03:15:08,122 --> 03:15:10,858 BECAUSE WE COULD NOT FIND OF 4754 03:15:10,858 --> 03:15:14,028 DATA ON DIET CONSUMED DURING 4755 03:15:14,028 --> 03:15:15,463 YOUNGER YEARS. 4756 03:15:15,463 --> 03:15:18,966 OUR OUTCOME IS INCIDENT BREAST 4757 03:15:18,966 --> 03:15:21,035 CANCER, KEY CONFOUNDERS, THERE'S 4758 03:15:21,035 --> 03:15:23,137 TWO KEY CONFOUNDERS SPECIFICALLY 4759 03:15:23,137 --> 03:15:25,907 ADDED FOR THIS OUTCOME WHICH IS 4760 03:15:25,907 --> 03:15:27,642 SCREENING FOR BREAST CANCER AS 4761 03:15:27,642 --> 03:15:32,346 WELL AS USE OF POST-MENOPAUSAL 4762 03:15:32,346 --> 03:15:32,780 HORMONES. 4763 03:15:32,780 --> 03:15:34,982 THIS IS BY POPULATION, THEN BY 4764 03:15:34,982 --> 03:15:36,184 MENOPAUSAL STATUS. 4765 03:15:36,184 --> 03:15:41,656 WE HAVE ENOUGH EVIDENCE, THEN WE 4766 03:15:41,656 --> 03:15:42,723 WILL EVALUATE MOLECULAR TYPES. 4767 03:15:42,723 --> 03:15:46,460 NEXT SLIDE PLEASE. 4768 03:15:46,460 --> 03:15:50,531 OUR UPDATED CONCLUSION STATEMENT 4769 03:15:50,531 --> 03:15:54,702 THAT IS BASED ON 26 INCLUDE 4770 03:15:54,702 --> 03:15:56,771 ARTICLES, ONE RCT, 24 4771 03:15:56,771 --> 03:16:01,809 PERSPECTIVE AND ONE CASE STUDY. 4772 03:16:01,809 --> 03:16:03,878 SO 26 FROM 20142023. 4773 03:16:03,878 --> 03:16:06,681 COMPARING WITH PAST REVIEWS, WE 4774 03:16:06,681 --> 03:16:12,520 COME TO THIS DRAFT STATEMENT 4775 03:16:12,520 --> 03:16:14,222 DIETARY PATTERNS CHARACTERIZED 4776 03:16:14,222 --> 03:16:16,824 BY HIGH INDEX OF VEGETABLES, 4777 03:16:16,824 --> 03:16:18,159 FRUITS, LEGUMES, NUTS, WHOLE 4778 03:16:18,159 --> 03:16:21,429 GRAINS AND ALSO LOWER INTAKES OF 4779 03:16:21,429 --> 03:16:24,699 RED AND PROCESSED MEATS, REFINED 4780 03:16:24,699 --> 03:16:30,838 GRAINS, SUGAR SWEETENED FOODS 4781 03:16:30,838 --> 03:16:32,573 AND BEVERAGED ASSOCIATED WITH 4782 03:16:32,573 --> 03:16:34,909 LOWER RISK. 4783 03:16:34,909 --> 03:16:35,910 DATA IN PRE-MENOPAUSAL BREAST 4784 03:16:35,910 --> 03:16:37,511 CANCER POINTS THE SAME 4785 03:16:37,511 --> 03:16:39,180 DIRECTION, EVIDENCE IS LESS 4786 03:16:39,180 --> 03:16:39,480 CONSISTENT. 4787 03:16:39,480 --> 03:16:44,418 THE GRADE WE CAME UP WITH IS 4788 03:16:44,418 --> 03:16:46,821 MODERATE, SAME AS PAST 4789 03:16:46,821 --> 03:16:48,289 COMMITTEES. 4790 03:16:48,289 --> 03:16:50,958 AND SO THE ELEMENTS AND CRITERIA 4791 03:16:50,958 --> 03:16:59,533 WE BASED ON GRADE ON WITH 4792 03:16:59,533 --> 03:17:07,174 CONSISTENCY, IT'S QUITE GOOD, 4793 03:17:07,174 --> 03:17:10,044 GENERALLY POINTING TO THE SAME 4794 03:17:10,044 --> 03:17:12,446 DIRECTION, PRECISIONS THAT MORE 4795 03:17:12,446 --> 03:17:13,447 VARIABILITY ESPECIALLY THOSE 4796 03:17:13,447 --> 03:17:14,949 STUDIES THAT DID NOT REACH 4797 03:17:14,949 --> 03:17:16,951 STATISTICAL SIGNIFICANCE. 4798 03:17:16,951 --> 03:17:18,786 RISK OF BIAS, SOME CONCERN, 4799 03:17:18,786 --> 03:17:20,388 MOSTLY BECAUSE OF CONFOUNDING 4800 03:17:20,388 --> 03:17:22,723 AND MOST OF THE TIME DIET WAS 4801 03:17:22,723 --> 03:17:26,661 ONLY MEASURED AT ONE TIME POINT 4802 03:17:26,661 --> 03:17:27,361 AT BASELINE. 4803 03:17:27,361 --> 03:17:30,164 DIRECTNESS WAS NOT MUCH OF A 4804 03:17:30,164 --> 03:17:32,466 CONCERN, BOTH OUTCOME AND 4805 03:17:32,466 --> 03:17:33,934 EXPOSURE WAS PRECISELY MEASURING 4806 03:17:33,934 --> 03:17:36,070 WHAT WE WANT TO MEASURE. 4807 03:17:36,070 --> 03:17:37,071 GENERALIZABILITY, ON THE OTHER 4808 03:17:37,071 --> 03:17:39,573 HAND, IS A DIFFERENT STORY. 4809 03:17:39,573 --> 03:17:41,175 WE HAVE SERIOUS CONCERNS ON THE 4810 03:17:41,175 --> 03:17:43,844 GENERALIZABILITY TO THE U.S. 4811 03:17:43,844 --> 03:17:47,114 POPULATION BECAUSE THE DATA 4812 03:17:47,114 --> 03:17:48,215 REALLY LACKS ETHNIC AND RACIAL 4813 03:17:48,215 --> 03:17:50,751 DIVERSITY IN THE OVERALL BODY OF 4814 03:17:50,751 --> 03:17:56,324 EVIDENCE, AND ONLY TWO STUDIES, 4815 03:17:56,324 --> 03:17:58,192 PRIMARILY FROM ETHNIC MINORITY 4816 03:17:58,192 --> 03:17:58,859 GROUPS, NON-WHITE. 4817 03:17:58,859 --> 03:18:01,462 I'M SURE EVERYBODY IS THINKING 4818 03:18:01,462 --> 03:18:02,163 ABOUT PRE-MENOPAUSAL BREAST 4819 03:18:02,163 --> 03:18:04,398 CANCER AS WELL AND THERE'S A 4820 03:18:04,398 --> 03:18:06,534 CONSIDERABLE AMOUNT OF EVIDENCE 4821 03:18:06,534 --> 03:18:07,735 ON THIS OUTCOME. 4822 03:18:07,735 --> 03:18:11,672 AND SO WE LOOK ACROSS DATA FROM 4823 03:18:11,672 --> 03:18:14,842 PAST REVIEWS AS WELL AS CURRENT 4824 03:18:14,842 --> 03:18:17,778 TIME PERIOD, AND ALTHOUGH THE 4825 03:18:17,778 --> 03:18:22,950 DATA GENERALLY POINTS TO THE 4826 03:18:22,950 --> 03:18:24,251 SAME DIRECTION AS POSITIVE 4827 03:18:24,251 --> 03:18:28,856 BREAST CANCER, MORE CURRENT BODY 4828 03:18:28,856 --> 03:18:33,828 OF EVIDENCE, THE VARIABILITY WAS 4829 03:18:33,828 --> 03:18:37,264 MORE VARIED THAN DIETARY 4830 03:18:37,264 --> 03:18:41,302 PATTERNS IN POSTMENOPAUSAL 4831 03:18:41,302 --> 03:18:41,535 STUDIES. 4832 03:18:41,535 --> 03:18:47,041 WHAT I MEANT, THE COMPONENTS OF 4833 03:18:47,041 --> 03:18:49,210 THE DIETARY PATTERNS WAS -- BODY 4834 03:18:49,210 --> 03:18:51,379 OF EVIDENCE, LESS CONSISTENT 4835 03:18:51,379 --> 03:18:53,047 WITHIN THE PRE-MENOPAUSAL BREAST 4836 03:18:53,047 --> 03:18:56,650 CANCER STUDIES, AND THEN WITHIN 4837 03:18:56,650 --> 03:19:01,355 EACH FOOD GROUP OF THOSE DIETAY 4838 03:19:01,355 --> 03:19:03,224 PATTERNS WHAT IS CONSIDERED WAS 4839 03:19:03,224 --> 03:19:04,291 ALSO MORE VARIED. 4840 03:19:04,291 --> 03:19:07,361 SO THEREFORE THAT MAKES MAKING A 4841 03:19:07,361 --> 03:19:09,563 SEPARATE CONCLUSION STATEMENT 4842 03:19:09,563 --> 03:19:13,067 MORE DIFFICULT. 4843 03:19:13,067 --> 03:19:19,507 HOWEVER, THERE IS INDEED A 4844 03:19:19,507 --> 03:19:22,243 PATTERN, SIMILARITIES, AND THE 4845 03:19:22,243 --> 03:19:25,079 DIRECTION IN GENERAL, SO WE 4846 03:19:25,079 --> 03:19:27,381 ADDED -- INCLUDED A STATEMENT ON 4847 03:19:27,381 --> 03:19:28,482 PRE-MENOPAUSAL BREAST CANCER IN 4848 03:19:28,482 --> 03:19:35,589 OUR CONCLUSION AND OVERALL 4849 03:19:35,589 --> 03:19:36,157 CONCLUSIONS. 4850 03:19:36,157 --> 03:19:40,528 WE WANTED TO EXAMINE MOLECULAR 4851 03:19:40,528 --> 03:19:41,862 SUBTYPES BUT STUDIES WAS MORE 4852 03:19:41,862 --> 03:19:42,096 NARROW. 4853 03:19:42,096 --> 03:19:46,667 WE TRIED TO LOOK AT EVERYTHING, 4854 03:19:46,667 --> 03:19:51,906 ESTROGEN RECEPTORS, 4855 03:19:51,906 --> 03:19:53,574 PROGESTERONE, HER-2, 4856 03:19:53,574 --> 03:19:54,975 COMBINATION, TRYING TO FIND 4857 03:19:54,975 --> 03:19:56,310 PATTERNS WITHIN THEM BUT THE 4858 03:19:56,310 --> 03:19:58,712 NUMBER OF STUDIES IS REALLY FEW 4859 03:19:58,712 --> 03:20:01,749 ON EACH OF THEM AND SO WE'RE 4860 03:20:01,749 --> 03:20:07,021 UNABLE TO MAKE SPECIFIC SUBTYPE 4861 03:20:07,021 --> 03:20:10,958 CONCLUSION STATEMENT ON THAT. 4862 03:20:10,958 --> 03:20:11,826 NEXT SLIDES. 4863 03:20:11,826 --> 03:20:14,328 OVER TO CHERYL UNLESS WE WANT TO 4864 03:20:14,328 --> 03:20:14,995 ASK QUESTIONS. 4865 03:20:14,995 --> 03:20:16,964 >> YEAH, JUST TO GIVE SOME 4866 03:20:16,964 --> 03:20:22,369 ORIENTATION TO THIS, WE HAD TO 4867 03:20:22,369 --> 03:20:23,971 UPDATE THE CONCLUSION STATEMENT 4868 03:20:23,971 --> 03:20:25,873 FOR DIETARY PATTERNS CONSUMED 4869 03:20:25,873 --> 03:20:27,408 AND RISK OF CARDIOVASCULAR 4870 03:20:27,408 --> 03:20:27,641 DISEASE. 4871 03:20:27,641 --> 03:20:29,910 SO CHERYL WILL TELL YOU ABOUT 4872 03:20:29,910 --> 03:20:30,311 THAT. 4873 03:20:30,311 --> 03:20:31,879 >> THANK YOU. 4874 03:20:31,879 --> 03:20:34,715 THE NEXT TWO SLIDES SHOW OUR 4875 03:20:34,715 --> 03:20:36,484 WORK ON DIETARY PATTERNS AND 4876 03:20:36,484 --> 03:20:38,018 RISK OF CARDIOVASCULAR DISEASE 4877 03:20:38,018 --> 03:20:39,153 IN CHILDREN. 4878 03:20:39,153 --> 03:20:41,555 AND SIMILAR TO WHAT YOU'VE SEEN 4879 03:20:41,555 --> 03:20:44,391 THUS FAR IN OTHER PORTIONS OF 4880 03:20:44,391 --> 03:20:45,593 THE AFTERNOON'S PRESENTATIONS 4881 03:20:45,593 --> 03:20:48,662 HERE IS THE ANALYTIC FRAMEWORK. 4882 03:20:48,662 --> 03:20:50,297 THE PORTION THAT'S RELEVANT TO 4883 03:20:50,297 --> 03:20:59,406 CHILDREN IS OUTLINED IN THIS 4884 03:20:59,406 --> 03:20:59,707 ORANGE BOX. 4885 03:20:59,707 --> 03:21:03,010 I WANT TO TALK ABOUT WHAT DEANNA 4886 03:21:03,010 --> 03:21:05,179 MENTIONED, WE PRESENTED RESULTS 4887 03:21:05,179 --> 03:21:07,014 OF THIS SYSTEMATIC REVIEW TO YOU 4888 03:21:07,014 --> 03:21:09,116 ALL DURING OUR LAST PUBLIC 4889 03:21:09,116 --> 03:21:10,851 MEETING, THE FIFTH MEETING, AND 4890 03:21:10,851 --> 03:21:13,187 AS A REMINDER IT INCLUDES 4891 03:21:13,187 --> 03:21:14,855 ARTICLES THAT WERE PUBLISHED 4892 03:21:14,855 --> 03:21:16,123 BETWEEN 2014 AND 2023. 4893 03:21:16,123 --> 03:21:18,526 IT TURNS OUT AFTER THE LAST 4894 03:21:18,526 --> 03:21:20,394 PUBLIC MEETING WE ACTUALLY FOUND 4895 03:21:20,394 --> 03:21:21,929 AN ADDITIONAL ARTICLE, AND 4896 03:21:21,929 --> 03:21:23,330 NEEDED TO INCLUDE IT. 4897 03:21:23,330 --> 03:21:27,501 AND SO THAT ARTICLE WAS 4898 03:21:27,501 --> 03:21:28,936 RANDOMIZED CLINICAL TRIAL, IT 4899 03:21:28,936 --> 03:21:32,439 HAD ALL OF THE CRITERIA MET FOR 4900 03:21:32,439 --> 03:21:33,641 INCLUSION, SO WE RE-REVIEWED 4901 03:21:33,641 --> 03:21:36,277 EVIDENCE AND WANTED TO LOOK AT 4902 03:21:36,277 --> 03:21:37,378 OUR CONCLUSION STATEMENT AND OUR 4903 03:21:37,378 --> 03:21:39,213 GRADE AND ENSURE IT REFLECTED 4904 03:21:39,213 --> 03:21:42,283 THE ENTIRE BODY OF EVIDENCE 4905 03:21:42,283 --> 03:21:43,651 INCLUDING THIS NEXT ARTICLE. 4906 03:21:43,651 --> 03:21:46,320 SO LET ME HAVE YOU GO TO THE 4907 03:21:46,320 --> 03:21:47,755 NEXT SLIDE. 4908 03:21:47,755 --> 03:21:49,590 SHOW YOU WHERE WE LANDED. 4909 03:21:49,590 --> 03:21:51,692 HERE IS CONCLUSION STATEMENT AND 4910 03:21:51,692 --> 03:21:52,459 GRADE. 4911 03:21:52,459 --> 03:21:53,761 READ IT ALONG WITH ME. 4912 03:21:53,761 --> 03:21:55,596 DIETARY PATTERNS CONSUMED BY 4913 03:21:55,596 --> 03:21:56,997 CHILDREN AND ADOLESCENTS 4914 03:21:56,997 --> 03:21:59,066 CHARACTERIZED BY HIGHER INTAKES 4915 03:21:59,066 --> 03:22:01,502 OF VEGETABLES, FRUITS, LEGUMES, 4916 03:22:01,502 --> 03:22:05,339 NUTS, WHOLE GRAINS, FISH AND/OR 4917 03:22:05,339 --> 03:22:06,874 SEAFOOD, UNSATURATED FATS AND 4918 03:22:06,874 --> 03:22:09,577 OILS AND LOWER INTAKES OF SUGAR 4919 03:22:09,577 --> 03:22:12,246 SWEETENED BEVERAGES AND FOODS 4920 03:22:12,246 --> 03:22:14,982 AND RED AND PROCESSED MEATS ARE 4921 03:22:14,982 --> 03:22:18,352 ASSOCIATED WITH LOWER SYSTOLIC 4922 03:22:18,352 --> 03:22:20,654 AND DIASTOLIC BLOOD PRESSURE AND 4923 03:22:20,654 --> 03:22:22,723 TRIGLYCERIDES LATER IN LIFE. 4924 03:22:22,723 --> 03:22:26,560 THE CALL-OUT OF THOSE THREE 4925 03:22:26,560 --> 03:22:29,530 PIECES ARE REALLY IMPORTANT IN 4926 03:22:29,530 --> 03:22:31,732 THAT THE MAJORITY OF WHAT WE 4927 03:22:31,732 --> 03:22:33,033 THINK ABOUT FOR CARDIOVASCULAR 4928 03:22:33,033 --> 03:22:35,002 DISEASE RISK AS RELATED TO 4929 03:22:35,002 --> 03:22:37,638 CHILDREN IS BASED ON FINDINGS IN 4930 03:22:37,638 --> 03:22:39,707 THOSE THREE HEALTH CONDITIONS. 4931 03:22:39,707 --> 03:22:41,241 THIS CONCLUSION STATEMENT IS 4932 03:22:41,241 --> 03:22:43,544 BASED ON EVIDENCE GRADED AS 4933 03:22:43,544 --> 03:22:44,044 MODERATE. 4934 03:22:44,044 --> 03:22:48,349 BODY OF EVIDENCE AS YOU SEE 4935 03:22:48,349 --> 03:22:51,518 INCLUDED 19 ARTICLES, THERE WERE 4936 03:22:51,518 --> 03:22:53,520 SOME CONCERNS WITH CONSISTENCY, 4937 03:22:53,520 --> 03:22:57,224 SO DESPITE HETEROGENEITY IN THE 4938 03:22:57,224 --> 03:22:59,026 FINDINGS, THE STUDIES REPORTED 4939 03:22:59,026 --> 03:23:00,728 INVERSE ASSOCIATION BETWEEN 4940 03:23:00,728 --> 03:23:02,696 DIETARY PATTERNS THAT WE 4941 03:23:02,696 --> 03:23:05,866 OUTLINED AND SYSTOLIC AND 4942 03:23:05,866 --> 03:23:06,734 DIASTOLIC BLOOD PRESSURE AND 4943 03:23:06,734 --> 03:23:07,167 TRIGLYCERIDES. 4944 03:23:07,167 --> 03:23:09,470 WHEN WE LOOK AT BODY OF STUDIES, 4945 03:23:09,470 --> 03:23:13,841 WE DON'T SEE A STATISTICALLY 4946 03:23:13,841 --> 03:23:15,709 SIGNIFICANT ASSOCIATION BETWEEN 4947 03:23:15,709 --> 03:23:18,445 THIS DIETARY PATTERN AND LDL OR 4948 03:23:18,445 --> 03:23:18,979 HDL. 4949 03:23:18,979 --> 03:23:19,546 SO THAT'S TAKEN INTO 4950 03:23:19,546 --> 03:23:22,282 CONSIDERATION WHEN IT COMES TO 4951 03:23:22,282 --> 03:23:23,150 CONSISTENCY. 4952 03:23:23,150 --> 03:23:24,785 WITH REGARD TO PRECISION, THERE 4953 03:23:24,785 --> 03:23:27,955 ARE SOME CONCERNS WITH A FEW 4954 03:23:27,955 --> 03:23:32,226 STUDIES HAVING A WIDE CONFIDENCE 4955 03:23:32,226 --> 03:23:38,599 INTERVAL, WE ALSO HAVE STUDIES 4956 03:23:38,599 --> 03:23:42,202 WITH REALLY GOOD SAMPLE SIZE, A 4957 03:23:42,202 --> 03:23:43,604 THOUSAND PARTICIPANTS IN SEVERAL 4958 03:23:43,604 --> 03:23:45,239 ARTICLES, AND THERE'S CONCERN OF 4959 03:23:45,239 --> 03:23:47,007 RISK OF BIAS WHERE SOME STUDIES 4960 03:23:47,007 --> 03:23:53,147 HAVE HIGH OR VERY HIGH RISK OF 4961 03:23:53,147 --> 03:23:55,749 BIAS DUE TO CONFOUNDING AND 4962 03:23:55,749 --> 03:23:57,284 MISSING THIS, YOU SAW THE LIST 4963 03:23:57,284 --> 03:23:59,253 ON THE PRIOR SLIDE. 4964 03:23:59,253 --> 03:24:01,455 FOR EXAMPLE, ALTHOUGH STUDIES 4965 03:24:01,455 --> 03:24:02,456 HAD CONFOUNDERS ACCOUNTED FOR, 4966 03:24:02,456 --> 03:24:03,657 SOMETIMES THEY DIDN'T ACCOUNT 4967 03:24:03,657 --> 03:24:06,493 FOR PHYSICAL ACTIVITY, 4968 03:24:06,493 --> 03:24:08,128 RACE/ETHNICITY, OR SOCIOECONOMIC 4969 03:24:08,128 --> 03:24:08,996 POSITION. 4970 03:24:08,996 --> 03:24:10,631 SO THAT WAS OF CONCERN IN THE 4971 03:24:10,631 --> 03:24:11,832 RISK OF BIAS. 4972 03:24:11,832 --> 03:24:15,703 WHEN IT COMES TO DIRECTNESS, IT 4973 03:24:15,703 --> 03:24:18,305 WAS GENERALLY A FEW CONCERNS. 4974 03:24:18,305 --> 03:24:19,640 THE POPULATION EXPOSURE TO 4975 03:24:19,640 --> 03:24:23,010 COMPARATOR AND OUTCOMES WERE 4976 03:24:23,010 --> 03:24:24,011 DIRECTLY RELATED TO THE QUESTION 4977 03:24:24,011 --> 03:24:25,846 IN MOST OF THE STUDIES. 4978 03:24:25,846 --> 03:24:28,048 BUT WHEN IT CAME TO 4979 03:24:28,048 --> 03:24:28,882 GENERALIZABILITY THERE WERE 4980 03:24:28,882 --> 03:24:30,584 SERIOUS CONCERNS, WE HAD ONLY 4981 03:24:30,584 --> 03:24:33,187 ONE STUDY CONDUCTED IN THE U.S. 4982 03:24:33,187 --> 03:24:35,055 SO ALL THINGS TAKEN INTO 4983 03:24:35,055 --> 03:24:42,663 ACCOUNT, WE LANDED ON THE GRADE 4984 03:24:42,663 --> 03:24:43,263 OF MODERATE. 4985 03:24:43,263 --> 03:24:45,499 >> THANK YOU. 4986 03:24:45,499 --> 03:24:52,139 SO ANY QUESTIONS OR DISCUSSION? 4987 03:24:52,139 --> 03:24:52,406 CRISTINA? 4988 03:24:52,406 --> 03:24:53,907 >> YOU MENTIONED THERE WAS A 4989 03:24:53,907 --> 03:24:54,141 CHANGE. 4990 03:24:54,141 --> 03:24:55,209 WHAT WAS THE CHANGE? 4991 03:24:55,209 --> 03:24:58,912 I DIDN'T GET THAT PART. 4992 03:24:58,912 --> 03:25:03,417 IT WAS BEFORE WHAT? 4993 03:25:03,417 --> 03:25:05,419 >> [OFF MICROPHONE]. 4994 03:25:05,419 --> 03:25:15,596 >> OH, NOW IT'S MODERATE. 4995 03:25:15,596 --> 03:25:20,501 >> THE QUESTION, WHAT WAS THE 4996 03:25:20,501 --> 03:25:21,735 GRADE BEFORE, BEING ASSIGNED 4997 03:25:21,735 --> 03:25:22,836 MODERATE, IT WAS LIMITED. 4998 03:25:22,836 --> 03:25:25,439 >> QUESTION FOR ED. 4999 03:25:25,439 --> 03:25:28,942 ON YOUR SLIDE CONCLUSION IT 5000 03:25:28,942 --> 03:25:30,611 MENTIONS SOME DIETARY PATTERNS 5001 03:25:30,611 --> 03:25:33,781 ALSO INCLUDE FISH, LOW FAT 5002 03:25:33,781 --> 03:25:34,882 DAIRY, TEA AND COFFEE. 5003 03:25:34,882 --> 03:25:38,285 WAS THERE A DIRECTION, HIGHER OR 5004 03:25:38,285 --> 03:25:38,919 LOWER? 5005 03:25:38,919 --> 03:25:41,889 >> THOSE WERE ALL IN -- LET ME 5006 03:25:41,889 --> 03:25:44,391 MAKE SURE I'M SAYING IT RIGHT. 5007 03:25:44,391 --> 03:25:46,693 SO COFFEE, YEAH, THOSE WERE ALL 5008 03:25:46,693 --> 03:25:57,070 IN THE GOOD DIRECTION, 5009 03:26:00,374 --> 03:26:00,808 PROTECTIVE. 5010 03:26:00,808 --> 03:26:01,708 >> QUESTION FOR CHERYL. 5011 03:26:01,708 --> 03:26:05,779 THE WAY THE STATEMENT READS, 5012 03:26:05,779 --> 03:26:08,048 ASSOCIATED WITH LOWER BLOOD 5013 03:26:08,048 --> 03:26:12,853 PRESSURE AND TRIGLYCERIDES LATER 5014 03:26:12,853 --> 03:26:15,289 IN LIFE. 5015 03:26:15,289 --> 03:26:17,357 IS THAT REVERSIBLE OR BECAUSE 5016 03:26:17,357 --> 03:26:21,628 PEOPLE MAINTAIN THE PATTERN? 5017 03:26:21,628 --> 03:26:23,130 SO IS IT REVERSIBLE ONCE YOU'VE 5018 03:26:23,130 --> 03:26:25,332 HAD THE EXPOSURE IN CHILDHOOD? 5019 03:26:25,332 --> 03:26:27,434 >> SO THE QUESTION, DO WE 5020 03:26:27,434 --> 03:26:31,138 UNDERSTAND TRAJECTORY, FOR THOSE 5021 03:26:31,138 --> 03:26:33,874 WHO MAY GO FROM EITHER STAY THE 5022 03:26:33,874 --> 03:26:38,111 SAME, GET BETTER, GET WORSE, THE 5023 03:26:38,111 --> 03:26:38,912 ASSOCIATIONS WERE PROSPECTIVE, 5024 03:26:38,912 --> 03:26:41,982 AND I DON'T THINK WE HAVE THE 5025 03:26:41,982 --> 03:26:43,884 ABILITY TO GO AS GRANULAR AS 5026 03:26:43,884 --> 03:26:48,255 COULD YOU CORRECT FOR IT AND SEE 5027 03:26:48,255 --> 03:26:49,556 A DIFFERENT OUTCOME. 5028 03:26:49,556 --> 03:26:51,658 THAT'S NOT IN THE LITERATURE, 5029 03:26:51,658 --> 03:26:58,899 THE 19 ARTICLES RIGHT NOW. 5030 03:26:58,899 --> 03:27:00,100 >> ARE THERE OTHER QUESTIONS ON 5031 03:27:00,100 --> 03:27:01,435 THESE PRESENTATIONS? 5032 03:27:01,435 --> 03:27:02,903 I CONGRATULATE EVERYONE, BUT I 5033 03:27:02,903 --> 03:27:04,438 SPOKE SO I FEEL WEIRD DOING 5034 03:27:04,438 --> 03:27:04,905 THAT. 5035 03:27:04,905 --> 03:27:11,144 EVERYBODY ELSE, YOU DID A GREAT 5036 03:27:11,144 --> 03:27:11,879 JOB. 5037 03:27:11,879 --> 03:27:12,145 [LAUGHTER] 5038 03:27:12,145 --> 03:27:16,283 ARE THERE ANY OTHER QUESTIONS ON 5039 03:27:16,283 --> 03:27:24,157 THE DIETARY PATTERNS THAT WAS 5040 03:27:24,157 --> 03:27:26,360 JUST PRESENTED? 5041 03:27:26,360 --> 03:27:27,661 HOLLIE AND VALERIE, I'M NOT SURE 5042 03:27:27,661 --> 03:27:28,662 IF YOU'RE ON SCREEN. 5043 03:27:28,662 --> 03:27:30,063 I BELIEVE YOU ARE. 5044 03:27:30,063 --> 03:27:35,669 IF YOU HAVE ANY QUESTIONS, 5045 03:27:35,669 --> 03:27:37,604 PLEASE LET US KNOW. 5046 03:27:37,604 --> 03:27:38,405 >> NO ADDITIONAL QUESTIONS. 5047 03:27:38,405 --> 03:27:39,172 THANK YOU. 5048 03:27:39,172 --> 03:27:40,374 >> NO QUESTIONS. 5049 03:27:40,374 --> 03:27:46,413 THANK YOU. 5050 03:27:46,413 --> 03:27:46,780 >> THANK YOU. 5051 03:27:46,780 --> 03:27:48,482 >> DEE DEE HAS A QUESTION. 5052 03:27:48,482 --> 03:27:49,683 >> IT WAS FROM YOUR 5053 03:27:49,683 --> 03:27:51,418 PRESENTATION, WHICH ALREADY 5054 03:27:51,418 --> 03:27:54,054 FEELS LIKE A LOT OF EVIDENCE 5055 03:27:54,054 --> 03:27:54,221 AGO. 5056 03:27:54,221 --> 03:27:56,790 SO WHEN LOOKING AT OUTCOMES, 5057 03:27:56,790 --> 03:27:58,325 RELATED TO COGNITIVE HEALTH AND 5058 03:27:58,325 --> 03:28:01,395 AGING, WHERE THESE ARE 5059 03:28:01,395 --> 03:28:03,797 OCCURRING, DECADES LATER THAN 5060 03:28:03,797 --> 03:28:05,866 SOME OTHER HEALTH OUTCOMES WE'RE 5061 03:28:05,866 --> 03:28:06,667 LOOKING AT FOR FUTURE DIRECTIONS 5062 03:28:06,667 --> 03:28:08,602 BECAUSE THIS IS SUCH AN 5063 03:28:08,602 --> 03:28:11,738 IMPORTANT AREA OF RESEARCH AND 5064 03:28:11,738 --> 03:28:13,507 THE ETIOLOGY OR RELEVANT TIME 5065 03:28:13,507 --> 03:28:14,675 WINDOWS NOT KNOWN, RIGHT? 5066 03:28:14,675 --> 03:28:17,778 SO YOU THINK ABOUT INTERVENING 5067 03:28:17,778 --> 03:28:19,279 WITH SHORTER-TERM TRIALS AMONG 5068 03:28:19,279 --> 03:28:21,581 OLDER POPULATIONS THAT MAY NOT 5069 03:28:21,581 --> 03:28:25,419 BE IN THE RELEVANT WINDOW, WE'LL 5070 03:28:25,419 --> 03:28:27,287 NEED LONGER TERM FOLLOW-UP 5071 03:28:27,287 --> 03:28:28,689 STUDIES. 5072 03:28:28,689 --> 03:28:33,060 MY QUESTION, ARE THERE 5073 03:28:33,060 --> 03:28:34,962 INTERMEDIATE RISK FACTORS OR -- 5074 03:28:34,962 --> 03:28:35,896 I MEAN, NOT BIOMARKERS BUT 5075 03:28:35,896 --> 03:28:40,167 ANYTHING THAT CAN BE USED TO 5076 03:28:40,167 --> 03:28:42,402 HELP AUGMENT THE OUTCOME 5077 03:28:42,402 --> 03:28:44,338 LITERATURE, OR IS IT MORE ALL 5078 03:28:44,338 --> 03:28:47,074 LIKE ASSESSMENT SCORES WHICH YOU 5079 03:28:47,074 --> 03:28:52,546 CAN'T GO BACK AND DO, WHAT'S 5080 03:28:52,546 --> 03:28:56,049 FEASIBLE IN THIS SPACE? 5081 03:28:56,049 --> 03:28:59,019 >> THIS IS A GREAT QUESTION. 5082 03:28:59,019 --> 03:29:03,924 AND IF YOU THINK ABOUT IT, ONE 5083 03:29:03,924 --> 03:29:10,063 OF THE CHALLENGES IS MOST PEOPLE 5084 03:29:10,063 --> 03:29:11,698 WHO ARE EXPERIENCING COGNITIVE 5085 03:29:11,698 --> 03:29:14,134 DECLINE LATER IN LIFE, THEY ARE 5086 03:29:14,134 --> 03:29:17,070 ACTUALLY NOT AWARE OF IT UNTIL 5087 03:29:17,070 --> 03:29:17,971 IT'S PRETTY MARKED. 5088 03:29:17,971 --> 03:29:21,441 AND YET MOST OF OUR ASSESSMENT 5089 03:29:21,441 --> 03:29:24,311 TOOLS ARE RELYING ON MEMORY OF 5090 03:29:24,311 --> 03:29:28,315 WHAT PEOPLE ATE, BUT ALSO THE 5091 03:29:28,315 --> 03:29:31,084 TOOLS THEMSELVES, THERE'S A LOT 5092 03:29:31,084 --> 03:29:32,819 OF TRAINING COMPONENT. 5093 03:29:32,819 --> 03:29:35,889 WE DID NOT DISCUSS THIS AS PART 5094 03:29:35,889 --> 03:29:37,758 OF OUR SMALL SUBCOMMITTEE GROUP 5095 03:29:37,758 --> 03:29:42,729 SO I WOULD WELCOME INPUT. 5096 03:29:42,729 --> 03:29:45,632 THERE IS A LOT OF RESEARCH 5097 03:29:45,632 --> 03:29:47,534 ACTIVITY IN THE SPACE OF 5098 03:29:47,534 --> 03:29:48,135 BIOMARKERS. 5099 03:29:48,135 --> 03:29:51,104 THERE WAS A VERY RECENT STUDY 5100 03:29:51,104 --> 03:29:53,540 RELEASED I THINK THREE WEEKS 5101 03:29:53,540 --> 03:29:56,309 AGO, WHERE THERE'S AN 5102 03:29:56,309 --> 03:29:59,679 INTERNATIONAL STUDY WHERE THERE 5103 03:29:59,679 --> 03:30:03,617 IS A PANEL OF BLOOD BIOMARKERS 5104 03:30:03,617 --> 03:30:10,424 THAT SEEMED TO BE QUITE ROBUST 5105 03:30:10,424 --> 03:30:13,326 IN PREDICTING DEMENTIA, I THINK, 5106 03:30:13,326 --> 03:30:13,693 YEAH, DEMENTIA. 5107 03:30:13,693 --> 03:30:16,196 SO I DO BELIEVE THAT'S THE WAY 5108 03:30:16,196 --> 03:30:18,331 IT'S GOING TO GO. 5109 03:30:18,331 --> 03:30:20,200 BECAUSE THIS IS IN PARTICULAR AN 5110 03:30:20,200 --> 03:30:25,038 OUTCOME THAT YOU WANT TO HAVE AS 5111 03:30:25,038 --> 03:30:27,140 LITTLE AS POSSIBLE EMPHASIS OR 5112 03:30:27,140 --> 03:30:27,574 RELIANCE ON MEMORY. 5113 03:30:27,574 --> 03:30:29,776 I DON'T KNOW IF THE OTHERS WOULD 5114 03:30:29,776 --> 03:30:32,512 LIKE TO -- BUT IT'S A GREAT 5115 03:30:32,512 --> 03:30:35,182 COMMENT, DEE DEE, AND I AGREE WE 5116 03:30:35,182 --> 03:30:45,692 SHOULD PUT THIS IN THE FUTURE 5117 03:30:47,994 --> 03:30:48,228 DIRECTIONS. 5118 03:30:48,228 --> 03:30:50,230 >> NOW WE'LL CONTINUE WITH 5119 03:30:50,230 --> 03:30:53,166 EVIDENCE REVIEW FOR BEVERAGES. 5120 03:30:53,166 --> 03:30:53,400 ANDREA? 5121 03:30:53,400 --> 03:30:56,236 >> OKAY. 5122 03:30:56,236 --> 03:30:56,870 GREAT. 5123 03:30:56,870 --> 03:30:57,671 NEXT SLIDE. 5124 03:30:57,671 --> 03:31:01,308 SO, THIS SLIDE IS SHOWING 5125 03:31:01,308 --> 03:31:05,479 ANALYTIC FRAMEWORK FOR THE FULL 5126 03:31:05,479 --> 03:31:07,647 QUESTION ON SUGAR-SWEETENED 5127 03:31:07,647 --> 03:31:08,648 BEVERAGE CONSUMPTION WITH 5128 03:31:08,648 --> 03:31:10,383 GROWTH, BODY COMPOSITION, RISK 5129 03:31:10,383 --> 03:31:12,919 OF OBESITY, INCLUDING SYSTEMATIC 5130 03:31:12,919 --> 03:31:14,554 REVIEW AND META-ANALYSIS. 5131 03:31:14,554 --> 03:31:16,723 AS DEANNA NOTED EARLIER IN THE 5132 03:31:16,723 --> 03:31:17,924 PRESENTATION, THE CONCLUSION 5133 03:31:17,924 --> 03:31:20,360 STATEMENTS FOR INFANTS, YOUNG 5134 03:31:20,360 --> 03:31:21,761 CHILDREN, AND ADOLESCENTS WERE 5135 03:31:21,761 --> 03:31:23,396 PRESENTED AT PUBLIC MEETING 5 IN 5136 03:31:23,396 --> 03:31:23,797 MAY. 5137 03:31:23,797 --> 03:31:27,134 SO, AS YOU CAN SEE BY THE RED 5138 03:31:27,134 --> 03:31:28,335 BOX, TODAY'S CONCLUSIONS ARE 5139 03:31:28,335 --> 03:31:30,537 GOING TO FOCUS ON ADULTS AND 5140 03:31:30,537 --> 03:31:32,506 OLDER ADULTS AS WELL AS 5141 03:31:32,506 --> 03:31:35,108 INDIVIDUALS DURING PREGNANCY AND 5142 03:31:35,108 --> 03:31:35,575 POSTPARTUM. 5143 03:31:35,575 --> 03:31:36,977 SO THIS QUESTION INCLUDED, IF 5144 03:31:36,977 --> 03:31:40,680 YOU LOOK DOWN THE COMPARATOR 5145 03:31:40,680 --> 03:31:43,884 COLUMN, THIS QUESTION INCLUDED 5146 03:31:43,884 --> 03:31:44,885 COMPARISON OF SUGAR-SWEETENED 5147 03:31:44,885 --> 03:31:49,556 BEVERAGE CONSUMPTION WITH LOW 5148 03:31:49,556 --> 03:31:51,091 AND NO-CALORIE SWEETENED 5149 03:31:51,091 --> 03:31:53,026 BEVERAGES, NOT INCLUDED IN THE 5150 03:31:53,026 --> 03:31:57,998 QUESTION WILL LOW AND NO CALORIE 5151 03:31:57,998 --> 03:31:59,199 SWEETENED BEVERAGE CONSUMPTION 5152 03:31:59,199 --> 03:32:00,400 PRESENTED DURING PUBLIC MEETING 5153 03:32:00,400 --> 03:32:00,934 4. 5154 03:32:00,934 --> 03:32:03,303 LOOKING AT KEY CONFOUNDERS YOU 5155 03:32:03,303 --> 03:32:05,972 CAN SEE THERE WERE SOME KEY 5156 03:32:05,972 --> 03:32:07,607 CONFOUNDERS INCLUDED WHEN 5157 03:32:07,607 --> 03:32:09,910 LOOKING DURING PREGNANCY AS WELL 5158 03:32:09,910 --> 03:32:13,847 AS POSTPARTUM. 5159 03:32:13,847 --> 03:32:14,681 OKAY. 5160 03:32:14,681 --> 03:32:14,981 NEXT SLIDE. 5161 03:32:14,981 --> 03:32:17,484 SO WHEN EXAMINING THE QUESTION 5162 03:32:17,484 --> 03:32:19,319 OF SUGAR SWEETENED BEVERAGE 5163 03:32:19,319 --> 03:32:21,087 CONSUMPTION IN RELATION TO BODY 5164 03:32:21,087 --> 03:32:23,924 COMPOSITION AND RISK OF OBESITY 5165 03:32:23,924 --> 03:32:27,427 AMONG ADULTS AND OLDER ADULTS WE 5166 03:32:27,427 --> 03:32:28,295 DREW SEPARATE STATEMENTS FOR 5167 03:32:28,295 --> 03:32:29,729 BODY COMPOSITION AND RISK OF 5168 03:32:29,729 --> 03:32:30,830 OBESITY OUTCOMES. 5169 03:32:30,830 --> 03:32:33,867 THIS SLIDE SHOWS THE CONCLUSION 5170 03:32:33,867 --> 03:32:36,636 STATEMENT FOR BODY COMPOSITION. 5171 03:32:36,636 --> 03:32:37,604 SUGAR-SWEETENED BEVERAGE 5172 03:32:37,604 --> 03:32:40,006 CONSUMPTION BY ADULTS AND OLDER 5173 03:32:40,006 --> 03:32:41,107 ADULTS ASSOCIATED WITH 5174 03:32:41,107 --> 03:32:42,309 UNFAVORABLE BODY COMPOSITION. 5175 03:32:42,309 --> 03:32:46,379 AND THIS CONCLUSION WAS BASED ON 5176 03:32:46,379 --> 03:32:48,114 EVIDENCE GRADED AS MODERATE. 5177 03:32:48,114 --> 03:32:50,517 THE DEVELOPMENT CONSIDERED BODY 5178 03:32:50,517 --> 03:32:52,752 OF EVIDENCE FROM RESULTS OF THE 5179 03:32:52,752 --> 03:32:54,354 META-ANALYSIS AS WELL AS ALL OF 5180 03:32:54,354 --> 03:32:56,089 THE ARTICLES THAT WERE INCLUDED 5181 03:32:56,089 --> 03:32:57,958 IN THE SYSTEMATIC REVIEW. 5182 03:32:57,958 --> 03:33:00,493 ROUGHLY HALF THE STUDIES 5183 03:33:00,493 --> 03:33:02,229 INCLUDED IN THIS SYSTEMATIC 5184 03:33:02,229 --> 03:33:05,398 REVIEW WERE ALSO INCLUDED IN AT 5185 03:33:05,398 --> 03:33:06,433 LEAST ONE META-ANALYSIS. 5186 03:33:06,433 --> 03:33:16,142 THIS IS PRIMARILY DUE TO TOO FW 5187 03:33:16,142 --> 03:33:19,112 STUDIES. 5188 03:33:19,112 --> 03:33:21,181 SO FOR THE META-ANALYSIS, THE 5189 03:33:21,181 --> 03:33:22,949 BODY COMPOSITION OUTCOMES THAT 5190 03:33:22,949 --> 03:33:25,785 WE FOCUSED ON WERE WAIST 5191 03:33:25,785 --> 03:33:26,853 CIRCUMFERENCE, CHANGE IN FAT 5192 03:33:26,853 --> 03:33:27,854 MASS. 5193 03:33:27,854 --> 03:33:30,257 THIS IS DUE AGAIN RELATIVELY TO 5194 03:33:30,257 --> 03:33:32,325 TOO FEW STUDIES REPORTING ON 5195 03:33:32,325 --> 03:33:33,093 OTHER OUTCOMES. 5196 03:33:33,093 --> 03:33:35,495 AND THEN FOR THE SYSTEMATIC 5197 03:33:35,495 --> 03:33:36,930 REVIEW, THE DATA WAS ON THE 5198 03:33:36,930 --> 03:33:39,566 BROADER SET OF BODY COMPOSITION 5199 03:33:39,566 --> 03:33:40,734 OUTCOMES. 5200 03:33:40,734 --> 03:33:43,737 SO WHEN WE LOOK AT GRADING 5201 03:33:43,737 --> 03:33:44,938 ELEMENTS STARTING WITH 5202 03:33:44,938 --> 03:33:46,573 CONSISTENCY, OVER HALF THE 5203 03:33:46,573 --> 03:33:48,541 STUDIES EXAMINING BODY 5204 03:33:48,541 --> 03:33:50,176 COMPOSITION OUTCOMES FOUND 5205 03:33:50,176 --> 03:33:55,115 RELATIONSHIP BETWEEN SUGAR 5206 03:33:55,115 --> 03:33:56,082 SWEETENED BEVERAGE CONSUMPTION 5207 03:33:56,082 --> 03:33:58,518 AND ONE BODY COMPOSITION 5208 03:33:58,518 --> 03:34:00,587 OUTCOMES INDICATING IT WAS 5209 03:34:00,587 --> 03:34:02,122 RELATED TO UNFAVORABLE BODY 5210 03:34:02,122 --> 03:34:03,690 COMPOSITION OUTCOMES, AND MANY 5211 03:34:03,690 --> 03:34:05,725 OF THE NON-SIGNIFICANT FINDINGS 5212 03:34:05,725 --> 03:34:07,360 TRENDED IN THAT DIRECTION. 5213 03:34:07,360 --> 03:34:10,630 DATA ON SUGAR SWEETENED BEVERAGE 5214 03:34:10,630 --> 03:34:12,699 CONSUMPTION VERSES LOW AND NO 5215 03:34:12,699 --> 03:34:14,334 CALORIE CAME FROM TRIALS. THERE 5216 03:34:14,334 --> 03:34:16,202 WERE NO NOTICEABLE DIFFERENCES 5217 03:34:16,202 --> 03:34:18,271 IN FINDINGS WHEN COMPARING SUGAR 5218 03:34:18,271 --> 03:34:19,072 SWEETENED BEVERAGE CON SUMMINGS 5219 03:34:19,072 --> 03:34:22,442 TO LOW AND NO CALORIE SWEETENED 5220 03:34:22,442 --> 03:34:25,178 BEVERAGES AND SUGAR SWEETENED 5221 03:34:25,178 --> 03:34:26,046 BEVERAGE CONSUMPTION VERSUS 5222 03:34:26,046 --> 03:34:27,914 WATER, SO NOT SEPARATE 5223 03:34:27,914 --> 03:34:29,449 CONCLUSION STATEMENTS DRAWN FOR 5224 03:34:29,449 --> 03:34:31,751 THESE SEPARATE COMPARATORS. 5225 03:34:31,751 --> 03:34:33,486 FOR THE META-ANALYSES, 5226 03:34:33,486 --> 03:34:39,759 SPECIFICALLY FINDINGS ON CHANGE 5227 03:34:39,759 --> 03:34:41,594 AND WARES CIRCUMFERENCE, WITH 5228 03:34:41,594 --> 03:34:43,997 HIGHER INTAKE INCREASES IN 5229 03:34:43,997 --> 03:34:44,931 CIRCUMFERENCE. 5230 03:34:44,931 --> 03:34:47,067 POOLED EFFECT SIZE SMALL, 5231 03:34:47,067 --> 03:34:49,035 CONFIDENCE INTERVALS INCLUDED 5232 03:34:49,035 --> 03:34:51,104 ZERO, STATISTICAL POWER LIMITED, 5233 03:34:51,104 --> 03:34:54,507 MODERATE TO HIGH HETEROGENEITY 5234 03:34:54,507 --> 03:35:00,113 IN MANY ANALYSES. 5235 03:35:00,113 --> 03:35:01,614 PRECISION, SAMPLE SIZES VARIED 5236 03:35:01,614 --> 03:35:02,615 CONSIDERABLY, MOST WERE 5237 03:35:02,615 --> 03:35:04,551 ADEQUATELY POWERED AND VAST 5238 03:35:04,551 --> 03:35:05,985 MAJORITY OF OBSERVATIONAL 5239 03:35:05,985 --> 03:35:07,654 STUDIES INCLUDED A THOUSAND 5240 03:35:07,654 --> 03:35:07,987 PARTICIPANTS. 5241 03:35:07,987 --> 03:35:10,490 TWO TRIALS DID NOT REPORT ON 5242 03:35:10,490 --> 03:35:12,258 POWER CALCULATIONS, AND APPEARED 5243 03:35:12,258 --> 03:35:13,426 TO BE UNDERPOWERED. 5244 03:35:13,426 --> 03:35:16,863 STUDIES HAD A MIX OF REASONABLE 5245 03:35:16,863 --> 03:35:22,635 OR WIDE 95% CONFIDENCE 5246 03:35:22,635 --> 03:35:23,837 INTERVALS. 5247 03:35:23,837 --> 03:35:25,171 PRIMARY SOURCE OF BIAS 5248 03:35:25,171 --> 03:35:25,805 INADEQUATE RANDOMIZATION METHODS 5249 03:35:25,805 --> 03:35:26,806 AND HIGH ATTRITION. 5250 03:35:26,806 --> 03:35:29,642 RISK OF BIAS WAS MORE PRONOUNCED 5251 03:35:29,642 --> 03:35:30,744 IN OBSERVATIONAL STUDIES WITH 5252 03:35:30,744 --> 03:35:34,013 MANY FAILING TO ADEQUATELY 5253 03:35:34,013 --> 03:35:35,548 ADJUST FOR CONFOUNDING OR 5254 03:35:35,548 --> 03:35:36,449 MISSING DATA. 5255 03:35:36,449 --> 03:35:38,051 DIRECTNESS MOST TRIALS WERE 5256 03:35:38,051 --> 03:35:40,587 DESIGNED TO TEST EFFECT OF 5257 03:35:40,587 --> 03:35:42,455 SWITCHING FROM SUGAR SWEETENED 5258 03:35:42,455 --> 03:35:43,223 BEVERAGE CONSUMPTION TO ANOTHER 5259 03:35:43,223 --> 03:35:46,059 TYPE SUCH AS LOW AND NO-CALORIE 5260 03:35:46,059 --> 03:35:49,129 SWEETENED BEVERAGES AND MAJORITY 5261 03:35:49,129 --> 03:35:50,096 OF OBSERVATIONAL STUDIES 5262 03:35:50,096 --> 03:35:52,065 EXAMINED THE RELATIONSHIP OF 5263 03:35:52,065 --> 03:35:52,332 INTEREST. 5264 03:35:52,332 --> 03:35:59,406 SO CONCERNS ABOUT DIRECTNESS 5265 03:35:59,406 --> 03:36:04,677 WITH THOSE WAS MINIMAL. 5266 03:36:04,677 --> 03:36:05,645 GENERALIZABILITY WAS LIMITED, 5267 03:36:05,645 --> 03:36:06,446 PARTICULARLY FOR TRIALS, 5268 03:36:06,446 --> 03:36:08,281 DIFFERENT GROUPS WERE BETTER 5269 03:36:08,281 --> 03:36:08,948 REPRESENTED IN OBSERVATIONAL 5270 03:36:08,948 --> 03:36:10,016 STUDIES THOUGH MULTIPLE STUDIES 5271 03:36:10,016 --> 03:36:13,753 DID NOT REPORT ON THIS 5272 03:36:13,753 --> 03:36:14,053 INFORMATION. 5273 03:36:14,053 --> 03:36:14,621 DIVERSITY AND SOCIOECONOMIC 5274 03:36:14,621 --> 03:36:16,956 POSITION AND AGE WAS MORE COMMON 5275 03:36:16,956 --> 03:36:19,192 IN THE OBSERVATIONAL STUDIES. 5276 03:36:19,192 --> 03:36:20,760 AND STUDIES INCLUDED IN 5277 03:36:20,760 --> 03:36:22,495 META-ANALYSIS WERE SIMILAR IN 5278 03:36:22,495 --> 03:36:22,829 GENERAL. 5279 03:36:22,829 --> 03:36:25,432 EXCEPT THAT THEY TEND TO SHOW 5280 03:36:25,432 --> 03:36:29,602 LESS RACIAL AND ETHNIC 5281 03:36:29,602 --> 03:36:29,869 DIVERSITY. 5282 03:36:29,869 --> 03:36:30,703 NEXT SLIDE. 5283 03:36:30,703 --> 03:36:33,106 THIS SLIDE IS SHOWING CONCLUSION 5284 03:36:33,106 --> 03:36:37,610 STATEMENT FOR RISK OF OBESITY. 5285 03:36:37,610 --> 03:36:38,912 SO CONSUMPTION IS ASSOCIATED 5286 03:36:38,912 --> 03:36:41,281 WITH HIGHER RISK OF OBESITY, AND 5287 03:36:41,281 --> 03:36:44,184 THIS CONCLUSION WAS BASED ON 5288 03:36:44,184 --> 03:36:46,786 EVIDENCE GRADED AS MODERATE. 5289 03:36:46,786 --> 03:36:47,787 SUBSTANTIALLY LARGER NUMBER 5290 03:36:47,787 --> 03:36:49,856 EXAMINED RISK OF OBESITY 5291 03:36:49,856 --> 03:36:51,491 OUTCOMES, AS BODY COMPOSITION 5292 03:36:51,491 --> 03:36:52,826 ROUGHLY HALF OF THE STUDIES 5293 03:36:52,826 --> 03:36:54,227 INCLUDED IN THE SYSTEMATIC 5294 03:36:54,227 --> 03:36:56,729 REVIEW WERE INCLUDED IN AT LEAST 5295 03:36:56,729 --> 03:36:58,298 ONE META-ANALYSIS. 5296 03:36:58,298 --> 03:37:03,770 AND THE OUTCOMES IN BOTH 5297 03:37:03,770 --> 03:37:05,872 META-ANALYSIS AND SYSTEMATIC 5298 03:37:05,872 --> 03:37:08,708 REVIEW WERE SIMILAR, WHEN WE 5299 03:37:08,708 --> 03:37:10,677 LOOK ACROSS GRADING COMPONENTS, 5300 03:37:10,677 --> 03:37:11,544 GRADING WAS SIMILAR FOR BODY 5301 03:37:11,544 --> 03:37:12,879 COMPOSITION AND THAT WAS BECAUSE 5302 03:37:12,879 --> 03:37:15,949 OF AN OVERLAP IN THE STUDIES 5303 03:37:15,949 --> 03:37:17,150 INCLUDED. 5304 03:37:17,150 --> 03:37:18,785 SO LOOKING AT CONSISTENCY, OVER 5305 03:37:18,785 --> 03:37:21,721 HALF EXAMINING RISK OF OBESITY 5306 03:37:21,721 --> 03:37:23,189 OUTCOMES FOUND A RELATIONSHIP 5307 03:37:23,189 --> 03:37:24,491 BETWEEN SUGAR SWEETENED BEVERAGE 5308 03:37:24,491 --> 03:37:26,793 CONSUMPTION AND ONE RISK OF 5309 03:37:26,793 --> 03:37:27,494 OBESITY OUTCOME. 5310 03:37:27,494 --> 03:37:29,729 MOST OF THE SIGNIFICANT FINDINGS 5311 03:37:29,729 --> 03:37:31,397 INDICATED THAT SUGAR SWEETENED 5312 03:37:31,397 --> 03:37:32,365 BEVERAGE CONSUMPTION WAS RELATED 5313 03:37:32,365 --> 03:37:35,802 TO HIGHER RISK OF OBESITY, AND 5314 03:37:35,802 --> 03:37:37,070 WITH NON-SIGNIFICANT FINDINGS 5315 03:37:37,070 --> 03:37:39,906 THEY STILL TRENDED IN THAT 5316 03:37:39,906 --> 03:37:40,974 DIRECTION. 5317 03:37:40,974 --> 03:37:41,674 FOR THE META-ANALYSIS, FINDINGS 5318 03:37:41,674 --> 03:37:44,511 ON CHANGE IN WEIGHT AND RISK OF 5319 03:37:44,511 --> 03:37:45,945 OVERWEIGHT OR OBESITY INDICATED 5320 03:37:45,945 --> 03:37:47,780 SIMILAR DIRECTION, WITH HIGHER 5321 03:37:47,780 --> 03:37:50,717 SUGAR SWEETENED BEVERAGE INTAKE 5322 03:37:50,717 --> 03:37:53,953 RELATED TO UNFAVORABLE OUTCOMES. 5323 03:37:53,953 --> 03:37:56,689 CONFIDENCE INTERVALS DID INCLUDE 5324 03:37:56,689 --> 03:38:04,030 ZERO, MODERATE TO HIGH 5325 03:38:04,030 --> 03:38:04,998 HETEROGENEITY IN MANY. 5326 03:38:04,998 --> 03:38:10,703 MOST TRIALS WEREE ADEQUATELY 5327 03:38:10,703 --> 03:38:12,138 POWERED, SAMPLE SIZES OVER A 5328 03:38:12,138 --> 03:38:12,672 THOUSAND PARTICIPANTS. 5329 03:38:12,672 --> 03:38:15,074 AND STUDIES HAD A MIX OF 5330 03:38:15,074 --> 03:38:16,743 REASONABLE OR WIDE 95% 5331 03:38:16,743 --> 03:38:18,244 CONFIDENCE INTERVALS. 5332 03:38:18,244 --> 03:38:20,246 FOR RISK OF BIAS, IN GENERAL, 5333 03:38:20,246 --> 03:38:22,982 RISK OF BIAS LOW IN TRIALS, MORE 5334 03:38:22,982 --> 03:38:25,385 SUBSTANTIAL IN THE OBSERVATIONAL 5335 03:38:25,385 --> 03:38:28,087 STUDIES, AND, AGAIN, THESE 5336 03:38:28,087 --> 03:38:30,056 OBSERVATIONAL STUDIES NORMALLY 5337 03:38:30,056 --> 03:38:36,996 THERE WERE ISSUES WITH ADJUSTIG 5338 03:38:36,996 --> 03:38:39,499 FOR CONFOUNDING OR MISSING DATA. 5339 03:38:39,499 --> 03:38:45,171 WITH DIRECTNESS AGAIN MOST 5340 03:38:45,171 --> 03:38:46,940 TRIALS WERE DESIGNED TO AFFECT 5341 03:38:46,940 --> 03:38:49,642 IN COMPARISON TO ANOTHER 5342 03:38:49,642 --> 03:38:50,643 BEVERAGE, MOST OF THE 5343 03:38:50,643 --> 03:38:51,844 OBSERVATIONAL STUDIES WERE 5344 03:38:51,844 --> 03:38:54,047 DIRECTLY ADDRESSING THIS 5345 03:38:54,047 --> 03:38:55,381 QUESTION. 5346 03:38:55,381 --> 03:38:57,116 AND AGAIN LASTLY FOR 5347 03:38:57,116 --> 03:38:59,085 GENERALIZABILITY IT WAS LIMITED 5348 03:38:59,085 --> 03:39:00,420 PARTICULARLY IN TRIALS, AND 5349 03:39:00,420 --> 03:39:02,622 AGAIN WE SAW BETTER 5350 03:39:02,622 --> 03:39:05,892 REPRESENTATION OF RACIAL AND 5351 03:39:05,892 --> 03:39:07,226 ETHNIC GROUPS IN OBSERVATIONAL 5352 03:39:07,226 --> 03:39:11,130 STUDIES, AND AGAIN FOR THE 5353 03:39:11,130 --> 03:39:12,765 META-ANALYSIS THERE WAS LESS 5354 03:39:12,765 --> 03:39:16,069 RACIAL AND ETHNIC DIVERSITY. 5355 03:39:16,069 --> 03:39:16,836 NEXT SLIDE. 5356 03:39:16,836 --> 03:39:20,106 SO NOW WE'LL LOOK AT PREGNANCY 5357 03:39:20,106 --> 03:39:22,742 AND GESTATIONALLY WEIGHT GAIN. 5358 03:39:22,742 --> 03:39:24,811 CONCLUSION STATEMENT COULD NOT 5359 03:39:24,811 --> 03:39:27,180 BE DRAWN RELATING SUGAR 5360 03:39:27,180 --> 03:39:28,548 SWEETENED BEVERAGE CONSUMPTION 5361 03:39:28,548 --> 03:39:30,516 BY INDIVIDUALS DURING PREGNANCY 5362 03:39:30,516 --> 03:39:32,919 AND GESTATIONAL WEIGHT GAIN DUE 5363 03:39:32,919 --> 03:39:34,320 TO CONCERNS WITH CONSISTENCY, 5364 03:39:34,320 --> 03:39:36,422 PRECISION, RISK OF BIAS, 5365 03:39:36,422 --> 03:39:37,023 DIRECTNESS, GENERALIZABILITY. 5366 03:39:37,023 --> 03:39:39,459 SO THERE WAS A SMALL NUMBER OF 5367 03:39:39,459 --> 03:39:42,962 ARTICLES WITH RELATIVELY SMALL 5368 03:39:42,962 --> 03:39:44,931 SAMPLE SIZES, RANGING FROM ABOUT 5369 03:39:44,931 --> 03:39:47,000 A HUNDRED TO 1400, BUT MOST 5370 03:39:47,000 --> 03:39:49,736 SAMPLE SIZES WERE IN THE 5371 03:39:49,736 --> 03:39:50,637 HUNDREDS. 5372 03:39:50,637 --> 03:39:52,605 IN SEVERAL CASES, THE DEFINITION 5373 03:39:52,605 --> 03:39:57,076 OF GESTATIONAL WEIGHT GAIN WAS 5374 03:39:57,076 --> 03:39:58,378 POORLY DEFINED. 5375 03:39:58,378 --> 03:39:59,379 SERIOUS CONCERNS WITH 5376 03:39:59,379 --> 03:40:01,247 CONSISTENCY ACROSS EXPOSURE AND 5377 03:40:01,247 --> 03:40:02,315 OUTCOME ASSESSMENTS SO EXPOSURE 5378 03:40:02,315 --> 03:40:04,751 WAS MEASURED AT DIFFERENT TIME 5379 03:40:04,751 --> 03:40:06,919 POINTS IN PREGNANCY USING 5380 03:40:06,919 --> 03:40:08,354 DIFFERENT ASSESSMENT METHODS. 5381 03:40:08,354 --> 03:40:09,455 STUDIES USED DIFFERENT 5382 03:40:09,455 --> 03:40:10,590 DEFINITIONS OF SUGAR SWEETENED 5383 03:40:10,590 --> 03:40:14,927 BEVERAGES SO SOMETIMES THEY ONLY 5384 03:40:14,927 --> 03:40:22,035 INCLUDED SOFT RANGES, OTHERS A 5385 03:40:22,035 --> 03:40:23,236 RANGE, GESTATIONAL WEIGHT GAIN 5386 03:40:23,236 --> 03:40:26,939 WAS MEASURED AT TIME POINTS, 5387 03:40:26,939 --> 03:40:28,608 TIMEFRAMES FOR GESTATIONAL 5388 03:40:28,608 --> 03:40:31,310 WEIGHT GAIN VARIED BETWEEN 5389 03:40:31,310 --> 03:40:32,645 BETWEEN STUDIES, MANY DID NOT 5390 03:40:32,645 --> 03:40:35,281 TAKE INTO ACCOUNT GESTATIONAL 5391 03:40:35,281 --> 03:40:35,748 AGE. 5392 03:40:35,748 --> 03:40:36,716 THESE CONCERNS PRECLUDED ABILITY 5393 03:40:36,716 --> 03:40:37,650 TO DISCERN THE RELEVANCE OF 5394 03:40:37,650 --> 03:40:41,020 FINDINGS TO THE U.S. POPULATION. 5395 03:40:41,020 --> 03:40:42,955 AND BECAUSE OF SMALLER SAMPLE 5396 03:40:42,955 --> 03:40:45,024 SIZES THERE WERE CONCERNS ABOUT 5397 03:40:45,024 --> 03:40:47,126 BEING UNDERPOWERED PARTICULARLY 5398 03:40:47,126 --> 03:40:48,294 FOR ADEQUACY OF GESTATIONAL 5399 03:40:48,294 --> 03:40:49,829 WEIGHT GAIN. 5400 03:40:49,829 --> 03:40:50,830 STUDIES ASSESSED HAVING HIGH 5401 03:40:50,830 --> 03:40:53,566 RISK OF BIAS IN AT LEAST ONE 5402 03:40:53,566 --> 03:40:54,901 DOMAIN AND MOST COMMONLY THIS IS 5403 03:40:54,901 --> 03:40:58,838 NOT ACCOUNTING FOR KEY 5404 03:40:58,838 --> 03:40:59,806 CONFOUNDERS, MISCLASSIFICATION, 5405 03:40:59,806 --> 03:41:01,674 NOT ACCOUNTING FOR MISSING DATA. 5406 03:41:01,674 --> 03:41:03,976 NONE OF THE STUDIES WERE 5407 03:41:03,976 --> 03:41:06,045 DESIGNED TO ASSESS RELATIONSHIP 5408 03:41:06,045 --> 03:41:07,714 BETWEEN SUGAR SWEETENED BEVERAGE 5409 03:41:07,714 --> 03:41:08,548 CONSUMPTION AND GESTATIONAL 5410 03:41:08,548 --> 03:41:12,151 WEIGHT GAIN SO ALL OF THEM ARE 5411 03:41:12,151 --> 03:41:14,353 LOOKING AT MULTIPLE DIETARY -- 5412 03:41:14,353 --> 03:41:17,423 DIFFERENT DIETARY EXPOSURES. 5413 03:41:17,423 --> 03:41:18,624 NEXT SLIDE. 5414 03:41:18,624 --> 03:41:20,793 SO, HERE WE'RE LOOKING AT 5415 03:41:20,793 --> 03:41:22,462 RELATIONSHIP BETWEEN SUGAR 5416 03:41:22,462 --> 03:41:24,630 SWEETENED BEVERAGE CONSUMPTION 5417 03:41:24,630 --> 03:41:25,865 IN POSTPARTUM WITH WEIGHT 5418 03:41:25,865 --> 03:41:26,933 CHANGE, AND UNFORTUNATELY AGAIN 5419 03:41:26,933 --> 03:41:27,934 CONCLUSION STATEMENT COULD NOT 5420 03:41:27,934 --> 03:41:30,903 BE DRAWN BECAUSE THERE WAS NOT 5421 03:41:30,903 --> 03:41:31,671 ENOUGH EVIDENCE AVAILABLE SO 5422 03:41:31,671 --> 03:41:33,740 THERE WERE ONLY FOUR ARTICLES 5423 03:41:33,740 --> 03:41:35,274 THAT ASSESSED THIS RELATIONSHIP, 5424 03:41:35,274 --> 03:41:37,043 AND THEY SHOWED LITTLE 5425 03:41:37,043 --> 03:41:38,344 CONSISTENCY IN EXPOSURE 5426 03:41:38,344 --> 03:41:39,545 DEFINITION, EXPOSURE ASSESSMENT 5427 03:41:39,545 --> 03:41:42,081 TIMING AND METHOD, AS WELL AS 5428 03:41:42,081 --> 03:41:44,584 DURATION OF FOLLOW-UP. 5429 03:41:44,584 --> 03:41:45,918 AND LIKE THE EVIDENCE-BASED AND 5430 03:41:45,918 --> 03:41:47,987 INDIVIDUAL DURING PREGNANCY ALL 5431 03:41:47,987 --> 03:41:49,422 ARTICLES IN INDIVIDUALS DURING 5432 03:41:49,422 --> 03:41:50,523 POSTPARTUM WERE ASSESSED HAVING 5433 03:41:50,523 --> 03:41:52,558 HIGH RISK OF BIAS IN AT LEAST 5434 03:41:52,558 --> 03:41:54,794 ONE DOMAIN, ONLY ONE OF THESE 5435 03:41:54,794 --> 03:41:55,661 ARTICLES WAS SPECIFICALLY 5436 03:41:55,661 --> 03:41:59,165 DESIGNED TO ASSESS THIS 5437 03:41:59,165 --> 03:41:59,499 RELATIONSHIP. 5438 03:41:59,499 --> 03:42:06,606 NEXT SLIDE PLEASE. 5439 03:42:06,606 --> 03:42:07,573 THAT'S IT. 5440 03:42:07,573 --> 03:42:11,410 >> THAT WAS A GREAT 5441 03:42:11,410 --> 03:42:13,513 PRESENTATION. 5442 03:42:13,513 --> 03:42:16,115 >> I'M GOOD AT READING. 5443 03:42:16,115 --> 03:42:17,884 [LAUGHTER] 5444 03:42:17,884 --> 03:42:18,251 >> QUESTIONS? 5445 03:42:18,251 --> 03:42:20,052 >> WE'RE GOING TO TALK ABOUT 5446 03:42:20,052 --> 03:42:24,190 ADEQUACY OF WEIGHT GAIN IN 5447 03:42:24,190 --> 03:42:25,625 PREGNANCY, LOOKING DID THEY GAIN 5448 03:42:25,625 --> 03:42:27,126 ENOUGH OR TOO MUCH? 5449 03:42:27,126 --> 03:42:30,463 >> WE WERE USING THE IOM 5450 03:42:30,463 --> 03:42:30,863 GUIDELINES. 5451 03:42:30,863 --> 03:42:31,764 >> WITHIN A RANGE. 5452 03:42:31,764 --> 03:42:32,498 >> YEAH. 5453 03:42:32,498 --> 03:42:32,832 >> OKAY. 5454 03:42:32,832 --> 03:42:38,671 >> YOU MIGHT CLARIFY THAT A 5455 03:42:38,671 --> 03:42:47,180 LITTLE BIT. 5456 03:42:47,180 --> 03:42:57,223 5457 03:43:15,708 --> 03:43:18,044 >> REVIEWS INCLUDING ADULTS, 5458 03:43:18,044 --> 03:43:19,579 WERE ADOLESCENTS DURING 5459 03:43:19,579 --> 03:43:24,517 PREGNANCY TAKEN OUT OF THESE 5460 03:43:24,517 --> 03:43:34,694 ANALYSES? 5461 03:43:38,130 --> 03:43:44,070 I DON'T THINK THAT'S GENERALLY 5462 03:43:44,070 --> 03:43:44,770 COMMONLY REPORTED. 5463 03:43:44,770 --> 03:43:45,004 >> HI. 5464 03:43:45,004 --> 03:43:48,140 I BELIEVE THERE WAS ONE OF THE 5465 03:43:48,140 --> 03:43:49,675 ARTICLES IN INDIVIDUALS DURING 5466 03:43:49,675 --> 03:43:52,378 PREGNANCY THAT WAS SPECIFICALLY 5467 03:43:52,378 --> 03:43:54,046 IN ADOLESCENTS DURING PREGNANCY. 5468 03:43:54,046 --> 03:43:55,248 THERE'S ONE ARTICLE WITH 5469 03:43:55,248 --> 03:44:01,153 POPULATION BUT VERY RARE WE 5470 03:44:01,153 --> 03:44:03,656 WOULD SEE THAT CAPTURED. 5471 03:44:03,656 --> 03:44:04,290 >> PREGNANCY STUDIES ARE SMALL 5472 03:44:04,290 --> 03:44:05,858 ANYWAY, SO FEW OF THEM BUT 5473 03:44:05,858 --> 03:44:07,827 CURIOUS IF THERE WAS ANY TYPE OF 5474 03:44:07,827 --> 03:44:09,996 GUIDELINE WHEN IT COMES TO 5475 03:44:09,996 --> 03:44:16,502 INCLUDING ADOLESCENTS WITHIN 5476 03:44:16,502 --> 03:44:16,869 THOSE STUDIES. 5477 03:44:16,869 --> 03:44:20,439 >> THAT WOULD BE A GOOD 5478 03:44:20,439 --> 03:44:21,407 FOLLOW-UP OR RECOMMENDATION, AN 5479 03:44:21,407 --> 03:44:27,546 AREA YOU MIGHT SEE HIGHER 5480 03:44:27,546 --> 03:44:28,547 CONSUMPTION IN ADOLESCENTS. 5481 03:44:28,547 --> 03:44:32,351 >> CAN I ASK YOU A QUESTION 5482 03:44:32,351 --> 03:44:38,057 THAT'S RELATED TO WHAT WE'VE 5483 03:44:38,057 --> 03:44:39,191 SEEN OVER DIETARY PATTERNS? 5484 03:44:39,191 --> 03:44:40,793 I'LL PUT YOU ON THE SPOT. 5485 03:44:40,793 --> 03:44:40,993 SORRY. 5486 03:44:40,993 --> 03:44:43,496 I DO BELIEVE I MADE THIS COMMENT 5487 03:44:43,496 --> 03:44:44,597 BEFORE BUT I'VE HAD SO MANY 5488 03:44:44,597 --> 03:44:51,404 MEETINGS I DON'T KNOW WHICH ONE. 5489 03:44:51,404 --> 03:44:54,674 IT'S REALLY REMARKABLE TO ME 5490 03:44:54,674 --> 03:44:57,743 THAT PRIOR COMMITTEES CONDUCT A 5491 03:44:57,743 --> 03:45:01,380 SYSTEMATIC REVIEW AND THIS GRADE 5492 03:45:01,380 --> 03:45:04,684 THE CONCLUSION STATEMENT AS 5493 03:45:04,684 --> 03:45:05,217 MODERATE. 5494 03:45:05,217 --> 03:45:09,155 AND WE CAN ADD 80, 100 MORE 5495 03:45:09,155 --> 03:45:10,790 STUDIES, AND THE CONCLUSION 5496 03:45:10,790 --> 03:45:12,358 STATEMENT, THE FOODS DON'T 5497 03:45:12,358 --> 03:45:14,193 CHANGE, AND THE GRADE STAYS 5498 03:45:14,193 --> 03:45:14,794 MODERATE. 5499 03:45:14,794 --> 03:45:18,698 BUT ONCE IN A BLUE MOON IT GOES 5500 03:45:18,698 --> 03:45:23,369 FROM MODERATE TO STRONG. 5501 03:45:23,369 --> 03:45:25,137 I WONDERED IN YOUR REVIEW WHERE 5502 03:45:25,137 --> 03:45:28,774 DO YOU THINK -- WELL, LET'S JUST 5503 03:45:28,774 --> 03:45:29,976 TAKE THE SUGAR-SWEETENED 5504 03:45:29,976 --> 03:45:31,077 BEVERAGES. 5505 03:45:31,077 --> 03:45:34,013 WHAT DO WE NEED FROM SCIENCE, 5506 03:45:34,013 --> 03:45:42,555 FROM RESEARCH, TO GET US FROM 5507 03:45:42,555 --> 03:45:45,057 MODERATE TO STRONG? 5508 03:45:45,057 --> 03:45:47,360 WHAT WERE SOME FACTORS THAT 5509 03:45:47,360 --> 03:45:53,399 JUST -- SORRY, I ASKED A HARD 5510 03:45:53,399 --> 03:45:53,666 QUESTION. 5511 03:45:53,666 --> 03:45:55,701 >> I HAVE A GENERAL ANSWER TO 5512 03:45:55,701 --> 03:45:56,469 THAT. 5513 03:45:56,469 --> 03:45:58,738 BASED ON FIVE CRITERIA THAT WE 5514 03:45:58,738 --> 03:46:00,840 USED IN GRADING, ESPECIALLY I 5515 03:46:00,840 --> 03:46:03,409 HAVE TO SAY BASED ON THE 5516 03:46:03,409 --> 03:46:06,879 SECTIONS AND OUTCOMES, IT IS 5517 03:46:06,879 --> 03:46:09,715 REALLY CONFOUNDING. 5518 03:46:09,715 --> 03:46:11,784 CONFOUNDING IS ONE THING. 5519 03:46:11,784 --> 03:46:16,155 SOMETIMES CONFOUNDERS WERE NOT 5520 03:46:16,155 --> 03:46:17,923 MEASURED AND ADJUSTED IN 5521 03:46:17,923 --> 03:46:18,991 SUFFICIENT DETAILS. 5522 03:46:18,991 --> 03:46:21,427 THAT'S NUMBER ONE. 5523 03:46:21,427 --> 03:46:23,829 NUMBER TWO THING IS DIET WAS 5524 03:46:23,829 --> 03:46:30,503 ONLY MEASURED AT ONE TIME POINT 5525 03:46:30,503 --> 03:46:31,270 ALONG, AND GENERALIZABILITY, 5526 03:46:31,270 --> 03:46:35,941 SITTING THROUGH THE SIXTH 5527 03:46:35,941 --> 03:46:37,276 MEETING, GENERALIZABILITY SEEMS 5528 03:46:37,276 --> 03:46:40,679 TO BE ONE THAT'S NOT QUITE THERE 5529 03:46:40,679 --> 03:46:40,980 YET. 5530 03:46:40,980 --> 03:46:45,151 PEOPLE ARE NOT PAYING ATTENTION. 5531 03:46:45,151 --> 03:46:45,918 BUT GENERALIZABILITY, IT COMES 5532 03:46:45,918 --> 03:46:51,057 FROM THE BAT. 5533 03:46:51,057 --> 03:46:52,124 AND DATA,GOOD OBSERVATIONAL DATA 5534 03:46:52,124 --> 03:46:56,529 REQUIRES A LOT OF FUNDING TO DO. 5535 03:46:56,529 --> 03:46:58,064 AND SO THEREFORE BACKTRACK IT 5536 03:46:58,064 --> 03:47:01,367 BACK, THEN IT ALMOST COMES FROM 5537 03:47:01,367 --> 03:47:02,234 THE FUNDING, ALSO SOMETHING 5538 03:47:02,234 --> 03:47:03,436 THAT'S GOING TO DRIVE THE 5539 03:47:03,436 --> 03:47:12,945 QUALITY OF THE DATA THAT WE 5540 03:47:12,945 --> 03:47:13,379 HAVE. 5541 03:47:13,379 --> 03:47:19,618 THE DIRECTION IS NOT THE 5542 03:47:19,618 --> 03:47:20,286 PROBLEM. 5543 03:47:20,286 --> 03:47:23,556 IT'S REALLY THE DIET 5544 03:47:23,556 --> 03:47:26,392 MEASUREMENT, FUNDING TO DO 5545 03:47:26,392 --> 03:47:28,694 MULTIPLE MEASUREMENTS, GOOD 5546 03:47:28,694 --> 03:47:31,564 MEASUREMENTS AND CONFOUNDERS FOR 5547 03:47:31,564 --> 03:47:36,035 THAT ARE. 5548 03:47:36,035 --> 03:47:41,841 >> I'M GOING TO LET HOLLI GO 5549 03:47:41,841 --> 03:47:42,408 FIRST. 5550 03:47:42,408 --> 03:47:44,343 >> TO ECHO THERESA'S COMMENT, I 5551 03:47:44,343 --> 03:47:45,344 THINK THE ISSUE OF 5552 03:47:45,344 --> 03:47:46,645 GENERALIZABILITY IS CONSISTENT 5553 03:47:46,645 --> 03:47:53,018 ACROSS MANY OF OUR SYSTEMATIC 5554 03:47:53,018 --> 03:47:55,855 REVIEWS, ESPECIALLY PUTTING THE 5555 03:47:55,855 --> 03:47:59,024 HEALTH EQUITY LENS, YOU BEGIN TO 5556 03:47:59,024 --> 03:47:59,892 NOTICE THAT MORE. 5557 03:47:59,892 --> 03:48:02,495 I THINK WHICH PREVIOUSLY MIGHT 5558 03:48:02,495 --> 03:48:04,497 NOT HAVE, YOU KNOW, BEEN 5559 03:48:04,497 --> 03:48:06,665 SOMETHING THOUGHT ABOUT QUITE AS 5560 03:48:06,665 --> 03:48:07,967 MUCH BUT THAT GENERALIZABILITY 5561 03:48:07,967 --> 03:48:09,635 ISSUE SEEMS TO BE PRETTY 5562 03:48:09,635 --> 03:48:18,210 CONSISTENT ACROSS MANY OF OUR 5563 03:48:18,210 --> 03:48:18,477 QUESTIONS. 5564 03:48:18,477 --> 03:48:19,311 >> THANK YOU, HOLLIE. 5565 03:48:19,311 --> 03:48:20,980 DEE DEE HAS A COMMENT. 5566 03:48:20,980 --> 03:48:22,548 >> WHAT ADDITIONAL EVIDENCE 5567 03:48:22,548 --> 03:48:23,916 WOULD BE NEEDED, I WROTE IT DOWN 5568 03:48:23,916 --> 03:48:28,854 IN A LIST BECAUSE I HAD THE SAME 5569 03:48:28,854 --> 03:48:29,622 QUESTION. 5570 03:48:29,622 --> 03:48:31,824 I THOUGHT OF, BECAUSE I THINK 5571 03:48:31,824 --> 03:48:37,396 THE CERTAINTY OF SUGARY 5572 03:48:37,396 --> 03:48:39,265 BEVERAGES AS A CAUSAL DIETARY 5573 03:48:39,265 --> 03:48:41,600 EXPOSURE FOR OBESITY IS NOT 5574 03:48:41,600 --> 03:48:42,768 WHAT'S BEING DEBATED AS MUCH AS 5575 03:48:42,768 --> 03:48:45,604 MAYBE SOME OF THE NUANCE THAT 5576 03:48:45,604 --> 03:48:49,675 PERHAPS THE PUN U. PUBLIC -- 5577 03:48:49,675 --> 03:48:51,110 PUBLIC OR INDUSTRY MAY BE MORE 5578 03:48:51,110 --> 03:48:52,778 INTERESTED IN THAT COULD BE 5579 03:48:52,778 --> 03:48:53,579 DRIVING UNCERTAINTY, LIKE DOSE 5580 03:48:53,579 --> 03:48:56,448 AND FREQUENCY, HOW MANY CAN I 5581 03:48:56,448 --> 03:48:57,049 HAVE, RIGHT? 5582 03:48:57,049 --> 03:48:58,651 WE DON'T NEED ANY. 5583 03:48:58,651 --> 03:49:00,519 IF IT'S RECREATIONAL, IS THERE A 5584 03:49:00,519 --> 03:49:02,688 CUT POINT? 5585 03:49:02,688 --> 03:49:04,990 ARE THERE TYPES THAT MAYBE ARE 5586 03:49:04,990 --> 03:49:09,161 MORE OR LESS CONSISTENT WITH THE 5587 03:49:09,161 --> 03:49:10,462 EVIDENCE IN EXAMPLES WE HEARD 5588 03:49:10,462 --> 03:49:15,067 LIKE MILK AND COFFEE DRINKS, 5589 03:49:15,067 --> 03:49:17,169 FLAVORED MILK, SPORTS DRINKS, 5590 03:49:17,169 --> 03:49:18,704 WHATEVER, ARE THESE ALL THE SAME 5591 03:49:18,704 --> 03:49:20,873 OR ARE THERE MAYBE SOME NUANCE 5592 03:49:20,873 --> 03:49:21,540 THERE. 5593 03:49:21,540 --> 03:49:25,477 AND WHAT'S THE REPLACEMENT 5594 03:49:25,477 --> 03:49:31,483 BEVERAGE, WHICH PRESUMABLY IS 5595 03:49:31,483 --> 03:49:35,454 WATER BUT THERE'S A LOT OF OTHER 5596 03:49:35,454 --> 03:49:38,123 THINGS PEOPLE ARE CONSUMING, 5597 03:49:38,123 --> 03:49:38,591 ARTIFICIALLY SWEETENED 5598 03:49:38,591 --> 03:49:39,258 BEVERAGES, REAL QUESTIONS IF YOU 5599 03:49:39,258 --> 03:49:41,460 SAY THEY ARE BAD THAT MAY 5600 03:49:41,460 --> 03:49:42,294 REQUIRE THAT NUANCE. 5601 03:49:42,294 --> 03:49:47,533 THOSE ARE ALL IMPORTANT AREAS OF 5602 03:49:47,533 --> 03:49:48,067 RESEARCH. 5603 03:49:48,067 --> 03:49:51,036 BUT I AGREE IT STILL SEEMS FUNNY 5604 03:49:51,036 --> 03:49:51,971 THAT IT'S MODERATE WHEN THIS 5605 03:49:51,971 --> 03:49:53,005 IS -- I DON'T THINK IT'S 5606 03:49:53,005 --> 03:49:54,306 SOMETHING THAT WE'RE GOING TO 5607 03:49:54,306 --> 03:49:56,175 SUDDENLY COME TO THE CONCLUSION, 5608 03:49:56,175 --> 03:49:59,245 OH, LET'S ADD IT IN, RIGHT? 5609 03:49:59,245 --> 03:50:04,283 SO BUT THERE ARE SOME GAPS, 5610 03:50:04,283 --> 03:50:05,150 IMPLEMENTATION OF ADVICE I'D 5611 03:50:05,150 --> 03:50:06,685 LOVE TO SEE FILLED BECAUSE I 5612 03:50:06,685 --> 03:50:10,155 THINK WE SAW IN SOME DATA 5613 03:50:10,155 --> 03:50:12,358 TRENDS, IT'S THE ONE FOOD AND 5614 03:50:12,358 --> 03:50:20,132 BEVERAGE ITEM THAT'S GONE DOWN 5615 03:50:20,132 --> 03:50:21,133 SIGNIFICANTLY, THAT'S HUGE, ONE 5616 03:50:21,133 --> 03:50:23,035 OF VERY FEW SUCCESS STORIES 5617 03:50:23,035 --> 03:50:23,235 TODAY. 5618 03:50:23,235 --> 03:50:32,411 THANK YOU FOR BRINGING UP THAT 5619 03:50:32,411 --> 03:50:32,911 QUESTION. 5620 03:50:32,911 --> 03:50:33,212 >> FATIMA? 5621 03:50:33,212 --> 03:50:33,545 >> OH, SORRY? 5622 03:50:33,545 --> 03:50:41,020 >> IN CONJUNCTION WE SAW NHANES 5623 03:50:41,020 --> 03:50:42,054 DATA YESTERDAY SEEING DECLINE OR 5624 03:50:42,054 --> 03:50:43,122 STABILIZATION OF OBESITY RATES 5625 03:50:43,122 --> 03:50:44,123 FOR THE FIRST TIME SINCE THEY 5626 03:50:44,123 --> 03:50:45,524 HAVE BEEN RECORDED. 5627 03:50:45,524 --> 03:50:49,461 I KNOW THAT WE'VE BEEN LOOKING 5628 03:50:49,461 --> 03:50:51,764 AT NHANES DATA FOR A LONG TIME, 5629 03:50:51,764 --> 03:50:53,832 MAYBE SOME INFORMATION WE'RE 5630 03:50:53,832 --> 03:50:56,035 REPORTING ON MAY JUXTAPOSE WHAT 5631 03:50:56,035 --> 03:50:56,802 YOU WERE SPEAKING OF, DEE DEE, 5632 03:50:56,802 --> 03:50:58,237 SOME OF THESE TRENDS THAT WE'VE 5633 03:50:58,237 --> 03:50:59,171 BEEN FOLLOWING. 5634 03:50:59,171 --> 03:51:00,706 WE HAVE A LOT OF WORK FOR 5635 03:51:00,706 --> 03:51:02,675 IMPROVEMENT SO I DON'T THINK WE 5636 03:51:02,675 --> 03:51:05,010 CAN PAT OURSELVES ON THE BACK OR 5637 03:51:05,010 --> 03:51:07,546 JUMP FOR JOY YET, BUT TO SEE THE 5638 03:51:07,546 --> 03:51:09,081 TREND, NOW WE DID SEE AN 5639 03:51:09,081 --> 03:51:13,252 INCREASE IN RATES OF SEVERE 5640 03:51:13,252 --> 03:51:15,554 OBESITY, IN THE CONTEXT OF DATA 5641 03:51:15,554 --> 03:51:18,324 THAT CAME OUT YESTERDAY SO WE 5642 03:51:18,324 --> 03:51:20,025 HAVE SIGNIFICANT WORK TO BE DONE 5643 03:51:20,025 --> 03:51:21,360 BUT SOME TRENDS ARE IMPROVING 5644 03:51:21,360 --> 03:51:23,962 OVER TIME AND SO I THINK WE CAN 5645 03:51:23,962 --> 03:51:26,098 CONTINUE TO MAKE KEY EFFORTS BUT 5646 03:51:26,098 --> 03:51:31,637 SOME TRENDS ARE SHOWING SOME 5647 03:51:31,637 --> 03:51:36,375 POTENTIAL PROMISE. 5648 03:51:36,375 --> 03:51:38,210 >> I LOVE POSITIVE NEWS. 5649 03:51:38,210 --> 03:51:39,978 >> THIS IS NOT NECESSARILY TO 5650 03:51:39,978 --> 03:51:41,714 SUGAR SWEETENED BEVERAGES BUT 5651 03:51:41,714 --> 03:51:42,948 OTHER SYSTEMATIC REVIEWS, BUT 5652 03:51:42,948 --> 03:51:46,685 ONE OF THE THINGS THAT WE FIND 5653 03:51:46,685 --> 03:51:49,521 IS EVIDENCE COMES FROM OTHER 5654 03:51:49,521 --> 03:51:51,790 COUNTRIES WITH LONG PROSPECTIVE 5655 03:51:51,790 --> 03:51:53,459 COHORT STUDIES, AND THE COHORT 5656 03:51:53,459 --> 03:51:55,294 STUDIES IN THE U.S. ARE NOT 5657 03:51:55,294 --> 03:51:59,031 BEING FUNDED AT THE SAME RATE AS 5658 03:51:59,031 --> 03:51:59,665 THEY WERE. 5659 03:51:59,665 --> 03:52:01,967 AND WHEN THEY COME FROM OTHER 5660 03:52:01,967 --> 03:52:03,302 COUNTRIES THE DIETARY PATTERNS 5661 03:52:03,302 --> 03:52:06,672 CAN BE VERY DIFFERENT TOO, SO 5662 03:52:06,672 --> 03:52:08,107 THERE'S SEVERAL FACTORS THERE. 5663 03:52:08,107 --> 03:52:10,075 I THINK ANOTHER THING IF YOU 5664 03:52:10,075 --> 03:52:12,378 LOOK AT OUR STRONG EVIDENCE, 5665 03:52:12,378 --> 03:52:13,779 LIKE THE CARDIOVASCULAR DISEASE, 5666 03:52:13,779 --> 03:52:15,881 WE WERE ABLE TO HONE DOWN TO 5667 03:52:15,881 --> 03:52:19,485 U.S. STUDIES AND STILL HAD A 5668 03:52:19,485 --> 03:52:22,521 VERY ROBUST BODY OF EVIDENCE, 5669 03:52:22,521 --> 03:52:25,190 DIABETES THE SAME WAY, BECAUSE 5670 03:52:25,190 --> 03:52:26,925 WE'VE HAD -- WE HAD A LARGE BODY 5671 03:52:26,925 --> 03:52:29,228 OF EVIDENCE AND THOSE ARE FUNDED 5672 03:52:29,228 --> 03:52:32,364 BY NHLBI FOR THE MOST PART, 5673 03:52:32,364 --> 03:52:34,666 NIDDK, WHEN YOU SEE THE U.S. 5674 03:52:34,666 --> 03:52:37,035 STUDIES, OTHER GROUPS AS WELL, 5675 03:52:37,035 --> 03:52:37,569 AMERICAN HEART, AMERICAN 5676 03:52:37,569 --> 03:52:38,203 DIABETES ASSOCIATION. 5677 03:52:38,203 --> 03:52:41,240 SO YOU KNOW YOU DO HAVE GROUPS 5678 03:52:41,240 --> 03:52:43,542 THAT ARE FUNDING THIS. 5679 03:52:43,542 --> 03:52:47,045 SO THINK THOSE ARE SOME 5680 03:52:47,045 --> 03:52:48,447 CONTRIBUTORS TO THAT. 5681 03:52:48,447 --> 03:52:51,116 >> I SEE A RECOMMENDATION TO 5682 03:52:51,116 --> 03:53:01,160 FEDERAL AGENCIES FORMING AS WE 5683 03:53:01,160 --> 03:53:01,360 SPEAK. 5684 03:53:01,360 --> 03:53:05,030 GREAT DISCUSSION. 5685 03:53:05,030 --> 03:53:06,331 OTHER QUESTIONS? 5686 03:53:06,331 --> 03:53:09,034 >> ONE MORE FUN FACT NOT TO PILE 5687 03:53:09,034 --> 03:53:11,336 ON POSITIVE NEWS BUT SUGARY 5688 03:53:11,336 --> 03:53:13,105 BEVERAGES STILL 10% OF OUR 5689 03:53:13,105 --> 03:53:14,306 CALORIE INTAKE, STILL REALLY 5690 03:53:14,306 --> 03:53:14,640 HIGH. 5691 03:53:14,640 --> 03:53:16,809 IT'S THE NUMBER ONE SOURCE OF 5692 03:53:16,809 --> 03:53:25,117 CALORIES ESPECIALLY IN TEENS. 5693 03:53:25,117 --> 03:53:26,452 THEY ARE GOING DOWNWARD BUT IT'S 5694 03:53:26,452 --> 03:53:30,255 GOT A LONG WAY TO GO. 5695 03:53:30,255 --> 03:53:30,556 >> THANKS. 5696 03:53:30,556 --> 03:53:36,395 I THINK WE HAVE A BREAK NOW. 5697 03:53:36,395 --> 03:53:38,130 >> I'M SO ENGAGED. 5698 03:53:38,130 --> 03:53:39,798 SO EXCITED ABOUT POSITIVE NEWS. 5699 03:53:39,798 --> 03:53:40,332 WE DO. 5700 03:53:40,332 --> 03:53:41,867 WE HAVE A BREAK. 5701 03:53:41,867 --> 03:53:44,603 MY APOLOGIES TO THE PUBLIC. 5702 03:53:44,603 --> 03:53:47,773 I'M LOSING TRACK OF TIME. 5703 03:53:47,773 --> 03:53:50,642 WE HAVE A BREAK UNTIL 2:40. 5704 03:53:50,642 --> 03:53:53,278 THANK YOU FOR THE GREAT 5705 03:53:53,278 --> 03:53:53,712 DISCUSSION. 5706 03:53:53,712 --> 03:53:56,804 AND LET'S CONTINUE. 5707 03:53:56,804 --> 03:54:01,275 THE LAST 5708 03:54:01,275 --> 03:54:03,578 SESSION OF THE DAY, AND WE HAD A 5709 03:54:03,578 --> 03:54:04,879 GREAT DISCUSSION BEFORE THE 5710 03:54:04,879 --> 03:54:07,415 BREAK, SO I'M GOING TO HAND IT 5711 03:54:07,415 --> 03:54:12,987 BACK TO YOU, DEANNA, TO LEAD THE 5712 03:54:12,987 --> 03:54:13,454 LAST SESSION 5713 03:54:13,454 --> 03:54:14,188 >> THANK YOU. 5714 03:54:14,188 --> 03:54:16,224 BEFORE WE GET STARTED ON THIS, 5715 03:54:16,224 --> 03:54:18,259 AGAIN I WANT TO THANK THE STAFF 5716 03:54:18,259 --> 03:54:25,266 AND THE COMMITTEE MEMBERS FOR 5717 03:54:25,266 --> 03:54:26,634 DOING THIS BECAUSE WE DID A LOT 5718 03:54:26,634 --> 03:54:28,869 OF WORK IN A SHORT PERIOD OF 5719 03:54:28,869 --> 03:54:30,471 TIME AND PEOPLE WILL TO BE 5720 03:54:30,471 --> 03:54:31,505 RESPONSIVE AND THEY WERE. 5721 03:54:31,505 --> 03:54:33,140 I APPRECIATE THAT. 5722 03:54:33,140 --> 03:54:34,875 TO START US OFF, JUST TO TELL 5723 03:54:34,875 --> 03:54:38,346 YOU HOW MASSIVE THIS WAS, WE 5724 03:54:38,346 --> 03:54:39,480 STARTED OUT WITH 36,000 5725 03:54:39,480 --> 03:54:39,914 ARTICLES. 5726 03:54:39,914 --> 03:54:43,517 AND SO WE ENDED UP WITH 100. 5727 03:54:43,517 --> 03:54:48,689 AND ALL OF THOSE HAD MULTIPLE 5728 03:54:48,689 --> 03:54:49,156 OUTCOMES. 5729 03:54:49,156 --> 03:54:53,594 SO YOU'LL SEE WHEN WE LOOK AT IT 5730 03:54:53,594 --> 03:54:55,563 WE'LL POINT THAT OUT AS WE GO 5731 03:54:55,563 --> 03:54:56,097 ALONG. 5732 03:54:56,097 --> 03:55:00,701 WE'RE GOING TO START OFF BY DR. 5733 03:55:00,701 --> 03:55:02,236 TOBIAS GIVING US SOME GROUND 5734 03:55:02,236 --> 03:55:04,105 RULES WE USED AND SOME OF THE 5735 03:55:04,105 --> 03:55:05,406 DATA BECAUSE WE'RE USING 5736 03:55:05,406 --> 03:55:07,375 SLIGHTLY DIFFERENT DATA THAN 5737 03:55:07,375 --> 03:55:09,477 WHAT WE'VE USED BEFORE, 5738 03:55:09,477 --> 03:55:10,111 DIFFERENT METHODOLOGIES, SO 5739 03:55:10,111 --> 03:55:12,313 SHE'LL EXPLAIN THAT. 5740 03:55:12,313 --> 03:55:16,017 AND THEN I'LL TALK ABOUT DAIRY 5741 03:55:16,017 --> 03:55:16,884 UNSATURATED FAT AND THEN DR. 5742 03:55:16,884 --> 03:55:19,287 GARDNER WILL COME IN AND TALK 5743 03:55:19,287 --> 03:55:22,023 ABOUT MEAT AND PLANT SOURCES OF 5744 03:55:22,023 --> 03:55:24,659 SATURATED FAT, AND I'LL END UP 5745 03:55:24,659 --> 03:55:26,294 WITH A SUMMARY BECAUSE WE DON'T 5746 03:55:26,294 --> 03:55:28,262 EXPECT YOU TO REMEMBER ALL 31 AS 5747 03:55:28,262 --> 03:55:29,797 WE GO THROUGH. 5748 03:55:29,797 --> 03:55:33,000 WE'LL GIVE A SUMMARY AT AT THED 5749 03:55:33,000 --> 03:55:34,068 AND HAVE A DISCUSSION. 5750 03:55:34,068 --> 03:55:36,937 >> I THINK WE SHOULD HAVE A TEST 5751 03:55:36,937 --> 03:55:44,412 AT THE END OF THIS SESSION. 5752 03:55:44,412 --> 03:55:44,945 [LAUGHTER] 5753 03:55:44,945 --> 03:55:46,247 >> ALL RIGHT. 5754 03:55:46,247 --> 03:55:48,382 THANK YOU. 5755 03:55:48,382 --> 03:55:49,917 NEXT SLIDE PLEASE. 5756 03:55:49,917 --> 03:55:52,753 THIS IS THE FRAMEWORK THAT WE 5757 03:55:52,753 --> 03:55:54,088 DEVELOPED OUR QUESTIONS FROM. 5758 03:55:54,088 --> 03:55:59,093 AND AS YOU CAN SEE, INTERVENTION 5759 03:55:59,093 --> 03:56:00,528 EXPOSURE COLUMN INCLUDE 5760 03:56:00,528 --> 03:56:04,131 CONSUMPTION OF SATURATED FATTY 5761 03:56:04,131 --> 03:56:05,199 ACID-RICH FOODS. 5762 03:56:05,199 --> 03:56:07,735 THOSE INCLUDED ANIMAL SOURCES OF 5763 03:56:07,735 --> 03:56:09,370 SATURATED FAT, DAIRY AND MEAT 5764 03:56:09,370 --> 03:56:17,244 WHICH INCLUDED WHITE MEAT, 5765 03:56:17,244 --> 03:56:20,981 PROCESSED MEAT, MILK, CHEESE, 5766 03:56:20,981 --> 03:56:22,717 YOGURT, BUTTER, GHEE, PLANT 5767 03:56:22,717 --> 03:56:23,718 SOURCES INCLUDING TROPICAL FOOD 5768 03:56:23,718 --> 03:56:33,227 SOURCES OF OILS, PALM OIL, 5769 03:56:33,227 --> 03:56:35,396 COCONUT OIL, CO-COA BUTTER, 5770 03:56:35,396 --> 03:56:44,939 SHORTENING, BAKED GOODS. 5771 03:56:44,939 --> 03:56:45,940 LOOKING WITHIN SATURATED FAT 5772 03:56:45,940 --> 03:56:50,511 FOODS AND THOSE THAT DON'T 5773 03:56:50,511 --> 03:56:54,048 QUALIFY, THE OUTCOMES LISTED 5774 03:56:54,048 --> 03:56:56,984 HERE ARE CARDIOVASCULAR DISEASE, 5775 03:56:56,984 --> 03:56:59,286 INTERMEDIATES AMONG CHILDREN, 5776 03:56:59,286 --> 03:57:01,021 ADOLESCENTS, AS WELL AS ADULTS, 5777 03:57:01,021 --> 03:57:03,524 BASED ON INCIDENCE OF 5778 03:57:03,524 --> 03:57:05,292 CARDIOVASCULAR EVENTS IN ADULTS 5779 03:57:05,292 --> 03:57:07,695 WE LOOKED ONLY AMONG THEM FOR 5780 03:57:07,695 --> 03:57:09,230 MORBIDITY AND MORTALITY. 5781 03:57:09,230 --> 03:57:10,865 MORBIDITY WOULD INCLUDE HEART 5782 03:57:10,865 --> 03:57:12,733 ATTACKS AND STROKE. 5783 03:57:12,733 --> 03:57:14,368 THAT WERE FATAL OR NON-FATAL. 5784 03:57:14,368 --> 03:57:17,772 KEEP THAT IN MIND WHEN POSSIBLE. 5785 03:57:17,772 --> 03:57:20,408 WE ATTEMPTED TO TEASE OUT 5786 03:57:20,408 --> 03:57:21,842 CARDIOVASCULAR DISEASE MORTALITY 5787 03:57:21,842 --> 03:57:25,980 AS ITS OWN ENDPOINT. 5788 03:57:25,980 --> 03:57:28,182 AS A SUBSET OF CVD MORBIDITY, 5789 03:57:28,182 --> 03:57:29,717 YOU'LL SEE MORTALITY IN SOME 5790 03:57:29,717 --> 03:57:32,353 CASES AS ITS OWN CONCLUSION 5791 03:57:32,353 --> 03:57:35,055 STATEMENT OR LISTED WITH OTHER 5792 03:57:35,055 --> 03:57:39,093 ENDPOINTS AND THAT'S FOR THAT 5793 03:57:39,093 --> 03:57:39,894 REASON. 5794 03:57:39,894 --> 03:57:41,629 KEY CONFOUNDERS ARE LISTED IN 5795 03:57:41,629 --> 03:57:44,598 THE FINAL COLUMN THERE. 5796 03:57:44,598 --> 03:57:45,900 NEXT SLIDE. 5797 03:57:45,900 --> 03:57:50,271 AND AS DEANNA MENTIONED JUST 5798 03:57:50,271 --> 03:57:52,907 SOME EPI101 OR MAYBE 1001 5799 03:57:52,907 --> 03:57:55,075 CONTEXT FOR WHAT THESE -- THE 5800 03:57:55,075 --> 03:57:58,712 COHORT ANALYSES IN PARTICULAR 5801 03:57:58,712 --> 03:58:00,881 ARE DOING. 5802 03:58:00,881 --> 03:58:03,617 REITERATING THREE BROAD 5803 03:58:03,617 --> 03:58:06,020 CATEGORIES, DAIRY, MEAT WHICH 5804 03:58:06,020 --> 03:58:08,222 INCLUDES POULTRY AND EGGS, PLANT 5805 03:58:08,222 --> 03:58:09,857 BASED SOURCES OF SATURATED FAT. 5806 03:58:09,857 --> 03:58:14,028 ALL THE OTHER FOODS AS WELL THAT 5807 03:58:14,028 --> 03:58:15,563 ARE NOT SATURATED FAT-CONTAINING 5808 03:58:15,563 --> 03:58:16,664 FOODS AND EVERY POSSIBLE 5809 03:58:16,664 --> 03:58:18,299 COMBINATION BETWEEN THEM. 5810 03:58:18,299 --> 03:58:19,834 IF YOU LOOKED AT RANDOMIZED 5811 03:58:19,834 --> 03:58:23,237 TRIAL LITERATURE YOU MIGHT SEE 5812 03:58:23,237 --> 03:58:26,040 SOMETHING LIKE HIGH FAT MILK 5813 03:58:26,040 --> 03:58:32,179 COMPARED TO LOW FAT MILK, 5814 03:58:32,179 --> 03:58:33,614 BUTTERMILK VERSUS BUTTER, LEAN 5815 03:58:33,614 --> 03:58:36,550 MEAT VERSUS EGGS AND 5816 03:58:36,550 --> 03:58:37,551 COMBINATIONS. 5817 03:58:37,551 --> 03:58:40,054 THE INTENT OF THIS QUESTION 5818 03:58:40,054 --> 03:58:42,423 OVERARCHING ALL OF THIS IS TO 5819 03:58:42,423 --> 03:58:47,728 REALLY UNDERSTAND IF THERE IS 5820 03:58:47,728 --> 03:58:49,897 NUANCE BETWEEN SATURATED 5821 03:58:49,897 --> 03:58:51,232 FAT-TAKE FOOD, ACKNOWLEDGING 5822 03:58:51,232 --> 03:58:53,834 FOODS ARE COMPLEX AND IF THERE 5823 03:58:53,834 --> 03:58:56,237 IS A DIFFERENCE BETWEEN ONE 5824 03:58:56,237 --> 03:58:57,671 SOURCE OF SATURATED FAT AND 5825 03:58:57,671 --> 03:58:59,640 ANOTHER, WHETHER ANIMAL OR PLANT 5826 03:58:59,640 --> 03:59:02,042 BASED SOURCE, THIS COULD BE 5827 03:59:02,042 --> 03:59:04,445 RELEVANT FOR TAILORING OR 5828 03:59:04,445 --> 03:59:08,315 MESSAGING OR EVEN MODIFYING. 5829 03:59:08,315 --> 03:59:11,452 SO, THIS IS THE HEAD-TO-HEAD 5830 03:59:11,452 --> 03:59:12,686 COMPARISON, REALLY AT THE FOOD 5831 03:59:12,686 --> 03:59:14,855 LEVEL WHAT WE WANTED TO 5832 03:59:14,855 --> 03:59:17,491 UNDERSTAND BETTER. 5833 03:59:17,491 --> 03:59:20,227 BUILDING ON PAST GUIDELINE 5834 03:59:20,227 --> 03:59:23,264 CYCLES THAT ESTABLISHED 5835 03:59:23,264 --> 03:59:23,931 OVERARCHING GUIDANCE AROUND 5836 03:59:23,931 --> 03:59:27,768 SATURATED FATS. 5837 03:59:27,768 --> 03:59:30,404 INCLUSION OF COHORT STUDIES 5838 03:59:30,404 --> 03:59:31,605 DESIGNING A RANDOMIZED 5839 03:59:31,605 --> 03:59:34,141 CONTROLLED TRIAL INTERESTED IN 5840 03:59:34,141 --> 03:59:36,544 DAIRY VERSUS SOMETHING ELSE, YOU 5841 03:59:36,544 --> 03:59:38,279 WOULD PROBABLY SPECIFY THAT 5842 03:59:38,279 --> 03:59:40,581 SOMETHING ELSE AND YOU MAY FEED 5843 03:59:40,581 --> 03:59:42,683 HALF OF YOUR PARTICIPANTS CHEESE 5844 03:59:42,683 --> 03:59:44,518 AND THE OTHER HALF BROCCOLI OR 5845 03:59:44,518 --> 03:59:46,520 WHATEVER IT MIGHT BE. 5846 03:59:46,520 --> 03:59:48,155 YOU WOULDN'T JUST FEED ONE HALF 5847 03:59:48,155 --> 03:59:52,192 CHEESE AND THEN GIVE THE OTHER 5848 03:59:52,192 --> 03:59:52,960 HALF NOTHING, SO THAT 5849 03:59:52,960 --> 03:59:54,795 SPECIFICATION OF A COMPARATOR IS 5850 03:59:54,795 --> 04:00:00,501 INHERENT IN DESIGN OF A TRIAL. 5851 04:00:00,501 --> 04:00:01,702 TRADITIONALLY, THE EPIDEMIOLOGIC 5852 04:00:01,702 --> 04:00:03,470 LITERATURE OF INDIVIDUAL FOODS 5853 04:00:03,470 --> 04:00:05,239 DOES NOT NECESSARILY HAVE TO 5854 04:00:05,239 --> 04:00:06,440 SPECIFY THAT COMPARATOR. 5855 04:00:06,440 --> 04:00:08,742 YOU CAN ASK QUESTIONS LIKE DO 5856 04:00:08,742 --> 04:00:10,277 PEOPLE WHO CONSUME HIGHER 5857 04:00:10,277 --> 04:00:13,213 AMOUNTS OF RED MEAT HAVE HIGHER 5858 04:00:13,213 --> 04:00:14,415 RISK OF CARDIOVASCULAR DISEASE 5859 04:00:14,415 --> 04:00:19,153 THAN THOSE WHO EAT LESS RED 5860 04:00:19,153 --> 04:00:19,386 MEAT? 5861 04:00:19,386 --> 04:00:21,021 IT'S VALID BUT VAGUE IF YOU'RE 5862 04:00:21,021 --> 04:00:22,756 TRYING TO UNDERSTAND COMPARED TO 5863 04:00:22,756 --> 04:00:23,657 WHAT. 5864 04:00:23,657 --> 04:00:27,261 SO WHAT ARE THE PEOPLE WHO ARE 5865 04:00:27,261 --> 04:00:29,229 NOT CONSUMING YOUR TOP CATEGORY 5866 04:00:29,229 --> 04:00:30,664 OF RED MEAT CONSUMING INSTEAD, 5867 04:00:30,664 --> 04:00:32,633 THAT'S INHERENT IN YOUR CONTROL 5868 04:00:32,633 --> 04:00:39,073 GROUP IN AN RCT. 5869 04:00:39,073 --> 04:00:40,941 IF YOU ARE FAMILIAR WITH 5870 04:00:40,941 --> 04:00:42,042 LITERATURE AROUND CARDIOVASCULAR 5871 04:00:42,042 --> 04:00:51,118 AND DIET YOU CAN ENVISION A 5872 04:00:51,118 --> 04:00:52,553 FOREST PLOT, MAYBE MESSY, MAYBE 5873 04:00:52,553 --> 04:00:54,989 NOT CONSISTENT ENOUGH TO DRAW A 5874 04:00:54,989 --> 04:00:56,824 CONCLUSION FROM ONE GIVEN FOOD, 5875 04:00:56,824 --> 04:00:58,092 PART COULD BE NOISE AND 5876 04:00:58,092 --> 04:01:00,995 CONFUSION AND DON'T KNOW WHAT TO 5877 04:01:00,995 --> 04:01:04,064 RECOMMEND BUT IT'S ACTUALLY AS 5878 04:01:04,064 --> 04:01:06,200 WE'VE ACCUMULATED THIS EVIDENCE 5879 04:01:06,200 --> 04:01:07,801 ACROSS GLOBAL COHORTS, WE HAVE 5880 04:01:07,801 --> 04:01:10,771 TO ACKNOWLEDGE THAT THERE'S THIS 5881 04:01:10,771 --> 04:01:12,306 REALLY MEANINGFUL COMPARATOR 5882 04:01:12,306 --> 04:01:14,541 GROUP THAT'S VERY DIFFERENT 5883 04:01:14,541 --> 04:01:16,377 ACROSS ALL POPULATIONS. 5884 04:01:16,377 --> 04:01:19,747 SO IF YOU'RE LOOKING IN 20 5885 04:01:19,747 --> 04:01:20,714 COUNTRIES AMONG COHORTS WHERE 5886 04:01:20,714 --> 04:01:23,350 YOU HAVE THE CATEGORY OF HIGH 5887 04:01:23,350 --> 04:01:25,986 RED MEAT INTAKE VERSUS LOW RED 5888 04:01:25,986 --> 04:01:26,620 MEAT INTAKE, THAT COMPARATOR, 5889 04:01:26,620 --> 04:01:29,023 WHAT ARE THE PEOPLE WHO AREN'T 5890 04:01:29,023 --> 04:01:30,591 EATING THAT AMOUNT OF RED MEAT 5891 04:01:30,591 --> 04:01:32,226 EATING INSTEAD, COULD LOOK VERY, 5892 04:01:32,226 --> 04:01:33,193 VERY DIFFERENT. 5893 04:01:33,193 --> 04:01:35,629 IT MIGHT BE SOMETHING HEALTHY, 5894 04:01:35,629 --> 04:01:39,333 MIGHT BE SOMETHING COMPLETELY 5895 04:01:39,333 --> 04:01:39,600 UNHEALTHY. 5896 04:01:39,600 --> 04:01:41,869 SO, WHEN YOU'RE NOT SPECIFYING 5897 04:01:41,869 --> 04:01:43,270 IT'S ACTUALLY STATISTICALLY THE 5898 04:01:43,270 --> 04:01:45,806 AVERAGE OF THE BACKGROUND DIET. 5899 04:01:45,806 --> 04:01:48,842 IF IT'S A HEALTHY POPULATION, 5900 04:01:48,842 --> 04:01:51,378 UNHEALTHY MIX, ALL OF THAT 5901 04:01:51,378 --> 04:01:53,147 MATTERS AND IN FACT MAY EXPLAIN 5902 04:01:53,147 --> 04:01:58,686 A LOT OF THAT SORT OF VISUALLY 5903 04:01:58,686 --> 04:02:00,988 SEEMING CONFUSION AND 5904 04:02:00,988 --> 04:02:01,321 HETEROGENEITY. 5905 04:02:01,321 --> 04:02:05,959 SO, TO ANCHOR THE SORT OF 5906 04:02:05,959 --> 04:02:07,061 SUBSTITUTION ANALYSES THAT WE'LL 5907 04:02:07,061 --> 04:02:09,663 INTRODUCE HERE AS WE'RE 5908 04:02:09,663 --> 04:02:11,532 COMPARING FOOD VERSUS FOOD, IS 5909 04:02:11,532 --> 04:02:16,670 BUILDING ON THE SORT OF SINGLE 5910 04:02:16,670 --> 04:02:19,506 FOOD EPIDEMIOLOGIC HYPOTHESES BY 5911 04:02:19,506 --> 04:02:20,174 SIMPLY SPECIFYING WHAT YOUR 5912 04:02:20,174 --> 04:02:22,576 COMPARATOR IS JUST LIKE AN RCT. 5913 04:02:22,576 --> 04:02:25,879 SO, IF THERE WERE ANALYSES OR 5914 04:02:25,879 --> 04:02:29,383 PAPERS THAT YOU'LL SEE WHERE 5915 04:02:29,383 --> 04:02:31,051 IT'S MAYBE POULTRY VERSUS TEN 5916 04:02:31,051 --> 04:02:33,454 DIFFERENT FOODS, WHAT THESE 5917 04:02:33,454 --> 04:02:36,190 ANALYSES ARE DOING IS SIMPLY 5918 04:02:36,190 --> 04:02:39,760 SWAPPING OUT WHAT THAT CONTRAST 5919 04:02:39,760 --> 04:02:41,762 SPECIFICALLY IS, SO IF IT'S RED 5920 04:02:41,762 --> 04:02:47,534 MEAT VERSUS POULTRY, DAIRY, 5921 04:02:47,534 --> 04:02:49,069 VEGETABLES, IT'S SAYING INSTEAD 5922 04:02:49,069 --> 04:02:50,704 OF PEOPLE WHO EAT RED MEAT 5923 04:02:50,704 --> 04:02:52,806 COMPARED TO PEOPLE WHO DON'T 5924 04:02:52,806 --> 04:02:56,610 IT'S PEOPLE WHO EAT RED MEAT 5925 04:02:56,610 --> 04:03:01,348 VERSUS PEOPLE WHO EAT LESS RED 5926 04:03:01,348 --> 04:03:03,951 MEAT AND MORE DAIRY, MORE 5927 04:03:03,951 --> 04:03:04,952 VEGETABLES, GETTING LEVEL OF 5928 04:03:04,952 --> 04:03:06,887 SPECIFICITY THAT YOU WOULD WANT 5929 04:03:06,887 --> 04:03:09,556 TO UNDERSTAND, YOU KNOW, DOES 5930 04:03:09,556 --> 04:03:12,192 THAT COMPARED TO WHAT MATTER FOR 5931 04:03:12,192 --> 04:03:14,928 YOUR EXPOSURE GROUPS OF 5932 04:03:14,928 --> 04:03:15,195 INTEREST. 5933 04:03:15,195 --> 04:03:20,734 SO, THAT WAS A LOT. 5934 04:03:20,734 --> 04:03:24,104 CONGRATULATIONS, YOU GOT 2.5 5935 04:03:24,104 --> 04:03:24,538 CREDITS, NUTRITIONAL 5936 04:03:24,538 --> 04:03:24,938 EPIDEMIOLOGY. 5937 04:03:24,938 --> 04:03:27,541 LET ME MAKE SURE THERE WEREN'T 5938 04:03:27,541 --> 04:03:30,477 ANY OTHER IMPORTANT POINTS WHILE 5939 04:03:30,477 --> 04:03:31,578 WE'RE GEEKING OUT ON METHODS 5940 04:03:31,578 --> 04:03:33,847 BEFORE I TURN TO RESULTS. 5941 04:03:33,847 --> 04:03:37,351 I REALLY THINK THAT COVERS IT. 5942 04:03:37,351 --> 04:03:40,654 AND, OH, SO THE FINAL SET OF 5943 04:03:40,654 --> 04:03:43,390 BULLETS HERE IS JUST THE 5944 04:03:43,390 --> 04:03:44,925 LANGUAGE WE'RE PUTTING AROUND, 5945 04:03:44,925 --> 04:03:48,195 WHEN WE ARE DRAWING CONCLUSIONS 5946 04:03:48,195 --> 04:03:49,730 FROM PREDOMINANTLY RCT EVIDENCE, 5947 04:03:49,730 --> 04:03:53,801 WHERE YOU HAVE THIS EXPLICIT 5948 04:03:53,801 --> 04:03:55,435 REPLACING OR CONTRASTING OF 5949 04:03:55,435 --> 04:03:56,737 FOODS VERSUS SUBSTITUTING WHICH 5950 04:03:56,737 --> 04:03:58,372 IF YOU'RE REFERRING TO 5951 04:03:58,372 --> 04:04:00,908 SUBSTITUTION ANALYSES, FOR SOME 5952 04:04:00,908 --> 04:04:02,442 CONCLUSIONS, IT'S A MIXED BAG, 5953 04:04:02,442 --> 04:04:07,014 WHATEVER WAS MOST I GUESS 5954 04:04:07,014 --> 04:04:08,982 PREDOMINANT STUDY DESIGN TYPE. 5955 04:04:08,982 --> 04:04:13,353 OH WITH THAT I'LL TURN IT OVER 5956 04:04:13,353 --> 04:04:17,124 TO TO DEANNA TO KICK OFF WITH 5957 04:04:17,124 --> 04:04:18,425 DAIRY. 5958 04:04:18,425 --> 04:04:20,060 >> THANKS FOR GOING INTO THAT 5959 04:04:20,060 --> 04:04:20,360 EXPLANATION. 5960 04:04:20,360 --> 04:04:21,929 YOU NEED IT WHEN YOU START TO 5961 04:04:21,929 --> 04:04:23,263 SEE THE EVIDENCE HERE. 5962 04:04:23,263 --> 04:04:25,766 SO I'M GOING TO TALK ABOUT DAIRY 5963 04:04:25,766 --> 04:04:27,501 SOURCES OF SATURATED FAT. 5964 04:04:27,501 --> 04:04:30,470 I HAVE SIX SLIDES WITH EIGHT 5965 04:04:30,470 --> 04:04:32,239 CONCLUSION STATEMENTS ON THEM. 5966 04:04:32,239 --> 04:04:34,541 SO, THE FIRST ONE HAS TWO 5967 04:04:34,541 --> 04:04:36,910 CONCLUSION STATEMENTS ON THEM. 5968 04:04:36,910 --> 04:04:40,647 SO I'LL START ON THE LEFT. 5969 04:04:40,647 --> 04:04:42,216 SUBSTITUTING HIGHER FAT DAIRY 5970 04:04:42,216 --> 04:04:44,484 WITH LOWER FAT DAIRY BY ADULTS 5971 04:04:44,484 --> 04:04:46,587 AND OLDER ADULTS IS NOT 5972 04:04:46,587 --> 04:04:49,089 ASSOCIATED WITH DIFFERENCE IN 5973 04:04:49,089 --> 04:04:51,391 RISK OF CARDIOVASCULAR DISEASE 5974 04:04:51,391 --> 04:04:52,159 MORBIDITY. 5975 04:04:52,159 --> 04:04:53,360 THIS CONCLUSION STATEMENT IS 5976 04:04:53,360 --> 04:04:56,663 BASED ON EVIDENCE GRADED AS 5977 04:04:56,663 --> 04:04:56,964 LIMITED. 5978 04:04:56,964 --> 04:04:59,600 SO FOR THIS I WANTED TO CALL OUT 5979 04:04:59,600 --> 04:05:01,368 A FEW POINTS. 5980 04:05:01,368 --> 04:05:04,338 FIRST IS IN THIS WHEN WE SAY 5981 04:05:04,338 --> 04:05:06,406 HIGHER FAT DAIRY WE MEAN VARIETY 5982 04:05:06,406 --> 04:05:07,374 OF DAIRY PRODUCTS. 5983 04:05:07,374 --> 04:05:11,645 SO IN THIS CASE WE HAD DAIRY NOT 5984 04:05:11,645 --> 04:05:12,079 SPECIFIED. 5985 04:05:12,079 --> 04:05:14,715 WE HAD MILK, CHEESE, YOGURT, 5986 04:05:14,715 --> 04:05:16,116 THEY WERE THE DAIRY PRODUCTS 5987 04:05:16,116 --> 04:05:19,386 INVOLVED IN THIS. 5988 04:05:19,386 --> 04:05:21,655 THE COMPARISONS AS DEE DEE 5989 04:05:21,655 --> 04:05:23,790 MENTIONED, SO BECAUSE THIS IS 5990 04:05:23,790 --> 04:05:25,859 MORBIDITY IT IS LIKELY TO HAVE 5991 04:05:25,859 --> 04:05:29,463 INCLUDED SOME MORTALITY IN IT AS 5992 04:05:29,463 --> 04:05:29,897 WELL. 5993 04:05:29,897 --> 04:05:33,500 LAST THING IS THIS STATEMENT, 5994 04:05:33,500 --> 04:05:36,169 JUST COMPARES THE TWO DAIRY, 5995 04:05:36,169 --> 04:05:40,641 HIGHER FAT AND LOWER FAT, WITH 5996 04:05:40,641 --> 04:05:42,709 CARDIOVASCULAR DISEASE RISK FOR 5997 04:05:42,709 --> 04:05:46,346 MORBIDITY SO IT DOESN'T COMPARE 5998 04:05:46,346 --> 04:05:49,716 THEM WITH CARDIOVASCULAR DISEASE 5999 04:05:49,716 --> 04:05:51,919 THEMSELVES, A IT'S A ONE-TO-ONE 6000 04:05:51,919 --> 04:05:52,219 COMPARISON. 6001 04:05:52,219 --> 04:05:57,491 BODY OF EVIDENCE FOR THIS WERE 6002 04:05:57,491 --> 04:05:59,893 EIGHT ARTICLES, ALL PROSPECTIVE 6003 04:05:59,893 --> 04:06:00,761 COHORT STUDIES, 14 COMPARISONS 6004 04:06:00,761 --> 04:06:03,630 WE LOOKED AT. 6005 04:06:03,630 --> 04:06:07,768 THERE WERE A FEW CEREBRAL 6006 04:06:07,768 --> 04:06:17,844 CORTEXES, MOST STUDIES 6007 04:06:17,844 --> 04:06:19,146 CONFIDENCE INTERVALS WERE 6008 04:06:19,146 --> 04:06:19,713 NARROW. 6009 04:06:19,713 --> 04:06:27,387 RISK OF BIAS WE HAD ISSUES WITH 6010 04:06:27,387 --> 04:06:28,789 SENSITIVITY, HOW EXPOSURE WAS 6011 04:06:28,789 --> 04:06:30,424 MEASURED AND REPORTED. 6012 04:06:30,424 --> 04:06:31,291 DAIRY WAS NON-SPECIFIED DAIRY, 6013 04:06:31,291 --> 04:06:35,128 THEY WOULD HAVE DAIRY LOW FAT, 6014 04:06:35,128 --> 04:06:40,167 DAIRY MIGHT HAVE INCLUDED 1%, 6015 04:06:40,167 --> 04:06:42,803 2%, YOU DIDN'T KNOW THE EXACT 6016 04:06:42,803 --> 04:06:43,303 PERCENTAGE. 6017 04:06:43,303 --> 04:06:46,406 STUDIES DID NOT HAVE A 6018 04:06:46,406 --> 04:06:48,342 PRE-SPECIFIED ANALYSIS PLAN SO 6019 04:06:48,342 --> 04:06:49,876 THAT RESULTED IN CONCERNS WITH 6020 04:06:49,876 --> 04:06:53,180 THE SELECTION OF REPORTED 6021 04:06:53,180 --> 04:06:53,413 RESULTS. 6022 04:06:53,413 --> 04:06:54,915 SO THE DIRECTNESS, THERE WERE 6023 04:06:54,915 --> 04:06:56,249 SOME CONCERNS WITH DIRECTNESS, 6024 04:06:56,249 --> 04:06:57,884 MAINLY BECAUSE WE DIDN'T HAVE 6025 04:06:57,884 --> 04:06:58,852 ANY TRIALS. 6026 04:06:58,852 --> 04:07:01,254 SO THOSE WERE THE CONCERNS 6027 04:07:01,254 --> 04:07:02,189 THERE. 6028 04:07:02,189 --> 04:07:06,526 THERE WERE SERIOUS CONCERNS WITH 6029 04:07:06,526 --> 04:07:08,161 GENERALIZABILITY, MOST STUDIES 6030 04:07:08,161 --> 04:07:11,798 CONDUCTED IN NON-U.S. SETTINGS. 6031 04:07:11,798 --> 04:07:14,968 SO RACE AND/OR ETHNICITY, 6032 04:07:14,968 --> 04:07:16,703 SOCIOECONOMIC POSITION WERE 6033 04:07:16,703 --> 04:07:17,904 OFTEN NOT REPORTED. 6034 04:07:17,904 --> 04:07:19,673 A LOT OF THE GRADING ELEMENTS 6035 04:07:19,673 --> 04:07:21,508 ARE THE SAME SO I WILL SKIP 6036 04:07:21,508 --> 04:07:23,377 THROUGH THEM WITH SOME OF THE 6037 04:07:23,377 --> 04:07:26,880 OTHER STATEMENTS AS I GO THROUGH 6038 04:07:26,880 --> 04:07:29,383 BECAUSE IT'S SIMILAR AS WHAT I 6039 04:07:29,383 --> 04:07:29,850 JUST SAID. 6040 04:07:29,850 --> 04:07:32,352 SO, ON THE RIGHT THE SECOND 6041 04:07:32,352 --> 04:07:33,653 CONCLUSION STATEMENT IS A 6042 04:07:33,653 --> 04:07:35,088 CONCLUSION STATEMENT CANNOT BE 6043 04:07:35,088 --> 04:07:36,723 DRAWN ABOUT THE RELATIONSHIP 6044 04:07:36,723 --> 04:07:38,258 BETWEEN HIGHER FAT DAIRY 6045 04:07:38,258 --> 04:07:41,094 CONSUMPTION COMPARED TO LOWER 6046 04:07:41,094 --> 04:07:44,064 FAT VERSIONS, BY ADULTS AND 6047 04:07:44,064 --> 04:07:46,133 OLDER ADULTS, AND BLOOD LIPIDS, 6048 04:07:46,133 --> 04:07:47,434 BLOOD PRESSURE, AND 6049 04:07:47,434 --> 04:07:48,301 CARDIOVASCULAR DISEASE MORTALITY 6050 04:07:48,301 --> 04:07:50,637 BECAUSE THERE'S NOT ENOUGH 6051 04:07:50,637 --> 04:07:51,805 EVIDENCE AVAILABLE. 6052 04:07:51,805 --> 04:08:00,714 THAT WAS A GRADE NON-ASSIGNABLE. 6053 04:08:00,714 --> 04:08:07,821 THERE WERE CEREBRAL CORTEXES 6054 04:08:07,821 --> 04:08:08,688 -- THERE WERE 6055 04:08:08,688 --> 04:08:16,129 CONCERNS WITH RISK OF BIAS, WITH 6056 04:08:16,129 --> 04:08:18,665 EXPOSURE WITH DAIRY 6057 04:08:18,665 --> 04:08:18,999 NON-SPECIFIED. 6058 04:08:18,999 --> 04:08:19,866 CONCERNS WITH GENERALIZABILITY. 6059 04:08:19,866 --> 04:08:21,301 NEXT SLIDE. 6060 04:08:21,301 --> 04:08:24,237 NEXT TWO SLIDES ARE COMPARING TO 6061 04:08:24,237 --> 04:08:25,639 FOOD SOURCES OF UNSATURATED 6062 04:08:25,639 --> 04:08:26,873 FATTY ACIDS. 6063 04:08:26,873 --> 04:08:32,145 THIS IS COMPARING DAIRY TO FOOD 6064 04:08:32,145 --> 04:08:34,548 SOURCES OF UNSATURATED FATTY 6065 04:08:34,548 --> 04:08:34,748 ACIDS. 6066 04:08:34,748 --> 04:08:35,749 SUBSTITUTING DAIRY WITH FOOD 6067 04:08:35,749 --> 04:08:46,293 SOURCE S MAY BE ASSOCIATED WITH 6068 04:08:49,796 --> 04:08:52,499 LOWER RISK, BASED ON EVIDENCE AS 6069 04:08:52,499 --> 04:08:52,732 LIMITED. 6070 04:08:52,732 --> 04:08:56,436 TO GROUND YOU, FOOD SOURCES OF 6071 04:08:56,436 --> 04:08:57,971 UNSATURATED FATTY ACIDS THAT 6072 04:08:57,971 --> 04:09:01,374 WERE THE COMPARATOR INCLUDED 6073 04:09:01,374 --> 04:09:03,143 FISH, OLEIVE OIL, AVOCADO, 6074 04:09:03,143 --> 04:09:05,512 EXAMPLES OF SOME STUDIES. 6075 04:09:05,512 --> 04:09:08,815 BODY OF EVIDENCE INCLUDED SEVEN 6076 04:09:08,815 --> 04:09:10,584 A LITTLER, TWO RCTs, FIVE 6077 04:09:10,584 --> 04:09:15,088 COHORT STUDIES BUT WE HAD 11 6078 04:09:15,088 --> 04:09:15,489 COMPARISONS. 6079 04:09:15,489 --> 04:09:19,126 AS BEFORE THERE WAS SOME 6080 04:09:19,126 --> 04:09:20,994 CONCERNS WITH CONSISTENCY, WITH 6081 04:09:20,994 --> 04:09:24,064 PRECISION, THE TRIALS HAD 6082 04:09:24,064 --> 04:09:27,667 SMALLER SAMPLE SIZES, HOWEVER 6083 04:09:27,667 --> 04:09:30,170 THE PROSPECTIVE COHORT STUDIES 6084 04:09:30,170 --> 04:09:32,439 HAD LARGE SAMPLE SIZES, 6085 04:09:32,439 --> 04:09:32,973 CONFIDENCE INTERVALS WERE 6086 04:09:32,973 --> 04:09:33,206 NARROW. 6087 04:09:33,206 --> 04:09:34,875 THERE WERE SOME CONCERNS WITH 6088 04:09:34,875 --> 04:09:38,712 RISK OF BIAS, USUALLY THOSE WERE 6089 04:09:38,712 --> 04:09:40,080 DUE TO CONFOUNDING DIRECTNESS, 6090 04:09:40,080 --> 04:09:42,549 AGAIN THERE WERE A LOT OF 6091 04:09:42,549 --> 04:09:46,153 MODELING STUDIES, NOT AS MANY 6092 04:09:46,153 --> 04:09:48,355 RCTs, SERIOUS CONCERNS WITH 6093 04:09:48,355 --> 04:09:48,755 GENERALIZABILITY. 6094 04:09:48,755 --> 04:09:50,957 THIS IS ONE THAT FIVE STUDIES 6095 04:09:50,957 --> 04:09:53,360 WERE CONDUCTED IN THE U.S. BUT 6096 04:09:53,360 --> 04:10:01,168 PARTICIPANTS ENROLLED STILL HAD 6097 04:10:01,168 --> 04:10:02,402 LIMITED DIVERSITY. 6098 04:10:02,402 --> 04:10:09,976 THIS IS BUTTER COMPARED TO 6099 04:10:09,976 --> 04:10:11,378 UNSATURATED FATTY ACIDS, ALL ARE 6100 04:10:11,378 --> 04:10:13,246 ADULTS AND OLDER ADULTS THAT I'M 6101 04:10:13,246 --> 04:10:14,347 GOING THROUGH NOW. 6102 04:10:14,347 --> 04:10:16,750 CONCLUSION STATEMENT TO THE LEFT 6103 04:10:16,750 --> 04:10:21,354 IS REPLACING BUTTER WITH 6104 04:10:21,354 --> 04:10:22,589 PLANT-BASED OILS WITH 6105 04:10:22,589 --> 04:10:24,658 UNSATURATED FATTY ACIDS BY 6106 04:10:24,658 --> 04:10:28,461 ADULTS AND OLDER ADULTS 6107 04:10:28,461 --> 04:10:33,967 DECREASES LDLC LEVELS, DOES NOT 6108 04:10:33,967 --> 04:10:39,339 AFFECT HDLC OR TRIGLYCERIDE 6109 04:10:39,339 --> 04:10:40,207 LEVELS, EVIDENCE STRONG. 6110 04:10:40,207 --> 04:10:43,276 PLANT BASED OILS AND SPREADS 6111 04:10:43,276 --> 04:10:46,012 INCLUDED OLIVE OIL, MARGARINES 6112 04:10:46,012 --> 04:10:56,289 WITH LOW FAT CONTENT, 6113 04:10:56,289 --> 04:10:58,391 BUTTER 6114 04:10:58,391 --> 04:10:58,592 MIXES. 6115 04:10:58,592 --> 04:11:01,228 12 RCTs, 11 WERE CROSSOVERS, 6116 04:11:01,228 --> 04:11:05,365 ONE A PARALLEL RCT, AND THEN 6117 04:11:05,365 --> 04:11:08,768 THERE WERE 21 COMPARISONS. 6118 04:11:08,768 --> 04:11:13,240 THIS WAS EXTREMELY CONSISTENT 6119 04:11:13,240 --> 04:11:13,473 RESULTS. 6120 04:11:13,473 --> 04:11:16,309 OF ALL OF THE -- THIS WAS THE 6121 04:11:16,309 --> 04:11:17,344 ONLY STRONG CONCLUSION STATEMENT 6122 04:11:17,344 --> 04:11:21,348 WE HAD, AND IT WAS VERY 6123 04:11:21,348 --> 04:11:23,984 EAVEDDENED, SO CHRISTOPHER LIKES 6124 04:11:23,984 --> 04:11:25,719 TO SAY BUTTER IS NOT BACK. 6125 04:11:25,719 --> 04:11:31,191 WHEN YOU LOOK AT ITS RESULTS ON 6126 04:11:31,191 --> 04:11:34,461 THE OUTCOMES OF LDL CHOLESTEROL 6127 04:11:34,461 --> 04:11:35,795 LEVELS IT SHOWED AN ASSOCIATION 6128 04:11:35,795 --> 04:11:36,796 WITH THAT. 6129 04:11:36,796 --> 04:11:42,168 IF THERE FEW CONCERNS WITH 6130 04:11:42,168 --> 04:11:44,104 PRECISION, LACK OF BIAS, 6131 04:11:44,104 --> 04:11:45,772 RANDOMIZATION METHODS, A FEW 6132 04:11:45,772 --> 04:11:46,973 CONCERNS WITH DIRECTNESS BECAUSE 6133 04:11:46,973 --> 04:11:48,608 OF THE TRIALS, BUT MAJORITY OF 6134 04:11:48,608 --> 04:11:51,444 THE TRIALS WERE NOT CONDUCTED IN 6135 04:11:51,444 --> 04:11:53,213 THE U.S. 6136 04:11:53,213 --> 04:11:54,748 THE SECOND CONCLUSION STATEMENT 6137 04:11:54,748 --> 04:11:56,149 HERE SUBSTITUTING BUTTER WITH 6138 04:11:56,149 --> 04:12:01,621 PLANT BASED OILS AND SPREADS BY 6139 04:12:01,621 --> 04:12:03,690 ADULTS AND OLDER ADULTS MAY BE 6140 04:12:03,690 --> 04:12:05,325 ASSOCIATED WITH DECREASED RISK 6141 04:12:05,325 --> 04:12:06,860 OF CARDIOVASCULAR DISEASE 6142 04:12:06,860 --> 04:12:10,697 MORBIDITY AND MORTALITY. 6143 04:12:10,697 --> 04:12:13,300 THIS IS BASED ON EVIDENCE GRADED 6144 04:12:13,300 --> 04:12:15,302 AS LIMITED. 6145 04:12:15,302 --> 04:12:19,339 THIS EVIDENCE BASE CONSISTED OF 6146 04:12:19,339 --> 04:12:20,573 SIX PROSPECTIVE COHORT STUDIES, 6147 04:12:20,573 --> 04:12:22,208 12 COMPARISONS. 6148 04:12:22,208 --> 04:12:25,145 AND SO THERE WERE SOME 6149 04:12:25,145 --> 04:12:26,146 SUBSTANTIAL CONCERNS WITH 6150 04:12:26,146 --> 04:12:28,982 CONSISTENCY, SOME CONCERNS WITH 6151 04:12:28,982 --> 04:12:31,918 PRECISION, RISK OF BIAS, AND 6152 04:12:31,918 --> 04:12:33,253 DIRECTNESS BECAUSE THERE WEREN'T 6153 04:12:33,253 --> 04:12:36,089 ANY TRIALS ASSOCIATED WITH THIS. 6154 04:12:36,089 --> 04:12:38,692 AND THEN SERIOUS CONCERNS WITH 6155 04:12:38,692 --> 04:12:39,759 GENERALIZABILITY. 6156 04:12:39,759 --> 04:12:43,096 THE EVIDENCE WASN'T AS STRONG 6157 04:12:43,096 --> 04:12:48,335 FOR LONG-TERM OUTCOMES. 6158 04:12:48,335 --> 04:12:48,635 NEXT SLIDE. 6159 04:12:48,635 --> 04:12:50,303 WE'RE COMPARING ONE FORM OF 6160 04:12:50,303 --> 04:12:52,806 DAIRY TO ANOTHER FORM FOR ADULTS 6161 04:12:52,806 --> 04:12:54,574 AND OLDER ADULTS. 6162 04:12:54,574 --> 04:12:55,542 CONCLUSION STATEMENT IS 6163 04:12:55,542 --> 04:12:57,410 SUBSTITUTING REPLACING ONE FORM 6164 04:12:57,410 --> 04:13:02,682 OF DAIRY AND THIS INCLUDED MILK 6165 04:13:02,682 --> 04:13:03,983 YOGURT CHEESE BUTTER, BUTTERMILK 6166 04:13:03,983 --> 04:13:06,586 WITH ANOTHER FORM OF DAIRY, NOT 6167 04:13:06,586 --> 04:13:08,788 ASSOCIATED WITH DIFFERENCE IN 6168 04:13:08,788 --> 04:13:10,657 RISK OF CARDIOVASCULAR DISEASE. 6169 04:13:10,657 --> 04:13:11,858 THIS CONCLUSION STATEMENT IS 6170 04:13:11,858 --> 04:13:14,494 BASED ON EVIDENCE GRADED AS 6171 04:13:14,494 --> 04:13:15,028 MODERATE. 6172 04:13:15,028 --> 04:13:19,632 HERE WE HAD TEN ARTICLES, SIX 6173 04:13:19,632 --> 04:13:22,235 RCTs, FOUR COHORT STUDIES WITH 6174 04:13:22,235 --> 04:13:23,470 66 COMPARISONS. 6175 04:13:23,470 --> 04:13:25,538 A LOT OF COMPARISONS HERE. 6176 04:13:25,538 --> 04:13:28,375 THERE WAS SOME CONCERNS WITH 6177 04:13:28,375 --> 04:13:30,577 CONSISTENCY BECAUSE WE DID HAVE 6178 04:13:30,577 --> 04:13:32,979 MANY STUDIES SHOWING NO EFFECT 6179 04:13:32,979 --> 04:13:35,048 OR ASSOCIATION, SOME CONCERNS 6180 04:13:35,048 --> 04:13:37,484 WITH PRECISION, RISK OF BIAS, 6181 04:13:37,484 --> 04:13:39,085 AGAIN CONCERNS WITH DIRECTNESS 6182 04:13:39,085 --> 04:13:42,288 AS I MENTIONED BEFORE, AND AGAIN 6183 04:13:42,288 --> 04:13:44,023 GENERALIZABILITY, A LOT OF THE 6184 04:13:44,023 --> 04:13:54,033 STUDIES WERE NOT CONDUCTED IN 6185 04:13:54,033 --> 04:13:54,534 THE U.S. 6186 04:13:54,534 --> 04:13:58,037 CHEESE TO LOW FAT OR WHOLE FAT 6187 04:13:58,037 --> 04:14:01,875 YOGURT OR WHOLE FAT YOGURT TO 6188 04:14:01,875 --> 04:14:02,776 BUTTERMILK, EVERY COMBINATION 6189 04:14:02,776 --> 04:14:08,882 YOU COULD THINK OF IN THESE 6190 04:14:08,882 --> 04:14:09,516 FORMS OF DAIRY. 6191 04:14:09,516 --> 04:14:10,283 NEXT SLIDE. 6192 04:14:10,283 --> 04:14:15,655 WE DID LOOK AT DAIRY SOURCES OF 6193 04:14:15,655 --> 04:14:18,358 SATURATED FAT COMPARED TO 6194 04:14:18,358 --> 04:14:21,561 CARBOHYDRATE AND PROTEIN, GRADE 6195 04:14:21,561 --> 04:14:25,932 NOT ASSIGNABLE, 12 ARTICLES, 10 6196 04:14:25,932 --> 04:14:28,668 RCTs, TWO COHORTS, 19 6197 04:14:28,668 --> 04:14:28,968 COMPARISONS. 6198 04:14:28,968 --> 04:14:32,972 THIS IS QUITE A FEW ARTICLES FOR 6199 04:14:32,972 --> 04:14:34,974 THIS, BUT THERE WERE A LOT OF 6200 04:14:34,974 --> 04:14:37,877 CONCERNS WITH CONSISTENCY IN THE 6201 04:14:37,877 --> 04:14:40,947 FINDINGS AND THEN THERE WAS 6202 04:14:40,947 --> 04:14:43,149 HETEROGENEITY IN BOTH 6203 04:14:43,149 --> 04:14:44,350 INTERVENTION AND COMPARATORS. 6204 04:14:44,350 --> 04:14:48,321 AN EXAMPLE THERE WERE STUDIES 6205 04:14:48,321 --> 04:14:51,591 THAT LOOKED AT EGGS, 6206 04:14:51,591 --> 04:14:52,892 SUGAR-SWEETENED BEVERAGES AND 6207 04:14:52,892 --> 04:14:54,093 LEGUMES, HARD TO FIND ENOUGH OF 6208 04:14:54,093 --> 04:14:56,062 ONE COMPARATOR TO PUT IT IN A 6209 04:14:56,062 --> 04:14:56,262 GROUP. 6210 04:14:56,262 --> 04:14:59,165 THIS IS DEFINITELY AN AREA WHERE 6211 04:14:59,165 --> 04:15:00,900 WE NEED MORE CONSISTENCY. 6212 04:15:00,900 --> 04:15:05,605 AND MORE WORK IN THE FUTURE. 6213 04:15:05,605 --> 04:15:06,806 SO NEXT SLIDE. 6214 04:15:06,806 --> 04:15:09,342 WE DID LOOK AT DAIRY SOURCES OF 6215 04:15:09,342 --> 04:15:12,612 SATURATED FAT IN CHILDREN AND 6216 04:15:12,612 --> 04:15:13,146 ADOLESCENTS. 6217 04:15:13,146 --> 04:15:13,713 CONCLUSION STATEMENT IS 6218 04:15:13,713 --> 04:15:15,114 CONCLUSION STATEMENT CANNOT BE 6219 04:15:15,114 --> 04:15:17,750 DRAWN ABOUT DAIRY SOURCES OF 6220 04:15:17,750 --> 04:15:20,386 SATURATED FAT AND COMPARATORS 6221 04:15:20,386 --> 04:15:23,223 CONSUMED BY CHILDREN AND 6222 04:15:23,223 --> 04:15:24,390 ADOLESCENTS AND RELATIONSHIP 6223 04:15:24,390 --> 04:15:30,430 WITH LIPIDS OR BLOOD PRESSURE. 6224 04:15:30,430 --> 04:15:31,865 COMPARATORS CONSIDERED INCLUDED 6225 04:15:31,865 --> 04:15:33,166 SIMILAR FOOD SOURCES WITH 6226 04:15:33,166 --> 04:15:37,136 DIFFERENT AMOUNTS OF TOTAL FAT, 6227 04:15:37,136 --> 04:15:45,778 FOOD SOURCES UNSATURATED FAT, 6228 04:15:45,778 --> 04:15:51,050 CARBOHYDRATE OR PROTEIN, GRADE 6229 04:15:51,050 --> 04:15:51,551 NON-ASSIGNABLE. 6230 04:15:51,551 --> 04:15:54,120 SO REALLY IN LOOKING AT THESE WE 6231 04:15:54,120 --> 04:15:56,189 SAW MIXED FINDINGS AND THERE WAS 6232 04:15:56,189 --> 04:15:58,258 A LOT OF HETEROGENEITY SO AGE 6233 04:15:58,258 --> 04:16:01,995 RANGE OF THE CHILDREN WAS VERY 6234 04:16:01,995 --> 04:16:03,530 DIFFERENT, BECAUSE THE AGE RANGE 6235 04:16:03,530 --> 04:16:06,165 VARIED THEY HAD DIFFERENT 6236 04:16:06,165 --> 04:16:08,434 REQUIREMENTS FOR DAIRY 6237 04:16:08,434 --> 04:16:09,536 CONSUMPTION. 6238 04:16:09,536 --> 04:16:11,738 THERE WAS SIMILAR CONCERNS WITH 6239 04:16:11,738 --> 04:16:13,139 GENERALIZABILITY ONLY ONE STUDY 6240 04:16:13,139 --> 04:16:15,141 CONDUCTED IN THE U.S. 6241 04:16:15,141 --> 04:16:16,976 SO THIS WAS SURPRISING TO US. 6242 04:16:16,976 --> 04:16:19,512 WE REALLY THOUGHT THERE WOULD BE 6243 04:16:19,512 --> 04:16:24,217 A LOT MORE STUDIES ON THIS 6244 04:16:24,217 --> 04:16:25,952 PARTICULAR TOPIC WITH KIDS. 6245 04:16:25,952 --> 04:16:28,121 ONE MORE CONCLUSION STATEMENT TO 6246 04:16:28,121 --> 04:16:28,588 GO. 6247 04:16:28,588 --> 04:16:32,191 THIS IS DAIRY COMPARED TO MEAT 6248 04:16:32,191 --> 04:16:35,595 SOURCES OF SATURATED FAT, A VERY 6249 04:16:35,595 --> 04:16:36,663 INTERESTING COMPARISON. 6250 04:16:36,663 --> 04:16:40,066 WE LOOKED AT TWO COMPARISONS AND 6251 04:16:40,066 --> 04:16:42,835 THIS IS IN ADULTS AND OLDER 6252 04:16:42,835 --> 04:16:43,269 ADULTS. 6253 04:16:43,269 --> 04:16:45,238 FIRST CONCLUSION STATEMENT IS 6254 04:16:45,238 --> 04:16:46,239 SUBSTITUTING PROCESSED MEAT AND 6255 04:16:46,239 --> 04:16:52,145 RHETT 6256 04:16:52,145 --> 04:16:55,515 RED MEAT IS ASSOCIATED WITH 6257 04:16:55,515 --> 04:16:57,717 LOWER RISK OF CARDIOVASCULAR 6258 04:16:57,717 --> 04:16:59,586 RISK MORTALITY, EVIDENCE GRADED 6259 04:16:59,586 --> 04:17:01,554 AS MODERATE. 6260 04:17:01,554 --> 04:17:03,623 SO HERE THE MEAT COMPARISONS 6261 04:17:03,623 --> 04:17:05,692 INCLUDED PROCESSED MEAT, RED 6262 04:17:05,692 --> 04:17:07,126 MEAT, TOTAL RED MEAT. 6263 04:17:07,126 --> 04:17:09,629 DAIRY INCLUDED LOW FAT AND HIGH 6264 04:17:09,629 --> 04:17:12,799 FAT DAIRY, NOT SPECIFIED, WHOLE 6265 04:17:12,799 --> 04:17:14,100 MILK AND CHEESE. 6266 04:17:14,100 --> 04:17:16,970 WE DID LOOK AT PROCESSED AND RED 6267 04:17:16,970 --> 04:17:18,871 MEAT SEPARATELY AND COMBINED 6268 04:17:18,871 --> 04:17:20,707 THEM BECAUSE THE RESULTS WERE 6269 04:17:20,707 --> 04:17:22,809 SIMILAR ACROSS THE TWO. 6270 04:17:22,809 --> 04:17:25,645 WE HAD TWO SIMILAR CONCLUSION 6271 04:17:25,645 --> 04:17:25,945 STATEMENTS. 6272 04:17:25,945 --> 04:17:29,382 SO THERE WERE SIX ARTICLES WHICH 6273 04:17:29,382 --> 04:17:32,318 WERE ALL PROSPECTIVE COHORT 6274 04:17:32,318 --> 04:17:33,319 STUDIES, 18 COMPARISONS. 6275 04:17:33,319 --> 04:17:36,723 THERE WERE FEW CONCERNS WITH 6276 04:17:36,723 --> 04:17:37,156 CONSISTENCY. 6277 04:17:37,156 --> 04:17:38,891 THIS WAS REALLY PRETTY 6278 04:17:38,891 --> 04:17:40,760 CONSISTENT ACROSS THE BOARD. 6279 04:17:40,760 --> 04:17:43,062 THERE WERE CONCERNS WITH 6280 04:17:43,062 --> 04:17:45,698 PRECISION, AGAIN WITH THE MEAT 6281 04:17:45,698 --> 04:17:49,736 OR THE DAIRY, EXACT SATURATED 6282 04:17:49,736 --> 04:17:50,503 FAT THERE. 6283 04:17:50,503 --> 04:17:54,540 CONCERNS WITH RISK OF BIAS, 6284 04:17:54,540 --> 04:17:56,075 DIRECTNESS, GENERALIZABILITY. 6285 04:17:56,075 --> 04:17:57,644 HERE MOST STUDIES WERE CONDUCTED 6286 04:17:57,644 --> 04:18:00,880 IN THE U.S., PARTICIPANTS HAD 6287 04:18:00,880 --> 04:18:02,548 LIMITED DIVERSITY. 6288 04:18:02,548 --> 04:18:03,983 THE LAST CONCLUSION STATEMENT 6289 04:18:03,983 --> 04:18:05,151 HERE IS CONCLUSION STATEMENT 6290 04:18:05,151 --> 04:18:07,687 CANNOT BE DRAWN ABOUT THE 6291 04:18:07,687 --> 04:18:08,554 RELATIONSHIP BETWEEN REPLACING 6292 04:18:08,554 --> 04:18:11,424 DAIRY WITH MEAT CONSUMPTION BY 6293 04:18:11,424 --> 04:18:14,494 ADULTS AND BLOOD LIPIDS, BLOOD 6294 04:18:14,494 --> 04:18:15,395 PRESSURE, CARDIOVASCULAR DISEASE 6295 04:18:15,395 --> 04:18:17,130 MORTALITY, BECAUSE THERE'S NOT 6296 04:18:17,130 --> 04:18:18,564 ENOUGH EVIDENCE AVAILABLE. 6297 04:18:18,564 --> 04:18:21,968 THERE WAS ONLY ONE NESTED CASE 6298 04:18:21,968 --> 04:18:23,469 CONTROL STUDY HERE, AND THERE 6299 04:18:23,469 --> 04:18:24,003 WERE SUBSTANTIAL CONCERNS 6300 04:18:24,003 --> 04:18:27,740 BECAUSE IT WAS A VERY LIMITED 6301 04:18:27,740 --> 04:18:28,608 BODY OF EVIDENCE. 6302 04:18:28,608 --> 04:18:30,576 AND SO WITH THAT, I'M GOING TO 6303 04:18:30,576 --> 04:18:32,345 TURN IT OVER TO CHRISTOPHER, FOR 6304 04:18:32,345 --> 04:18:35,081 THE MEAT AND PLANT SOURCES. 6305 04:18:35,081 --> 04:18:37,016 >> THANK YOU, DEE DEE AND DEANNA 6306 04:18:37,016 --> 04:18:39,018 FOR SETTING ME UP LIKE THIS. 6307 04:18:39,018 --> 04:18:43,489 THANKS TO CHERYL ANDERSON AND TO 6308 04:18:43,489 --> 04:18:44,924 CHRIS FOR HELPING US AND THE 6309 04:18:44,924 --> 04:18:46,092 WHOLE COMMITTEE. 6310 04:18:46,092 --> 04:18:48,861 BEFORE I GO TO THE NEXT SLIDE I 6311 04:18:48,861 --> 04:18:53,332 HAVE TO DO 11 SLIDES, 16 6312 04:18:53,332 --> 04:18:53,866 CONCLUSIONS. 6313 04:18:53,866 --> 04:18:55,401 SO THEY GROUP NICELY INTO A 6314 04:18:55,401 --> 04:18:57,270 COUPLE SETS. 6315 04:18:57,270 --> 04:18:58,371 THAT'S GOING TO HELP. 6316 04:18:58,371 --> 04:19:01,874 I'M GOING TO END UP WITH 7 6317 04:19:01,874 --> 04:19:03,142 MODERATE CONCLUSIONS, 3 LIMITED 6318 04:19:03,142 --> 04:19:04,744 GRADED CONCLUSIONS, 7 THAT ARE 6319 04:19:04,744 --> 04:19:07,146 NOT GRADED, 4 HAD NO PAPERS AT 6320 04:19:07,146 --> 04:19:10,650 ALL, TO SET YOU UP AHEAD OF 6321 04:19:10,650 --> 04:19:11,317 TIME. 6322 04:19:11,317 --> 04:19:12,185 AS YOU GO THROUGH IT, I DON'T 6323 04:19:12,185 --> 04:19:14,320 THINK I CAN READ THROUGH ALL THE 6324 04:19:14,320 --> 04:19:17,757 DIFFERENT PARTS, THERE'S A 6325 04:19:17,757 --> 04:19:18,958 LITTLE ONE THAT GETS TWEAKED 6326 04:19:18,958 --> 04:19:19,625 EACH TIME. 6327 04:19:19,625 --> 04:19:23,062 WHEN IT COMES TO PROCESSED AND 6328 04:19:23,062 --> 04:19:25,198 UNPROCESSED MEATS IT WAS 6329 04:19:25,198 --> 04:19:27,366 STUNNING WE NEVER SEPARATED THEM 6330 04:19:27,366 --> 04:19:27,767 OUT. 6331 04:19:27,767 --> 04:19:30,336 IT'S USUALLY TOTAL AND 6332 04:19:30,336 --> 04:19:31,437 PROCESSED, AND UNPROCESSED, 6333 04:19:31,437 --> 04:19:37,043 BECAUSE THEY WERE SO CONSISTENT 6334 04:19:37,043 --> 04:19:38,044 THERE'S NOT ENOUGH STUDIES, 6335 04:19:38,044 --> 04:19:39,879 WE'LL FIND SOMETHING ELSE, 6336 04:19:39,879 --> 04:19:42,615 MOSTLY YOU'LL SEE PROCESSED AND 6337 04:19:42,615 --> 04:19:44,050 UNPROCESSED WHICH MEANT TOTAL. 6338 04:19:44,050 --> 04:19:46,786 IF YOU WANT TO KNOW WHAT RED 6339 04:19:46,786 --> 04:19:48,721 MEAT IS, ALMOST ALWAYS BEEF. 6340 04:19:48,721 --> 04:19:51,924 SOMETIMES IT'S PORK. 6341 04:19:51,924 --> 04:19:53,459 VERY INFREQUENTLY LAMB. 6342 04:19:53,459 --> 04:19:55,428 COMPARATORS ARE A WHOLE SET OF 6343 04:19:55,428 --> 04:19:57,163 PLANT THINGS, WATCH THE 6344 04:19:57,163 --> 04:19:58,364 COMPARATORS CHANGE. 6345 04:19:58,364 --> 04:20:00,566 IT'S GOING TO BE PROTEIN PLANT 6346 04:20:00,566 --> 04:20:03,503 SOURCES, A COMBINATION OF 6347 04:20:03,503 --> 04:20:05,171 LEGUMES, BEANS, NUTS, SOY. 6348 04:20:05,171 --> 04:20:08,407 IT'S GOING TO BE ANIMAL BASED 6349 04:20:08,407 --> 04:20:09,542 SOURCES, WHITE MEAT, FISH AND 6350 04:20:09,542 --> 04:20:11,511 SEAFOOD, EGGS OR DAIRY BUT NOT 6351 04:20:11,511 --> 04:20:13,813 DAIRY FOR ME JUST YOU JUST 6352 04:20:13,813 --> 04:20:14,113 COVERED IT. 6353 04:20:14,113 --> 04:20:15,648 THAT ONE IS ALREADY TAKEN. 6354 04:20:15,648 --> 04:20:17,550 EVERYTHING IS IN ADULTS AND 6355 04:20:17,550 --> 04:20:20,186 OLDER ADULTS, NOTHING IS IN 6356 04:20:20,186 --> 04:20:22,155 KIDS. 6357 04:20:22,155 --> 04:20:23,689 ALL THOSE HAD ZERO PAPERS. 6358 04:20:23,689 --> 04:20:25,958 WHEN IT COMES TO OUTCOME, TO 6359 04:20:25,958 --> 04:20:27,393 SUMMARIZE IT'S FUN LOOKING 6360 04:20:27,393 --> 04:20:28,795 THROUGH IT. 6361 04:20:28,795 --> 04:20:30,563 TOPIC IS CARDIOVASCULAR DISEASE. 6362 04:20:30,563 --> 04:20:32,064 THE WAY WE APPROACHED IT, DEE 6363 04:20:32,064 --> 04:20:34,600 DEE SET US UP SO NICELY, IF IT'S 6364 04:20:34,600 --> 04:20:38,838 INTERMEDIATE IT WAS A RANDOMIZD 6365 04:20:38,838 --> 04:20:40,072 CONTROLLED TRIAL, LIPIDS AND 6366 04:20:40,072 --> 04:20:40,940 BLOOD PRESSURE. 6367 04:20:40,940 --> 04:20:42,809 YOU COULD TELL FROM WHAT DEANNA 6368 04:20:42,809 --> 04:20:49,916 WAS PRESENTING IF IT WAS AN RCT 6369 04:20:49,916 --> 04:20:53,986 QUITE OFTEN ONLY LDL, FINDINGS 6370 04:20:53,986 --> 04:20:57,456 FOUND NO ASSOCIATION, INSTEAD OF 6371 04:20:57,456 --> 04:21:01,894 SAYING LDL, HDL, TRIGLYCERIDES 6372 04:21:01,894 --> 04:21:02,728 SAID LIP ITS. 6373 04:21:02,728 --> 04:21:03,830 BLOOD PRESSURE IS ALWAYS 6374 04:21:03,830 --> 04:21:05,264 INCLUDED, NOT ALWAYS STATED. 6375 04:21:05,264 --> 04:21:06,999 NO REAL MECHANISM TO EXPLAIN 6376 04:21:06,999 --> 04:21:12,171 CHANGE IN BLOOD PRESSURE BUT 6377 04:21:12,171 --> 04:21:14,040 PART OF INTERMEDIATE OUTCOMES, 6378 04:21:14,040 --> 04:21:17,743 NO, OUTCOMES -- 6379 04:21:17,743 --> 04:21:18,611 NOT ALWAYS CONSISTENTLY 6380 04:21:18,611 --> 04:21:18,945 MEASURED. 6381 04:21:18,945 --> 04:21:21,881 ALMOST ALL OF WHAT I'LL PRESENT 6382 04:21:21,881 --> 04:21:22,548 IS MORBIDITY, INCLUDING 6383 04:21:22,548 --> 04:21:23,716 MORTALITY, NOT NECESSARILY, BUT 6384 04:21:23,716 --> 04:21:26,452 IT CAN. 6385 04:21:26,452 --> 04:21:30,323 FEW STUDIES SAID ANYTHING ABOUT 6386 04:21:30,323 --> 04:21:31,290 MORTALITY. 6387 04:21:31,290 --> 04:21:34,627 ONLY PLACE YOU'LL SEE THAT WHEN 6388 04:21:34,627 --> 04:21:39,265 WE REFER TO NULL FINDINGS, 6389 04:21:39,265 --> 04:21:45,805 NOTHING FOR CARDIOVASCULAR 6390 04:21:45,805 --> 04:21:46,339 DISEASE, EITHER LIPIDS OR 6391 04:21:46,339 --> 04:21:47,440 MORBIDITY AND MORTALITY. 6392 04:21:47,440 --> 04:21:50,710 ALL THESE THINGS KEEP CHANGING 6393 04:21:50,710 --> 04:21:53,446 IN MY 16 CONCLUSIONS, DRUM ROLL 6394 04:21:53,446 --> 04:21:53,779 PLEASE. 6395 04:21:53,779 --> 04:21:55,114 NEXT SLIDE. 6396 04:21:55,114 --> 04:21:58,517 LET'S START WITH RED MEAT VERSUS 6397 04:21:58,517 --> 04:21:59,518 PLANT SOURCES OF PROTEIN. 6398 04:21:59,518 --> 04:22:02,021 LOOK AT THE TOP. 6399 04:22:02,021 --> 04:22:03,556 PROCESSED AND UNPROCESSED MEATS. 6400 04:22:03,556 --> 04:22:07,393 SPECIFICALLY THE PLANT SOURCES 6401 04:22:07,393 --> 04:22:11,197 OF PROTEIN, LEGUMES AND NUTS, 6402 04:22:11,197 --> 04:22:11,364 SOY. 6403 04:22:11,364 --> 04:22:12,531 IT'S SPECIFICALLY MORBIDITY. 6404 04:22:12,531 --> 04:22:14,934 AND IT'S A LOWER RISK OF 6405 04:22:14,934 --> 04:22:16,569 MORBIDITY WITH THE PLANT 6406 04:22:16,569 --> 04:22:19,972 RELATIVE TO THE RED MEAT, AND 6407 04:22:19,972 --> 04:22:20,606 MODERATE. 6408 04:22:20,606 --> 04:22:25,678 AND THE NEXT ONES WILL BE WHOLE 6409 04:22:25,678 --> 04:22:27,513 GRAINS AND -- WHAT'S THE OTHER 6410 04:22:27,513 --> 04:22:27,847 ONE? 6411 04:22:27,847 --> 04:22:28,180 VEGGIES. 6412 04:22:28,180 --> 04:22:31,017 IT'S SORT OF THE SAME PILE OF 6413 04:22:31,017 --> 04:22:33,886 CONSISTENCY, PRECISION, RISK OF 6414 04:22:33,886 --> 04:22:34,854 BIAS, DIRECTNESS, 6415 04:22:34,854 --> 04:22:35,421 GENERALIZABILITY, ALMOST ALL 6416 04:22:35,421 --> 04:22:38,257 IDENTICAL. 6417 04:22:38,257 --> 04:22:42,194 ALMOST ALL OF THEM ARE SOME ARE 6418 04:22:42,194 --> 04:22:42,395 FEW. 6419 04:22:42,395 --> 04:22:45,765 SOME WERE NOT IN THE U.S., 6420 04:22:45,765 --> 04:22:48,434 RARELY ADDRESSED RATE AND 6421 04:22:48,434 --> 04:22:50,069 ETHNICITY, RARELY ADDRESSED 6422 04:22:50,069 --> 04:22:51,037 SOCIOECONOMIC POSITION SO 6423 04:22:51,037 --> 04:22:53,806 NOTHING EVER ROSE TO STRONG. 6424 04:22:53,806 --> 04:22:56,442 THEY ARE ALL JUST LIKE THIS. 6425 04:22:56,442 --> 04:22:58,277 THREE PLANT SOURCES ARE 6426 04:22:58,277 --> 04:23:06,419 STUNNINGLY CONSISTENT. 6427 04:23:06,419 --> 04:23:07,853 NEXT SLIDE. 6428 04:23:07,853 --> 04:23:10,456 ALMOST IDENTICAL. 6429 04:23:10,456 --> 04:23:12,458 LOOK AT THE EXPOSURE, OUTCOME, 6430 04:23:12,458 --> 04:23:13,726 GRADE, DIRECTION. 6431 04:23:13,726 --> 04:23:16,562 IF YOU WENT THROUGH THE FIVE 6432 04:23:16,562 --> 04:23:18,664 CRITERIA, WITH A GRADE, VERY, 6433 04:23:18,664 --> 04:23:23,369 VERY MODEST DIFFERENCE BUT ALL 6434 04:23:23,369 --> 04:23:30,009 THE SUM OR FEW, 6435 04:23:30,009 --> 04:23:32,979 GENERALIZABILITY, WE NEED MORE 6436 04:23:32,979 --> 04:23:33,980 STUDIES. 6437 04:23:33,980 --> 04:23:37,483 NEXT IS SAME, SWITCH TO VEGGIES. 6438 04:23:37,483 --> 04:23:39,352 SAME EXPOSURE, DIFFERENT 6439 04:23:39,352 --> 04:23:39,885 COMPARATOR. 6440 04:23:39,885 --> 04:23:50,396 SAME OUTCOME, STILL ADULTS AND 6441 04:23:52,298 --> 04:23:54,033 OLDER, SAME GRADE. 6442 04:23:54,033 --> 04:23:57,236 FIRST WAS EIGHT STUDIES, ALL 6443 04:23:57,236 --> 04:23:59,905 PROSPECTIVE, NO RCTs, 33 6444 04:23:59,905 --> 04:24:00,206 COMPARISONS. 6445 04:24:00,206 --> 04:24:02,274 THESE LAST TWO WITH FOUR 6446 04:24:02,274 --> 04:24:05,911 STUDIES, EACH WITH 10 OR 12 6447 04:24:05,911 --> 04:24:06,712 COMPARISONS. 6448 04:24:06,712 --> 04:24:08,748 BASICALLY THE FIRST ONE AT EIGHT 6449 04:24:08,748 --> 04:24:10,850 STUDIES SAME AS FOUR IN THE 6450 04:24:10,850 --> 04:24:13,152 OTHER ONEs BUT THE FOUR OTHER 6451 04:24:13,152 --> 04:24:15,021 ONES DIDN'T ALWAYS ADDRESS 6452 04:24:15,021 --> 04:24:16,088 PLANT-BASED SOURCES OF PROTEIN. 6453 04:24:16,088 --> 04:24:17,623 IT'S THE SAME SET OF STUDIES 6454 04:24:17,623 --> 04:24:21,127 AGAIN AND AGAIN AND AGAIN USING 6455 04:24:21,127 --> 04:24:22,762 MULTIPLE SETS OF COMPARATORS, 6456 04:24:22,762 --> 04:24:24,830 AND STUNNINGLY CONSISTENT IN 6457 04:24:24,830 --> 04:24:25,097 FINDINGS. 6458 04:24:25,097 --> 04:24:28,234 I WANT TO WRAP THAT UP AND I 6459 04:24:28,234 --> 04:24:29,435 LOVE THAT SARAH TOTALLY SET ME 6460 04:24:29,435 --> 04:24:30,202 UP FOR THIS. 6461 04:24:30,202 --> 04:24:34,240 WHAT WOULD IT TAKE TO MOVE THIS 6462 04:24:34,240 --> 04:24:35,341 TO STRONG? 6463 04:24:35,341 --> 04:24:37,977 THEY ARE ALL IN THE SAME 6464 04:24:37,977 --> 04:24:40,713 DIRECTION, SAME KIND OF 6465 04:24:40,713 --> 04:24:41,347 CONCLUSIONS. 6466 04:24:41,347 --> 04:24:43,349 WHAT WOULD IT TAKE TO BRING 6467 04:24:43,349 --> 04:24:45,718 HEALTH EQUITY UP? 6468 04:24:45,718 --> 04:24:47,053 ONE CONCLUSION THIS TIME IS 6469 04:24:47,053 --> 04:24:48,687 CARDIOVASCULAR DISEASE AND DIET. 6470 04:24:48,687 --> 04:24:49,922 WITH A PATTERN WE'VE GOT STRONG 6471 04:24:49,922 --> 04:24:52,658 AND HEALTH EQUITY. 6472 04:24:52,658 --> 04:24:57,663 FROM THE HEALTH EQUITY 6473 04:24:57,663 --> 04:24:58,998 PERSPECTIVE, NO SOCIOECONOMIC 6474 04:24:58,998 --> 04:24:59,832 POSITION. 6475 04:24:59,832 --> 04:25:02,902 CALL OUT TO FUTURE TRIALISTS AND 6476 04:25:02,902 --> 04:25:03,469 EPIDEMIOLOGISTS, YEAH, LET'S 6477 04:25:03,469 --> 04:25:04,437 INCLUDE THAT. 6478 04:25:04,437 --> 04:25:06,439 WHAT WOULD IT TAKE TO MAKE IT 6479 04:25:06,439 --> 04:25:08,941 STRONG AFTER THAT? 6480 04:25:08,941 --> 04:25:10,910 IT WOULD TAKE DIRECT RCTs. 6481 04:25:10,910 --> 04:25:13,646 WHO IS GOING TO SIGN UP TO BE 6482 04:25:13,646 --> 04:25:15,848 RANDOMIZED FOR 10 OR 20 YEARS TO 6483 04:25:15,848 --> 04:25:20,019 RED MEAT OR BEANS? 6484 04:25:20,019 --> 04:25:22,088 NO ONE. 6485 04:25:22,088 --> 04:25:23,856 MAYBE YOU COULD IMPROVE 6486 04:25:23,856 --> 04:25:26,158 GENERALIZABILITY BUT WE'LL NOT 6487 04:25:26,158 --> 04:25:27,026 IMPROVE DIRECTNESS. 6488 04:25:27,026 --> 04:25:29,128 THIS CONCLUSION WILL LIKELY 6489 04:25:29,128 --> 04:25:33,399 NEVER MOVE TO STRONG. 6490 04:25:33,399 --> 04:25:36,001 NOTICE NO TRIALS ON 6491 04:25:36,001 --> 04:25:37,870 INTERMEDIATES, NOTHING ON RED 6492 04:25:37,870 --> 04:25:39,839 MEAT VERSUS BABIES AND PEACE OR 6493 04:25:39,839 --> 04:25:40,606 VEGGIES OR WHOLE GRAINS, WITH 6494 04:25:40,606 --> 04:25:41,707 LIPIDS AND BLOOD PRESSURE. 6495 04:25:41,707 --> 04:25:46,979 I FIND THAT STRIKING. 6496 04:25:46,979 --> 04:25:48,914 I CAME TO THIS EPIPHANY TODAY. 6497 04:25:48,914 --> 04:25:50,883 I THINK I'VE DONE THREE TRIALS 6498 04:25:50,883 --> 04:25:53,385 THAT COULD BE INCLUDED THERE. 6499 04:25:53,385 --> 04:25:54,954 BUT WHAT IS CHALLENGING ABOUT 6500 04:25:54,954 --> 04:25:57,890 THIS TOPIC WHEN WE WENT FROM 6501 04:25:57,890 --> 04:25:59,758 36,000 PAPERS WHICH WAS 6502 04:25:59,758 --> 04:26:01,060 OBVIOUSLY UNMANAGEABLE TO 100, 6503 04:26:01,060 --> 04:26:02,595 THE CHALLENGE WAS THE SEARCH 6504 04:26:02,595 --> 04:26:03,395 TERMS. 6505 04:26:03,395 --> 04:26:04,897 I THOUGHT OF THE THREE TRIALS, 6506 04:26:04,897 --> 04:26:06,899 I'VE DONE THAT COULD HAVE 6507 04:26:06,899 --> 04:26:08,134 ADDRESSED THIS, THERE'S NO WAY 6508 04:26:08,134 --> 04:26:10,202 THEY WERE WRITTEN UP THAT THEY 6509 04:26:10,202 --> 04:26:12,037 WOULD HAVE BEEN IDENTIFIED IN A 6510 04:26:12,037 --> 04:26:12,972 STANDARD SEARCH. 6511 04:26:12,972 --> 04:26:16,208 IT WASN'T THE PURPOSE OF MY 6512 04:26:16,208 --> 04:26:16,775 TRIAL. 6513 04:26:16,775 --> 04:26:19,078 SO THINKING ABOUT BROADENING 6514 04:26:19,078 --> 04:26:21,480 THIS LITERATURE IT MIGHT ALSO 6515 04:26:21,480 --> 04:26:22,681 INVOLVE APPROACHING THIS SEARCH 6516 04:26:22,681 --> 04:26:26,385 IN A DIFFERENT WAY BUT COULD BE 6517 04:26:26,385 --> 04:26:28,821 MORE DIRECT WITH INTERMEDIATES 6518 04:26:28,821 --> 04:26:29,455 BUT WE'LL NEVER HAVE MORBIDITY 6519 04:26:29,455 --> 04:26:31,457 AND MORTALITY TRIAL WHERE YOU 6520 04:26:31,457 --> 04:26:33,225 RANDOMIZE PEOPLE TO RED MEAT AND 6521 04:26:33,225 --> 04:26:33,692 PLANTS. 6522 04:26:33,692 --> 04:26:36,595 SO THIS MAY NEVER MOVE PAST 6523 04:26:36,595 --> 04:26:37,596 MODERATE, JUST AS A STATEMENT, 6524 04:26:37,596 --> 04:26:41,534 LOVE THAT YOU SET ME UP, SARAH, 6525 04:26:41,534 --> 04:26:43,602 WE SHOULD GO FOR STRONG 6526 04:26:43,602 --> 04:26:46,572 CONCLUSIONS WITH HEALTH EQUITY. 6527 04:26:46,572 --> 04:26:48,541 NEXT SLIDE PLEASE. 6528 04:26:48,541 --> 04:26:50,075 NOW ANOTHER THREE TRIALS ALL IN 6529 04:26:50,075 --> 04:26:53,779 A SET. 6530 04:26:53,779 --> 04:26:59,351 THIS ONE HAS A FOURTH MINI 6531 04:26:59,351 --> 04:27:03,189 CONCLUSION RCTs. 6532 04:27:03,189 --> 04:27:06,458 WHITE MEAT STARTS WITH EIGHT 6533 04:27:06,458 --> 04:27:07,326 STUDIES, SIX CONTROL. 6534 04:27:07,326 --> 04:27:09,528 IF YOU WATCH FROM RED MEAT TO 6535 04:27:09,528 --> 04:27:12,064 WHITE MEAT, THERE'S NO 6536 04:27:12,064 --> 04:27:14,433 DIFFERENCE, NO ASSOCIATION, NO 6537 04:27:14,433 --> 04:27:15,100 DIFFERENTIAL ASSOCIATION FOUND 6538 04:27:15,100 --> 04:27:16,869 IN CARDIOVASCULAR DISEASE. 6539 04:27:16,869 --> 04:27:18,404 AND THAT'S WHAT YOU'LL SEE FOR 6540 04:27:18,404 --> 04:27:20,573 ALL OF THE RED MEAT VERSUS 6541 04:27:20,573 --> 04:27:24,310 SWITCH TO ANOTHER SOURCE OF 6542 04:27:24,310 --> 04:27:25,311 ANIMAL FOOD. 6543 04:27:25,311 --> 04:27:27,079 ALL MODERATE, ALL NO 6544 04:27:27,079 --> 04:27:28,681 ASSOCIATION. 6545 04:27:28,681 --> 04:27:29,481 ALL ASSOCIATIONS WITH 6546 04:27:29,481 --> 04:27:31,217 DIRECTIONALITY WERE RED MEAT 6547 04:27:31,217 --> 04:27:32,985 SWITCHING TO PLANT SOURCES. 6548 04:27:32,985 --> 04:27:37,456 SO, THIS ONE IS SAME KIND OF FEW 6549 04:27:37,456 --> 04:27:40,326 CONCERNS WITH CONSISTENCY, FEW 6550 04:27:40,326 --> 04:27:41,927 SUBSTANTIAL, SOME, SOME, PRETTY 6551 04:27:41,927 --> 04:27:43,462 MODERATE FOR WHITE MEAT, 6552 04:27:43,462 --> 04:27:46,966 REASONABLE NUMBER OF COHORT 6553 04:27:46,966 --> 04:27:48,367 STUDIES. 6554 04:27:48,367 --> 04:27:50,169 AGAIN, THIS IS STILL -- 6555 04:27:50,169 --> 04:27:52,204 INTERESTING, THIS JUST SAYS ONLY 6556 04:27:52,204 --> 04:27:52,471 PROCESSED. 6557 04:27:52,471 --> 04:28:02,915 OH, GOOD, I'M ON THE WRONG 6558 04:28:05,851 --> 04:28:06,118 SLIDE. 6559 04:28:06,118 --> 04:28:07,319 CVD SAME THING. 6560 04:28:07,319 --> 04:28:08,854 VERY SIMILAR EXCEPT FOR LACK OF 6561 04:28:08,854 --> 04:28:09,788 DIRECTION, NO ASSOCIATION HERE. 6562 04:28:09,788 --> 04:28:13,759 AS YOU MOVE TO THE RIGHT OF THE 6563 04:28:13,759 --> 04:28:15,394 PAGE, THIS WAS PROBLEMATIC. 6564 04:28:15,394 --> 04:28:17,730 WHEN YOU LOOKED AT RED MEAT 6565 04:28:17,730 --> 04:28:19,465 STUDIES VERSUS WHITE MEAT 6566 04:28:19,465 --> 04:28:20,566 STUDIES, INTERESTINGLY THEY WERE 6567 04:28:20,566 --> 04:28:24,403 BOTH ALWAYS IN LEAN AND 6568 04:28:24,403 --> 04:28:24,803 UNPROCESSED. 6569 04:28:24,803 --> 04:28:27,006 IF YOU READ ALL THE PAPERS THEY 6570 04:28:27,006 --> 04:28:28,540 WERE GAMED A LITTLE BIT. 6571 04:28:28,540 --> 04:28:31,844 THEY WERE SET UP TO MAKE IT SOME 6572 04:28:31,844 --> 04:28:34,013 WHITE MEAT ARMS HAD AS MUCH OR 6573 04:28:34,013 --> 04:28:36,181 MORE SATURATED FAT THAN RED MEAT 6574 04:28:36,181 --> 04:28:37,182 ARMS WHICH DOESN'T MAKE MUCH 6575 04:28:37,182 --> 04:28:39,818 SENSE TO ME FROM A FOOD 6576 04:28:39,818 --> 04:28:40,452 PERSPECTIVE. 6577 04:28:40,452 --> 04:28:42,021 THREE OR FOUR WERE OUT OF THE 6578 04:28:42,021 --> 04:28:42,554 U.S. 6579 04:28:42,554 --> 04:28:46,492 FOUR OUT OF SIX FUNDED BY MEAT 6580 04:28:46,492 --> 04:28:46,992 INDUSTRY. 6581 04:28:46,992 --> 04:28:50,329 AS WE GO DOWN FOR CONCERNS MORE 6582 04:28:50,329 --> 04:28:52,498 SUBSTANTIAL CONCERNS IN THIS. 6583 04:28:52,498 --> 04:28:53,766 THERE WASN'T A DIRECTIONALITY. 6584 04:28:53,766 --> 04:28:56,635 IT LOOKED LIKE THERE WAS NO 6585 04:28:56,635 --> 04:28:58,537 DIFFERENCE BUT LIMITED FOR A 6586 04:28:58,537 --> 04:28:59,505 GRADE BECAUSE OF MULTIPLE 6587 04:28:59,505 --> 04:28:59,772 CONCERNS. 6588 04:28:59,772 --> 04:29:02,474 THIS IS ONE OF THE FEW RCT 6589 04:29:02,474 --> 04:29:05,311 STATEMENTS THAT WE HAVE IN HERE. 6590 04:29:05,311 --> 04:29:09,615 WE HAD A FEW RCTs AND MANY 6591 04:29:09,615 --> 04:29:10,549 CONCLUSIONS WITH ONE OR TWO, 6592 04:29:10,549 --> 04:29:12,418 THIS IS THE ONLY ONE WITH SIX. 6593 04:29:12,418 --> 04:29:13,519 THERE'S ONE OTHER ONE THAT MIGHT 6594 04:29:13,519 --> 04:29:16,221 HAVE HAD SIX BUT USUALLY THE 6595 04:29:16,221 --> 04:29:18,424 RCTs WE HAD TO TOSS BECAUSE WE 6596 04:29:18,424 --> 04:29:20,192 ONLY HAD ONE. 6597 04:29:20,192 --> 04:29:23,696 NEXT SLIDE, DIFFERENT ANIMAL 6598 04:29:23,696 --> 04:29:23,929 SOURCE. 6599 04:29:23,929 --> 04:29:28,400 FISH AND SEAFOOD. 6600 04:29:28,400 --> 04:29:29,702 SAME THING. 6601 04:29:29,702 --> 04:29:30,903 NOT ASSOCIATED. 6602 04:29:30,903 --> 04:29:33,105 JUST WITH MORBIDITY. 6603 04:29:33,105 --> 04:29:34,206 THESE ARE ONLY PROSPECTIVE 6604 04:29:34,206 --> 04:29:35,841 COHORT TRIALS. 6605 04:29:35,841 --> 04:29:38,877 GRADE IS LIMITED. 6606 04:29:38,877 --> 04:29:42,281 ALL THE SAME FEW, SOME, FEW, 6607 04:29:42,281 --> 04:29:43,382 SOME, SUBSTANTIAL. 6608 04:29:43,382 --> 04:29:45,150 THIS IS -- I WANT TO BRING OUT A 6609 04:29:45,150 --> 04:29:50,022 POINT THAT DEE DEE OR DIANA OR 6610 04:29:50,022 --> 04:29:51,790 BOTH SAID. 6611 04:29:51,790 --> 04:29:53,125 BEING LIMITED, OTHERS WERE 6612 04:29:53,125 --> 04:29:54,326 MODERATE, BEING LIMITED, ONE OF 6613 04:29:54,326 --> 04:29:57,496 THE THINGS IF YOU'VE GOT MORE 6614 04:29:57,496 --> 04:29:59,031 STUDIES, MORE LIKELY IT'S 6615 04:29:59,031 --> 04:30:00,232 POSSIBLE TO OVERTURN IT. 6616 04:30:00,232 --> 04:30:03,202 SO WHEN WE SAY LIMITED, OH, IT'S 6617 04:30:03,202 --> 04:30:04,069 THERE, BUT WOULDN'T TAKE ALL 6618 04:30:04,069 --> 04:30:06,038 THAT MUCH MORE TO GET US TO 6619 04:30:06,038 --> 04:30:07,373 CHANGE OUR MIND. 6620 04:30:07,373 --> 04:30:10,542 INTERESTINGLY THE FISH AND 6621 04:30:10,542 --> 04:30:12,411 SEAFOOD WOULD PROVIDE 6622 04:30:12,411 --> 04:30:14,813 OMEGA-3s, LOWER SOURCES OF 6623 04:30:14,813 --> 04:30:16,215 SATURATED FAT, WOULD OFFERING 6624 04:30:16,215 --> 04:30:18,417 SOMETHING ELSE, MIGHT BE A 6625 04:30:18,417 --> 04:30:19,518 HYPOTHESIS FOR BENEFIT. 6626 04:30:19,518 --> 04:30:21,019 FOR FISH. 6627 04:30:21,019 --> 04:30:24,223 I WAS SURPRISED TO SEE THIS BE 6628 04:30:24,223 --> 04:30:24,456 LIMITED. 6629 04:30:24,456 --> 04:30:26,859 NO ASSOCIATION. 6630 04:30:26,859 --> 04:30:29,361 MAYBE THE FISH MIGHT HAVE BEEN 6631 04:30:29,361 --> 04:30:35,868 BETTER, MAYBE ANOTHER DAY, BUT 6632 04:30:35,868 --> 04:30:38,437 WE'RE EXAMINING DATA, THIS IS 6633 04:30:38,437 --> 04:30:39,438 THE EVIDENCE, NO ASSOCIATION. 6634 04:30:39,438 --> 04:30:40,739 HERE IS EGGS. 6635 04:30:40,739 --> 04:30:43,942 THIS IS THE LAST OF THE TRIO OF 6636 04:30:43,942 --> 04:30:47,312 REPLACING RED MEAT WITH ANIMAL 6637 04:30:47,312 --> 04:30:49,248 SOURCE OF LOWER SATURATED FAT 6638 04:30:49,248 --> 04:30:50,716 AND IT'S THE SAME. 6639 04:30:50,716 --> 04:30:53,118 EGGS IS A COMPARATOR, NOT 6640 04:30:53,118 --> 04:30:55,421 ASSOCIATED, MODERATE GRADE, 6641 04:30:55,421 --> 04:30:57,589 SEVEN ARTICLES, 12 COMPARISONS, 6642 04:30:57,589 --> 04:30:59,892 SOME FEW, SUBSTANTIAL SOME, 6643 04:30:59,892 --> 04:31:00,192 SUBSTANTIAL. 6644 04:31:00,192 --> 04:31:02,961 THIS WHOLE SET OF THREE WAS VERY 6645 04:31:02,961 --> 04:31:04,963 INTERESTINGLY SORT OF AT THE 6646 04:31:04,963 --> 04:31:05,864 SAME LEVEL OF MODERATE BECAUSE 6647 04:31:05,864 --> 04:31:09,001 IT WAS ALMOST THE SAME NUMBER OF 6648 04:31:09,001 --> 04:31:11,437 PROSPECTIVE COHORT TRIALS, SAME 6649 04:31:11,437 --> 04:31:12,838 NUMBER OF MULTIPLE COMPARISONS, 6650 04:31:12,838 --> 04:31:14,273 THE SAME LIMITATION. 6651 04:31:14,273 --> 04:31:16,775 DIFFERENT COUNTRIES, NOT SO MANY 6652 04:31:16,775 --> 04:31:18,744 IN THE U.S., NO SOCIOECONOMIC, 6653 04:31:18,744 --> 04:31:21,280 VERY LITTLE RACE AND ETHNICITY. 6654 04:31:21,280 --> 04:31:23,015 THIS IS ANOTHER INTERESTING 6655 04:31:23,015 --> 04:31:24,883 CLUSTER OF THREE, ESPECIALLY 6656 04:31:24,883 --> 04:31:26,185 COMPARED TO THE LAST THREE THAT 6657 04:31:26,185 --> 04:31:31,323 I SHOWED YOU. 6658 04:31:31,323 --> 04:31:31,990 NEXT SLIDE PLEASE. 6659 04:31:31,990 --> 04:31:33,826 WHITE MEAT IS NOT A SOURCE OF 6660 04:31:33,826 --> 04:31:36,495 SATURATED FAT BUT WE WERE 6661 04:31:36,495 --> 04:31:38,464 LOOKING FOR EVERY POSSIBLE 6662 04:31:38,464 --> 04:31:38,764 COMPARISON. 6663 04:31:38,764 --> 04:31:41,834 AND THIS ONE HAD ENOUGH STUDIES 6664 04:31:41,834 --> 04:31:44,369 THAT WE THREW IT IN THERE. 6665 04:31:44,369 --> 04:31:49,308 WE'VE GOT FROM RED MEAT TO WHITE 6666 04:31:49,308 --> 04:31:51,276 MEAT. 6667 04:31:51,276 --> 04:31:52,811 SO WHITE MEAT VERSUS PLANT 6668 04:31:52,811 --> 04:31:55,414 BASED, NOW TALKING ABOUT 6669 04:31:55,414 --> 04:31:56,315 EVERYTHING, TALKING ABOUT BEANS, 6670 04:31:56,315 --> 04:31:58,717 PEAS, AND LENTILS AND WHOLE 6671 04:31:58,717 --> 04:32:01,887 GRAINS AND VEGGIES, IF THAT'S 6672 04:32:01,887 --> 04:32:03,188 WHAT THEY LOOKED AT. 6673 04:32:03,188 --> 04:32:06,225 STILL ONLY ADULTS AND OLDER 6674 04:32:06,225 --> 04:32:09,528 ADULTS, STILL ONLY MORBIDITY, NO 6675 04:32:09,528 --> 04:32:10,529 ASSOCIATION, AND IT'S MODERATE. 6676 04:32:10,529 --> 04:32:12,164 SAME KIND OF THING IN THE BODY 6677 04:32:12,164 --> 04:32:14,566 OF EVIDENCE. 6678 04:32:14,566 --> 04:32:19,505 SIX ARTICLES, 11 COMPARISONS, 6679 04:32:19,505 --> 04:32:20,606 SOME, FEW, SOME, SOME, SOME. 6680 04:32:20,606 --> 04:32:24,076 NEXT SLIDE PLEASE. 6681 04:32:24,076 --> 04:32:25,010 WHITE MEAT VERSUS FISH, PRETTY 6682 04:32:25,010 --> 04:32:28,580 MUCH THE SAME AS THE LAST ONE, 6683 04:32:28,580 --> 04:32:31,116 VERY, VERY REPRODUCIBLE HERE. 6684 04:32:31,116 --> 04:32:33,051 ADULTS AND OLDER ADULTS, NOT 6685 04:32:33,051 --> 04:32:37,656 ASSOCIATED, MODERATE CONCLUSION, 6686 04:32:37,656 --> 04:32:41,059 SIX ARTICLES, SOME COMPARISONS, 6687 04:32:41,059 --> 04:32:42,060 VERY, VERY CONSISTENT. 6688 04:32:42,060 --> 04:32:46,465 SO THOSE ARE THE ONLY TWO FOR 6689 04:32:46,465 --> 04:32:47,432 WHITE MEAT. 6690 04:32:47,432 --> 04:32:49,067 ONE OF THE DIFFERENCES HERE IT 6691 04:32:49,067 --> 04:32:51,904 WAS NOT A PROCESSED AND 6692 04:32:51,904 --> 04:32:52,771 UNPROCESSED WHITE MEAT, STILL 6693 04:32:52,771 --> 04:32:55,173 NOT SURE WHY WE DID WHITE MEAT. 6694 04:32:55,173 --> 04:32:58,810 WE WERE GOING TO DO DAIRY, RED 6695 04:32:58,810 --> 04:33:00,212 MEAT, PLANT BASED SOURCES, THIS 6696 04:33:00,212 --> 04:33:03,181 ONE STICKS OUT AS BEING A LITTLE 6697 04:33:03,181 --> 04:33:03,515 ODD. 6698 04:33:03,515 --> 04:33:04,816 BUT SWITCHING WHITE MEAT FOR 6699 04:33:04,816 --> 04:33:07,119 ANOTHER ANIMAL SOURCE MADE NO 6700 04:33:07,119 --> 04:33:08,720 DIFFERENCE. 6701 04:33:08,720 --> 04:33:10,022 THAT'S THE OVERALL CONCLUSION. 6702 04:33:10,022 --> 04:33:14,326 SWITCH TO THE NEXT SLIDE PLEASE 6703 04:33:14,326 --> 04:33:17,195 NOW WE'VE GOT ALL THE GRADE NOT 6704 04:33:17,195 --> 04:33:17,462 ASSIGNED. 6705 04:33:17,462 --> 04:33:20,232 HERE WE'VE GOT AT THE VERY TOP 6706 04:33:20,232 --> 04:33:24,636 LET'S KEEP THESE BRIEFER, FIVE 6707 04:33:24,636 --> 04:33:27,272 ARTICLES, ALL RCTs, THIS 6708 04:33:27,272 --> 04:33:29,975 PARTICULAR TOPIC IS UNPROCESSED 6709 04:33:29,975 --> 04:33:30,943 MEAT CONSUMPTION, COMPARED TO 6710 04:33:30,943 --> 04:33:33,045 ALL PLANT FOODS AND THIS IS ONLY 6711 04:33:33,045 --> 04:33:35,781 ON LIPIDS AND BLOOD PRESSURE. 6712 04:33:35,781 --> 04:33:37,649 AND THEY ARE SO DIFFERENT. 6713 04:33:37,649 --> 04:33:39,918 THERE'S NO WAY TO POOL THEM. 6714 04:33:39,918 --> 04:33:43,221 THAT'S THE SUM OF ALL PLANT 6715 04:33:43,221 --> 04:33:44,523 FOODS AGAINST UNPROCESSED RED 6716 04:33:44,523 --> 04:33:47,392 MEAT, LIPIDS AND BLOOD PRESSURE 6717 04:33:47,392 --> 04:33:48,193 WAS TOO MUCH. 6718 04:33:48,193 --> 04:33:49,494 COULDN'T FIND ANYTHING THERE. 6719 04:33:49,494 --> 04:33:51,663 NEXT ONE WAS EVEN WORSE. 6720 04:33:51,663 --> 04:33:54,099 RED MEAT WITH DIFFERENT AMOUNTS 6721 04:33:54,099 --> 04:33:55,500 OF SATURATED FAT. 6722 04:33:55,500 --> 04:33:57,569 OH MY GOD. 6723 04:33:57,569 --> 04:33:59,538 DIFFERENT AMOUNT OF SATURATED 6724 04:33:59,538 --> 04:34:01,506 FAT COULD HAVE BEEN RIDE RANGE, 6725 04:34:01,506 --> 04:34:07,546 WE ONLY HAD TWO RCTS, ONE COHORT 6726 04:34:07,546 --> 04:34:08,080 STUDY. 6727 04:34:08,080 --> 04:34:13,452 THE NEXT ONE IS MEAT WITH 6728 04:34:13,452 --> 04:34:16,088 DIFFERENT AMOUNTS OF SATURATED 6729 04:34:16,088 --> 04:34:17,189 FAT, ZERO ARTICLES, WORTHWHILE 6730 04:34:17,189 --> 04:34:19,891 QUESTION AT THE TIME. 6731 04:34:19,891 --> 04:34:26,465 HOPE YOU DON'T MIND IF I MOVE 6732 04:34:26,465 --> 04:34:27,566 PAST THAT QUICKLY. 6733 04:34:27,566 --> 04:34:30,302 WE TRIED TO LOOK AT 31 QUESTIONS 6734 04:34:30,302 --> 04:34:33,805 THAT BRANCHED OUT OF THE MAIN 6735 04:34:33,805 --> 04:34:34,072 QUESTION. 6736 04:34:34,072 --> 04:34:34,673 NEXT SLIDE PLEASE. 6737 04:34:34,673 --> 04:34:36,875 THERE WERE MORE, SORRY. 6738 04:34:36,875 --> 04:34:38,610 THERE'S ANOTHER SAID OF GRADE 6739 04:34:38,610 --> 04:34:40,379 NOT ASSIGNED. 6740 04:34:40,379 --> 04:34:47,285 ONE RCT, FIVE COHORT STUDIES, 6741 04:34:47,285 --> 04:34:48,353 PROCESSED VERSUS UNPROCESSED, 6742 04:34:48,353 --> 04:34:52,290 ISN'T THAT AN OPENED QUESTION? 6743 04:34:52,290 --> 04:34:54,192 LOOK AT AVAILABLE DATA FROM THE 6744 04:34:54,192 --> 04:34:57,362 TRIALS WE WERE ABLE TO FIND, 6745 04:34:57,362 --> 04:34:59,498 THERE WAS NO CONSISTENCY AND 6746 04:34:59,498 --> 04:35:01,967 THEY WERE ASKING THE QUESTION IN 6747 04:35:01,967 --> 04:35:06,872 DIFFERENT WAYS, TOO MANY WAYS TO 6748 04:35:06,872 --> 04:35:08,840 CHOOSE DIFFERENT COMPARATORS AND 6749 04:35:08,840 --> 04:35:11,376 EXPOSURES, ZERO ARTICLES FOR THE 6750 04:35:11,376 --> 04:35:14,646 NEXT TWO QUESTIONS, PROCESSED 6751 04:35:14,646 --> 04:35:16,948 VERSUS UNPROCESSED WHITE MEAT, 6752 04:35:16,948 --> 04:35:17,382 NOTHING. 6753 04:35:17,382 --> 04:35:20,352 MEAT SOURCES OF SATURATED FAT 6754 04:35:20,352 --> 04:35:21,553 VERSUS PLANT SOURCES, YEW 6755 04:35:21,553 --> 04:35:23,488 LOOKING FOR A TRIAL THAT 6756 04:35:23,488 --> 04:35:25,457 COMPARES STEAK TO COCONUT OIL, 6757 04:35:25,457 --> 04:35:29,528 NO ONE DECIDED TO LOOK AT TAKE 6758 04:35:29,528 --> 04:35:32,264 VERSUS COCONUT OIL, NO PAPERS. 6759 04:35:32,264 --> 04:35:33,465 NOTHING IN KIDS. 6760 04:35:33,465 --> 04:35:35,200 NO ARTICLES. 6761 04:35:35,200 --> 04:35:44,543 NOT EVEN ON LIPIDS OR BLOOD 6762 04:35:44,543 --> 04:35:44,910 PRESSURE. 6763 04:35:44,910 --> 04:35:47,512 WE'RE GOING TO PAUSE AND DO ONE 6764 04:35:47,512 --> 04:35:48,280 MORE. 6765 04:35:48,280 --> 04:35:50,115 I ALSO GOT TROPICAL OILS 6766 04:35:50,115 --> 04:35:51,650 ASSIGNED BUT THAT'S THE END OF 6767 04:35:51,650 --> 04:35:52,417 MY BUCKET. 6768 04:35:52,417 --> 04:35:56,154 SO THREE FOR RED MEAT VERSUS 6769 04:35:56,154 --> 04:35:57,889 PLANTS, THREE VERSUS ANIMAL 6770 04:35:57,889 --> 04:36:00,625 SOURCES, TWO FOR WHITE MEAT, AND 6771 04:36:00,625 --> 04:36:03,895 OTHER ANIMAL SOURCES, AND SIX 6772 04:36:03,895 --> 04:36:09,701 WITH GRADE NOT ASSIGNED, ONE 6773 04:36:09,701 --> 04:36:10,135 KID. 6774 04:36:10,135 --> 04:36:10,335 DONE. 6775 04:36:10,335 --> 04:36:11,570 NEXT SLIDE PLEASE. 6776 04:36:11,570 --> 04:36:21,313 IT'S A WHOLE DIFFERENT QUESTION. 6777 04:36:21,313 --> 04:36:23,381 THERE'S PLANT SOURCES, COCONUT 6778 04:36:23,381 --> 04:36:26,885 OIL, COCONUT BUTTER, PALM OIL. 6779 04:36:26,885 --> 04:36:28,019 NEXT SLIDE PLEASE. 6780 04:36:28,019 --> 04:36:31,289 I HAVE FOUR SLIDES NOW BUT I 6781 04:36:31,289 --> 04:36:33,024 ONLY HAVE TWO GRADED CONCLUSIONS 6782 04:36:33,024 --> 04:36:36,328 AND A LOT OF GNA. 6783 04:36:36,328 --> 04:36:38,964 THIS ONE WAS DOABLE. 6784 04:36:38,964 --> 04:36:47,072 THESE ARE ALL RCTs, NINE 6785 04:36:47,072 --> 04:36:49,808 RCTs, 11 COMPARISONS, PLANT 6786 04:36:49,808 --> 04:36:57,015 SOURCES HIGHER IN SATURATED 6787 04:36:57,015 --> 04:36:57,249 FAT. 6788 04:36:57,249 --> 04:37:00,452 I HAVE TO STOP UNLESS THERE'S 6789 04:37:00,452 --> 04:37:10,962 SEED OIL CONSPIRACY THEORISTS. 6790 04:37:12,397 --> 04:37:14,432 VEGETABLE AND SEED OILS, WE 6791 04:37:14,432 --> 04:37:17,502 DECIDED NOT TO PUT SEED OILS IN. 6792 04:37:17,502 --> 04:37:19,004 IT'S NOT VEGETABLE OILS, IT'S 6793 04:37:19,004 --> 04:37:21,106 PLANT OILS, ALL FROM PLANTS. 6794 04:37:21,106 --> 04:37:22,741 NO, ACTUALLY QUITE A FEW OF 6795 04:37:22,741 --> 04:37:25,243 PAPERS SAID THESE ARE VEGETABLE 6796 04:37:25,243 --> 04:37:25,811 OILS. 6797 04:37:25,811 --> 04:37:36,321 EVEN IF THEY MAYBE BOTANICALLY 6798 04:37:37,489 --> 04:37:38,323 WEREN'T VEGETABLES, DOES NOT 6799 04:37:38,323 --> 04:37:39,724 INCLUDE PLANT OILS, DOESN'T SAY 6800 04:37:39,724 --> 04:37:42,994 SEED OILS BUT CONTAINS ALL 6801 04:37:42,994 --> 04:37:44,095 THOSE. 6802 04:37:44,095 --> 04:37:46,064 VEGETABLE OILS WERE CANOLA, 6803 04:37:46,064 --> 04:37:47,799 SUNFLOWER, OLIVE, THINK OF ALL 6804 04:37:47,799 --> 04:37:49,367 THE OILS. 6805 04:37:49,367 --> 04:37:50,869 NOT ALL WERE STUDIED. 6806 04:37:50,869 --> 04:37:53,205 ANYTHING THAT WE FOUND FIT INTO 6807 04:37:53,205 --> 04:37:56,608 THIS CATEGORY, AND ANYTIME YOU 6808 04:37:56,608 --> 04:37:59,244 HAD SATURATED TYPE OF TROPICAL 6809 04:37:59,244 --> 04:38:01,079 OIL, YOU REPLACED IT, NOW WE 6810 04:38:01,079 --> 04:38:02,414 REPLACE IT BECAUSE IT'S A 6811 04:38:02,414 --> 04:38:06,451 CROSSOVER TRIAL, MOST OF THEM 6812 04:38:06,451 --> 04:38:08,386 WERE CROSSOVERS, IT DECREASES 6813 04:38:08,386 --> 04:38:09,387 LDL BUT DOESN'T HAVE EFFECT ON 6814 04:38:09,387 --> 04:38:10,255 BLOOD PRESSURE. 6815 04:38:10,255 --> 04:38:14,893 THE REASON YOU WON'T SEE HDL AND 6816 04:38:14,893 --> 04:38:16,962 TRIGLYCERIDE IT WAS DIFFERENT, 6817 04:38:16,962 --> 04:38:18,029 HARD TO FEEL COMFORTABLE PUTTING 6818 04:38:18,029 --> 04:38:19,331 IT IN THE STATEMENT SO IT WILL 6819 04:38:19,331 --> 04:38:20,765 BE THE NOTES BUT REALLY NOTHING 6820 04:38:20,765 --> 04:38:23,168 HERE I PRESENTED SO FAR HAD ANY 6821 04:38:23,168 --> 04:38:24,502 IMPACT ON BLOOD PRESSURE. 6822 04:38:24,502 --> 04:38:28,540 OFTEN IT WAS LEFT OUT, FOCUS HAS 6823 04:38:28,540 --> 04:38:30,709 BEEN ON LDL BUT THIS IS 6824 04:38:30,709 --> 04:38:31,376 MODERATE. 6825 04:38:31,376 --> 04:38:32,577 FEW CONCERNS, SOME CONCERNS, 6826 04:38:32,577 --> 04:38:34,346 SOME CONCERNS, FEW CONCERNS, WE 6827 04:38:34,346 --> 04:38:38,583 COULD USE MORE STUDIES IN THE 6828 04:38:38,583 --> 04:38:42,520 U.S., BETTER RACE AND ETHNICITY 6829 04:38:42,520 --> 04:38:44,022 AN BETTER SOCIOECONOMIC POSITION 6830 04:38:44,022 --> 04:38:44,289 COVERAGE. 6831 04:38:44,289 --> 04:38:45,290 WE WERE AT MODERATE. 6832 04:38:45,290 --> 04:38:48,693 HERE WE HAVE A LIMITED -- SO AN 6833 04:38:48,693 --> 04:38:49,794 INTERESTING THING HAPPENED WHEN 6834 04:38:49,794 --> 04:38:52,831 THE DATA WERE SET OUT FOR US, 6835 04:38:52,831 --> 04:38:55,000 FIRST WE WOULD LOOK AT THE WHOLE 6836 04:38:55,000 --> 04:38:56,801 THING TO SEE WHAT KIND OF 6837 04:38:56,801 --> 04:38:59,638 BUCKETS WE MIGHT COME UP WITH. 6838 04:38:59,638 --> 04:39:00,805 SOME INSIDE BASEBALL HERE TO 6839 04:39:00,805 --> 04:39:04,242 BEGIN THIS THERE WERE SO MANY 6840 04:39:04,242 --> 04:39:05,877 POSSIBLE BUCKETS THAT DEANNA AND 6841 04:39:05,877 --> 04:39:07,712 I SPENT A COUPLE SESSIONS WITH 6842 04:39:07,712 --> 04:39:09,514 SUPPORT STAFF THINKING HOW MANY 6843 04:39:09,514 --> 04:39:10,282 BUCKETS COULD THERE BE? 6844 04:39:10,282 --> 04:39:16,621 ONE OF THE WAYS WE LOOKED WAS 6845 04:39:16,621 --> 04:39:18,356 LOOKING DOWN AFTER SORTING, WHAT 6846 04:39:18,356 --> 04:39:20,091 POPS OUT? 6847 04:39:20,091 --> 04:39:22,961 THIS ONE DID. 6848 04:39:22,961 --> 04:39:26,464 SOMEWHAT CONSISTENT FINDINGS 6849 04:39:26,464 --> 04:39:29,501 ABOUT PALM OLEIN. 6850 04:39:29,501 --> 04:39:35,206 FOR THOSE NOT FAMILY WITH PALM 6851 04:39:35,206 --> 04:39:45,583 OLEIN, YOU CAN GROW IT 6852 04:39:46,017 --> 04:39:49,354 DIFFERENTLY OR PROCESS 6853 04:39:49,354 --> 04:39:49,654 DIFFERENTLY. 6854 04:39:49,654 --> 04:39:52,657 PALM OLEIN IS NOT AS HIGH AS 6855 04:39:52,657 --> 04:39:56,461 COCONUT OIL, COCOA BUTTER OR 6856 04:39:56,461 --> 04:39:59,097 PALM OIL. 6857 04:39:59,097 --> 04:40:00,632 HIGHER IN UNSATURATED FAT, 6858 04:40:00,632 --> 04:40:04,336 WASN'T AN EFFECT ON BLOOD LIPIDS 6859 04:40:04,336 --> 04:40:06,871 DIFFERENCE IS NOT AS BIG AS 6860 04:40:06,871 --> 04:40:08,940 PREVIOUS CATEGORY. 6861 04:40:08,940 --> 04:40:12,243 SIX ARTICLES, ALL RCTs, ALL 6862 04:40:12,243 --> 04:40:12,544 COMPARISONS. 6863 04:40:12,544 --> 04:40:14,813 SOME, SOME, SOME, FEW CONCERNS, 6864 04:40:14,813 --> 04:40:17,615 SUBSTANTIAL ONCE AGAIN AT THE 6865 04:40:17,615 --> 04:40:17,983 END. 6866 04:40:17,983 --> 04:40:21,553 LIMITED GRADE. 6867 04:40:21,553 --> 04:40:22,220 NEXT SLIDE. 6868 04:40:22,220 --> 04:40:26,024 SO THESE SEEM TO BE REASONABLE. 6869 04:40:26,024 --> 04:40:29,527 OTHER COMPARISONS BUT FOOD 6870 04:40:29,527 --> 04:40:30,495 SOURCES OF CARBOHYDRATE AND 6871 04:40:30,495 --> 04:40:33,231 PROTEIN COMPARED TO HIGH PLANT 6872 04:40:33,231 --> 04:40:34,899 SATURATED FAT, JUST TWO 6873 04:40:34,899 --> 04:40:36,534 ARTICLES, NOT ENOUGH. 6874 04:40:36,534 --> 04:40:38,303 HOW ABOUT THE TROPICAL OILS 6875 04:40:38,303 --> 04:40:40,372 COMPARED TO DIFFERENT FOOD 6876 04:40:40,372 --> 04:40:41,473 SOURCES OF SATURATED FAT? 6877 04:40:41,473 --> 04:40:42,340 THAT'S TOO MANY. 6878 04:40:42,340 --> 04:40:45,377 BY THE TIME YOU TRY TO LOOK AT 6879 04:40:45,377 --> 04:40:47,579 THESE COMPARE TONS YOU COULDN'T 6880 04:40:47,579 --> 04:40:49,347 BUCKET THEM TOGETHER AND POOL 6881 04:40:49,347 --> 04:40:50,115 IT. 6882 04:40:50,115 --> 04:40:52,384 IN SOME OTHER CASES SIX RCTs 6883 04:40:52,384 --> 04:40:53,184 WAS ENOUGH. 6884 04:40:53,184 --> 04:40:55,487 IT WAS TOO HARD TO COME UP WITH 6885 04:40:55,487 --> 04:40:57,655 A CONCLUSION. 6886 04:40:57,655 --> 04:40:59,324 GRADE NOT ASSIGNED. 6887 04:40:59,324 --> 04:41:07,198 NEXT SLIDE PLEASE. 6888 04:41:07,198 --> 04:41:08,099 NOTHING IN KIDS. 6889 04:41:08,099 --> 04:41:09,000 ONE MORE SLIDE. 6890 04:41:09,000 --> 04:41:10,301 THAT'S ME. 6891 04:41:10,301 --> 04:41:11,836 BACK TO YOU, DEANNA. 6892 04:41:11,836 --> 04:41:12,570 >> OKAY. 6893 04:41:12,570 --> 04:41:14,672 I KNOW WE WENT THROUGH A LOT OF 6894 04:41:14,672 --> 04:41:15,640 CONCLUSION STATEMENTS. 6895 04:41:15,640 --> 04:41:18,710 NOW WE'LL SUMMARIZE THEM FOR YOU 6896 04:41:18,710 --> 04:41:19,811 IN BUCKETS. 6897 04:41:19,811 --> 04:41:20,912 THANKS, CHRISTOPHER, FOR THE 6898 04:41:20,912 --> 04:41:23,448 GREAT JOB. 6899 04:41:23,448 --> 04:41:24,315 AND NEXT SLIDE. 6900 04:41:24,315 --> 04:41:29,454 SO THESE ARE ALL THE FOOD 6901 04:41:29,454 --> 04:41:32,223 SOURCES OF SATURATED FAT 6902 04:41:32,223 --> 04:41:35,593 CONCLUSION STATEMENTS INCREASING 6903 04:41:35,593 --> 04:41:37,228 DECREASED CVD OUTCOME, ADULTS 6904 04:41:37,228 --> 04:41:41,933 AND OLDER ADULTS, ONE STRONG 6905 04:41:41,933 --> 04:41:44,135 REPLACED BUTTER WITH UNSATURATED 6906 04:41:44,135 --> 04:41:49,607 FATTY ACIDS, FIVE MODERATE, ONE 6907 04:41:49,607 --> 04:41:51,476 PROCESSED MEAT WITH DAIRY, WITH 6908 04:41:51,476 --> 04:41:56,581 PLANT SOURCES LIKE CHRISTOPHER 6909 04:41:56,581 --> 04:42:05,023 SAID, PROCESSED OR UNPROCESSED, 6910 04:42:05,023 --> 04:42:06,224 REPLACING PLANT SOURCES HIGHER 6911 04:42:06,224 --> 04:42:07,892 IN SATURATED FAT THAT 6912 04:42:07,892 --> 04:42:10,028 CHRISTOPHER WENT OVER WITH 6913 04:42:10,028 --> 04:42:12,263 VEGETABLE OILS, HIGHER IN 6914 04:42:12,263 --> 04:42:14,132 UNSATURATED FAT, DECREASE THE 6915 04:42:14,132 --> 04:42:14,332 LDLC. 6916 04:42:14,332 --> 04:42:16,701 AND WE HAD TWO LIMITED. 6917 04:42:16,701 --> 04:42:19,771 SO SUBSTITUTING DAIRY WITH FOOD 6918 04:42:19,771 --> 04:42:21,840 SOURCES OF UNSATURATED FATTY'S A 6919 04:42:21,840 --> 04:42:24,909 ITS, THAT WAS OLIVE OIL AND SO 6920 04:42:24,909 --> 04:42:25,910 ON. 6921 04:42:25,910 --> 04:42:26,978 SUBSTITUTING BUTTER WITH 6922 04:42:26,978 --> 04:42:30,615 PLANT-BASED OILS AND SPREADS 6923 04:42:30,615 --> 04:42:34,018 WITH PREDOMINANTLY UNSATURATED 6924 04:42:34,018 --> 04:42:34,552 FAD. 6925 04:42:34,552 --> 04:42:37,288 NEXT SLIDE WHAT WE HAVE LEER 6926 04:42:37,288 --> 04:42:39,257 FIFER MODERATE STATEMENTS AND 6927 04:42:39,257 --> 04:42:39,891 FOUR LIMITED. 6928 04:42:39,891 --> 04:42:43,194 THESE WERE WHETHER YOU HAD NO 6929 04:42:43,194 --> 04:42:44,329 DIFFERENCE IN CARDIOVASCULAR 6930 04:42:44,329 --> 04:42:47,031 DISEASE RISK WHEN YOU COMPARED 6931 04:42:47,031 --> 04:42:47,665 THE TWO. 6932 04:42:47,665 --> 04:42:50,101 SO, ONE WAS ONE FORM OF DAIRY 6933 04:42:50,101 --> 04:42:53,938 WITH ANOTHER FORM OF DAIRY, 6934 04:42:53,938 --> 04:42:55,340 PROCESSED OR UNPROCESSED RED 6935 04:42:55,340 --> 04:42:57,842 MEAT WITH WHITE, RED MEAT WITH 6936 04:42:57,842 --> 04:43:02,247 EGGS, WHITE MEAT WITH PLANT 6937 04:43:02,247 --> 04:43:05,850 BASED FOODS, WHITE WITH PLANT 6938 04:43:05,850 --> 04:43:06,951 BASED SEAFOOD, SUBSTITUTING 6939 04:43:06,951 --> 04:43:17,495 HIGHER WITH LOW FAT DAIRY WAS 6940 04:43:17,495 --> 04:43:18,363 LIMITED. 6941 04:43:18,363 --> 04:43:24,369 LEAN MEAT WAS LIMITED, AND PALM 6942 04:43:24,369 --> 04:43:27,005 OLEIN WAS LIMITED. 6943 04:43:27,005 --> 04:43:28,873 THE THIRD BUCKET, IF WE COULD 6944 04:43:28,873 --> 04:43:31,843 HAVE THE NEXT SLIDE, THESE HAD 6945 04:43:31,843 --> 04:43:32,810 CONCLUSION STATEMENTS THAT 6946 04:43:32,810 --> 04:43:35,113 COULDN'T BE DRAWN. 6947 04:43:35,113 --> 04:43:39,284 SO A LOT OF THESE ARE THE HIGHER 6948 04:43:39,284 --> 04:43:40,685 FAT DAIRY AND DAIRY PRODUCTS 6949 04:43:40,685 --> 04:43:43,321 COMPARED TO LOWER FAT VERSIONS, 6950 04:43:43,321 --> 04:43:51,496 DAIRY COMPARED TO FOOD SOURCES 6951 04:43:51,496 --> 04:43:56,501 OF CARBOHYDRATE AND PROTEIN, 6952 04:43:56,501 --> 04:43:57,902 UNPROCESSED WITH PLANT BASED 6953 04:43:57,902 --> 04:44:01,272 FOOD, RED MEAT WITH DIFFERENT 6954 04:44:01,272 --> 04:44:03,708 AMOUNTS OF SATURATED FAT, WHITE 6955 04:44:03,708 --> 04:44:05,677 MEAT, PROCESSED RED MEAT 6956 04:44:05,677 --> 04:44:07,445 COMPARED TO UNPROCESSED RED MEAT 6957 04:44:07,445 --> 04:44:11,950 AND THE SAME WITH WHITE MEAT. 6958 04:44:11,950 --> 04:44:21,025 MEAT SOURCES COMPARED TO PLANT, 6959 04:44:21,025 --> 04:44:25,530 AND THEN THE LAST ONE PLANT 6960 04:44:25,530 --> 04:44:26,831 SOURCES HIGHER IN SATURATED FATE 6961 04:44:26,831 --> 04:44:28,499 COMPARED TO A DIFFERENCE SOUTH 6962 04:44:28,499 --> 04:44:28,900 OF SATURATED FAT. 6963 04:44:28,900 --> 04:44:30,435 A LOT OF THINGS WE DON'T KNOW 6964 04:44:30,435 --> 04:44:32,003 THE ANSWER TO. 6965 04:44:32,003 --> 04:44:36,441 WE COULDN'T DRAW A CONCLUSION 6966 04:44:36,441 --> 04:44:37,008 STATEMENT. 6967 04:44:37,008 --> 04:44:38,243 LAST SUMMARY, NEXT SLIDE, JUST 6968 04:44:38,243 --> 04:44:40,311 WITH KIDS. 6969 04:44:40,311 --> 04:44:43,181 AS YOU SAW NO MATTER WHAT YOU 6970 04:44:43,181 --> 04:44:45,583 COMPARED, THERE WASN'T ENOUGH 6971 04:44:45,583 --> 04:44:50,521 DATA FOR US TO DERIVE A 6972 04:44:50,521 --> 04:44:51,189 CONCLUSION STATEMENT. 6973 04:44:51,189 --> 04:44:53,458 SO, WE DON'T NEED HAVE A QUIZ 6974 04:44:53,458 --> 04:44:56,861 NOW ON ALL OF THESE BUT I THINK 6975 04:44:56,861 --> 04:45:00,031 WE'VE JUST MAPPED OUT A RESEARCH 6976 04:45:00,031 --> 04:45:01,566 AGENDA FOR THE NUTRITION 6977 04:45:01,566 --> 04:45:03,701 COMMUNITY FOR THE NEXT TEN 6978 04:45:03,701 --> 04:45:03,901 YEARS. 6979 04:45:03,901 --> 04:45:05,503 >> I CAN COMMENT I THINK OUR 6980 04:45:05,503 --> 04:45:06,604 FIRST CONCLUSION STATEMENT TOOK 6981 04:45:06,604 --> 04:45:08,773 US SIX WEEKS AND WE DID SIX 6982 04:45:08,773 --> 04:45:10,108 CONCLUSIONS IN ONE MONTH. 6983 04:45:10,108 --> 04:45:15,446 SO WE LEARNED A LOT FROM THE 6984 04:45:15,446 --> 04:45:15,780 STAFF. 6985 04:45:15,780 --> 04:45:24,088 THANK YOU. 6986 04:45:24,088 --> 04:45:26,391 6987 04:45:26,391 --> 04:45:27,925 >> WOW, I'M EXHAUSTED. 6988 04:45:27,925 --> 04:45:30,662 I FEEL LIKE I JUST GOT OFF A 6989 04:45:30,662 --> 04:45:31,763 ROLLER COASTER. 6990 04:45:31,763 --> 04:45:33,798 WOW, I'M SO IMPRESSED. 6991 04:45:33,798 --> 04:45:38,870 AND KUDOS TO ALL OF YOU. 6992 04:45:38,870 --> 04:45:42,707 AND DEE DEE, ANYTIME YOU WANT TO 6993 04:45:42,707 --> 04:45:44,342 TEACH ME NUTRITIONAL 6994 04:45:44,342 --> 04:45:45,109 EPIDEMIOLOGY, I'M GAME. 6995 04:45:45,109 --> 04:45:47,412 SO WE'RE GOING TO OPEN IT UP FOR 6996 04:45:47,412 --> 04:45:49,047 QUESTIONS BUT CAN I JUST TAKE 6997 04:45:49,047 --> 04:45:50,581 PURVIEW OF BEING THE CHAIR FOR 6998 04:45:50,581 --> 04:45:53,284 ONCE AND ASK A QUESTION. 6999 04:45:53,284 --> 04:45:58,690 WHY ARE MOST OF THE STUDIES FOR 7000 04:45:58,690 --> 04:46:02,293 THESE QUESTIONS NOT CONDUCTED IN 7001 04:46:02,293 --> 04:46:06,064 THE UNITED STATES? 7002 04:46:06,064 --> 04:46:06,664 >> OH. 7003 04:46:06,664 --> 04:46:08,933 >> A LOT OF PROSPECTIVE COHORT 7004 04:46:08,933 --> 04:46:10,601 STUDIES WERE FROM OTHER 7005 04:46:10,601 --> 04:46:12,770 COUNTRIES SO THERE WERE DANISH 7006 04:46:12,770 --> 04:46:16,841 STUDIES, I FORGET WHERE ELSE. 7007 04:46:16,841 --> 04:46:20,545 >> DAIRY IS VERY POPULAR IN 7008 04:46:20,545 --> 04:46:21,045 DANISH STUDIES. 7009 04:46:21,045 --> 04:46:28,419 >> I REMEMBER THE DANISH STUDY. 7010 04:46:28,419 --> 04:46:30,488 TROPICAL OILS SEEMED LIKE ASIAN 7011 04:46:30,488 --> 04:46:30,888 STUDIES, MALAYSIA. 7012 04:46:30,888 --> 04:46:33,591 >> THAT WAS ONE OF THE MOST 7013 04:46:33,591 --> 04:46:34,892 SURPRISING OBSERVATIONS I MADE 7014 04:46:34,892 --> 04:46:37,061 IN YOUR PRESENTATION BECAUSE I 7015 04:46:37,061 --> 04:46:40,365 AGREE WITH WHAT YOU SAID, 7016 04:46:40,365 --> 04:46:44,535 CHRISTOPHER, TALKING ABOUT 7017 04:46:44,535 --> 04:46:46,637 SUBSTITUTION OF FOOD, IF FOOD 7018 04:46:46,637 --> 04:46:49,240 SUBSTITUTIONS ARE NOT FOODS 7019 04:46:49,240 --> 04:46:50,875 NORMALLY CONSUMED IN THE U.S. 7020 04:46:50,875 --> 04:46:52,410 THAT MAKES THESE COMPARISONS 7021 04:46:52,410 --> 04:46:54,512 EVEN MORE CHALLENGING. 7022 04:46:54,512 --> 04:46:58,750 I FOUND THAT AN EXTRAORDINARY 7023 04:46:58,750 --> 04:46:59,817 OPTS OBSERVATION. 7024 04:46:59,817 --> 04:47:01,819 >> TWO RED MEAT STUDIES VERSUS 7025 04:47:01,819 --> 04:47:03,688 WHITE MALE WERE DONE IN SPAIN, 7026 04:47:03,688 --> 04:47:06,758 AND THEY MADE A POINT TO SAY HOW 7027 04:47:06,758 --> 04:47:09,160 SPECIAL THEIR LAMB WAS THAT THEY 7028 04:47:09,160 --> 04:47:10,661 WERE USING. 7029 04:47:10,661 --> 04:47:13,765 WELL, YEAH, THAT'S RED MEAT 7030 04:47:13,765 --> 04:47:17,802 VERSUS WHITE BUT AMOUNT OF LAMB 7031 04:47:17,802 --> 04:47:28,279 EATEN AS RED WHEAT PALES IN 7032 04:47:37,855 --> 04:47:38,356 COMPARISON. 7033 04:47:38,356 --> 04:47:41,626 >> REALLY INTERESTING. 7034 04:47:41,626 --> 04:47:44,796 I'M WONDERING ABOUT TWO OF THE 7035 04:47:44,796 --> 04:47:47,532 FINDINGS YOU PRESENTED WITH 7036 04:47:47,532 --> 04:47:50,701 MODERATE EVIDENCE, THAT WAS FOR 7037 04:47:50,701 --> 04:47:54,005 THE RED MEAT WITH SUBSTITUTING 7038 04:47:54,005 --> 04:47:55,873 THAT WITH -- I DON'T REMEMBER, I 7039 04:47:55,873 --> 04:47:59,444 THINK SUBSTITUTING BECAUSE THEY 7040 04:47:59,444 --> 04:48:05,249 WERE BOTH PROSPECTIVE COHORT 7041 04:48:05,249 --> 04:48:06,984 STUDIES, SUBSTITUTION WITH WHOLE 7042 04:48:06,984 --> 04:48:08,519 GRAINS AND VEGETABLES. 7043 04:48:08,519 --> 04:48:12,256 BOTH WERE BASED ON FOUR 7044 04:48:12,256 --> 04:48:14,992 PROSPECTIVE COHORT STUDIES SO I 7045 04:48:14,992 --> 04:48:19,030 WONDERED WITH LIKE WHATEVER 7046 04:48:19,030 --> 04:48:21,332 YOU'RE DOING COHORT STUDIES, 7047 04:48:21,332 --> 04:48:24,502 MEASURING SO MANY DIFFERENT 7048 04:48:24,502 --> 04:48:26,370 POTENTIAL CONFOUNDERS, STARTING 7049 04:48:26,370 --> 04:48:30,308 POINTS, ALL THESE THINGS BECOME 7050 04:48:30,308 --> 04:48:32,743 IMPORTANT, TO HAVE FOUR STUDIES 7051 04:48:32,743 --> 04:48:36,614 IS KIND OF LIMITED. 7052 04:48:36,614 --> 04:48:38,716 AND ANOTHER THING I WONDERED 7053 04:48:38,716 --> 04:48:40,485 WERE THE AUTHOR GROUPS 7054 04:48:40,485 --> 04:48:42,653 DIFFERENT, WONDER IF YOU COULD 7055 04:48:42,653 --> 04:48:44,388 SHARE MORE INFORMATION. 7056 04:48:44,388 --> 04:48:44,689 >> GREAT. 7057 04:48:44,689 --> 04:48:45,823 PICTURE US ORGANICALLY GOING 7058 04:48:45,823 --> 04:48:46,824 THROUGH THIS. 7059 04:48:46,824 --> 04:48:50,528 OH, LET'S JUST DO ALL PANTS. 7060 04:48:50,528 --> 04:48:53,164 AND THEN THE STAFF 7061 04:48:53,164 --> 04:48:54,465 SUBCATEGORIZED INTO THE 7062 04:48:54,465 --> 04:48:55,333 VEGETABLES AND BRAINS AND 7063 04:48:55,333 --> 04:48:56,601 PROTEIN GROUPS. 7064 04:48:56,601 --> 04:48:59,103 WE SAW A SIMILAR PATTERN ACROSS 7065 04:48:59,103 --> 04:49:01,906 THE ENTIRE THING. 7066 04:49:01,906 --> 04:49:03,875 VERY STRIKINGLY SIMILAR. 7067 04:49:03,875 --> 04:49:06,511 WELL, WAIT, ARE THERE ENOUGH 7068 04:49:06,511 --> 04:49:09,914 WHOLE GRAINS AND ENOUGH 7069 04:49:09,914 --> 04:49:10,781 VEGETABLE STUDIES. 7070 04:49:10,781 --> 04:49:13,484 MANY HAD FOUR AND FIVE 7071 04:49:13,484 --> 04:49:19,223 COMPARISONS, DIDN'T LOOK LIKE 7072 04:49:19,223 --> 04:49:20,424 THERE WERE FOUR FINDINGS, BUT 7073 04:49:20,424 --> 04:49:21,225 THERE WEREN'T. 7074 04:49:21,225 --> 04:49:23,494 WE DID WRESTLE WITH THAT, WE 7075 04:49:23,494 --> 04:49:25,129 COULD HAVE CALAMITIES THE WHOLE 7076 04:49:25,129 --> 04:49:26,964 GROUP AND JUST SAID PLANT FOODS. 7077 04:49:26,964 --> 04:49:31,235 I'D LOVE TO HEAR WHAT DEANNA OR 7078 04:49:31,235 --> 04:49:34,438 CHERYL OR DEE DEE HAVE TO SAY, 7079 04:49:34,438 --> 04:49:35,740 SO WE DID STRUGGLE. 7080 04:49:35,740 --> 04:49:37,375 WAIT, THERE'S FOUR. 7081 04:49:37,375 --> 04:49:39,043 BUT THERE'S MULTIPLE 7082 04:49:39,043 --> 04:49:39,477 COMPARISONS. 7083 04:49:39,477 --> 04:49:41,646 OH MY GOD, IT'S CONSISTENT, 7084 04:49:41,646 --> 04:49:46,050 SHOULD WE GO THERE? 7085 04:49:46,050 --> 04:49:51,489 ALL THE CHRIS KITSCH, WE'RE 7086 04:49:51,489 --> 04:49:53,457 QUITE SIMILAR. 7087 04:49:53,457 --> 04:49:55,326 WE DECIDED TO BREAK IT APART 7088 04:49:55,326 --> 04:49:56,761 INSTEAD OF LUMP THEM TOGETHER. 7089 04:49:56,761 --> 04:49:58,062 IF WE DID THAT, SOMEBODY WOULD 7090 04:49:58,062 --> 04:50:01,132 HAVE SAID WHAT ABOUT THE WHOLE 7091 04:50:01,132 --> 04:50:03,634 GRAINS, DID THAT STICK OUT, WHAT 7092 04:50:03,634 --> 04:50:05,269 ABOUT THE VEGGIES, DID THAT 7093 04:50:05,269 --> 04:50:06,504 STICK OUT? 7094 04:50:06,504 --> 04:50:10,541 SO WE DID THEM SEPARATELY. 7095 04:50:10,541 --> 04:50:13,377 >> YEAH, RESULTS WERE VERY 7096 04:50:13,377 --> 04:50:15,212 CONSISTENT WITH THOSE. 7097 04:50:15,212 --> 04:50:18,382 AND SO THEY WERE ALSO LARGE 7098 04:50:18,382 --> 04:50:21,919 COHORTS, SO THEY WERE NARROW 7099 04:50:21,919 --> 04:50:23,020 CONFIDENCE INTERVALS. 7100 04:50:23,020 --> 04:50:25,489 SOME OF THOSE GRADING ELEMENTS 7101 04:50:25,489 --> 04:50:31,996 KENNED TO 7102 04:50:31,996 --> 04:50:33,030 KENNED -- TENDED TO BE MODERATE 7103 04:50:33,030 --> 04:50:33,431 OR STRONG. 7104 04:50:33,431 --> 04:50:36,267 >> ONE MORE QUESTION WITH THAT. 7105 04:50:36,267 --> 04:50:38,569 THAT WAS THINKING ABOUT THOSE 7106 04:50:38,569 --> 04:50:40,404 FINDINGS AND THEN I KNOW A LOT 7107 04:50:40,404 --> 04:50:42,940 OF THE STUDIES WEREN'T DONE IN 7108 04:50:42,940 --> 04:50:46,877 THE U.S. BUT DATA I JUST 7109 04:50:46,877 --> 04:50:49,480 PRESENTED WERE DIETARY INTAKES 7110 04:50:49,480 --> 04:50:54,118 WE SEE USUALLY MEAT INTAKES ARE 7111 04:50:54,118 --> 04:50:55,753 ABOVE RECOMMENDATIONS, AND 7112 04:50:55,753 --> 04:50:59,690 VEGETABLES AND WHOLE GAINS ARE 7113 04:50:59,690 --> 04:51:00,324 BELOW. 7114 04:51:00,324 --> 04:51:02,193 AND SO YOU JUST WONDER PUTTING 7115 04:51:02,193 --> 04:51:05,796 THAT TOGETHER IS IT REALLY 7116 04:51:05,796 --> 04:51:11,502 BRINGING PEOPLE DOWN TO THE 7117 04:51:11,502 --> 04:51:14,905 RECOMMENDATIONS THAT IS LINKED 7118 04:51:14,905 --> 04:51:16,841 WITH LOWER CVD RISK. 7119 04:51:16,841 --> 04:51:17,742 >> YES, THAT'S WHAT INTEGRATION 7120 04:51:17,742 --> 04:51:20,011 IS ALL ABOUT. 7121 04:51:20,011 --> 04:51:23,948 THIS TOTALLY -- I'M LOVING THE 7122 04:51:23,948 --> 04:51:27,451 DISINTEGRATION STAGE BECAUSE 7123 04:51:27,451 --> 04:51:29,353 THAT SUPPORTS YOUR MODELING. 7124 04:51:29,353 --> 04:51:30,888 >> CHRIS, DID YOU HAVE A 7125 04:51:30,888 --> 04:51:35,793 RESPONSE TO HEATHER'S FIRST 7126 04:51:35,793 --> 04:51:36,060 QUESTION? 7127 04:51:36,060 --> 04:51:37,528 >> YEAH, I THINK THAT WAS WHAT 7128 04:51:37,528 --> 04:51:40,598 MADE THINGS DIFFERENT WHEN WE 7129 04:51:40,598 --> 04:51:42,033 MADE THESE SLIDES, LOOK AT 7130 04:51:42,033 --> 04:51:44,769 NUMBER OF STUDIES, ALSO ADD 7131 04:51:44,769 --> 04:51:46,337 NUMBER OF COMPARISONS BECAUSE I 7132 04:51:46,337 --> 04:51:48,506 HEARD COMMENTS AROUND HOW MANY 7133 04:51:48,506 --> 04:51:50,141 ARTICLES ARE SCREENED AND HOW 7134 04:51:50,141 --> 04:51:52,343 MANY ENDED UP GETTING HERE TO 7135 04:51:52,343 --> 04:51:53,177 ANSWER THESE COMPLEX QUESTIONS 7136 04:51:53,177 --> 04:51:54,645 FOR THE DATA. 7137 04:51:54,645 --> 04:51:59,250 BUT THE NUMBER OF COMPARISONS 7138 04:51:59,250 --> 04:52:02,620 MADE FOR A REALLY BIG RICH BODY 7139 04:52:02,620 --> 04:52:03,821 OF EVIDENCE. 7140 04:52:03,821 --> 04:52:06,791 THEY WERE COMING ACROSS AS 7141 04:52:06,791 --> 04:52:10,061 DIFFERENT RESEARCH GROUPS. 7142 04:52:10,061 --> 04:52:12,096 THERE WERE MULTIPLE OUTCOMES AND 7143 04:52:12,096 --> 04:52:13,998 MULTIPLE RESEARCH GROUPS THAT 7144 04:52:13,998 --> 04:52:14,665 ARE EVIDENT. 7145 04:52:14,665 --> 04:52:17,301 SO, YOU KIND OF HAD THIS -- IT 7146 04:52:17,301 --> 04:52:19,637 WAS LIKE FACTORIAL IN A WAY 7147 04:52:19,637 --> 04:52:21,906 BECAUSE YOU'RE GETTING SO MANY 7148 04:52:21,906 --> 04:52:22,807 COMPARISONS, NOT HAVING TO SAY 7149 04:52:22,807 --> 04:52:24,875 WHAT IF YOU DID THIS AND YOU 7150 04:52:24,875 --> 04:52:26,844 HAVE TO ASSUME WHAT HAPPENED IF 7151 04:52:26,844 --> 04:52:29,146 THEY MADE THIS COMPARISON TO 7152 04:52:29,146 --> 04:52:29,346 THAT. 7153 04:52:29,346 --> 04:52:31,015 THEY MAPPED THEM ALL OUT. 7154 04:52:31,015 --> 04:52:33,951 AND THAT ALLOWED US TO REALLY 7155 04:52:33,951 --> 04:52:35,152 SEE I THINK WHAT THE 7156 04:52:35,152 --> 04:52:36,687 BEAUTIFUL -- WITH A WOULD BE 7157 04:52:36,687 --> 04:52:38,756 BEAUTIFUL IS TO HAVE COLORED 7158 04:52:38,756 --> 04:52:41,158 ARROWS, YOU LOOK AT IT, ALL OF 7159 04:52:41,158 --> 04:52:43,594 THESE ARE GREEN UP ARROWS SAYING 7160 04:52:43,594 --> 04:52:46,530 THERE'S AN -- IT HELPS TO SEE 7161 04:52:46,530 --> 04:52:49,400 THE STRIKING IMPACT OF WHERE 7162 04:52:49,400 --> 04:52:50,601 SOME CONSISTENCIES OR 7163 04:52:50,601 --> 04:52:53,704 INCONSISTENCIES LIE ACROSS THE 7164 04:52:53,704 --> 04:52:54,538 MULTIPLE COMPARISONS. 7165 04:52:54,538 --> 04:52:55,940 >> THE REAL FUN WAS GOING FROM 7166 04:52:55,940 --> 04:52:59,777 ALL TO NONE OF THEM. 7167 04:52:59,777 --> 04:53:00,778 IT'S JUST STAGGERING. 7168 04:53:00,778 --> 04:53:01,946 ALL THE PLANT BASED 7169 04:53:01,946 --> 04:53:03,514 SUBSTITUTIONS WERE UP AND 7170 04:53:03,514 --> 04:53:11,055 POSITIVE, ALL ANIMAL FOR ANIMAL 7171 04:53:11,055 --> 04:53:13,691 WERE NOTHING. 7172 04:53:13,691 --> 04:53:17,862 >> WE HAVE A LOT OF PEOPLE WITH 7173 04:53:17,862 --> 04:53:18,596 QUESTIONS. 7174 04:53:18,596 --> 04:53:19,597 THERESA, ED, CRISTINA, ANGELA, 7175 04:53:19,597 --> 04:53:30,074 AND THEN WE'LL START AGAIN. 7176 04:53:30,741 --> 04:53:32,209 >> YOU DID A GOOD JOB REMINDING 7177 04:53:32,209 --> 04:53:33,477 US WHAT'S IMPORTANT. 7178 04:53:33,477 --> 04:53:36,647 FROM THE RESULTS THEY DIVE INTO 7179 04:53:36,647 --> 04:53:37,681 GIVING RECOMMENDATIONS WITHOUT 7180 04:53:37,681 --> 04:53:39,483 THINKING OF CONTEXT THAT SETS 7181 04:53:39,483 --> 04:53:40,951 THE STAGE AND AFFECTING 7182 04:53:40,951 --> 04:53:42,887 EVERYTHING DOWNSTREAM. 7183 04:53:42,887 --> 04:53:44,288 THANK YOU FOR REMINDING US THAT 7184 04:53:44,288 --> 04:53:46,157 WILL SET YOU THE IN THE RIGHT 7185 04:53:46,157 --> 04:53:46,423 DIRECTION. 7186 04:53:46,423 --> 04:53:49,794 >> I'M GOING TO ASK THAT YOU 7187 04:53:49,794 --> 04:53:51,996 SPEAK MORE IN THE MICROPHONE. 7188 04:53:51,996 --> 04:53:55,499 >> THE QUESTION FOR CHRISTOPHER. 7189 04:53:55,499 --> 04:53:56,700 LOOKING AT INDIVIDUAL FOODS, 7190 04:53:56,700 --> 04:53:59,003 FOODS ARE NOT CONSUMED IN 7191 04:53:59,003 --> 04:54:01,739 ISOLATION, SO HOW WELL WERE 7192 04:54:01,739 --> 04:54:03,040 THOSE STUDIES ADJUSTING FOR 7193 04:54:03,040 --> 04:54:05,376 OTHER COMPONENTS OF THE DIET? 7194 04:54:05,376 --> 04:54:06,343 >> YEAH, GREAT QUESTION. 7195 04:54:06,343 --> 04:54:07,678 THAT'S WHY IT'S MODERATE. 7196 04:54:07,678 --> 04:54:11,615 IT'S NOT STRONG. 7197 04:54:11,615 --> 04:54:13,384 THESE ARE ALL OBSERVATIONAL EPI 7198 04:54:13,384 --> 04:54:15,653 STUDIES, NOT GETTING AT THAT 7199 04:54:15,653 --> 04:54:17,955 LEVEL OF DETAIL, LOOKING AT FOOD 7200 04:54:17,955 --> 04:54:18,656 GROUPS. 7201 04:54:18,656 --> 04:54:20,024 BECAUSE IT'S THE SUBSTITUTION 7202 04:54:20,024 --> 04:54:22,259 THOUGH IT'S SO MUCH BETTER THAN 7203 04:54:22,259 --> 04:54:24,862 WHAT DEE DEE DESCRIBED. 7204 04:54:24,862 --> 04:54:26,096 YEAH, SO THERE'S ANOTHER LEVEL 7205 04:54:26,096 --> 04:54:28,098 YET, WHAT DID YOU PUT ON THE 7206 04:54:28,098 --> 04:54:28,432 WHOLE GRAIN? 7207 04:54:28,432 --> 04:54:31,635 WHAT DID YOU COOK YOUR VEGGIES 7208 04:54:31,635 --> 04:54:31,869 IN? 7209 04:54:31,869 --> 04:54:33,270 ABSOLUTELY NOT, NO WAY TO GET AT 7210 04:54:33,270 --> 04:54:35,606 THAT FROM THE FOOD FREQUENCY 7211 04:54:35,606 --> 04:54:37,975 QUESTIONNAIRES THAT WERE USED TO 7212 04:54:37,975 --> 04:54:38,742 GENERATE DATA FOR POPULATION 7213 04:54:38,742 --> 04:54:39,977 THAT THEY WERE FINDING. 7214 04:54:39,977 --> 04:54:42,479 I WILL ADD IF ANYBODY WANTS AN 7215 04:54:42,479 --> 04:54:43,681 EXTENSION OF THE GREAT DEE DEE 7216 04:54:43,681 --> 04:54:46,750 TALK YOU JUST HEARD SHE HAS A 7217 04:54:46,750 --> 04:54:47,651 GREAT EDITORIAL ON EXACTLY 7218 04:54:47,651 --> 04:54:50,487 WHAT'S GOING ON WHICH IS A 7219 04:54:50,487 --> 04:54:57,795 CHOLESTEROL CARDIOVASCULAR 7220 04:54:57,795 --> 04:55:02,833 DISEASE EDITORIAL, SHE DID IT 7221 04:55:02,833 --> 04:55:05,069 FOR THE WORLD ALREADY. 7222 04:55:05,069 --> 04:55:07,338 >> I WILL ADD IN A LOT OF THESE 7223 04:55:07,338 --> 04:55:12,610 MODELS THE COMPONENTS WHEN 7224 04:55:12,610 --> 04:55:13,244 CONSIDERING MULTIPLE DIETARY 7225 04:55:13,244 --> 04:55:16,981 CONTRASTS ADJUST FOR ALL THOSE 7226 04:55:16,981 --> 04:55:18,949 FACTORS WHICH SPEAKS TO 7227 04:55:18,949 --> 04:55:20,584 CONSISTENCY IF IT WERE JUST 7228 04:55:20,584 --> 04:55:22,786 GRAINS THEN IN THESE TYPES OF 7229 04:55:22,786 --> 04:55:24,955 ANALYSES THAT WOULD BE WHERE THE 7230 04:55:24,955 --> 04:55:27,157 SIGNAL IS AND EVERYTHING ELSE 7231 04:55:27,157 --> 04:55:29,226 ADJUSTING FOR GRAINS BUT MAYBE 7232 04:55:29,226 --> 04:55:33,264 CORRELATED WITH GRAINS WOULD BE 7233 04:55:33,264 --> 04:55:35,266 RELATIVELY NULL. 7234 04:55:35,266 --> 04:55:38,002 CONSISTENCY INDEPENDENTLY ACROSS 7235 04:55:38,002 --> 04:55:41,071 ALL THESE NON-SATURATED FAT 7236 04:55:41,071 --> 04:55:46,744 EXPOSURES IS WHAT OVERALL WAS 7237 04:55:46,744 --> 04:55:48,979 STRIKING. 7238 04:55:48,979 --> 04:55:49,380 >> GREAT. 7239 04:55:49,380 --> 04:55:52,082 ED, CHRISTINA, AND THEN ANGELA. 7240 04:55:52,082 --> 04:55:54,285 >> A LOT OF GREAT WORK. 7241 04:55:54,285 --> 04:55:57,588 A QUESTION, I DON'T KNOW IF THIS 7242 04:55:57,588 --> 04:56:00,791 IS MAYBE TECHNICAL TYPE OF 7243 04:56:00,791 --> 04:56:04,128 QUESTION BUT ONE OF THE 7244 04:56:04,128 --> 04:56:05,562 CONCLUSION STATEMENTS 7245 04:56:05,562 --> 04:56:06,530 SUBSTITUTING PROCESSED AND 7246 04:56:06,530 --> 04:56:10,467 UNPROCESSED RED MEAT WITH PLANT 7247 04:56:10,467 --> 04:56:12,569 SOURCES OF PROTEIN, IN 7248 04:56:12,569 --> 04:56:13,437 PARENTHESES BEANS, PEAS, 7249 04:56:13,437 --> 04:56:15,639 LENTILS, ET CETERA. 7250 04:56:15,639 --> 04:56:17,474 LIKE ARE THESE STUDIES LIKE ARE 7251 04:56:17,474 --> 04:56:22,713 THEY COME LIKE ALL PLANT 7252 04:56:22,713 --> 04:56:23,814 SOURCES? 7253 04:56:23,814 --> 04:56:25,382 LIKE THE RED MEAT CONSUMPTION IS 7254 04:56:25,382 --> 04:56:28,852 SO MUCH HIGHER THAN LET'S SAY 7255 04:56:28,852 --> 04:56:31,388 PEAS, I DON'T KNOW HOW YOU 7256 04:56:31,388 --> 04:56:33,791 COMPARE PROTEIN FROM RED MEAT TO 7257 04:56:33,791 --> 04:56:36,727 PROTEIN FROM PEAS IN AN 7258 04:56:36,727 --> 04:56:39,029 OBSERVATIONAL STUDY BECAUSE IT'S 7259 04:56:39,029 --> 04:56:40,764 PROBABLY LIKE 100:1 RATIO IN 7260 04:56:40,764 --> 04:56:43,200 TERMS OF GRAMS OF PROTEIN. 7261 04:56:43,200 --> 04:56:46,070 SO IS THAT LIKE COMBINING ALL OF 7262 04:56:46,070 --> 04:56:48,872 THE OTHER PLANT SOURCES, LOOKING 7263 04:56:48,872 --> 04:56:49,340 AT THEM INDIVIDUALLY? 7264 04:56:49,340 --> 04:56:50,908 >> LET ME ANSWER ONE WAY AND ASK 7265 04:56:50,908 --> 04:56:52,509 DEE DEE TO HELP. 7266 04:56:52,509 --> 04:56:55,479 AS YOU LOOK DOWN COMPARATORS, 7267 04:56:55,479 --> 04:56:58,015 ONE WOULD BE LEGUMES, ONE BEANS, 7268 04:56:58,015 --> 04:57:00,284 ONE NUTS, ONE WOULD BE LEGUMES 7269 04:57:00,284 --> 04:57:02,486 AND BEANS, ONE LEGUMES AND NUTS, 7270 04:57:02,486 --> 04:57:05,889 ONE WOULD BE NUTS AND BEANS. 7271 04:57:05,889 --> 04:57:09,760 CLEARLY THERE'S A SET THAT 7272 04:57:09,760 --> 04:57:10,627 BELONGS TOGETHER. 7273 04:57:10,627 --> 04:57:13,797 WE WEREN'T TEASING THAT APART 7274 04:57:13,797 --> 04:57:15,866 FOR A SERVING SIZE, JUST WE HAD 7275 04:57:15,866 --> 04:57:17,735 A COMPARATOR AND THE STAFF DID 7276 04:57:17,735 --> 04:57:18,602 AN AMAZING JOB. 7277 04:57:18,602 --> 04:57:20,804 IF YOU WENT INTO FURTHER DETAILS 7278 04:57:20,804 --> 04:57:22,873 YOU'D SEE HOW MANY GRAMS OF 7279 04:57:22,873 --> 04:57:27,911 BEANS, HOW MANY GRAMS OF NUTS, 7280 04:57:27,911 --> 04:57:29,680 HOW MANY OUNCES OF MEAT. 7281 04:57:29,680 --> 04:57:32,082 AT THAT LEVEL WE WEREN'T TEASING 7282 04:57:32,082 --> 04:57:32,783 ANYTHING APART. 7283 04:57:32,783 --> 04:57:35,886 WE COULD FIND ALL THE OUNCES, 7284 04:57:35,886 --> 04:57:41,925 ALL THE GRAMS, BUT LOOKING AT 7285 04:57:41,925 --> 04:57:42,259 PATTERNS. 7286 04:57:42,259 --> 04:57:43,927 WE DIDN'T TAKE THAT INTO ACCOUNT 7287 04:57:43,927 --> 04:57:46,797 FOR SERVING SIZE OR AMOUNT. 7288 04:57:46,797 --> 04:57:47,898 IT WAS SUBSTITUTION ANALYSIS 7289 04:57:47,898 --> 04:57:49,867 MAYBE DEE DEE WILL HELP ME WITH 7290 04:57:49,867 --> 04:57:50,200 FURTHER. 7291 04:57:50,200 --> 04:57:55,739 I CAN SPEAK TO SUBSTITUTION PART 7292 04:57:55,739 --> 04:57:55,973 OF THAT. 7293 04:57:55,973 --> 04:57:58,375 SO, YOU'RE CORRECT IN THAT THE 7294 04:57:58,375 --> 04:58:01,311 FREQUENCY AND AMOUNT OF INTAKE 7295 04:58:01,311 --> 04:58:03,514 COULD VARY DRASTICALLY AMONG TWO 7296 04:58:03,514 --> 04:58:04,381 EXPOSURES OF INTEREST. 7297 04:58:04,381 --> 04:58:06,050 IF DISTRIBUTION AND SOMETHING 7298 04:58:06,050 --> 04:58:09,520 LIKE RED MEAT IS REALLY WIDE, 7299 04:58:09,520 --> 04:58:14,558 BUT IT'S CONTRASTED AGAINST LIKE 7300 04:58:14,558 --> 04:58:17,628 ALL-COME UP NUTS, WALNUTS, 7301 04:58:17,628 --> 04:58:18,729 WHATEVER, PEANUTS, THE 7302 04:58:18,729 --> 04:58:25,069 DISTRIBUTION IS SO TINY. 7303 04:58:25,069 --> 04:58:26,303 IF YOU'RE MODELING TWO SERVINGS 7304 04:58:26,303 --> 04:58:29,573 A WEEK, PER SERVING PER WEEK, 7305 04:58:29,573 --> 04:58:31,308 IT'S EVEN MORE REMARKABLE HOW 7306 04:58:31,308 --> 04:58:34,812 JUST THAT MUCH OF A SHIFT WOULD 7307 04:58:34,812 --> 04:58:38,048 BE -- IS RELATED TO THAT 7308 04:58:38,048 --> 04:58:41,985 MAGNITUDE OF POTENTIAL BENEFIT. 7309 04:58:41,985 --> 04:58:47,591 BUT WHAT MODELS DO NOT DO, IF 7310 04:58:47,591 --> 04:58:54,631 YOU'RE AN UP EPIDEMIOLOGIST DOT 7311 04:58:54,631 --> 04:58:56,700 EXTRAPOLATE BEYOND YOUR 7312 04:58:56,700 --> 04:58:57,034 DISTRIBUTION. 7313 04:58:57,034 --> 04:59:00,437 IF WE REPLACE WITH NUTS BUT 7314 04:59:00,437 --> 04:59:01,538 NOBODY IS EATING THAT 7315 04:59:01,538 --> 04:59:02,906 CONSUMPTION OF NUTS YOU MAY BE 7316 04:59:02,906 --> 04:59:05,275 ABLE TO GENERATE A NUMBER 7317 04:59:05,275 --> 04:59:06,677 ANALYTICALLY BUT THAT'S NOT 7318 04:59:06,677 --> 04:59:07,544 WHAT'S HAPPENING HERE. 7319 04:59:07,544 --> 04:59:09,513 IT'S USUALLY AT THE LEVEL OF 7320 04:59:09,513 --> 04:59:12,583 SERVING PER WEEK, PER DAY, 7321 04:59:12,583 --> 04:59:13,884 THERE'S ENOUGH CONSUMPTION AT 7322 04:59:13,884 --> 04:59:15,219 THAT LEVEL. 7323 04:59:15,219 --> 04:59:16,286 >> YEAH, THAT'S RIGHT. 7324 04:59:16,286 --> 04:59:20,224 THERE IS AN ASSUMPTION OF 7325 04:59:20,224 --> 04:59:21,125 LINEARITY, LIKE EFFECTS ARE 7326 04:59:21,125 --> 04:59:23,193 GOING TO BE LINEAR BECAUSE IF 7327 04:59:23,193 --> 04:59:26,797 THEY ARE NOT LINEAR THEN THE 7328 04:59:26,797 --> 04:59:28,365 ASSUMPTION MIGHT NOT HOLD 7329 04:59:28,365 --> 04:59:28,999 ENTIRELY. 7330 04:59:28,999 --> 04:59:31,869 >> CAN I JUMP IN, GIVEN THE 7331 04:59:31,869 --> 04:59:33,704 PROBLEMS YOU SUGGESTED WATT IT 7332 04:59:33,704 --> 04:59:37,441 DRIVE CONCLUSION TOWARD THE 7333 04:59:37,441 --> 04:59:39,309 NULL, NOT TOWARDS ASSOCIATION 7334 04:59:39,309 --> 04:59:41,278 THAT'S SIGNIFICANT? 7335 04:59:41,278 --> 04:59:42,346 >> NOT NECESSARILY, BUT -- 7336 04:59:42,346 --> 04:59:42,846 >> OKAY. 7337 04:59:42,846 --> 04:59:43,914 >> YEAH, I DON'T KNOW IF YOU 7338 04:59:43,914 --> 04:59:49,520 WANT TO GET INTO THAT HERE. 7339 04:59:49,520 --> 04:59:50,687 >> WE'RE HERE TO LEARN. 7340 04:59:50,687 --> 04:59:53,891 WE LEARN SO MUCH TOGETHER WHEN 7341 04:59:53,891 --> 04:59:54,992 WE'RE HERE. 7342 04:59:54,992 --> 04:59:58,028 >> NON-LINEARITY ISSUE, AT A 7343 04:59:58,028 --> 04:59:59,463 POPULATION, HIGH INTAKE HAS 7344 04:59:59,463 --> 05:00:01,098 FLATTENED OUT, SHIFTING TO MAYBE 7345 05:00:01,098 --> 05:00:03,300 NOTHING BUT IF YOU'RE DOWN AT 7346 05:00:03,300 --> 05:00:06,136 LOWER INTAKE, YOU'RE STILL 7347 05:00:06,136 --> 05:00:07,671 GETTING BENEFIT, LIKE PER 7348 05:00:07,671 --> 05:00:10,974 ADDITIONAL SERVING, MAYBE YOU 7349 05:00:10,974 --> 05:00:15,445 WOULD. 7350 05:00:15,445 --> 05:00:16,880 DEPENDS. 7351 05:00:16,880 --> 05:00:19,816 >> IF THERE'S A THRESHOLD, YOU 7352 05:00:19,816 --> 05:00:21,018 GET A BAD EFFECT WHEN YOU REACH 7353 05:00:21,018 --> 05:00:23,987 A HIGH AMOUNT BUT ONLY ONE OF 7354 05:00:23,987 --> 05:00:25,856 THE PEOPLE IS REACHING THAT HIGH 7355 05:00:25,856 --> 05:00:28,292 AMOUNT, THE OTHER PEOPLE ARE NOT 7356 05:00:28,292 --> 05:00:30,661 REACHING THAT AMOUNT SO THAT'S 7357 05:00:30,661 --> 05:00:37,134 LIKE A NON-LINEAR REACTION. 7358 05:00:37,134 --> 05:00:43,173 SO THEN COMPARISON ISN'T QUITE 7359 05:00:43,173 --> 05:00:44,274 HERE. 7360 05:00:44,274 --> 05:00:45,475 >> CRISTINA? 7361 05:00:45,475 --> 05:00:47,110 >> MY QUESTION TO THERESA. 7362 05:00:47,110 --> 05:00:49,846 SO YOU SAID THAT NOT ALL THE 7363 05:00:49,846 --> 05:00:52,482 STUDIES CONTROL FOR ENERGY 7364 05:00:52,482 --> 05:00:52,716 INTAKE. 7365 05:00:52,716 --> 05:00:55,552 IF YOU WOULD HAVE -- NO? 7366 05:00:55,552 --> 05:00:56,653 THAT WAS NOT? 7367 05:00:56,653 --> 05:00:58,422 SHE WAS QUESTIONING ABOUT -- YOU 7368 05:00:58,422 --> 05:01:01,158 SAID IT WAS MODERATE, NOT 7369 05:01:01,158 --> 05:01:01,592 STRONG. 7370 05:01:01,592 --> 05:01:03,393 >> I CANNOT TALK ABOUT ADJUSTED 7371 05:01:03,393 --> 05:01:04,761 FOR ENERGY INTAKE. 7372 05:01:04,761 --> 05:01:06,296 >> THAT'S THE CONFOUNDER, 7373 05:01:06,296 --> 05:01:12,436 SOMETHING WE ASSESSED. 7374 05:01:12,436 --> 05:01:13,403 >> OKAY. 7375 05:01:13,403 --> 05:01:14,204 SINCE COMPETITORS WERE DIFFERENT 7376 05:01:14,204 --> 05:01:17,007 SUBSTITUTING DAIRY WITH MAYBE 7377 05:01:17,007 --> 05:01:18,542 YOGURT WITH BUTTER MIGHT HAVE 7378 05:01:18,542 --> 05:01:20,844 SIGNIFICANT CHANGE IN CALORIE 7379 05:01:20,844 --> 05:01:21,211 INTAKE. 7380 05:01:21,211 --> 05:01:24,248 HOW DO YOU -- SO -- I'M STILL 7381 05:01:24,248 --> 05:01:25,115 TRYING TO UNDERSTAND COMPARISONS 7382 05:01:25,115 --> 05:01:30,053 BECAUSE IT SEEMS LIKE CALORIES 7383 05:01:30,053 --> 05:01:31,922 WILL BE VERY DIFFERENT. 7384 05:01:31,922 --> 05:01:37,928 >> SIMULATION. 7385 05:01:37,928 --> 05:01:38,795 SIMULATION ATTEMPTS TO ADDRESS 7386 05:01:38,795 --> 05:01:39,263 THAT. 7387 05:01:39,263 --> 05:01:40,797 I TAKE IT BACK. 7388 05:01:40,797 --> 05:01:42,399 >> SOMETIMES IT'S A PRAGMATIC 7389 05:01:42,399 --> 05:01:44,401 QUESTION, A SERVING VERSUS A 7390 05:01:44,401 --> 05:01:47,137 SERVING, THAT'S HOW YOU EAT THIS 7391 05:01:47,137 --> 05:01:48,639 ENTREE VERSUS THAT ENTREE, 7392 05:01:48,639 --> 05:01:54,278 THAT'S THE CONTRAST OF INTEREST, 7393 05:01:54,278 --> 05:01:55,579 CALORIC, MAYBE IF YOU WERE 7394 05:01:55,579 --> 05:01:57,614 DESIGNING A FEEDING TRIAL GIVE 7395 05:01:57,614 --> 05:01:59,483 500 CALORIES OF THIS VERSUS 7396 05:01:59,483 --> 05:02:03,887 THAT, LOOKING AT EFFECT OF FOOD, 7397 05:02:03,887 --> 05:02:04,655 NOT THROUGH ENERGY CHANGES. 7398 05:02:04,655 --> 05:02:08,659 THEN THAT WOULD BE HOW THE 7399 05:02:08,659 --> 05:02:11,528 SUBSTITUTE MODELS COULD ALSO 7400 05:02:11,528 --> 05:02:14,665 REFLECT, AND IMPRECISION IS A 7401 05:02:14,665 --> 05:02:19,536 CONCERN BUT THE IMPRECISION 7402 05:02:19,536 --> 05:02:22,272 BETWEEN THE FOODS IS SOMETHING 7403 05:02:22,272 --> 05:02:24,174 TO CONSIDER AND THAT MAY NOT BE 7404 05:02:24,174 --> 05:02:25,542 AS BIG OF A DEAL. 7405 05:02:25,542 --> 05:02:30,580 YOU COULD SET UP SERVING PER 7406 05:02:30,580 --> 05:02:36,153 SERVING, 100 CAL CALORIES OF TS 7407 05:02:36,153 --> 05:02:39,556 VERSUS THAT, IT MAY HAVE BEEN A 7408 05:02:39,556 --> 05:02:40,657 COMBINATION, SERVINGS OR EGGS 7409 05:02:40,657 --> 05:02:42,025 PER DAY, SOMETHING THAT MADE 7410 05:02:42,025 --> 05:02:46,229 SENSE RATHER THAN 50 CALORIES OF 7411 05:02:46,229 --> 05:02:46,763 EGGS. 7412 05:02:46,763 --> 05:02:47,664 >> YOU WERE MENTIONING SOME 7413 05:02:47,664 --> 05:02:50,634 STUDIES THAT YOU HAVE DONE MAY 7414 05:02:50,634 --> 05:02:52,703 HAVE -- THAT WERE NOT INCLUDED 7415 05:02:52,703 --> 05:02:55,672 THAT COULD HAVE, WONDERING IF 7416 05:02:55,672 --> 05:02:56,773 WERE THERE ANY PROSPECTIVE 7417 05:02:56,773 --> 05:02:58,508 STUDIES THAT YOU KNOW IN THE 7418 05:02:58,508 --> 05:03:01,011 U.S. THAT YOU WERE SURPRISED 7419 05:03:01,011 --> 05:03:02,679 THAT WERE NOT CAPTURED? 7420 05:03:02,679 --> 05:03:04,181 MAYBE NOT EXACTLY DOING WHAT 7421 05:03:04,181 --> 05:03:08,485 YOU'RE DOING BUT THEY WERE NOT 7422 05:03:08,485 --> 05:03:08,752 CAPTURED? 7423 05:03:08,752 --> 05:03:10,554 I WAS JUST -- I WAS THINKING 7424 05:03:10,554 --> 05:03:11,655 ABOUT THAT. 7425 05:03:11,655 --> 05:03:13,190 >> I WAS TALKING ABOUT TRIALS. 7426 05:03:13,190 --> 05:03:17,227 SO I DID A TRIAL IN 2005 THAT 7427 05:03:17,227 --> 05:03:19,296 MATCHED SATURATED FAT, ONE WAS 7428 05:03:19,296 --> 05:03:21,264 CONVENIENCE FOOD, ONE WAS 7429 05:03:21,264 --> 05:03:21,565 VEGETARIAN. 7430 05:03:21,565 --> 05:03:22,599 IT OCCURRED THAT WOULD HAVE BEEN 7431 05:03:22,599 --> 05:03:24,368 FIT ALTHOUGH IT WAS WEIRD 7432 05:03:24,368 --> 05:03:26,436 BECAUSE I MATCHED SATURATED FAT, 7433 05:03:26,436 --> 05:03:28,538 A CONTRIVED PORTION BUT ONE WAS 7434 05:03:28,538 --> 05:03:31,475 HIGHER IN PLANTS, ONE HIGHER IN 7435 05:03:31,475 --> 05:03:33,910 MEAT, EVEN SO SATURATED WAS 7436 05:03:33,910 --> 05:03:34,911 MATCHED LDL CHOLESTEROL WENT 7437 05:03:34,911 --> 05:03:37,314 DOWN TWICE AS MUCH IN THE PLANT 7438 05:03:37,314 --> 05:03:38,482 GROUP. 7439 05:03:38,482 --> 05:03:40,117 >> WHAT ABOUT THE OTHER 7440 05:03:40,117 --> 05:03:42,386 PROSPECTIVE STUDY IN THE U.S., 7441 05:03:42,386 --> 05:03:44,488 WE HAVE LONG AND -- THEY WERE 7442 05:03:44,488 --> 05:03:45,055 NOT CAPTURED? 7443 05:03:45,055 --> 05:03:47,891 >> I THINK THAT'S A REALLY GOOD 7444 05:03:47,891 --> 05:03:48,625 QUESTION. 7445 05:03:48,625 --> 05:03:53,597 I THINK MAYBE THIS -- I DON'T 7446 05:03:53,597 --> 05:03:55,665 KNOW IF WE REITERATED AS 7447 05:03:55,665 --> 05:03:57,734 STRONGLY AS WE DID. 7448 05:03:57,734 --> 05:04:00,170 INDIVIDUAL FOODS AND SATURATED 7449 05:04:00,170 --> 05:04:01,571 FAT HAS BEEN EXHAUSTIVELY 7450 05:04:01,571 --> 05:04:02,706 REVIEWED. 7451 05:04:02,706 --> 05:04:05,075 QUESTIONS WE WERE TRYING TO 7452 05:04:05,075 --> 05:04:07,611 GRAPPLE WITH WERE WITHIN SOURCES 7453 05:04:07,611 --> 05:04:10,981 OF SATURATED FAT OR SATURATED 7454 05:04:10,981 --> 05:04:13,517 FAT FOODS VERSUS NON-SATURATED 7455 05:04:13,517 --> 05:04:17,020 FAT, IS THERE A HIERARCHY OR 7456 05:04:17,020 --> 05:04:18,555 WITHIN THE HETEROGENEITY ACROSS 7457 05:04:18,555 --> 05:04:21,057 THESE FOODS AND COMPARISONS, IS 7458 05:04:21,057 --> 05:04:22,592 THERE SOMETHING THAT COULD BE, 7459 05:04:22,592 --> 05:04:26,196 YOU KNOW, ARE THERE SECTIONS, 7460 05:04:26,196 --> 05:04:28,398 SUBTYPES THAT DEVIATE FROM 7461 05:04:28,398 --> 05:04:31,368 OTHERS OR WHATEVER THAT MAY 7462 05:04:31,368 --> 05:04:33,103 OFFER ADDITIONAL NUANCE TO 7463 05:04:33,103 --> 05:04:36,173 SATURATED FAT CONVERSATION. 7464 05:04:36,173 --> 05:04:38,809 SO THE EXPLICIT COMPARISON IS IN 7465 05:04:38,809 --> 05:04:41,878 ADDITION TO THE ALREADY EXISTING 7466 05:04:41,878 --> 05:04:43,313 LITERATURE ON JUST SATURATED FAT 7467 05:04:43,313 --> 05:04:44,748 FOODS IN GENERAL LIKE DAIRY, 7468 05:04:44,748 --> 05:04:47,117 WHICH WOULD BE A LOT OF COHORTS 7469 05:04:47,117 --> 05:04:48,985 THAT AREN'T DOING SUBSTITUTION 7470 05:04:48,985 --> 05:04:51,388 MODELING BUT LOOKING DO PEOPLE 7471 05:04:51,388 --> 05:04:54,157 EAT MORE DAIRY HAVE HIGHER RISK 7472 05:04:54,157 --> 05:04:55,792 OF CARDIOVASCULAR DISEASE THAN 7473 05:04:55,792 --> 05:04:57,961 THOSE WHO DON'T, THOSE ARE 7474 05:04:57,961 --> 05:04:59,162 REPRESENTED ELSEWHERE, NOT 7475 05:04:59,162 --> 05:04:59,729 NECESSARILY CONTRASTING 7476 05:04:59,729 --> 05:05:00,464 EXPOSURE. 7477 05:05:00,464 --> 05:05:02,332 >> CAN I BUILD ON THAT ABOUT THE 7478 05:05:02,332 --> 05:05:03,133 U.S. STUDY? 7479 05:05:03,133 --> 05:05:05,101 SARAH MENTIONED IT. 7480 05:05:05,101 --> 05:05:06,536 NOW YOU MENTIONED IT. 7481 05:05:06,536 --> 05:05:08,705 I THINK I EXAGGERATED HOW OFTEN 7482 05:05:08,705 --> 05:05:10,006 U.S. WAS NOT REPRESENTED. 7483 05:05:10,006 --> 05:05:11,775 IN SOME OF THEM, MOST STUDIES 7484 05:05:11,775 --> 05:05:14,077 WERE IN U.S., SOME HALF THE 7485 05:05:14,077 --> 05:05:17,013 STUDIES IN U.S., AND IN MY NOTES 7486 05:05:17,013 --> 05:05:18,748 I ADDED THEM AND I THINK I TRIED 7487 05:05:18,748 --> 05:05:20,417 TO TALK ABOUT ADDING THEM TO THE 7488 05:05:20,417 --> 05:05:21,618 SLIDES SO WE HAD A LITTLE 7489 05:05:21,618 --> 05:05:22,619 DISCUSSION ABOUT THAT. 7490 05:05:22,619 --> 05:05:25,322 I WAS LOOKING AT MY SLIDES, 7491 05:05:25,322 --> 05:05:26,857 LOOKING AT NEW SLIDES, RAN OUT 7492 05:05:26,857 --> 05:05:28,058 OF TIME. 7493 05:05:28,058 --> 05:05:30,026 I MAY HAVE BEEN INACCURATE IN 7494 05:05:30,026 --> 05:05:33,530 DISMISSING U.S. 7495 05:05:33,530 --> 05:05:37,033 GENERALIZABILITY WAS MORE OFTEN 7496 05:05:37,033 --> 05:05:39,870 NO RACE AND ETHNICITY, NO 7497 05:05:39,870 --> 05:05:41,304 SOCIOECONOMIC POSITION, I 7498 05:05:41,304 --> 05:05:42,439 APOLOGIZE IF I MISREPRESENTED. 7499 05:05:42,439 --> 05:05:43,840 IT WAS MORE LIKE HALF IN 7500 05:05:43,840 --> 05:05:44,074 GENERAL. 7501 05:05:44,074 --> 05:05:45,575 I DON'T THINK WE WERE MISSING 7502 05:05:45,575 --> 05:05:53,149 MAJOR U.S. STUDIES LIKE NURSES 7503 05:05:53,149 --> 05:05:53,383 HEALTH. 7504 05:05:53,383 --> 05:05:55,118 >> THANK YOU FOR THE 7505 05:05:55,118 --> 05:05:55,452 CLARIFICATION. 7506 05:05:55,452 --> 05:05:56,853 >> DID YOU WANT TO SAY 7507 05:05:56,853 --> 05:05:57,120 SOMETHING? 7508 05:05:57,120 --> 05:05:59,289 >> THAT'S RIGHT. 7509 05:05:59,289 --> 05:06:01,658 WE DID CAPTURE A NUMBER OF U.S. 7510 05:06:01,658 --> 05:06:04,194 STUDIES, A APPROPRIATE TO SEE 7511 05:06:04,194 --> 05:06:08,899 THE DIVERSITY WAS NOT THERE. 7512 05:06:08,899 --> 05:06:12,269 IT WAS INCLUDED. 7513 05:06:12,269 --> 05:06:15,672 WE HAD AN EQUAL PROPORTION, 7514 05:06:15,672 --> 05:06:18,975 AUSTRALIA, NEW ZEALAND, EUROPEAN 7515 05:06:18,975 --> 05:06:19,743 COHORTS. 7516 05:06:19,743 --> 05:06:21,378 U.S. STUDIES GOT CAPTURED BUT 7517 05:06:21,378 --> 05:06:30,987 NOT HAVING THE DIVERSITY IN 7518 05:06:30,987 --> 05:06:32,122 DPCBD WAS MUCH RICHER. 7519 05:06:32,122 --> 05:06:36,026 >> WHEN WE WERE DECIDING WHAT TO 7520 05:06:36,026 --> 05:06:39,429 DO FOR FOOD SOURCES WE DECIDED 7521 05:06:39,429 --> 05:06:40,864 WITH DIETARY PATTERNS WE ALREADY 7522 05:06:40,864 --> 05:06:43,233 CAPTURE A LOT OF DIETARY 7523 05:06:43,233 --> 05:06:46,002 PATTERNS HIGHER IN SATURATED FAT 7524 05:06:46,002 --> 05:06:48,071 SO WE DIDN'T TO REPEAT WORK THAT 7525 05:06:48,071 --> 05:06:52,342 WE HAD DONE SO THAT'S WHY 7526 05:06:52,342 --> 05:06:55,779 ANOTHER RATIONALE FOR WHY WE DID 7527 05:06:55,779 --> 05:06:57,247 THIS. 7528 05:06:57,247 --> 05:06:58,682 >> THANK YOU FOR THE 7529 05:06:58,682 --> 05:06:59,015 CLARIFICATION. 7530 05:06:59,015 --> 05:06:59,983 IT'S AN IMPORTANT DISTINCTION. 7531 05:06:59,983 --> 05:07:10,060 I'M GOING TO HAND IT OVER TO 7532 05:07:10,060 --> 05:07:10,293 ANGELA. 7533 05:07:10,293 --> 05:07:12,462 >> IT'S SUPER INTERESTING. 7534 05:07:12,462 --> 05:07:17,601 I HAD TWO QUICK QUESTIONS. 7535 05:07:17,601 --> 05:07:19,769 ONE IS PROCESSED VERSUS 7536 05:07:19,769 --> 05:07:20,070 UNPROCESSED. 7537 05:07:20,070 --> 05:07:22,405 WITH PLANT PROTEIN SOURCES THEY 7538 05:07:22,405 --> 05:07:25,342 DIDN'T INCLUDE PROCESSED. 7539 05:07:25,342 --> 05:07:27,444 WAS IT ONLY UNPROCESSED PLANT? 7540 05:07:27,444 --> 05:07:30,046 >> THAT CAN'T BE ANSWER RIGHT 7541 05:07:30,046 --> 05:07:31,715 NOW, BEYOND MEAT, IMPOSSIBLE 7542 05:07:31,715 --> 05:07:33,550 MEAT, THEY WEREN'T AVAILABLE, 7543 05:07:33,550 --> 05:07:34,818 MOST WERE COHORT STUDIES. 7544 05:07:34,818 --> 05:07:44,728 YOU'RE NOT GOING TO -- IT WAS 7545 05:07:44,728 --> 05:07:53,503 WHOLE GRAINS, VEGGIES, BABIES, 7546 05:07:53,503 --> 05:07:54,437 PEAS, LENTILS. 7547 05:07:54,437 --> 05:07:56,973 I DON'T THINK FOOD FREQUENCY 7548 05:07:56,973 --> 05:08:02,212 QUESTIONNAIRES WOULD CAPTURE 7549 05:08:02,212 --> 05:08:04,180 THAT. 7550 05:08:04,180 --> 05:08:05,515 .1% WAS PROCESSED MEAT 7551 05:08:05,515 --> 05:08:07,584 ALTERNATIVES, TOFU WAS THE 7552 05:08:07,584 --> 05:08:08,518 CATEGORY. 7553 05:08:08,518 --> 05:08:09,285 >> SO THEY DIDN'T -- 7554 05:08:09,285 --> 05:08:11,087 >> NOT CAPTURED. 7555 05:08:11,087 --> 05:08:13,256 >> THEY DIDN'T CAPTURE IT. 7556 05:08:13,256 --> 05:08:13,490 >> NO. 7557 05:08:13,490 --> 05:08:16,826 >> THEY ONLY LOOKED AT 7558 05:08:16,826 --> 05:08:20,930 UNPROCESSED IT. 7559 05:08:20,930 --> 05:08:23,867 >> PROSPECTIVE STUDIES WITH 7560 05:08:23,867 --> 05:08:28,805 MORBIDITY WOULD BE QUITE OLD. 7561 05:08:28,805 --> 05:08:29,372 >> SUBSTITUTING VERSUS 7562 05:08:29,372 --> 05:08:30,740 REPLACING, SOMEBODY ASKED THE 7563 05:08:30,740 --> 05:08:34,177 QUESTION LIKE THIS, AS FAR AS -- 7564 05:08:34,177 --> 05:08:36,813 ASSUMING THEY HAD A 7565 05:08:36,813 --> 05:08:38,314 DOSE-RESPONSE ESSENTIALLY, THE 7566 05:08:38,314 --> 05:08:41,384 IDEA ABOUT IS REPLACING ONE 7567 05:08:41,384 --> 05:08:42,318 THING AND SUBSTITUTING SOMETHING 7568 05:08:42,318 --> 05:08:45,655 DIFFERENT OR IS THE IDEA OF 7569 05:08:45,655 --> 05:08:46,656 USING THOSE DIFFERENT 7570 05:08:46,656 --> 05:08:49,592 TERMINOLOGIES, DO THEY MEAN 7571 05:08:49,592 --> 05:08:50,126 SOMETHING DIFFERENT OR -- 7572 05:08:50,126 --> 05:08:50,927 >> VERY. 7573 05:08:50,927 --> 05:08:52,562 DEE DEE CAPTURED IT. 7574 05:08:52,562 --> 05:08:53,763 >> WHAT'S THE DIFFERENCE? 7575 05:08:53,763 --> 05:08:56,933 >> YEAH, WE ONLY HAD A COUPLE 7576 05:08:56,933 --> 05:08:59,002 BULLETS, JUST DEFINING IT. 7577 05:08:59,002 --> 05:09:00,637 MORE FOR OUR INTERNAL 7578 05:09:00,637 --> 05:09:01,504 CONSISTENCY. 7579 05:09:01,504 --> 05:09:04,507 I DON'T KNOW THAT THERE'S 7580 05:09:04,507 --> 05:09:06,142 NECESSARILY LIKE OFFICIAL 7581 05:09:06,142 --> 05:09:08,211 LANGUAGE AROUND WHICH IS 7582 05:09:08,211 --> 05:09:08,678 PREFERRED. 7583 05:09:08,678 --> 05:09:10,513 WE FELT REPLACING WAS CONSISTENT 7584 05:09:10,513 --> 05:09:12,348 WITH WHAT'S OCCURRING IN A 7585 05:09:12,348 --> 05:09:15,518 FEEDING TRIAL OR CROSSOVER STUDY 7586 05:09:15,518 --> 05:09:16,953 WHERE YOU HAVE INDIVIDUALS 7587 05:09:16,953 --> 05:09:19,155 CONSUMING ONE THING, REPLACING 7588 05:09:19,155 --> 05:09:21,558 WITH ANOTHER. 7589 05:09:21,558 --> 05:09:25,061 SUBSTITUTION IS REFLECTING LIKE 7590 05:09:25,061 --> 05:09:26,162 MODELING, SUBSTITUTION MODEL, 7591 05:09:26,162 --> 05:09:27,997 COULD BE CONTRASTING OR 7592 05:09:27,997 --> 05:09:28,264 SOMETHING. 7593 05:09:28,264 --> 05:09:32,936 >> DID IT GET ELIMINATED IN THAT 7594 05:09:32,936 --> 05:09:34,771 CROSSOVER? 7595 05:09:34,771 --> 05:09:37,974 I'M CURIOUS, ESSENTIALLY IN THE 7596 05:09:37,974 --> 05:09:43,680 OTHER STUDIES MORE ABOUT AMOUNT 7597 05:09:43,680 --> 05:09:45,615 OR FREQUENCY OF CONSUMPTION. 7598 05:09:45,615 --> 05:09:47,617 >> THOSE THAT AREN'T INCLUDED 7599 05:09:47,617 --> 05:09:48,885 HERE? 7600 05:09:48,885 --> 05:09:49,452 >> YEAH. 7601 05:09:49,452 --> 05:09:50,687 >> SO, THOSE I MEAN THAT'S LIKE 7602 05:09:50,687 --> 05:09:52,388 WHY WE'RE BUILDING ON IT IN THIS 7603 05:09:52,388 --> 05:09:52,956 WAY. 7604 05:09:52,956 --> 05:09:54,390 YOU DON'T KNOW WHAT PEOPLE WHO 7605 05:09:54,390 --> 05:09:56,359 AREN'T CONSUMING YOUR FOOD OF 7606 05:09:56,359 --> 05:09:59,195 INTEREST ARE EATING INSTEAD. 7607 05:09:59,195 --> 05:10:02,599 IT'S NOT DEFINED IN YOUR 7608 05:10:02,599 --> 05:10:03,266 HYPOTHESIS. 7609 05:10:03,266 --> 05:10:04,467 PEOPLE WHO EAT MEAT, IT'S NOT 7610 05:10:04,467 --> 05:10:06,202 CLEAR WHAT PEOPLE WHO AREN'T 7611 05:10:06,202 --> 05:10:09,606 EATING MEAT ARE EATING INSTEAD. 7612 05:10:09,606 --> 05:10:10,140 REPLACING, SUBSTITUTING, 7613 05:10:10,140 --> 05:10:11,574 WHATEVER IT MIGHT BE, 7614 05:10:11,574 --> 05:10:12,142 SPECIFICALLY. 7615 05:10:12,142 --> 05:10:14,878 IT'S JUST THE BACKGROUND AVERAGE 7616 05:10:14,878 --> 05:10:16,112 DIET FOR THAT SPECIFIC 7617 05:10:16,112 --> 05:10:16,412 POPULATION. 7618 05:10:16,412 --> 05:10:21,351 I DON'T KNOW IF THAT'S ANSWERING 7619 05:10:21,351 --> 05:10:24,120 YOUR QUESTION. 7620 05:10:24,120 --> 05:10:26,289 >> SUBSTITUTION THAT YOU'RE 7621 05:10:26,289 --> 05:10:31,094 MODELING IS THE IDEA THAT -- 7622 05:10:31,094 --> 05:10:33,363 THESE ARE COHORT STUDIES, YOU 7623 05:10:33,363 --> 05:10:35,799 HAVE VARIABILITY OF PEOPLE, SOME 7624 05:10:35,799 --> 05:10:37,967 EATING ZERO, SOME EATING ALL I 7625 05:10:37,967 --> 05:10:38,401 GUESS. 7626 05:10:38,401 --> 05:10:40,370 SO IN THE MODEL DOES IT ACCOUNT 7627 05:10:40,370 --> 05:10:44,641 FOR THAT OR REMEMBER I'M NOT AN 7628 05:10:44,641 --> 05:10:47,143 EPIDEMIOLOGIST SO WE CAN PUT 7629 05:10:47,143 --> 05:10:47,944 THAT TOGETHER. 7630 05:10:47,944 --> 05:10:49,112 >> IT'S IMPORTANT TO REMEMBER 7631 05:10:49,112 --> 05:10:50,346 DISTRIBUTION OF THESE FOODS THAT 7632 05:10:50,346 --> 05:10:53,082 ARE THAT ARE BEING LOOKED AT CAN 7633 05:10:53,082 --> 05:10:56,686 BE WIDE WITHIN A POPULATION. 7634 05:10:56,686 --> 05:10:58,054 BENEFIT OF COHORTS, YOU'RE NOT 7635 05:10:58,054 --> 05:11:00,390 LIMITED TO 100 GRAMS VERSUS ZERO 7636 05:11:00,390 --> 05:11:05,094 BUT ACROSS POPULATIONS YOU HAVE 7637 05:11:05,094 --> 05:11:06,529 SOME REGIONALLY CONSUMING VERY 7638 05:11:06,529 --> 05:11:08,398 DIFFERENT AMOUNTS, IT'S HARD TO 7639 05:11:08,398 --> 05:11:10,099 PUT A QUANTITY OF WHAT YOU ARE 7640 05:11:10,099 --> 05:11:12,869 IN THAT. 7641 05:11:12,869 --> 05:11:14,737 >> WHEN YOU SAY REPLACING, IT 7642 05:11:14,737 --> 05:11:15,939 ACCOUNTS FOR DISTRIBUTION IS 7643 05:11:15,939 --> 05:11:18,141 WHAT I'M ASKING? 7644 05:11:18,141 --> 05:11:22,445 >> REPLACING WITH A TRIAL. 7645 05:11:22,445 --> 05:11:24,514 >> SUBSTITUTING. 7646 05:11:24,514 --> 05:11:26,916 >> YEAH, SUBSTITUTING WOULD BE A 7647 05:11:26,916 --> 05:11:28,918 ONE-TO-ONE SLOT OF WHATEVER FOOD 7648 05:11:28,918 --> 05:11:36,359 YOU'RE CONTRASTING AND QUANTITY 7649 05:11:36,359 --> 05:11:37,527 YOU'RE SPECIFYING. 7650 05:11:37,527 --> 05:11:37,827 >> AILEEN? 7651 05:11:37,827 --> 05:11:39,095 >> WE SHOULD HAVE STARTED WITH 7652 05:11:39,095 --> 05:11:49,639 THIS ONE IN THE MORNING, RIGHT? 7653 05:11:52,842 --> 05:11:53,509 SO, SORRY. 7654 05:11:53,509 --> 05:11:56,579 SO, I'M TRYING TO LIKE GO 7655 05:11:56,579 --> 05:11:58,882 THROUGH AGAIN AND AGAIN THE 7656 05:11:58,882 --> 05:12:00,850 SUMMARY SLIDES TO WRAP MY HEAD 7657 05:12:00,850 --> 05:12:01,084 AROUND. 7658 05:12:01,084 --> 05:12:02,185 I UNDERSTAND WHAT YOU'RE TRYING 7659 05:12:02,185 --> 05:12:05,889 TO DO, WHICH IS NOT FOCUS ON 7660 05:12:05,889 --> 05:12:07,657 SATURATED FAT BUT THE FOOD 7661 05:12:07,657 --> 05:12:08,157 COMPONENT, RIGHT? 7662 05:12:08,157 --> 05:12:11,794 SO WHEN YOU FOUND NO DIFFERENCE 7663 05:12:11,794 --> 05:12:14,330 IN CARDIOVASCULAR RISK FOR HIGH 7664 05:12:14,330 --> 05:12:18,134 FAT DAIRY VERSUS LOW FAT DAIRY 7665 05:12:18,134 --> 05:12:25,174 FOR EXAMPLE OR PROCESSED RED 7666 05:12:25,174 --> 05:12:26,276 MEAT AND SEAFOOD THAT'S COUNTER 7667 05:12:26,276 --> 05:12:28,778 TO WHAT WE WOULD HAVE EXPECTED. 7668 05:12:28,778 --> 05:12:31,281 ESPECIALLY IN THE FIRST ONE, 7669 05:12:31,281 --> 05:12:33,683 HIGH FAT VERSUS LOW FAT, 7670 05:12:33,683 --> 05:12:37,420 WOULDN'T BE OTHER COMPONENT LIKE 7671 05:12:37,420 --> 05:12:39,055 FROM ANIMAL VERSUS PLANT, RIGHT? 7672 05:12:39,055 --> 05:12:41,224 IT COULD BE MAYBE A FIBER 7673 05:12:41,224 --> 05:12:43,092 CONTENT OR SOMETHING ELSE IN 7674 05:12:43,092 --> 05:12:45,395 THAT FOOD BECAUSE IT'S JUST FAT 7675 05:12:45,395 --> 05:12:46,429 CONTENT THAT'S REDUCED. 7676 05:12:46,429 --> 05:12:49,766 I WAS WONDERING IF YOU COULD 7677 05:12:49,766 --> 05:12:51,968 KIND OF COMMENT ON THAT. 7678 05:12:51,968 --> 05:12:54,270 BECAUSE MAYBE I WAS TAKEN ABACK 7679 05:12:54,270 --> 05:12:56,539 BY THE RESULTS, I'M SURE YOU ALL 7680 05:12:56,539 --> 05:12:57,540 WERE TOO. 7681 05:12:57,540 --> 05:12:58,942 AND WHAT DOES THAT MEAN MAYBE ON 7682 05:12:58,942 --> 05:13:02,245 SOME OF THE THINGS THAT WE 7683 05:13:02,245 --> 05:13:04,647 THOUGHT WAS BETTER TO GO WITH 7684 05:13:04,647 --> 05:13:06,049 LOW FAT DAIRY FOR RISK OF 7685 05:13:06,049 --> 05:13:06,549 CARDIOVASCULAR DISEASE. 7686 05:13:06,549 --> 05:13:08,384 >> LET ME START WITH THE FIRST 7687 05:13:08,384 --> 05:13:09,819 STATEMENT WHICH I WISH I SAID, I 7688 05:13:09,819 --> 05:13:11,020 MEANT TO. 7689 05:13:11,020 --> 05:13:14,290 I THOUGHT AN IMPORTANT PART WAS 7690 05:13:14,290 --> 05:13:17,360 NOT JUST ENOUGH TO GET LOWER 7691 05:13:17,360 --> 05:13:18,461 UNSATURATED FAT, AND HIGH IN 7692 05:13:18,461 --> 05:13:20,430 FIBER IS THE THING THAT STUCK 7693 05:13:20,430 --> 05:13:20,763 OUT. 7694 05:13:20,763 --> 05:13:22,932 I CAN'T BELIEVE NOBODY ASKED 7695 05:13:22,932 --> 05:13:26,436 UNTIL YOU DID, LOW FAT DAIRY, 7696 05:13:26,436 --> 05:13:29,172 HIGH FAT DAIRY ARE NOT DAIRY IT 7697 05:13:29,172 --> 05:13:31,040 SAID, IT'S A LIMITED CONCLUSION. 7698 05:13:31,040 --> 05:13:37,380 WHAT WAS MORE STRIKING HOW 7699 05:13:37,380 --> 05:13:39,015 INADEQUATE THAT DATABASE WAS. 7700 05:13:39,015 --> 05:13:41,517 IT WAS NOT ASSOCIATED. 7701 05:13:41,517 --> 05:13:43,386 >> YEAH, PART OF THE REASON WAS 7702 05:13:43,386 --> 05:13:47,323 THEY SAID LIKE LOW FAT, IT WOULD 7703 05:13:47,323 --> 05:13:49,192 BE 2% AND 1%, AND SO DEFINITIONS 7704 05:13:49,192 --> 05:13:51,728 FOR HIGH AND LOW FAT OFTEN 7705 05:13:51,728 --> 05:13:52,261 WEREN'T GIVEN. 7706 05:13:52,261 --> 05:13:56,099 SO IT WAS KIND OF HARD TO 7707 05:13:56,099 --> 05:13:56,332 DEDUCE. 7708 05:13:56,332 --> 05:13:58,601 THEY JUST WOULD SAY HIGHER 7709 05:13:58,601 --> 05:14:00,269 VERSUS LOWER. 7710 05:14:00,269 --> 05:14:03,039 OR THEY WERE NON-SPECIFIED. 7711 05:14:03,039 --> 05:14:03,239 SO -- 7712 05:14:03,239 --> 05:14:03,940 >> AND FEWER TRIALS THAN WE 7713 05:14:03,940 --> 05:14:04,941 WOULD HAVE SHOT. 7714 05:14:04,941 --> 05:14:06,142 SHOULDN'T WE BE DOING TRIALS 7715 05:14:06,142 --> 05:14:10,513 LIKE THAT? 7716 05:14:10,513 --> 05:14:12,582 WAS IT MOSTLY EPI? 7717 05:14:12,582 --> 05:14:14,450 THAT'S AN ANSWERABLE QUESTION 7718 05:14:14,450 --> 05:14:15,451 FOR SOMETHING LIKE LIPIDS. 7719 05:14:15,451 --> 05:14:17,620 NOTHING IN KIDS. 7720 05:14:17,620 --> 05:14:19,155 REMEMBER, NOTHING IN KIDS. 7721 05:14:19,155 --> 05:14:21,891 THIS IS ONLY IN ADULTS AND OLDER 7722 05:14:21,891 --> 05:14:24,327 ADULTS, NOT EVEN IN OLDER ADULTS 7723 05:14:24,327 --> 05:14:27,163 AND ADULTS AND SHOULD BE KIDS IF 7724 05:14:27,163 --> 05:14:28,564 WE'RE MAKING THAT KIND OF 7725 05:14:28,564 --> 05:14:30,633 FEDERAL DECISION ABOUT ONLY 7726 05:14:30,633 --> 05:14:33,836 SKIM, LOW FAT MILK, NO WHOLE FAT 7727 05:14:33,836 --> 05:14:34,904 MILK IN SCHOOL. 7728 05:14:34,904 --> 05:14:39,842 >> WHAT ABOUT RED MEAT AND THE 7729 05:14:39,842 --> 05:14:41,477 FISH? 7730 05:14:41,477 --> 05:14:46,082 >> SAY THAT AGAIN. 7731 05:14:46,082 --> 05:14:46,482 YEAH. 7732 05:14:46,482 --> 05:14:51,387 >> CAN PEOPLE USE MICROPHONES 7733 05:14:51,387 --> 05:14:58,961 WHOLE MILK IS 50%, SO 50% OF 7734 05:14:58,961 --> 05:15:01,731 CALORIES IN WHOLE MILK ARE FROM 7735 05:15:01,731 --> 05:15:02,932 FAT. 7736 05:15:02,932 --> 05:15:07,203 SO WHATEVER PROPORTION OF 7737 05:15:07,203 --> 05:15:10,907 SATURATED FAT, FROM 2% TO 1%, 7738 05:15:10,907 --> 05:15:13,309 SOMETHING LIKE 35% TOTAL FAT IN 7739 05:15:13,309 --> 05:15:15,945 2%, 15% TOTAL FAT IN 1%, AND 7740 05:15:15,945 --> 05:15:19,015 ZERO IN SKIM BECAUSE THAT'S THE 7741 05:15:19,015 --> 05:15:19,549 DEFINITION. 7742 05:15:19,549 --> 05:15:22,518 >> WHAT YOU'RE GETTING AT IS 7743 05:15:22,518 --> 05:15:24,153 EFFECT SIZE? 7744 05:15:24,153 --> 05:15:25,788 >> OR MAGNITUDE OF EXPOSURE. 7745 05:15:25,788 --> 05:15:31,694 IF IT'S ONE GLASS OF MILK OR TWO 7746 05:15:31,694 --> 05:15:33,062 GLASSES OF MILK, GRAMS OF 7747 05:15:33,062 --> 05:15:34,430 SATURATED FAT, IF YOU WANTED TO 7748 05:15:34,430 --> 05:15:37,633 LOOK AT THAT LEVEL SOME OF THE 7749 05:15:37,633 --> 05:15:39,802 COMPARISONS OF AMOUNT OF 7750 05:15:39,802 --> 05:15:41,237 SATURATED FAT BETWEEN THE 7751 05:15:41,237 --> 05:15:43,639 EXPOSURE AND COMPARATOR WERE 7752 05:15:43,639 --> 05:15:45,074 QUITE MODEST. 7753 05:15:45,074 --> 05:15:47,143 WHICH WOULD EXPLAIN LACK OF 7754 05:15:47,143 --> 05:15:50,646 ASSOCIATION OR EFFECT IN A 7755 05:15:50,646 --> 05:15:50,847 TRIAL. 7756 05:15:50,847 --> 05:15:52,615 >> YEAH, IT WAS CHEESE AND 7757 05:15:52,615 --> 05:15:54,684 YOGURT TOO, IT WAS OTHER FOODS 7758 05:15:54,684 --> 05:15:56,552 THAT THEY LOOKED AT WITHIN THAT, 7759 05:15:56,552 --> 05:15:59,388 THAT WE LOOKED AT WITHIN THAT 7760 05:15:59,388 --> 05:15:59,722 CATEGORY. 7761 05:15:59,722 --> 05:16:00,823 >> THERE WERE THREE CATEGORIES 7762 05:16:00,823 --> 05:16:03,893 OF HIGH FAT DAIRY, LOW FAT 7763 05:16:03,893 --> 05:16:04,193 DAIRY. 7764 05:16:04,193 --> 05:16:06,062 MILK, CHEESE, YOGURT. 7765 05:16:06,062 --> 05:16:09,665 >> ARE THERE OTHER QUESTIONS 7766 05:16:09,665 --> 05:16:11,801 FROM COMMITTEE MEMBERS? 7767 05:16:11,801 --> 05:16:13,302 YES, HEATHER. 7768 05:16:13,302 --> 05:16:13,603 >> THANKS. 7769 05:16:13,603 --> 05:16:16,239 I WANTED TO FOLLOW UP ON 7770 05:16:16,239 --> 05:16:17,540 ANGELA'S COMMENT. 7771 05:16:17,540 --> 05:16:20,943 THAT REALLY WAS MAKING ME WONDER 7772 05:16:20,943 --> 05:16:25,681 MORE, LIKE IT ALMOST SOUNDS LIKE 7773 05:16:25,681 --> 05:16:27,550 WITH THE PROSPECTIVE COHORT 7774 05:16:27,550 --> 05:16:31,254 STUDIES MEAT VERSUS LIKE WHOLE 7775 05:16:31,254 --> 05:16:32,922 GRAINS AND VEGETABLE STUDIES, 7776 05:16:32,922 --> 05:16:35,324 WERE THOSE MODELING EXERCISES OR 7777 05:16:35,324 --> 05:16:42,899 WERE THEY ACTUALLY LIKE MEASURED 7778 05:16:42,899 --> 05:16:44,634 INTAKES GOING PROSPECTIVELY OVER 7779 05:16:44,634 --> 05:16:45,067 TIME? 7780 05:16:45,067 --> 05:16:48,905 SOUNDS LIKE THEY WERE MODELING 7781 05:16:48,905 --> 05:16:50,239 EXERCISES. 7782 05:16:50,239 --> 05:16:51,407 >> MODELING AND LIKE REGRESSION 7783 05:16:51,407 --> 05:16:52,175 MODELING? 7784 05:16:52,175 --> 05:16:56,646 THEY ARE NOT SIMULATIONS. 7785 05:16:56,646 --> 05:16:59,415 >> WRONG WORD, I APOLOGIZE. 7786 05:16:59,415 --> 05:17:00,416 >> IN PROSPECTIVE COHORT DIE SET 7787 05:17:00,416 --> 05:17:03,686 CAPTURED IN A NUMBER OF WAYS, 7788 05:17:03,686 --> 05:17:04,287 FOOD FREQUENCY QUESTIONNAIRES 7789 05:17:04,287 --> 05:17:05,221 ARE THE MOST COMMON. 7790 05:17:05,221 --> 05:17:07,623 I WOULD HAVE A QUANTITY AND 7791 05:17:07,623 --> 05:17:10,493 FREQUENCY OF X NUMBER OF FOODS, 7792 05:17:10,493 --> 05:17:13,863 AND 7793 05:17:13,863 --> 05:17:15,965 AND -- . 7794 05:17:15,965 --> 05:17:17,500 >> THEY DID MEASURE LIKE A 7795 05:17:17,500 --> 05:17:18,467 BASELINE IN TIME. 7796 05:17:18,467 --> 05:17:21,637 >> IF THEY WERE INTERESTED IN 7797 05:17:21,637 --> 05:17:27,043 DAIRY ONLY, CONTRASTING YOUR 7798 05:17:27,043 --> 05:17:30,112 BETA COEFFICIENT FROM DAIRY AND 7799 05:17:30,112 --> 05:17:31,981 WHOLE GRAINS AND FISH, THAT'S 7800 05:17:31,981 --> 05:17:34,784 REGRESSION MODEL BUT NOT A 7801 05:17:34,784 --> 05:17:35,318 SIMULATION. 7802 05:17:35,318 --> 05:17:38,087 >> SOUNDED LIKE IT WAS A 7803 05:17:38,087 --> 05:17:41,257 SIMULATION BUT THEY WERE ACTUAL 7804 05:17:41,257 --> 05:17:43,125 INTAKES MEASURED SELF-REPORTED. 7805 05:17:43,125 --> 05:17:46,062 >> CORRECT, YES, YES. 7806 05:17:46,062 --> 05:17:46,362 ABSOLUTELY. 7807 05:17:46,362 --> 05:17:48,798 >> CAN I GO ONE STEP FURTHER? 7808 05:17:48,798 --> 05:17:52,301 CORRECT ME, WHEN YOU FIRST HAD 7809 05:17:52,301 --> 05:17:54,937 36,000 AND THEN GOT TO 100, AND 7810 05:17:54,937 --> 05:17:57,240 THEN THEY SAID WE'RE GETTING RID 7811 05:17:57,240 --> 05:18:00,743 OF SIMULATION MODELS, OH MY GOD 7812 05:18:00,743 --> 05:18:01,377 NOW THERE'S NOTHING. 7813 05:18:01,377 --> 05:18:03,346 WE HAD TO GO BACK. 7814 05:18:03,346 --> 05:18:04,880 NO, NO, NO, WE WOULD BE 7815 05:18:04,880 --> 05:18:07,516 INTERESTED -- DID I SAY 7816 05:18:07,516 --> 05:18:08,384 SIMULATION AGAIN? 7817 05:18:08,384 --> 05:18:09,051 SUBSTITUTION. 7818 05:18:09,051 --> 05:18:10,486 IF WE DON'T DO SUBSTITUTION. 7819 05:18:10,486 --> 05:18:12,755 I SAW THE WORD MODELING MULTIPLE 7820 05:18:12,755 --> 05:18:13,122 TIMES. 7821 05:18:13,122 --> 05:18:16,392 CAN WE USE THE WORD MODELING? 7822 05:18:16,392 --> 05:18:17,593 >> YOU'RE RUNNING A REGRESSION 7823 05:18:17,593 --> 05:18:17,827 MODEL. 7824 05:18:17,827 --> 05:18:21,564 >> I WOULD ALSO DO WHEN LOOKING 7825 05:18:21,564 --> 05:18:23,399 AT RCT DATA. 7826 05:18:23,399 --> 05:18:23,799 >> OKAY. 7827 05:18:23,799 --> 05:18:27,236 >> BUT NOT MODELING IF THAT'S 7828 05:18:27,236 --> 05:18:28,437 LIKE SIMULATION MODELING. 7829 05:18:28,437 --> 05:18:32,375 >> I'M GOING TO HAVE YOU SHUT 7830 05:18:32,375 --> 05:18:34,977 YOUR MICROPHONE OFF, 7831 05:18:34,977 --> 05:18:36,812 CHRISTOPHER, AND LET ANGELA -- 7832 05:18:36,812 --> 05:18:38,914 >> CAN I ELABORATE ON THIS? 7833 05:18:38,914 --> 05:18:43,953 WHEN WE KIND OF HONED DOWN TO 7834 05:18:43,953 --> 05:18:45,821 THE NUMBER, WE WANTED HEAD TO 7835 05:18:45,821 --> 05:18:47,456 HEAD OR ONE-TO-ONE COMPARISONS. 7836 05:18:47,456 --> 05:18:57,099 THAT'S WHY WE ENDED UP USING THE 7837 05:18:57,099 --> 05:18:59,268 MODEL THAT WE DID. 7838 05:18:59,268 --> 05:19:02,071 >> THAT'S THROWING ME A LITTLE 7839 05:19:02,071 --> 05:19:02,338 BIT. 7840 05:19:02,338 --> 05:19:05,508 IN A PROSPECTIVE COHORT STUDY 7841 05:19:05,508 --> 05:19:08,844 YOU HAVE PEOPLE, IT'S THE VERB 7842 05:19:08,844 --> 05:19:13,382 THAT IS THROWING ME, REPLACING 7843 05:19:13,382 --> 05:19:16,218 OR SUBSTITUTING, BECAUSE IS IT 7844 05:19:16,218 --> 05:19:18,688 PEOPLE SUBSTITUTING OR IS IT 7845 05:19:18,688 --> 05:19:21,891 PEOPLE COMPARED TO OTHER PEOPLE, 7846 05:19:21,891 --> 05:19:22,525 EATING -- PEOPLE EATING ONE 7847 05:19:22,525 --> 05:19:26,696 THING AND ANOTHER PERSON EATING 7848 05:19:26,696 --> 05:19:29,532 ONE THING VERSUS WE TELL PEOPLE 7849 05:19:29,532 --> 05:19:33,469 IF WE'RE DOING EDUCATION, WE SAY 7850 05:19:33,469 --> 05:19:35,671 SUBSTITUTE BLANK FOR BLANK, AND 7851 05:19:35,671 --> 05:19:37,206 THEN ONCE THEY SUBSTITUTE THEN 7852 05:19:37,206 --> 05:19:40,710 THEY ACTUALLY SHOULD BE IN A 7853 05:19:40,710 --> 05:19:41,677 BETTER POSITION. 7854 05:19:41,677 --> 05:19:44,780 BUT WHEN YOU SAY, OH, YOU 7855 05:19:44,780 --> 05:19:46,749 REPLACE BLANK FOR BLANK THAT 7856 05:19:46,749 --> 05:19:49,151 MAKES ME THINK THAT A PERSON, 7857 05:19:49,151 --> 05:19:51,921 ALONG -- YOU KNOW, THIS TIME, 7858 05:19:51,921 --> 05:19:55,191 LIKE THERE'S A TIME GRADIENT, 7859 05:19:55,191 --> 05:19:57,827 THAT THEY ACTUALLY REPLACED 7860 05:19:57,827 --> 05:20:01,130 BLANK AND THEIR BLANK WENT DOWN 7861 05:20:01,130 --> 05:20:04,967 VERSUS THE IDEA OF SAYING THAT A 7862 05:20:04,967 --> 05:20:08,137 PERSON A IN CONTRAST TO PERSON B 7863 05:20:08,137 --> 05:20:12,274 ATE MORE OR LESS OF SOMETHING. 7864 05:20:12,274 --> 05:20:16,812 THAT'S -- I'M WONDERING THE 7865 05:20:16,812 --> 05:20:18,547 REPLACING AND SUBSTITUTING, IF 7866 05:20:18,547 --> 05:20:20,850 THAT GETS -- SOME OTHER THINGS 7867 05:20:20,850 --> 05:20:22,184 ARE EXPRESSED IN DIFFERENT WAY, 7868 05:20:22,184 --> 05:20:25,554 IT'S LIKE A AND B ARE RELATED 7869 05:20:25,554 --> 05:20:26,522 BUT IT'S NOT SUBSTITUTING. 7870 05:20:26,522 --> 05:20:29,024 >> I THINK WE CAN WORKSHOP THE 7871 05:20:29,024 --> 05:20:29,625 NOMENCLATURE FOR SURE BECAUSE 7872 05:20:29,625 --> 05:20:34,063 THE INTENT IS NOT TO MAKE 7873 05:20:34,063 --> 05:20:37,266 CONFUSION BUT TO MAKE CLEAR. 7874 05:20:37,266 --> 05:20:40,536 TO YOUR POINT ABOUT ARE 7875 05:20:40,536 --> 05:20:41,504 INDIVIDUALS SUBSTITUTING, THE 7876 05:20:41,504 --> 05:20:43,506 ANALYSES CAN DO THAT, COHORTS 7877 05:20:43,506 --> 05:20:46,242 WITH REPEATED MEASURES OF DIET 7878 05:20:46,242 --> 05:20:49,945 ARE LIMITED. 7879 05:20:49,945 --> 05:20:53,449 AND SOME WILL BE CHANGE ANALYSES 7880 05:20:53,449 --> 05:20:56,185 WHERE YOU'RE DEFINING DID THIS 7881 05:20:56,185 --> 05:20:58,053 INDIVIDUAL DECREASE SUGARY 7882 05:20:58,053 --> 05:20:59,855 BEVERAGES AND INCREASE 7883 05:20:59,855 --> 05:21:00,322 ARTIFICIALLY SWEETENED 7884 05:21:00,322 --> 05:21:01,991 BEVERAGEDDAGES, AT THE 7885 05:21:01,991 --> 05:21:05,394 INDIVIDUAL LEVEL, WHICH WOULD BE 7886 05:21:05,394 --> 05:21:06,362 WHAT YOU'RE DESCRIBING. 7887 05:21:06,362 --> 05:21:10,533 BUT OTHER TIMES IT'S NOT. 7888 05:21:10,533 --> 05:21:12,401 AND IT IS THE, YOU KNOW, IF 7889 05:21:12,401 --> 05:21:15,271 EVERYBODY HAD BEEN CONSUMING 7890 05:21:15,271 --> 05:21:17,106 THIS VERSUS CONSUMING THAT, AND 7891 05:21:17,106 --> 05:21:19,375 YOU'RE CONTRASTING CONSUMERS OF 7892 05:21:19,375 --> 05:21:22,244 THIS VERSUS THAT, ALL OF THE 7893 05:21:22,244 --> 05:21:25,080 ASSUMPTIONS AROUND THAT WHICH OF 7894 05:21:25,080 --> 05:21:27,783 COURSE ARE IMPERFECT, IT'S THE 7895 05:21:27,783 --> 05:21:32,755 CONSISTENCY THAT HELPS, I THINK, 7896 05:21:32,755 --> 05:21:34,690 WITH THAT. 7897 05:21:34,690 --> 05:21:36,625 >> THANK YOU. 7898 05:21:36,625 --> 05:21:39,462 >> I WANTED TO ASK HOLLIE AND 7899 05:21:39,462 --> 05:21:40,830 VALERIE IF THEY HAD ANY 7900 05:21:40,830 --> 05:21:49,638 QUESTIONS OR COMMENTS ON THESE 7901 05:21:49,638 --> 05:21:50,105 ANALYSES. 7902 05:21:50,105 --> 05:21:51,307 >> THIS IS HOLLIE. 7903 05:21:51,307 --> 05:21:52,508 I DON'T HAVE ADDITIONAL 7904 05:21:52,508 --> 05:21:54,677 QUESTIONS BUT I'M IMPRESSED WITH 7905 05:21:54,677 --> 05:21:55,277 THE WORK OF THE SUBCOMMITTEE, 7906 05:21:55,277 --> 05:21:57,413 THANK YOU SO MUCH FOR THAT. 7907 05:21:57,413 --> 05:21:59,448 >> NO, NO ADDITIONAL COMMENTS OR 7908 05:21:59,448 --> 05:21:59,715 QUESTIONS. 7909 05:21:59,715 --> 05:22:00,716 THANK YOU. 7910 05:22:00,716 --> 05:22:02,651 >> THANK YOU BOTH. 7911 05:22:02,651 --> 05:22:07,356 ARE THERE ANY OTHER QUESTIONS OR 7912 05:22:07,356 --> 05:22:07,857 COMMENTS? 7913 05:22:07,857 --> 05:22:08,791 YES, CRISTINA? 7914 05:22:08,791 --> 05:22:10,192 >> I WAS SURPRISED TO SEE, MAYBE 7915 05:22:10,192 --> 05:22:15,664 AGAIN IT'S THE LACK OF 7916 05:22:15,664 --> 05:22:18,634 UNDERSTANDING OF THE ANALYSIS, 7917 05:22:18,634 --> 05:22:20,836 WHEN YOU WERE RECEIVING RESULTS 7918 05:22:20,836 --> 05:22:24,673 ON DAIRY PRODUCTS LOOKING AT 7919 05:22:24,673 --> 05:22:29,278 BUTTER, OKAY, BUTTER VERSUS -- 7920 05:22:29,278 --> 05:22:31,881 SO YOGURT, THERE WAS NOTHING 7921 05:22:31,881 --> 05:22:32,982 WITH YOGURT? 7922 05:22:32,982 --> 05:22:34,517 IF YOU SUBSTITUTE BUTTER WITH 7923 05:22:34,517 --> 05:22:38,020 YOGURT WOULDN'T THAT BE BETTER? 7924 05:22:38,020 --> 05:22:39,555 I'M PROBABLY NOT UNDERSTANDING 7925 05:22:39,555 --> 05:22:39,822 ANALYSIS. 7926 05:22:39,822 --> 05:22:41,524 >> YEAH, WHEN WE LOOKED AT THE 7927 05:22:41,524 --> 05:22:43,459 SOURCES THERE WAS NO DIFFERENCE. 7928 05:22:43,459 --> 05:22:51,233 YEAH, SO THERE WERE ALL THOSE 7929 05:22:51,233 --> 05:22:51,534 COMPARISONS. 7930 05:22:51,534 --> 05:22:54,870 NO, A LOT OF IT, YOU KNOW, THERE 7931 05:22:54,870 --> 05:22:57,273 WERE ISSUES WITH SATURATED FAT 7932 05:22:57,273 --> 05:22:58,807 CONTENT OF THE COMPARISONS, SO 7933 05:22:58,807 --> 05:23:02,278 THAT PROBABLY WEIGHED IN ON IT. 7934 05:23:02,278 --> 05:23:06,048 BUT, NO, WE DIDN'T SEE ANY 7935 05:23:06,048 --> 05:23:06,348 CHANGES. 7936 05:23:06,348 --> 05:23:11,820 >> BACK TO THE POINT. 7937 05:23:11,820 --> 05:23:12,888 >> NO, CHRISTOPHER. 7938 05:23:12,888 --> 05:23:13,889 CHRISTOPHER, DON'T. 7939 05:23:13,889 --> 05:23:18,060 THERESA HAS A QUESTION. 7940 05:23:18,060 --> 05:23:20,696 >> WAS SATURATED FAT CONSTANT? 7941 05:23:20,696 --> 05:23:26,635 IF YOU HOLD IT CONSTANT -- 7942 05:23:26,635 --> 05:23:26,969 >> NO. 7943 05:23:26,969 --> 05:23:27,670 >> OH. 7944 05:23:27,670 --> 05:23:30,573 >> THAT'S WHY IT'S FOOD SOURCES 7945 05:23:30,573 --> 05:23:34,009 OF SATURATED FAT. 7946 05:23:34,009 --> 05:23:42,585 NOT MATCHING THE SATURATED FAT. 7947 05:23:42,585 --> 05:23:45,321 >> LIKE BUTTERMILK COMPARED TO 7948 05:23:45,321 --> 05:23:46,655 YOGURT, BUTTERMILK COMPARED TO 7949 05:23:46,655 --> 05:23:48,190 BUTTER, THERE WERE COMPARISONS 7950 05:23:48,190 --> 05:23:48,624 THERE. 7951 05:23:48,624 --> 05:23:51,226 WE DID LOOK SEPARATELY AND ENDED 7952 05:23:51,226 --> 05:23:51,894 UP COMBINING THEM. 7953 05:23:51,894 --> 05:23:54,196 IF YOU BROKE THEM APART THERE 7954 05:23:54,196 --> 05:23:54,964 WASN'T ANY DIFFERENCE. 7955 05:23:54,964 --> 05:23:58,133 >> I'M GOING TO TURN THE FLOOR 7956 05:23:58,133 --> 05:23:59,335 OVER TO CHERYL. 7957 05:23:59,335 --> 05:24:01,203 >> A QUICK POINT. 7958 05:24:01,203 --> 05:24:03,706 OFTEN IF YOU DON'T DESIGN THE 7959 05:24:03,706 --> 05:24:04,807 PRIMARY STUDY TO ANSWER THE 7960 05:24:04,807 --> 05:24:07,109 QUESTION, BUT YOU HAVE THE 7961 05:24:07,109 --> 05:24:09,078 EXISTING DATA AND FOR 7962 05:24:09,078 --> 05:24:10,746 EFFICIENCILY YOU CREATE A 7963 05:24:10,746 --> 05:24:12,481 QUESTION AND DO SECONDARY DATA 7964 05:24:12,481 --> 05:24:14,116 ANALYSIS IT MAKES IT HARD TO DO 7965 05:24:14,116 --> 05:24:16,185 WHAT THERESA ASKED ABOUT SO WE 7966 05:24:16,185 --> 05:24:18,387 SEE A LOT OF LITERATURE 7967 05:24:18,387 --> 05:24:24,760 ATTEMPTING TO DO THIS IN A 7968 05:24:24,760 --> 05:24:25,527 SECONDARY ANALYSIS. 7969 05:24:25,527 --> 05:24:26,261 >> CHRIS? 7970 05:24:26,261 --> 05:24:28,564 >> JUST THE OTHER THING I WANTED 7971 05:24:28,564 --> 05:24:31,266 TO ADD FOR CONTEXT, I DO THE 7972 05:24:31,266 --> 05:24:34,370 REAL QUICK MATH, 2,000 CALORIES 7973 05:24:34,370 --> 05:24:37,139 AT 10% UNSATURATED FAT AND 9 7974 05:24:37,139 --> 05:24:38,540 GRAMS OF CALORIES, 9 CALORIES 7975 05:24:38,540 --> 05:24:40,943 PER GRAM OF SATURATED FAT WE'RE 7976 05:24:40,943 --> 05:24:45,114 TALKING ABOUT 22 GRAMS OF 7977 05:24:45,114 --> 05:24:47,416 SATURATED FAT BEING DISTRIBUTED 7978 05:24:47,416 --> 05:24:48,884 ACROSS MULTIPLE FOOD SOURCES, 7979 05:24:48,884 --> 05:24:50,252 WHICH MEANS WHEN YOU START 7980 05:24:50,252 --> 05:24:52,554 GETTING INTO BREAKING IT APART 7981 05:24:52,554 --> 05:24:54,590 FROM MEAT AND DAIRY AND OTHER 7982 05:24:54,590 --> 05:24:56,925 SOURCES OF SORT IN THE DIET WHEN 7983 05:24:56,925 --> 05:25:00,429 YOU CHANGE THE SATURATED FROM 7984 05:25:00,429 --> 05:25:01,530 ONE DAIRY SOURCE TO ANOTHER 7985 05:25:01,530 --> 05:25:04,566 YOU'RE REALLY LOOKING AT JUST A 7986 05:25:04,566 --> 05:25:06,669 SMALL PORTION OF THAT 22 GRAMS 7987 05:25:06,669 --> 05:25:07,870 ACROSS THE DAY. 7988 05:25:07,870 --> 05:25:10,839 SO IT ADDS AN EXTRA LAYER OF 7989 05:25:10,839 --> 05:25:12,341 COMPLEXITY, AROUND THE PRECISION 7990 05:25:12,341 --> 05:25:14,109 OF THAT GRAM DIFFERENCE BUT THE 7991 05:25:14,109 --> 05:25:16,712 MAGNITUDE OF THE GRAM DIFFERENCE 7992 05:25:16,712 --> 05:25:19,148 THAT COMPLICATES THINGS A LITTLE 7993 05:25:19,148 --> 05:25:26,722 BIT MORE THAT MAY NOT 7994 05:25:26,722 --> 05:25:28,424 IMMEDIATELY JUMP OUT. 7995 05:25:28,424 --> 05:25:31,293 >> TO REMEMBERA LOT OF OUR DATA 7996 05:25:31,293 --> 05:25:33,062 ARE DIETS HIGHER IN SATURATED 7997 05:25:33,062 --> 05:25:35,497 FAT ARE LOWER, TO CHRIS' POINT, 7998 05:25:35,497 --> 05:25:37,766 IF YOU'RE CHANGING ONE THING IN 7999 05:25:37,766 --> 05:25:39,968 THE DIET, YOU DO HAVE A CERTAIN 8000 05:25:39,968 --> 05:25:41,003 AMOUNT OF SATURATED FAT SO 8001 05:25:41,003 --> 05:25:45,741 PEOPLE MIGHT WANT TO TAKE IT IN 8002 05:25:45,741 --> 05:25:46,108 DIFFERENT FORMS. 8003 05:25:46,108 --> 05:25:49,044 SO, THAT'S SOMETHING ELSE TO 8004 05:25:49,044 --> 05:25:49,344 CONSIDER. 8005 05:25:49,344 --> 05:25:50,446 SO THANKS, CHRIS. 8006 05:25:50,446 --> 05:25:51,547 >> CHRISTOPHER, I'M GOING TO 8007 05:25:51,547 --> 05:25:54,149 GIVE YOU THE LAST WORD. 8008 05:25:54,149 --> 05:25:56,151 >> WHAT I REALLY LIKED ABOUT 8009 05:25:56,151 --> 05:25:58,454 BEING ABLE TO CLUSTER THESE WAS 8010 05:25:58,454 --> 05:26:01,957 WHAT IF WHITE MEAT HAS A LITTLE 8011 05:26:01,957 --> 05:26:03,726 LESS SATURATED FAT, IF FISH HAS 8012 05:26:03,726 --> 05:26:08,764 LESS THAN THAT BUT PLANTS HAVE 8013 05:26:08,764 --> 05:26:11,600 AN EVEN BIGGER DECREMENT AND 8014 05:26:11,600 --> 05:26:12,801 THEY HAVE FIBER, YOU DON'T SEE 8015 05:26:12,801 --> 05:26:14,670 IT BUT GET A BIGGER DIFFERENCE 8016 05:26:14,670 --> 05:26:18,273 AND THE HAVE THE FIBER THAT'S 8017 05:26:18,273 --> 05:26:23,512 WHEN YOU START NOTICING. 8018 05:26:23,512 --> 05:26:23,779 >> OKAY. 8019 05:26:23,779 --> 05:26:26,014 I GAVE CHRISTOPHER THE LAST 8020 05:26:26,014 --> 05:26:26,215 WORD. 8021 05:26:26,215 --> 05:26:28,884 I JUST WANT TO MAKE SURE THOUGH 8022 05:26:28,884 --> 05:26:30,419 THAT YOU HAD MORE SLIDES. 8023 05:26:30,419 --> 05:26:31,386 >> ONE MORE SLIDE. 8024 05:26:31,386 --> 05:26:32,588 >> THAT'S WHAT I THOUGHT. 8025 05:26:32,588 --> 05:26:35,290 I'M GIVING IT TO YOU SO THAT WE 8026 05:26:35,290 --> 05:26:39,828 CAN WRAP THE DAY UP. 8027 05:26:39,828 --> 05:26:41,997 >> WE HAVE NEXT TO COMPLETE PEER 8028 05:26:41,997 --> 05:26:43,432 REVIEW, SO SOMEONE WILL HAVE A 8029 05:26:43,432 --> 05:26:46,702 LOT OF FUN WITH OUR CONCLUSION 8030 05:26:46,702 --> 05:26:47,102 STATEMENTS. 8031 05:26:47,102 --> 05:26:50,005 AND THEN INCORPORATE CHANGES TO 8032 05:26:50,005 --> 05:26:51,073 SYSTEMATIC REVIEWS AS NEEDED, 8033 05:26:51,073 --> 05:26:53,375 WE'RE WORKING ON OUR CHAPTERS 8034 05:26:53,375 --> 05:26:58,313 BASED ON THESE SYSTEMATIC 8035 05:26:58,313 --> 05:26:59,748 REVIEWS, A CHAPTER ON BEVERAGES 8036 05:26:59,748 --> 05:27:01,817 IS IN GOOD SHAPE ALREADY, AND 8037 05:27:01,817 --> 05:27:03,152 WE'LL PRESENT AN OVERVIEW ACROSS 8038 05:27:03,152 --> 05:27:08,824 REVIEWS AT OUR NEXT MEETING. 8039 05:27:08,824 --> 05:27:12,895 SO THANK YOU. 8040 05:27:12,895 --> 05:27:15,164 >> WHAT A FANTASTIC DAY AND RICH 8041 05:27:15,164 --> 05:27:15,464 DISCUSSION. 8042 05:27:15,464 --> 05:27:18,367 THANKS SO MUCH TO THE COMMITTEE 8043 05:27:18,367 --> 05:27:19,802 FOR YOUR LOVELY PRESENTATIONS 8044 05:27:19,802 --> 05:27:21,436 AND WONDERFUL STAFF FOR YOUR 8045 05:27:21,436 --> 05:27:22,738 SUPPORT IN GETTING HERE. 8046 05:27:22,738 --> 05:27:26,375 IT'S A LOT OF PREP IN ADVANCE OF 8047 05:27:26,375 --> 05:27:26,742 MEETINGS. 8048 05:27:26,742 --> 05:27:29,645 SO TOMORROW WE'RE STARTING AT 8049 05:27:29,645 --> 05:27:33,182 8:30 A.M. EASTERN TIME, 30 8050 05:27:33,182 --> 05:27:34,817 MINUTES EARLIER THAN TODAY. 8051 05:27:34,817 --> 05:27:36,952 JUST THE BRIEF OVERVIEW OF THE 8052 05:27:36,952 --> 05:27:42,391 AGENDA, THERE WILL BE AN UPDATE 8053 05:27:42,391 --> 05:27:44,026 ON FEDERAL EFFORTS, RELATED TO 8054 05:27:44,026 --> 05:27:45,227 THE DIETARY GUIDELINES, 8055 05:27:45,227 --> 05:27:47,229 COMMITTEE WILL DISCUSS DIET IN 8056 05:27:47,229 --> 05:27:51,166 PREGNANCY AND BIRTH THROUGH 8057 05:27:51,166 --> 05:27:52,801 ADOLESCENCE, MORE FOOD PATTERN 8058 05:27:52,801 --> 05:27:54,570 MODELING, UPDATE ON HEALTH 8059 05:27:54,570 --> 05:27:57,172 EQUITY WORKING GROUP, AND I WILL 8060 05:27:57,172 --> 05:27:59,908 GO OVER NEXT STEPS IN THE 8061 05:27:59,908 --> 05:28:00,809 DIETARY GUIDELINES PROCESS, 8062 05:28:00,809 --> 05:28:03,212 AFTER WE RECEIVE THE COMMITTEE'S 8063 05:28:03,212 --> 05:28:08,450 REPORT AND THEN WE'LL WRAP UP 8064 05:28:08,450 --> 05:28:09,484 TOMORROW WITH A COMMITTEE 8065 05:28:09,484 --> 05:28:10,385 FACILITATED DISCUSSION. 8066 05:28:10,385 --> 05:28:11,820 I THANK THE PUBLIC FOR TUNING 8067 05:28:11,820 --> 05:28:12,154 IN. 8068 05:28:12,154 --> 05:28:13,922 WITH THAT I WILL CONCLUDE THE 8069 05:28:13,922 --> 05:28:14,489 MEETING. 8070 05:28:14,489 --> 05:28:24,489 THANK YOU VERY MUCH.