1 00:00:05,880 --> 00:00:07,440 >> WELCOME TO EVERYONE. 2 00:00:07,440 --> 00:00:09,080 DEPENDING WHERE YOU'RE JOINING 3 00:00:09,080 --> 00:00:10,840 FROM, GOOD MORNING, GOOD 4 00:00:10,840 --> 00:00:13,440 AFTERNOON, OR GOOD EVENING. 5 00:00:13,440 --> 00:00:14,800 I'M DREW BREMER, MY ABSOLUTE 6 00:00:14,800 --> 00:00:15,960 HONOR AND PLEASURE TO WELCOME 7 00:00:15,960 --> 00:00:18,720 YOU TO THE KICKOFF MEETING FOR 8 00:00:18,720 --> 00:00:21,120 THE AGRICULTURE AND DIET VALUE 9 00:00:21,120 --> 00:00:22,760 ADDED FOR NUTRITION TRANSLATION 10 00:00:22,760 --> 00:00:25,960 AND ADAPTATION IN A GLOBAL 11 00:00:25,960 --> 00:00:27,200 ECOLOGY, OR ADVANTAGE PROJECT. 12 00:00:27,200 --> 00:00:29,080 YOU'LL HEAR MORE ABOUT IT IN A 13 00:00:29,080 --> 00:00:31,400 FEW MINUTES FROM DR. DAN RAIDEN 14 00:00:31,400 --> 00:00:32,680 AND OVER THE NEXT SEVERAL WEEKS, 15 00:00:32,680 --> 00:00:34,680 THE PROJECT IS AN EFFORT TO 16 00:00:34,680 --> 00:00:36,640 BETTER UNDERSTAND THE 17 00:00:36,640 --> 00:00:39,080 INTERSECTION OF FOOD SYSTEMS, 18 00:00:39,080 --> 00:00:44,160 DIET, NUTRITION, AND HEALTH IN A 19 00:00:44,160 --> 00:00:44,680 CHANGING ENVIRONMENT BY 20 00:00:44,680 --> 00:00:45,520 ADDRESSING REALITIES OF CLIMATE 21 00:00:45,520 --> 00:00:48,680 AND ENVIRONMENTAL CHANGE ARE 22 00:00:48,680 --> 00:00:49,880 AFFECTING DIETARY CHOICES, 23 00:00:49,880 --> 00:00:50,760 PATTERNS, RELEVANT ASPECT 24 00:00:50,760 --> 00:00:52,640 RESPECT OF THE FOOD SYSTEM AS 25 00:00:52,640 --> 00:00:53,720 WELL AS IMPLICATIONS FOR 26 00:00:53,720 --> 00:00:56,000 SPECIFIC PUBLIC HEALTH OUTCOMES 27 00:00:56,000 --> 00:00:57,120 OF INTEREST. 28 00:00:57,120 --> 00:00:58,520 SPECIFICALLY, THIS EFFORT SEEKS 29 00:00:58,520 --> 00:01:00,840 TO DETERMINE HOW AN ECOLOGICAL 30 00:01:00,840 --> 00:01:03,160 APPROACH CAN BE APPLIED TO 31 00:01:03,160 --> 00:01:04,040 ASSESS IMPACT OF THESE 32 00:01:04,040 --> 00:01:06,440 RELATIONSHIPS AND HOW TO BEST 33 00:01:06,440 --> 00:01:07,640 TRANSLATE THE EVIDENCE GENERATED 34 00:01:07,640 --> 00:01:10,600 TO SUPPORT DIE TEAR GUIDANCE AND 35 00:01:10,600 --> 00:01:12,800 PROMOTE HEALTH AND PREVENT 36 00:01:12,800 --> 00:01:13,040 DISEASE. 37 00:01:13,040 --> 00:01:16,920 ADVANTAGE IS INTENDED TO AID THE 38 00:01:16,920 --> 00:01:18,040 GLOBAL COMMUNITY IN ADDRESSING 39 00:01:18,040 --> 00:01:21,200 IMPACTS OF CLIMATE AND 40 00:01:21,200 --> 00:01:22,080 ENVIRONMENTAL CHANGE, FOOD 41 00:01:22,080 --> 00:01:24,160 SYSTEMS, NUTRITION AND HEALTH BY 42 00:01:24,160 --> 00:01:25,000 FOCUSING ON EVIDENCE, 43 00:01:25,000 --> 00:01:26,360 SPECIFICALLY WHAT IS KNOWN AND 44 00:01:26,360 --> 00:01:29,320 WHAT IS NOT KNOWN AND HOW GAPS 45 00:01:29,320 --> 00:01:33,440 MIGHT BE ADDRESS AND HOW TO 46 00:01:33,440 --> 00:01:38,920 APPLY EVIDENCE AND SUPPORT A 47 00:01:38,920 --> 00:01:41,480 SUSTAINABLE RESILIENT PROGRAMS 48 00:01:41,480 --> 00:01:43,200 AND POLICIES AND EMPLOY APPROACH 49 00:01:43,200 --> 00:01:46,480 TO ACCOUNT FOR ELEMENTS OF 50 00:01:46,480 --> 00:01:47,680 NUTRITION ECOLOGY TO ACHIEVE 51 00:01:47,680 --> 00:01:49,440 PUBLIC HEALTH GOALS THROUGH 52 00:01:49,440 --> 00:01:52,520 DEVELOPMENT OF CONTEXT SPECIFIC, 53 00:01:52,520 --> 00:01:53,520 EQUITABLE, SAFE, EFFICACIOUS 54 00:01:53,520 --> 00:01:55,000 INTERVENTIONS AND GUIDANCE. 55 00:01:55,000 --> 00:01:56,480 ADVANTAGE WILL ALSO PROVIDE 56 00:01:56,480 --> 00:01:58,320 VALUE ADDED SUPPORT TO THE 57 00:01:58,320 --> 00:02:01,800 AGENCIES AND ORGANIZATIONS THAT 58 00:02:01,800 --> 00:02:03,680 DEVELOP DIETARY GUIDELINES, 59 00:02:03,680 --> 00:02:04,560 RECOMMENDATIONS, POLICIES AND 60 00:02:04,560 --> 00:02:05,000 PROGRAMS. 61 00:02:05,000 --> 00:02:06,120 AS PART OF THIS VERY IMPORTANT 62 00:02:06,120 --> 00:02:08,400 PROJECT THERE WILL BE FIVE 63 00:02:08,400 --> 00:02:11,240 WORKSHOPS, FIRST IS TODAY. 64 00:02:11,240 --> 00:02:12,240 FOCUS ON ON IMPLICATION OF 65 00:02:12,240 --> 00:02:13,640 CLIMATE AND ENVIRONMENTAL CHANGE 66 00:02:13,640 --> 00:02:15,320 ON PRIORITY HEALTH OUTCOMES. 67 00:02:15,320 --> 00:02:17,080 THE NEXT WORKSHOP WILL BE 68 00:02:17,080 --> 00:02:18,800 THURSDAY, APRIL 20, FOCUSED ON 69 00:02:18,800 --> 00:02:21,200 IMPACT OF CLIMATE AND 70 00:02:21,200 --> 00:02:23,080 ENVIRONMENTAL CHANGE, DIETARY 71 00:02:23,080 --> 00:02:24,120 PATTERNS, ATTITUDES, BELIEFS, 72 00:02:24,120 --> 00:02:24,360 CHOICES. 73 00:02:24,360 --> 00:02:27,000 THE THIRD WORKSHOP WILL BE ON 74 00:02:27,000 --> 00:02:28,760 THURSDAY, APRIL 27, FOCUSED ON 75 00:02:28,760 --> 00:02:29,760 IMPACT OF CLIMATE AND 76 00:02:29,760 --> 00:02:32,120 ENVIRONMENTAL CHANGE ON FOOD 77 00:02:32,120 --> 00:02:33,560 SYSTEMS. 78 00:02:33,560 --> 00:02:35,640 THE FOURTH WORKSHOP WILL BE 79 00:02:35,640 --> 00:02:37,480 THURSDAY MAY 11, DEVELOPING 80 00:02:37,480 --> 00:02:38,360 INTEGRATIVE APPROACH TO 81 00:02:38,360 --> 00:02:40,440 UNDERSTAND INTERSECTION OF 82 00:02:40,440 --> 00:02:41,880 CLIMATE AND ENVIRONMENTAL CHANGE 83 00:02:41,880 --> 00:02:43,440 IN FOOD SYSTEMS, NUTRITION AND 84 00:02:43,440 --> 00:02:45,040 HEALTH. 85 00:02:45,040 --> 00:02:46,760 AND THE FIFTH WORKSHOP 86 00:02:46,760 --> 00:02:49,520 ORIGINALLY TUESDAY MAY 16, WILL 87 00:02:49,520 --> 00:02:52,280 NOW BE HELD IN JUNE, TO BE 88 00:02:52,280 --> 00:02:53,920 DETERMINED, ON NEEDS AND 89 00:02:53,920 --> 00:02:57,000 APPROACHES TO TRANSLATION OF 90 00:02:57,000 --> 00:02:58,400 EMERGING EVIDENCE TO SUPPORT 91 00:02:58,400 --> 00:02:59,920 CONTEXT-SPECIFIC, EQUITABLE, 92 00:02:59,920 --> 00:03:02,160 SAFE AND EFFICACIOUS 93 00:03:02,160 --> 00:03:02,760 INTERVENTIONS, DIETARY GUIDANCE, 94 00:03:02,760 --> 00:03:05,760 STANDARDS OF CARE IN A CHANGING 95 00:03:05,760 --> 00:03:07,160 ENVIRONMENT AND WE'LL KEEP THE 96 00:03:07,160 --> 00:03:08,480 REGISTRATION WEBSITE UP TO DATE 97 00:03:08,480 --> 00:03:13,040 AS FINAL DETAILS ARE FLOWN. 98 00:03:13,040 --> 00:03:15,160 I WANT TO RECOGNIZE DR. DAN 99 00:03:15,160 --> 00:03:19,760 RAIDEN FROM EUNICE KENNEDY 100 00:03:19,760 --> 00:03:20,560 SHRIVER INSTITUTE, FEARLESS 101 00:03:20,560 --> 00:03:26,280 LEADER OF THE PROJECT AND DR. 102 00:03:26,280 --> 00:03:27,720 ALLISON STIVER. 103 00:03:27,720 --> 00:03:30,600 THE WORKSHOPS WOULD NOT BE 104 00:03:30,600 --> 00:03:32,280 POSSIBLE WITHOUT DAN, ALLISON, 105 00:03:32,280 --> 00:03:34,400 AND ALLISON'S SPECTACULAR TEAM 106 00:03:34,400 --> 00:03:35,240 FROM THE ACADEMY. 107 00:03:35,240 --> 00:03:35,840 WE'RE GRATEFUL. 108 00:03:35,840 --> 00:03:38,240 I WOULD LIKE TO THANK ALL THE 109 00:03:38,240 --> 00:03:38,760 INDIVIDUALS WHO WORKED 110 00:03:38,760 --> 00:03:41,200 TIRELESSLY BEHIND THE SCENES TO 111 00:03:41,200 --> 00:03:42,000 COORDINATE THESE VIRTUAL 112 00:03:42,000 --> 00:03:43,280 WORKSHOPS, WE'RE ALL USED TO 113 00:03:43,280 --> 00:03:45,360 THESE MEETINGS BY NOW, WE ALSO 114 00:03:45,360 --> 00:03:46,640 KNOW THEY JUST DON'T HAPPEN 115 00:03:46,640 --> 00:03:48,880 WITHOUT A TREMENDOUS AMOUNT OF 116 00:03:48,880 --> 00:03:50,280 LOGISTICAL AND I.T. SUPPORT. 117 00:03:50,280 --> 00:03:55,720 TO THE ENTIRE ADVANTAGE TEAM, 118 00:03:55,720 --> 00:03:58,040 THANK YOU. 119 00:03:58,040 --> 00:03:58,880 FOR THOSE JOINING BY VIDEOCAST, 120 00:03:58,880 --> 00:04:01,760 PLEASE FEEL FREE TO SEND 121 00:04:01,760 --> 00:04:09,240 QUESTIONS AND COMMENTS TO 122 00:04:09,240 --> 00:04:09,760 ADVANTAGE-NICHD@NIH.GOV. 123 00:04:09,760 --> 00:04:12,640 I PROMISED TO KEEP MY REMARKS 124 00:04:12,640 --> 00:04:12,840 SHORT. 125 00:04:12,840 --> 00:04:18,440 IT'S MY PLEASURE AND HONOR TO 126 00:04:18,440 --> 00:04:23,680 INTRODUCE DR. ALISON CERNICH, 127 00:04:23,680 --> 00:04:25,440 DEPUTY DIRECTOR, A TREMENDOUS 128 00:04:25,440 --> 00:04:26,520 LEADER AND HAS BEEN AND 129 00:04:26,520 --> 00:04:29,000 CONTINUES TO BE A TREMENDOUS 130 00:04:29,000 --> 00:04:31,120 ADVOCATE AND CHAMPION FOR 131 00:04:31,120 --> 00:04:32,080 NUTRITION-RELATED RESEARCH 132 00:04:32,080 --> 00:04:33,200 DOMESTICALLY AND GLOBALLY. 133 00:04:33,200 --> 00:04:40,200 WE'RE SO GRATEFUL TO HAVE HER 134 00:04:40,200 --> 00:04:40,960 HERE THIS MORNING. 135 00:04:40,960 --> 00:04:41,760 >> THANKS, DREW. 136 00:04:41,760 --> 00:04:48,320 I WANT TO ECHO MY THANKS FOR 137 00:04:48,320 --> 00:04:50,320 EVERYBODY JOINING US TODAY AND 138 00:04:50,320 --> 00:04:53,600 ADD MY THANKS TO DREW AND DAN 139 00:04:53,600 --> 00:04:57,840 AND ALLISON, NICE TO RECOGNIZE 140 00:04:57,840 --> 00:05:04,520 ANOTHER ALLISON THAT'S SPELLED 141 00:05:04,520 --> 00:05:04,720 RIGHT. 142 00:05:04,720 --> 00:05:07,280 WE HAVE HAD AN AMAZING JOURNEY, 143 00:05:07,280 --> 00:05:10,320 I'VE BEEN WORKING WITH THEM FOR 144 00:05:10,320 --> 00:05:11,960 NUTRITION PROGRAM WAS USAID AS 145 00:05:11,960 --> 00:05:13,720 OFFICE OF NUTRITION RESEARCH 146 00:05:13,720 --> 00:05:14,920 HERE AT NIH. 147 00:05:14,920 --> 00:05:16,760 AND I HAVE LEARNED SO MUCH FROM 148 00:05:16,760 --> 00:05:18,040 THEM AND THE COMMUNITY. 149 00:05:18,040 --> 00:05:20,480 AND SO I WANT TO THANK EVERYONE 150 00:05:20,480 --> 00:05:21,880 INVOLVED IN THE ADVANTAGE 151 00:05:21,880 --> 00:05:23,120 PROJECT AND WELCOME EVERYONE 152 00:05:23,120 --> 00:05:30,360 JOINING TODAY TO THE FIRST OF 153 00:05:30,360 --> 00:05:33,600 ADVANTAGE'S FIVE PUBLIC 154 00:05:33,600 --> 00:05:34,080 MEETINGS. 155 00:05:34,080 --> 00:05:38,960 WE LIVE IN A COMPLEX WORK. 156 00:05:38,960 --> 00:05:40,680 IT STRIKES ME THERE'S AN 157 00:05:40,680 --> 00:05:42,280 INCREASING IMPLICATION OF THE 158 00:05:42,280 --> 00:05:44,760 INTERSECTION OF CLIMATE AND 159 00:05:44,760 --> 00:05:45,960 ENVIRONMENTAL CHANGE, FOOD 160 00:05:45,960 --> 00:05:47,320 SYSTEMS, DIET, NUTRITION AND 161 00:05:47,320 --> 00:05:50,760 HEALTH ACROSS THE LIFE COURSE. 162 00:05:50,760 --> 00:05:52,120 WE REALLY HAVE SEEN MULTIPLE 163 00:05:52,120 --> 00:05:55,720 EFFORTS REFLECTING THE CHANGE OF 164 00:05:55,720 --> 00:05:56,320 EXPERTISE REPRESENTED BY 165 00:05:56,320 --> 00:05:59,000 AGENCIES IN THE U.S. GOVERNMENT, 166 00:05:59,000 --> 00:06:01,800 AND NIH THROUGH OUR SUPPORT OF 167 00:06:01,800 --> 00:06:03,520 THE EXTRAMURAL RESEARCH 168 00:06:03,520 --> 00:06:04,200 COMMUNITY IS PLAYING AN 169 00:06:04,200 --> 00:06:05,480 INCREASINGLY ACTIVE ROLE IN 170 00:06:05,480 --> 00:06:07,680 ADDRESSING THE INTERSECTION OF 171 00:06:07,680 --> 00:06:08,240 THESE FACTORS. 172 00:06:08,240 --> 00:06:10,640 BOTH IN TERMS OF THE IMPACT ON 173 00:06:10,640 --> 00:06:12,480 HUMAN HEALTH AND EFFECTS OF THE 174 00:06:12,480 --> 00:06:15,040 STRUCTURAL COMPONENTS OF SYSTEMS 175 00:06:15,040 --> 00:06:19,320 NEEDED TO DEVELOP AND IMPLEMENT 176 00:06:19,320 --> 00:06:19,880 EVIDENCE-INFORMED GUIDANCE, 177 00:06:19,880 --> 00:06:20,560 PROGRAMS, INTERVENTIONS. 178 00:06:20,560 --> 00:06:22,480 WHETHER IT IS THE ABILITY TO 179 00:06:22,480 --> 00:06:24,240 WITHSTAND THE IMPACT OF 180 00:06:24,240 --> 00:06:26,520 INCREASING VECTOR BORNE DISEASES 181 00:06:26,520 --> 00:06:29,240 AND FOOD BORNE ILLNESS OR 182 00:06:29,240 --> 00:06:34,200 RESILIENCY IN THE FACE OF 183 00:06:34,200 --> 00:06:35,400 CLIMATE-RELATED STRESS OUR 184 00:06:35,400 --> 00:06:37,640 APPRECIATION OF NUTRITION IN 185 00:06:37,640 --> 00:06:39,240 THIS COMPLEX ENVIRONMENT DEMANDS 186 00:06:39,240 --> 00:06:40,880 AN INTEGRATED APPROACH. 187 00:06:40,880 --> 00:06:43,480 WHAT'S GREAT FOR US WE'RE IN AN 188 00:06:43,480 --> 00:06:44,880 ENVIRONMENT HIGHLY CONDUCIVE TO 189 00:06:44,880 --> 00:06:46,320 BETTER UNDERSTAND THESE COMPLEX 190 00:06:46,320 --> 00:06:48,640 RELATIONSHIPS, THERE ARE SO MANY 191 00:06:48,640 --> 00:06:50,160 U.S. GOVERNMENT INITIATIVES 192 00:06:50,160 --> 00:06:51,480 FORMED TO ENGAGE STAKEHOLDER 193 00:06:51,480 --> 00:06:54,960 COMMUNITIES AND DEVELOPMENT OF 194 00:06:54,960 --> 00:06:55,760 EVIDENCE-BASED PROGRAMS, 195 00:06:55,760 --> 00:06:56,520 INTERVENTIONS, RECOMMENDATIONS 196 00:06:56,520 --> 00:06:59,040 TO RESPOND TO THE CHALLENGES 197 00:06:59,040 --> 00:07:00,920 IMPOSED BY CLIMATE ENVIRONMENTAL 198 00:07:00,920 --> 00:07:01,640 CHANGE. 199 00:07:01,640 --> 00:07:03,720 SO THESE INCLUDE INTERAGENCY 200 00:07:03,720 --> 00:07:04,600 CROSS-CUTTING GROUP ON CLIMATE 201 00:07:04,600 --> 00:07:05,920 CHANGE AND HUMAN HEALTH WHICH 202 00:07:05,920 --> 00:07:08,680 HAS A DEDICATED WORK STREAM ON 203 00:07:08,680 --> 00:07:10,960 FOOD SYSTEMS AND NUTRITION 204 00:07:10,960 --> 00:07:11,960 SECURITY SPECIFICALLY ATTEMPTS 205 00:07:11,960 --> 00:07:14,680 TO IDENTIFY INDICATORS OF FOOD 206 00:07:14,680 --> 00:07:15,880 SAFETY AND NUTRITION SECURITY 207 00:07:15,880 --> 00:07:22,240 AND U.S. GOVERNMENT'S GLOBAL 208 00:07:22,240 --> 00:07:24,360 NUTRITION PLAN 2.0, CLIMATE, 209 00:07:24,360 --> 00:07:25,640 HEALTH, AGRICULTURE AND 210 00:07:25,640 --> 00:07:28,600 NUTRITION IN A GLOBAL ECOLOGY, 211 00:07:28,600 --> 00:07:31,440 OR CHANGE. 212 00:07:31,440 --> 00:07:32,520 THE GOAL IS TO COORDINATE 213 00:07:32,520 --> 00:07:34,320 FEDERAL WORK TO ADDRESS IMPACT 214 00:07:34,320 --> 00:07:35,600 OF CLIMATE AND ENVIRONMENTAL 215 00:07:35,600 --> 00:07:36,840 CHANGE ON PROGRAMS AND TO 216 00:07:36,840 --> 00:07:39,560 IDENTIFY AND RESPOND TO THE ROAM 217 00:07:39,560 --> 00:07:43,360 OF NUTRITION IN HEALTH PROMOTION 218 00:07:43,360 --> 00:07:44,440 AND DISEASE PREVENTION. 219 00:07:44,440 --> 00:07:50,040 THESE WILL ISSUE INCLUDE COLLAN 220 00:07:50,040 --> 00:07:52,760 IN THE U.S. COMMUNITY AND GLOBAL 221 00:07:52,760 --> 00:07:58,720 RESEARCH ENTERPRISE. 222 00:07:58,720 --> 00:08:00,000 IN PARALLEL, NIH INITIATIVE 223 00:08:00,000 --> 00:08:00,600 INCLUDES REPRESENTATION FROM 224 00:08:00,600 --> 00:08:02,640 INSTITUTES AND CENTERS AT NIH, 225 00:08:02,640 --> 00:08:05,640 AND REFLECTS THE FILL BREADTH OF 226 00:08:05,640 --> 00:08:06,800 INTEREST AND ACTIVITIES ACROSS 227 00:08:06,800 --> 00:08:07,680 THE NIH COMMUNITY. 228 00:08:07,680 --> 00:08:10,080 THIS EFFORT IS INFORMED BY AN 229 00:08:10,080 --> 00:08:10,760 EXECUTIVE COMMITTEE CONSISTING 230 00:08:10,760 --> 00:08:12,480 OF DIRECTORS FROM MULTIPLE NIH 231 00:08:12,480 --> 00:08:15,640 INSTITUTES INCLUDING OUR OWN 232 00:08:15,640 --> 00:08:17,320 DIRECTOR, DR. DIANA BIANCHI, AND 233 00:08:17,320 --> 00:08:19,640 THIS PROVIDES GUIDANCE AND 234 00:08:19,640 --> 00:08:21,680 DIRECTION AND SETS PRIORITIES TO 235 00:08:21,680 --> 00:08:22,560 ADDRESS CHALLENGES FACING THE 236 00:08:22,560 --> 00:08:24,440 BIOMEDICAL COMMUNITY IN THE 237 00:08:24,440 --> 00:08:25,440 CLIMATE CHANGE SPACE. 238 00:08:25,440 --> 00:08:27,280 WE REALLY SERVE ON THE STEERING 239 00:08:27,280 --> 00:08:29,040 COMMITTEE OF THIS CLIMATE CHANGE 240 00:08:29,040 --> 00:08:30,320 AND HEALTH INITIATIVE AND WE'VE 241 00:08:30,320 --> 00:08:31,960 TRIED TO HELP FOCUS THIS ON THE 242 00:08:31,960 --> 00:08:33,520 DEVELOPMENT OF FRAMEWORK THAT 243 00:08:33,520 --> 00:08:35,760 ADDRESSES MANY CRITICAL 244 00:08:35,760 --> 00:08:36,480 COMPONENTS OF RESEARCH, 245 00:08:36,480 --> 00:08:38,120 ADDRESSING CLIMATE CHANGE AND 246 00:08:38,120 --> 00:08:38,880 HEALTH, INCLUDING STRUCTURAL 247 00:08:38,880 --> 00:08:41,480 ISSUE SUCH AS HEALTH SYSTEMS AND 248 00:08:41,480 --> 00:08:42,400 ENVIRONMENTAL HEALTH QUALITY, 249 00:08:42,400 --> 00:08:47,960 AND WE'VE ALSO ENSURED WE HAVE A 250 00:08:47,960 --> 00:08:49,440 FOCUS ON THE LIFE COURSE 251 00:08:49,440 --> 00:08:50,680 SPECIFICALLY ON DEVELOPMENT. 252 00:08:50,680 --> 00:08:52,000 IN THIS RAPIDLY CHANGING 253 00:08:52,000 --> 00:08:53,640 ENVIRONMENT THAT CONFRONTS OUR 254 00:08:53,640 --> 00:08:59,000 FOOD INTRODUCTION SYSTEM, IT 255 00:08:59,000 --> 00:09:00,960 WILL SHAPE OUR FOOD CHOICES AND 256 00:09:00,960 --> 00:09:01,320 INTERVENTIONS. 257 00:09:01,320 --> 00:09:03,280 THAT BRINGS US TO THE WORKSHOP, 258 00:09:03,280 --> 00:09:04,640 I'M GRATEFUL TO HELP KICK THIS 259 00:09:04,640 --> 00:09:06,560 OFF, FIRST IN THE SERIES OF PART 260 00:09:06,560 --> 00:09:08,200 OF THE AGRICULTURAL AND DIET 261 00:09:08,200 --> 00:09:11,160 VALUE ADDED FOR NUTRITION, 262 00:09:11,160 --> 00:09:14,560 TRANSLATION, ADAPTATION AND 263 00:09:14,560 --> 00:09:16,840 GLOBAL ECOLOGY OR ADVANTAGE 264 00:09:16,840 --> 00:09:17,080 PROJECT. 265 00:09:17,080 --> 00:09:19,440 I THANK NICHD AND ACADEMY FOR 266 00:09:19,440 --> 00:09:20,880 NUTRITION AND DIETETICS. 267 00:09:20,880 --> 00:09:21,880 THE GOAL OF ADVANTAGE IS TO 268 00:09:21,880 --> 00:09:23,760 DETERMINE WHAT WE KNOW AND WHAT 269 00:09:23,760 --> 00:09:25,920 WE DO NOT KNOW ABOUT THESE 270 00:09:25,920 --> 00:09:31,400 CRITICAL ISSUES AND IN DOING SO 271 00:09:31,400 --> 00:09:32,400 DEVELOP AN IMPLEMENTABLE 272 00:09:32,400 --> 00:09:35,680 RESEARCH AGENDA TO ADDRESS THESE 273 00:09:35,680 --> 00:09:35,880 NEEDS. 274 00:09:35,880 --> 00:09:36,520 I EXPRESSION APPRECIATION FOR 275 00:09:36,520 --> 00:09:37,880 SUPPORT OF THIS PROJECT FROM THE 276 00:09:37,880 --> 00:09:39,520 ACADEMY FOR NUTRITION AND 277 00:09:39,520 --> 00:09:40,720 DIETETICS AND OUR PARTNER 278 00:09:40,720 --> 00:09:42,000 AGENCIES THROUGHOUT THE U.S. 279 00:09:42,000 --> 00:09:44,120 GOVERNMENT, AS REFLECTED BY THE 280 00:09:44,120 --> 00:09:45,080 MEMBERSHIP OF OUR SCIENTIFIC 281 00:09:45,080 --> 00:09:45,520 STEERING COMMITTEE. 282 00:09:45,520 --> 00:09:48,600 THANK YOU FOR YOUR SERVICE. 283 00:09:48,600 --> 00:09:51,320 I KNOW WHAT I KNOW ARE VERY BUSY 284 00:09:51,320 --> 00:09:51,600 SCHEDULES. 285 00:09:51,600 --> 00:09:53,200 THE PANEL DISCUSSION WILL START 286 00:09:53,200 --> 00:09:54,360 WITH REFLECTIONs BY MEMBERS OF 287 00:09:54,360 --> 00:09:56,240 THE STEERING COMMITTEE ON THE 288 00:09:56,240 --> 00:09:57,440 CHALLENGES OF CLIMATE AND 289 00:09:57,440 --> 00:09:58,640 ENVIRONMENTAL CHANGES AND VALUE 290 00:09:58,640 --> 00:10:00,520 OF ADVANTAGE TO MEET THEM. 291 00:10:00,520 --> 00:10:03,080 WITH THAT, I WILL HAND IT BACK 292 00:10:03,080 --> 00:10:04,800 TO DRAW AND AGAIN THANK YOU ALL 293 00:10:04,800 --> 00:10:06,120 FOR YOUR PARTICIPATION IN BOTH 294 00:10:06,120 --> 00:10:07,600 THIS AND THE FOLLOWING MEETINGS 295 00:10:07,600 --> 00:10:09,640 AND LOOK FORWARD TO HEARING THE 296 00:10:09,640 --> 00:10:12,480 RESULTS OF THESE CONVERSATIONS. 297 00:10:12,480 --> 00:10:13,280 THANKS, DREW. 298 00:10:13,280 --> 00:10:13,720 >> GREAT, ALISON. 299 00:10:13,720 --> 00:10:16,520 THANK YOU SO MUCH. 300 00:10:16,520 --> 00:10:18,160 I WILL QUICKLY PIVOT AND TURN 301 00:10:18,160 --> 00:10:23,280 THE FLOOR OVER TO DAN. 302 00:10:23,280 --> 00:10:25,600 >> THANK YOU, DR. CERNICH. 303 00:10:25,600 --> 00:10:27,120 PLEASE CONVEY OUR GRATITUDE TO 304 00:10:27,120 --> 00:10:33,240 DR. BIANCHI FOR HER SUPPORT OF 305 00:10:33,240 --> 00:10:34,560 THIS EFFORT. 306 00:10:34,560 --> 00:10:37,200 THANKS TO MY PARTNERS AND 307 00:10:37,200 --> 00:10:39,600 MEMBERS OF THE SCIENTIFIC 308 00:10:39,600 --> 00:10:41,680 STEERING COMMITTEE WHO HELPED 309 00:10:41,680 --> 00:10:49,000 DEVELOP THIS PROJECT. 310 00:10:49,000 --> 00:10:50,920 I'M GOING TO GIVE YOU SOME 311 00:10:50,920 --> 00:10:52,520 BACKGROUND OF WHAT WE'RE TRYING 312 00:10:52,520 --> 00:10:54,040 TO ACCOMPLISH. 313 00:10:54,040 --> 00:10:54,720 NEXT SLIDE. 314 00:10:54,720 --> 00:10:56,800 WE ALL HEAR THE MANTRA OF 315 00:10:56,800 --> 00:10:58,200 EVIDENCE-BASED PROGRAMS AND 316 00:10:58,200 --> 00:10:59,520 POLICIES AND UNDERSTAND NICHD 317 00:10:59,520 --> 00:11:01,280 WHAT OUR ROLE IS IN THAT 318 00:11:01,280 --> 00:11:01,640 CONTINUUM. 319 00:11:01,640 --> 00:11:04,560 OUR ROLE IS THE EVIDENCE 320 00:11:04,560 --> 00:11:06,120 GENERATORS, WE'RE HERE TO 321 00:11:06,120 --> 00:11:07,080 SUPPORT CONSTITUENCY IN THE 322 00:11:07,080 --> 00:11:09,480 EXTRAMURAL COMMUNITY BUT WE ALSO 323 00:11:09,480 --> 00:11:10,920 RECOGNIZE THERE'S A BALANCE 324 00:11:10,920 --> 00:11:12,800 BETWEEN CONDUCT OF BASIC 325 00:11:12,800 --> 00:11:14,440 BIOMEDICAL RESEARCH AND THE 326 00:11:14,440 --> 00:11:16,640 TRANSLATION OF THAT BASIC 327 00:11:16,640 --> 00:11:19,120 BIOMEDICAL RESEARCH TO 328 00:11:19,120 --> 00:11:19,920 ASSESSMENT APPROACHES, 329 00:11:19,920 --> 00:11:21,120 INTERVENTION APPROACHES, AND 330 00:11:21,120 --> 00:11:21,960 STANDARDS OF CARE. 331 00:11:21,960 --> 00:11:24,080 AND SO THAT BALANCE IS REALLY 332 00:11:24,080 --> 00:11:25,160 IMPORTANT. 333 00:11:25,160 --> 00:11:26,560 WE TRY TO BUILD THIS BALANCE 334 00:11:26,560 --> 00:11:28,000 INTO EVERYTHING THAT WE DO WITH 335 00:11:28,000 --> 00:11:37,640 ALL THE PROJECTS THAT WE DO. 336 00:11:37,640 --> 00:11:38,400 NEXT SLIDE. 337 00:11:38,400 --> 00:11:40,120 IT'S IMPORTANT TO HAVE A COMMON 338 00:11:40,120 --> 00:11:40,440 VERNACULAR. 339 00:11:40,440 --> 00:11:41,800 WE'RE GOING TO DEVELOP THAT, 340 00:11:41,800 --> 00:11:44,920 HOPEFULLY TO HELP INFORM THE 341 00:11:44,920 --> 00:11:46,800 CONVERSATIONS ACROSS THE 342 00:11:46,800 --> 00:11:47,080 COMMUNITY. 343 00:11:47,080 --> 00:11:47,800 NEXT SLIDE. 344 00:11:47,800 --> 00:11:58,080 SOME KEY ISSUES WE'RE GOING TO 345 00:11:58,080 --> 00:12:01,160 HEAR ABOUT HERE ARE LISTED HERE. 346 00:12:01,160 --> 00:12:03,320 WE'RE REFERRING TO INTERACTION 347 00:12:03,320 --> 00:12:05,000 OF COMPLEX BIOLOGICAL SYSTEM, 348 00:12:05,000 --> 00:12:06,600 INTERNAL AND EXTERNAL 349 00:12:06,600 --> 00:12:07,000 ENVIRONMENT. 350 00:12:07,000 --> 00:12:08,480 ALL SYSTEMS HAVE AN ECOLOGY. 351 00:12:08,480 --> 00:12:11,240 AND IN ORDER TO BE PRECISE IN 352 00:12:11,240 --> 00:12:13,320 HOW WE ADDRESS THE CHALLENGES 353 00:12:13,320 --> 00:12:15,080 WE'RE FACED WITH, WE FEEL 354 00:12:15,080 --> 00:12:17,480 STRONGLY THAT WE NEED TO TAKE A 355 00:12:17,480 --> 00:12:19,000 MORE ECOLOGICAL APPROACH IN 356 00:12:19,000 --> 00:12:22,200 DOING THINGS. 357 00:12:22,200 --> 00:12:31,480 HEALTH IS THE RESULT OF THAT 358 00:12:31,480 --> 00:12:34,080 ECOLOGY, INCLUDING FOOD 359 00:12:34,080 --> 00:12:35,840 NUTRITION AND PHYSICAL 360 00:12:35,840 --> 00:12:37,480 ENVIRONMENT. 361 00:12:37,480 --> 00:12:39,800 THE NEXT COUPLE SLIDES, I'M NOT 362 00:12:39,800 --> 00:12:44,360 TELLING YOU WHAT THESE TERMS 363 00:12:44,360 --> 00:12:45,600 MEAN BUT IT'S IMPORTANT TO MAKE 364 00:12:45,600 --> 00:12:47,880 A DISTINCTION BETWEEN FOOD AS A 365 00:12:47,880 --> 00:12:50,720 DELIVERY VEHICLE FOR NUTRIENTS 366 00:12:50,720 --> 00:12:53,040 AND BIOLOGIC SUBSTANCES TO 367 00:12:53,040 --> 00:12:55,240 SUPPORT HEALTH. 368 00:12:55,240 --> 00:12:58,920 DIET, THE COMPOSITE OF FOODS AND 369 00:12:58,920 --> 00:13:02,200 BIOLOGICALLY ACTIVE DIETARY 370 00:13:02,200 --> 00:13:04,600 SUBSTANCES. 371 00:13:04,600 --> 00:13:06,680 AND NUTRITIONAL STATUS WHICH IS 372 00:13:06,680 --> 00:13:08,800 A BIOLOGICAL VARIABLE. 373 00:13:08,800 --> 00:13:10,040 WE CONFLATE FOOD AND NUTRITION, 374 00:13:10,040 --> 00:13:12,600 THEY ARE NOT THE SAME. 375 00:13:12,600 --> 00:13:14,800 WE'LL TRY TO MAKE THAT 376 00:13:14,800 --> 00:13:16,280 DISTINCTION CLEAR. 377 00:13:16,280 --> 00:13:19,040 NUTRITIONAL STATUS AS A 378 00:13:19,040 --> 00:13:19,920 BIOLOGICAL VARIABLE IS ACHIEVED 379 00:13:19,920 --> 00:13:21,680 AS A RESULT OF A SERIES OF 380 00:13:21,680 --> 00:13:23,960 PROCESS THAT STARTS WITH 381 00:13:23,960 --> 00:13:29,680 INGESTION BUT INCLUDES MULTIPLE 382 00:13:29,680 --> 00:13:31,880 PROCESSES INTERNALLY, AFFECT AND 383 00:13:31,880 --> 00:13:34,480 ARE AFFECTED BY NUTRITION. 384 00:13:34,480 --> 00:13:36,240 NUTRITION STATUS IS AN INPUT TO 385 00:13:36,240 --> 00:13:37,320 THE BIOLOGICAL SYSTEMS AND 386 00:13:37,320 --> 00:13:43,480 PROCESSES AS WELL AS OUTCOME OF 387 00:13:43,480 --> 00:13:44,880 PERTURBATIONS IN THOSE SYSTEMS. 388 00:13:44,880 --> 00:13:45,880 THE LAST TERM IS ENVIRONMENT. 389 00:13:45,880 --> 00:13:47,640 I DON'T KNOW IF WE ALL USE IT 390 00:13:47,640 --> 00:13:48,920 THE SAME WAY. 391 00:13:48,920 --> 00:13:50,120 NEXT SLIDE. 392 00:13:50,120 --> 00:13:53,000 THIS IS A CARTOON THAT 393 00:13:53,000 --> 00:13:57,280 REPRESENTS OUR HOLISTIC VIEW OF 394 00:13:57,280 --> 00:13:59,560 THE ENVIRONMENT THAT INCLUDES 395 00:13:59,560 --> 00:14:02,200 THE HUMAN BIOLOGY, FOOD, 396 00:14:02,200 --> 00:14:05,040 NUTRITION, LAND, WATER, PHYSICAL 397 00:14:05,040 --> 00:14:06,680 CLIMATE, PHYSICAL SYSTEMS, 398 00:14:06,680 --> 00:14:07,400 SOCIAL, BEHAVIORAL, ECONOMIC 399 00:14:07,400 --> 00:14:08,640 SYSTEMS, ET CETERA. 400 00:14:08,640 --> 00:14:09,680 THESE ARE ALL INTERACTING AND 401 00:14:09,680 --> 00:14:11,160 ARE ALL PART OF THE ENVIRONMENT 402 00:14:11,160 --> 00:14:12,240 THAT WE'LL BE ADDRESSING 403 00:14:12,240 --> 00:14:15,320 THROUGHOUT THIS PROJECT. 404 00:14:15,320 --> 00:14:15,760 NEXT SLIDE. 405 00:14:15,760 --> 00:14:18,040 A CRITICAL ELEMENT IS THE 406 00:14:18,040 --> 00:14:19,000 CONVERSATIONS THAT WE'LL BE 407 00:14:19,000 --> 00:14:22,000 HAVING IS THE FOOD SYSTEMS. 408 00:14:22,000 --> 00:14:25,480 FOOD SYSTEMS WHETHER PLANT, 409 00:14:25,480 --> 00:14:28,680 ANIMAL, MARINE, OR OTHER, ARE 410 00:14:28,680 --> 00:14:30,720 ALL AN ARRAY OF -- REPRESENT 411 00:14:30,720 --> 00:14:32,280 ANOTHER ECOLOGY. 412 00:14:32,280 --> 00:14:34,560 THIS CARTOON REPRESENTS THAT 413 00:14:34,560 --> 00:14:34,920 ECOLOGY. 414 00:14:34,920 --> 00:14:37,200 IT INCLUDES INPUT, THE ROLE OF 415 00:14:37,200 --> 00:14:42,960 HUMANS, ROAM -- ROLE OF THE 416 00:14:42,960 --> 00:14:43,880 ENVIRONMENT, SOCIAL, BEHAVIORAL, 417 00:14:43,880 --> 00:14:46,600 ECONOMIC ENVIRONMENT, ET CETERA. 418 00:14:46,600 --> 00:14:47,480 NEXT SLIDE. 419 00:14:47,480 --> 00:14:50,800 ONE OF THE IMPORTANT ISSUES WITH 420 00:14:50,800 --> 00:14:51,880 REGARD TO THE INTERSECTION THAT 421 00:14:51,880 --> 00:14:54,160 WE'LL BE TALKING ABOUT IS THIS 422 00:14:54,160 --> 00:14:55,840 INTERACTION BETWEEN FOOD SYSTEMS 423 00:14:55,840 --> 00:14:57,040 AND CLIMATE AND ENVIRONMENTAL 424 00:14:57,040 --> 00:14:57,240 CHANGE. 425 00:14:57,240 --> 00:14:59,960 AND THE POINT OF THIS SLIDE HERE 426 00:14:59,960 --> 00:15:03,360 IS THAT IT'S A RECIPROCAL 427 00:15:03,360 --> 00:15:03,680 RELATIONSHIP. 428 00:15:03,680 --> 00:15:05,320 THEY AFFECT OR ARE AFFECTED BY 429 00:15:05,320 --> 00:15:06,080 EACH OTHER. 430 00:15:06,080 --> 00:15:09,760 WE TEND OFTEN TO SEE ONE OF 431 00:15:09,760 --> 00:15:10,680 THESE PERSPECTIVES REPRESENTED 432 00:15:10,680 --> 00:15:13,000 TO THE EXCLUSION OF ANOTHER AND 433 00:15:13,000 --> 00:15:16,160 IT'S IMPORTANT TO RECOGNIZE THAT 434 00:15:16,160 --> 00:15:19,440 THERE IS A RECIPROCAL 435 00:15:19,440 --> 00:15:19,880 RELATIONSHIP. 436 00:15:19,880 --> 00:15:21,840 AND THAT RECIPROCAL RELATIONSHIP 437 00:15:21,840 --> 00:15:24,240 HAS A TEMPORAL COMPONENT TO IT 438 00:15:24,240 --> 00:15:25,440 AS WELL, THAT INCLUDES -- WE 439 00:15:25,440 --> 00:15:27,440 NEED TO BE CLEAR ABOUT WHAT 440 00:15:27,440 --> 00:15:29,240 WE'RE TALKING ABOUT WITH CLIMATE 441 00:15:29,240 --> 00:15:31,480 CHANGE AND YOU'LL HEAR FROM DR. 442 00:15:31,480 --> 00:15:33,720 EBI TODAY ABOUT THE IMPORTANCE 443 00:15:33,720 --> 00:15:35,760 OF RECOGNIZING THAT THERE'S A 444 00:15:35,760 --> 00:15:37,720 DIFFERENCE BETWEEN ACUTE EFFECTS 445 00:15:37,720 --> 00:15:39,160 AND LONG-TERM CHANGES IN WEATHER 446 00:15:39,160 --> 00:15:39,840 AND CLIMATE. 447 00:15:39,840 --> 00:15:43,120 AND IT'S IMPORTANT IN OUR 448 00:15:43,120 --> 00:15:44,640 ANALYSIS AND UNDERSTANDING TO 449 00:15:44,640 --> 00:15:46,640 ACCOUNT FOR DIFFERENCES. 450 00:15:46,640 --> 00:15:49,360 NEXT SLIDE PLEASE. 451 00:15:49,360 --> 00:15:49,560 NEXT. 452 00:15:49,560 --> 00:15:51,480 SO, ON THE RIGHT SIDE OF THE 453 00:15:51,480 --> 00:15:53,800 SLIDE IS THIS VICIOUS CYCLE. 454 00:15:53,800 --> 00:15:55,280 WE'RE ALL AWARE OF WHAT HAPPENS 455 00:15:55,280 --> 00:15:58,440 WHEN YOU HAVE AN IMPAIRED FOOD 456 00:15:58,440 --> 00:15:58,680 SYSTEM. 457 00:15:58,680 --> 00:16:01,280 YOU HAVE LIMITATIONS IN FOOD, IN 458 00:16:01,280 --> 00:16:02,600 NUTRITIONAL QUALITY OF THE FOOD. 459 00:16:02,600 --> 00:16:04,240 THAT HAS AN IMPACT ON HEALTH. 460 00:16:04,240 --> 00:16:07,640 THAT IMPACT ON HEALTH HAS AN 461 00:16:07,640 --> 00:16:08,960 IMPACT ON PERFORMANCE AND IT'S A 462 00:16:08,960 --> 00:16:17,520 NEGATIVE FEEDBACK. 463 00:16:17,520 --> 00:16:18,920 THIS IS BEING IMPACTED BY 464 00:16:18,920 --> 00:16:20,480 CLIMATE AND IS IMPACTING WHAT 465 00:16:20,480 --> 00:16:24,600 WE'RE SEEING IN THE CHANGING 466 00:16:24,600 --> 00:16:24,920 ENVIRONMENT. 467 00:16:24,920 --> 00:16:25,560 NEXT SLIDE. 468 00:16:25,560 --> 00:16:27,000 WHAT WE'RE GOING TO HIGHLIGHT IN 469 00:16:27,000 --> 00:16:28,400 THIS PROJECT I THINK ONE OF THE 470 00:16:28,400 --> 00:16:31,000 THINGS WE'LL HIGHLIGHT IS IT'S 471 00:16:31,000 --> 00:16:33,600 MORE THAN JUST FOOD. 472 00:16:33,600 --> 00:16:36,520 WE HAVE A VERY COMPLEX GLOBAL 473 00:16:36,520 --> 00:16:37,040 HEALTH SCENARIO. 474 00:16:37,040 --> 00:16:41,800 THE TOP LINE IS THE TRADITIONAL 475 00:16:41,800 --> 00:16:42,000 VIEW. 476 00:16:42,000 --> 00:16:44,320 WE FOCUS A LOT OF ENERGY ON 477 00:16:44,320 --> 00:16:45,960 DEALING WITH UNDERNUTRITION. 478 00:16:45,960 --> 00:16:49,000 WE NOW AND WILL HEAR IN WORKING 479 00:16:49,000 --> 00:16:51,640 GROUP 2 NEXT WEEK ABOUT THE 480 00:16:51,640 --> 00:16:52,320 NUTRITION TRANSITION, CHANGING 481 00:16:52,320 --> 00:16:55,720 THE WAY PEOPLE ARE EATING, 482 00:16:55,720 --> 00:16:57,800 TRANSITIONING FROM TRADITIONAL 483 00:16:57,800 --> 00:16:59,640 DIETS TO MORE COMMERCIAL DIETS 484 00:16:59,640 --> 00:17:01,400 WITH PROCESSED FOODS, ET CETERA. 485 00:17:01,400 --> 00:17:04,040 THAT'S LEADING TO ALL SORTS OF 486 00:17:04,040 --> 00:17:07,000 ISSUES INCLUDING DOUBLE BURDEN. 487 00:17:07,000 --> 00:17:09,200 ON THAT BOTTOM ROW YOU SEE THE 488 00:17:09,200 --> 00:17:13,200 FACT THAT WE ALSO HAVE THIS 489 00:17:13,200 --> 00:17:15,200 SITUATION WITH PANDEMIC 490 00:17:15,200 --> 00:17:20,000 INFECTIONS, WHETHER HIV, TB, 491 00:17:20,000 --> 00:17:24,720 MALARIA, COVID, OR THE NEXT NEW 492 00:17:24,720 --> 00:17:25,480 INFECTION, POTENTIAL STATUS 493 00:17:25,480 --> 00:17:28,080 WE'LL HEAR LATER ON TODAY. 494 00:17:28,080 --> 00:17:32,760 AND OF COURSE GROWING PANDEMICS 495 00:17:32,760 --> 00:17:33,560 NON-COMMUNICABLE DISEASES. 496 00:17:33,560 --> 00:17:35,440 IN THE MIDDLE IS RECOGNITION 497 00:17:35,440 --> 00:17:38,600 MUCH OF WHAT IS GOING ON 498 00:17:38,600 --> 00:17:39,360 INTERNALLY, THAT INTERNAL 499 00:17:39,360 --> 00:17:41,680 ECOLOGY FOR ALL THESE THINGS IS 500 00:17:41,680 --> 00:17:42,880 MEDIATED THROUGH THE 501 00:17:42,880 --> 00:17:45,720 RELATIONSHIP TO THE MICROBIOME 502 00:17:45,720 --> 00:17:47,400 AND INFLAMMATORY PROCESS, 503 00:17:47,400 --> 00:17:49,000 CRITICAL COMPONENT OF THE 504 00:17:49,000 --> 00:17:49,880 BIOMEDICAL RESEARCH ENTERPRISE. 505 00:17:49,880 --> 00:17:51,880 AT THE BOTTOM IS RECOGNITION OF 506 00:17:51,880 --> 00:17:55,040 THIS LIFE COURSE, DR. CERNICH 507 00:17:55,040 --> 00:17:57,160 SAID, WE'RE VERY COMMITTED TO 508 00:17:57,160 --> 00:17:59,440 DEVELOPMENTAL ISSUES IN THE LIFE 509 00:17:59,440 --> 00:18:00,120 COURSE. 510 00:18:00,120 --> 00:18:02,120 AND THINGS LIKE DIETARY GUIDANCE 511 00:18:02,120 --> 00:18:04,680 AND RECOMMENDATIONS FOR OTHER 512 00:18:04,680 --> 00:18:06,560 TYPES OF INTERVENTIONS NEED TO 513 00:18:06,560 --> 00:18:08,600 ACCOUNT FOR THE DIFFERENCES 514 00:18:08,600 --> 00:18:10,240 ACROSS THE LIFE COURSE. 515 00:18:10,240 --> 00:18:13,000 WE OF COURSE -- THERE'S 516 00:18:13,000 --> 00:18:14,640 RECOGNITION OF THE DOHaD 517 00:18:14,640 --> 00:18:16,160 HYPOTHESIS, AN IMPORTANT ASPECT 518 00:18:16,160 --> 00:18:17,040 OF RESEARCH ENDEAVOR, TRYING TO 519 00:18:17,040 --> 00:18:19,320 FIGURE OUT WHAT THE IMPACT OF 520 00:18:19,320 --> 00:18:21,480 THOSE EARLY LIFE INSULTS ARE ON 521 00:18:21,480 --> 00:18:23,680 LATER HEALTH OUTCOMES. 522 00:18:23,680 --> 00:18:26,760 NEXT SLIDE PLEASE. 523 00:18:26,760 --> 00:18:27,320 NEXT. 524 00:18:27,320 --> 00:18:30,120 SO WHEN WE PUT THIS TOGETHER, 525 00:18:30,120 --> 00:18:31,800 THIS IS THE NUTRITION ECOLOGY 526 00:18:31,800 --> 00:18:33,520 THAT WE'RE REFERRING TO. 527 00:18:33,520 --> 00:18:35,840 THIS IS THE APPROACH THAT WE'RE 528 00:18:35,840 --> 00:18:36,160 USING. 529 00:18:36,160 --> 00:18:38,360 WE'RE TRYING TO IMPROVE 530 00:18:38,360 --> 00:18:40,200 PRECISION, IMPROVE RIGOR AND 531 00:18:40,200 --> 00:18:41,840 REPRODUCIBILITY OF RESEARCH, 532 00:18:41,840 --> 00:18:44,160 IMPROPER OUR ABILITY TO MAKE -- 533 00:18:44,160 --> 00:18:45,400 TO ATTRIBUTE CAUSATION TO THINGS 534 00:18:45,400 --> 00:18:47,440 THAT ARE GOING IN THE 535 00:18:47,440 --> 00:18:48,640 ENVIRONMENT BY RECOGNIZING THE 536 00:18:48,640 --> 00:18:50,640 COMPLEXITY OF THIS ENVIRONMENT 537 00:18:50,640 --> 00:18:53,040 AND FIGURING OUT HOW WAYS TO 538 00:18:53,040 --> 00:18:53,920 DEAL WITH THIS COMPLEXITY. 539 00:18:53,920 --> 00:18:56,760 THIS IS A REPRESENTATION OF THAT 540 00:18:56,760 --> 00:18:57,880 COMPLEXITY. 541 00:18:57,880 --> 00:18:58,720 NEXT SLIDE. 542 00:18:58,720 --> 00:18:59,080 NEXT. 543 00:18:59,080 --> 00:19:00,160 I'M NOT GOING TO SPEND A LOT OF 544 00:19:00,160 --> 00:19:02,920 TIME IN THE NEXT COUPLE SLIDES. 545 00:19:02,920 --> 00:19:04,760 DREW HAS ALREADY REVIEWED THESE. 546 00:19:04,760 --> 00:19:07,280 BUT WHAT I WANT TO EMPHASIZE 547 00:19:07,280 --> 00:19:10,560 HERE IS THAT THIS PROJECT IS NOT 548 00:19:10,560 --> 00:19:12,080 INTENDED TO MAKE DIETARY 549 00:19:12,080 --> 00:19:12,960 GUIDANCE. 550 00:19:12,960 --> 00:19:15,360 IT'S NOT INTENDED TO MAKE 551 00:19:15,360 --> 00:19:16,200 RECOMMENDATIONS OR POLICY. 552 00:19:16,200 --> 00:19:19,160 IT IS INTENDED TO REVIEW THE 553 00:19:19,160 --> 00:19:19,400 EVIDENCE. 554 00:19:19,400 --> 00:19:20,600 AND WE'LL DO THAT BY ENGAGING 555 00:19:20,600 --> 00:19:23,120 THE COMMUNITY IN A 556 00:19:23,120 --> 00:19:24,840 MULTI-DISCIPLINARY EFFORT TO 557 00:19:24,840 --> 00:19:26,960 ADDRESS THE EVIDENCE AS WE FIND 558 00:19:26,960 --> 00:19:30,760 IT NOW, AND IDENTIFY GAPS IN 559 00:19:30,760 --> 00:19:32,200 EVIDENCE, MOVE THE AGENDA 560 00:19:32,200 --> 00:19:34,720 FORWARD, SUPPORT THOSE WHO ARE 561 00:19:34,720 --> 00:19:35,360 MAKING RECOMMENDATIONS, WHO ARE 562 00:19:35,360 --> 00:19:36,120 DOING GUIDANCE. 563 00:19:36,120 --> 00:19:38,000 THIS REALLY IS A PROJECT 564 00:19:38,000 --> 00:19:39,880 INTENDED TO SUPPORT THE 565 00:19:39,880 --> 00:19:40,960 COMMUNITY'S EFFORTS TO ADDRESS 566 00:19:40,960 --> 00:19:42,400 THE ISSUES OF DIET AND HEALTH IN 567 00:19:42,400 --> 00:19:48,600 A CHANGING ENVIRONMENT. 568 00:19:48,600 --> 00:19:49,000 NEXT SLIDE. 569 00:19:49,000 --> 00:19:49,520 NEXT. 570 00:19:49,520 --> 00:19:49,720 NEXT. 571 00:19:49,720 --> 00:19:51,800 DREW ALREADY WENT THROUGH THOSE. 572 00:19:51,800 --> 00:19:54,760 THIS IS JUST THE STRUCTURE OF 573 00:19:54,760 --> 00:19:56,000 THE PROJECT. 574 00:19:56,000 --> 00:19:57,000 WE'VE ORGANIZED THIS PROJECT. 575 00:19:57,000 --> 00:19:59,680 YOU'VE HEARD A LITTLE BIT ABOUT 576 00:19:59,680 --> 00:20:02,000 THIS IN THE EARLIER COMMENTS. 577 00:20:02,000 --> 00:20:03,520 PROJECT IS ORGANIZED BY THE 578 00:20:03,520 --> 00:20:06,600 SECRETARY, LED BY THE STAFF AT 579 00:20:06,600 --> 00:20:11,960 NICHD, DREW AND HIS TEAM. 580 00:20:11,960 --> 00:20:13,280 IT'S ALSO INCLUDING ALISON AND 581 00:20:13,280 --> 00:20:21,160 HER TEAM AT ACADEMY FOR 582 00:20:21,160 --> 00:20:21,800 NUTRITION AND DIETETICS. 583 00:20:21,800 --> 00:20:24,000 EVERY ONE HAS A LEAD MEMBER OF 584 00:20:24,000 --> 00:20:26,400 THE SECRETARY FROM THE A&D TEAM, 585 00:20:26,400 --> 00:20:27,480 WITHOUT THIS NONE OF THIS 586 00:20:27,480 --> 00:20:27,720 HAPPENS. 587 00:20:27,720 --> 00:20:29,120 IN THE BEGINNING OF THE PROJECT, 588 00:20:29,120 --> 00:20:32,040 YOU'LL FLARE A COUPLE MEMBERS OF 589 00:20:32,040 --> 00:20:32,640 THE SCIENTIFIC -- HEAR FROM 590 00:20:32,640 --> 00:20:33,840 MEMBERS OF THE STEERING 591 00:20:33,840 --> 00:20:35,120 COMMITTEE WE ORGANIZED 592 00:20:35,120 --> 00:20:36,240 REPRESENTATIVES FROM AGENCIES 593 00:20:36,240 --> 00:20:37,680 AND STAKEHOLDERS COMMUNITIES 594 00:20:37,680 --> 00:20:39,080 WITH AN INVESTMENT IN THIS 595 00:20:39,080 --> 00:20:41,280 ISSUE, AND TO GET THEIR INPUT 596 00:20:41,280 --> 00:20:42,600 AND HELP US ORGANIZE THINKING 597 00:20:42,600 --> 00:20:47,160 AROUND HOW BEST TO MOVE THIS 598 00:20:47,160 --> 00:20:48,160 PROCESS FORWARD. 599 00:20:48,160 --> 00:20:49,800 THEN THAT FINAL CIRCLE IS 600 00:20:49,800 --> 00:20:50,680 WORKING GROUPS. 601 00:20:50,680 --> 00:20:52,600 I WILL SAY NOW AND SAY 602 00:20:52,600 --> 00:20:53,840 THROUGHOUT THIS PROCESS HOW 603 00:20:53,840 --> 00:20:55,200 GRATEFUL WE ARE FOR ALL OF THE 604 00:20:55,200 --> 00:20:57,240 MEMBERS OF ALL THE WORKING 605 00:20:57,240 --> 00:20:58,240 GROUPS. 606 00:20:58,240 --> 00:21:00,080 WE HAVE FIVE WORKING GROUPS, 607 00:21:00,080 --> 00:21:02,240 BETWEEN FIVE AND EIGHT MEMBERS 608 00:21:02,240 --> 00:21:03,920 IN EACH WORKING GROUP. 609 00:21:03,920 --> 00:21:05,760 AND WE'RE GRATEFUL FOR THEIR 610 00:21:05,760 --> 00:21:08,200 COMMITMENT AND WILLINGNESS TO 611 00:21:08,200 --> 00:21:11,120 TAKE THIS CHALLENGE ON. 612 00:21:11,120 --> 00:21:11,440 NEXT SLIDE. 613 00:21:11,440 --> 00:21:13,240 SO, WE PUT THIS TOGETHER, 614 00:21:13,240 --> 00:21:14,080 CONCEPTUALLY, THIS IS THE 615 00:21:14,080 --> 00:21:17,800 ECOLOGY AND THIS IS HOW WE 616 00:21:17,800 --> 00:21:18,240 OPERATIONALIZED IT. 617 00:21:18,240 --> 00:21:19,360 WE HAVE THREE CORE WORKING 618 00:21:19,360 --> 00:21:21,120 GROUPS THAT ARE GOING TO REALLY 619 00:21:21,120 --> 00:21:23,840 BE FOCUSED ON EXAMINING THE 620 00:21:23,840 --> 00:21:24,800 EVIDENCE AND IDENTIFYING 621 00:21:24,800 --> 00:21:25,560 RESEARCH GAPS. 622 00:21:25,560 --> 00:21:27,120 THOSE THREE GROUPS THAT YOU'LL 623 00:21:27,120 --> 00:21:29,000 HEAR ABOUT TODAY YOU'LL HEAR 624 00:21:29,000 --> 00:21:31,400 FROM THE WORKING GROUP 1, WHICH 625 00:21:31,400 --> 00:21:34,240 IS THE FOCUS ON HEALTH. 626 00:21:34,240 --> 00:21:35,800 NEXT WEEK WORKING GROUP 2 627 00:21:35,800 --> 00:21:37,640 FOCUSED ON DIETARY PATTERNS. 628 00:21:37,640 --> 00:21:39,480 AND THEN WORKING GROUP 3 WILL 629 00:21:39,480 --> 00:21:43,000 FOCUS ON FOOD SYSTEMS. 630 00:21:43,000 --> 00:21:43,720 AND WE RECOGNIZE IT'S A VENN 631 00:21:43,720 --> 00:21:45,480 DIAGRAM FOR A REASON. 632 00:21:45,480 --> 00:21:46,680 THESE THINGS OVERLAP AND AFFECT 633 00:21:46,680 --> 00:21:48,920 AND ARE AFFECTED BY EACH OTHER. 634 00:21:48,920 --> 00:21:50,200 OBVIOUSLY OVERLAPPING THAT IS 635 00:21:50,200 --> 00:21:51,840 THE IMPACT OF CLIMATE AND 636 00:21:51,840 --> 00:21:53,000 ENVIRONMENTAL CHANGE. 637 00:21:53,000 --> 00:21:56,480 THE NEXT -- FOURTH WORKING GROUP 638 00:21:56,480 --> 00:21:57,680 IS FOCUSED ON ANALYSIS. 639 00:21:57,680 --> 00:22:01,960 HOW DO WE TAKE THIS EMERGING 640 00:22:01,960 --> 00:22:02,480 EVIDENCE, VERY COMPLICATED 641 00:22:02,480 --> 00:22:04,680 SYSTEMS, AND PUT IT TOGETHER IN 642 00:22:04,680 --> 00:22:06,760 A MEANINGFUL WAY TO ANALYZE 643 00:22:06,760 --> 00:22:08,200 THESE RELATIONSHIPS. 644 00:22:08,200 --> 00:22:10,800 BOTH FROM RESEARCH PERSPECTIVE 645 00:22:10,800 --> 00:22:12,080 AND FROM PERHAPS SURVEILLANCE 646 00:22:12,080 --> 00:22:12,560 PERSPECTIVE. 647 00:22:12,560 --> 00:22:16,280 HOW DO WE INTEGRATE THIS KIND OF 648 00:22:16,280 --> 00:22:17,160 DATA INTO NATIONAL SURVEILLANCE 649 00:22:17,160 --> 00:22:18,680 PROGRAM TO REALLY GET US AN 650 00:22:18,680 --> 00:22:20,880 ANSWER ABOUT WHAT'S GOING ON IN 651 00:22:20,880 --> 00:22:22,200 THE POPULATION. 652 00:22:22,200 --> 00:22:23,920 FINALLY, WORKING GROUP 5 WILL 653 00:22:23,920 --> 00:22:26,040 FOCUS ON THIS ISSUE OF -- THESE 654 00:22:26,040 --> 00:22:27,680 ISSUES OF TRANSLATION AND 655 00:22:27,680 --> 00:22:28,040 IMPLEMENTATION. 656 00:22:28,040 --> 00:22:31,720 ONE OF THE -- WHAT ARE THE CORE 657 00:22:31,720 --> 00:22:33,000 PRINCIPLES AND WHAT'S THE 658 00:22:33,000 --> 00:22:34,440 FRAMEWORK FOR TAKING NEW 659 00:22:34,440 --> 00:22:37,400 EVIDENCE AND INTEGRATING IT INTO 660 00:22:37,400 --> 00:22:40,360 RESEARCH DESIGN AS WELL AS 661 00:22:40,360 --> 00:22:41,880 PROGRAM DEVELOPMENT AND 662 00:22:41,880 --> 00:22:42,480 IMPLEMENTATION. 663 00:22:42,480 --> 00:22:43,520 SO, THAT'S A CRITICAL PIECE OF 664 00:22:43,520 --> 00:22:47,600 WHAT WE'RE DOING AND WE'RE 665 00:22:47,600 --> 00:22:47,880 GRATEFUL. 666 00:22:47,880 --> 00:22:48,480 NEXT SLIDE. 667 00:22:48,480 --> 00:22:51,000 THIS IS A LISTING OF THE FIVE 668 00:22:51,000 --> 00:22:52,520 WORKING GROUPS AND CO-CHAIRS. 669 00:22:52,520 --> 00:22:58,440 THEY ARE ALL LISTED. 670 00:22:58,440 --> 00:23:04,560 TODAY YOU'LL HEAR FROM KRISTIE 671 00:23:04,560 --> 00:23:05,960 EBI. 672 00:23:05,960 --> 00:23:08,400 THESE FOLKS ARE BUSY AND IT'S A 673 00:23:08,400 --> 00:23:09,280 TREMENDOUS PROGRAM. 674 00:23:09,280 --> 00:23:11,400 WE'RE GRATEFUL FOR THE EFFORTS. 675 00:23:11,400 --> 00:23:13,080 THAT'S THE END OF IT. 676 00:23:13,080 --> 00:23:14,760 I WANT TO ISSUE EVERYBODY THE 677 00:23:14,760 --> 00:23:14,960 BEST. 678 00:23:14,960 --> 00:23:16,680 THANK YOU FOR JOINING US. 679 00:23:16,680 --> 00:23:17,880 I THANK WORKING GROUP MEMBERS 680 00:23:17,880 --> 00:23:19,760 FOR BEING HERE. 681 00:23:19,760 --> 00:23:26,320 WE'RE LOOKING FORWARD TO 682 00:23:26,320 --> 00:23:27,720 PRESENTATIONS. 683 00:23:27,720 --> 00:23:27,960 THANK YOU. 684 00:23:27,960 --> 00:23:28,840 >> THANKS, DAN. 685 00:23:28,840 --> 00:23:31,120 FOR THE SAKE OF TIME WE'LL 686 00:23:31,120 --> 00:23:31,800 SEGUE. 687 00:23:31,800 --> 00:23:34,360 WE'RE SUPER APPRECIATIVE OF 688 00:23:34,360 --> 00:23:36,840 THOSE MEMBERS OF OTHER AGENCIES 689 00:23:36,840 --> 00:23:39,160 THAT HAVE TAKEN THEIR TIME TO 690 00:23:39,160 --> 00:23:42,880 PROVIDE INPUT IN DISCUSSIONS AND 691 00:23:42,880 --> 00:23:45,520 WE'LL KICK THINGS OFF WITH CINDY 692 00:23:45,520 --> 00:23:45,720 DAVIS. 693 00:23:45,720 --> 00:23:46,040 TAKE IT AWAY. 694 00:23:46,040 --> 00:23:47,320 >> WAITING FOR MY SLIDES TO 695 00:23:47,320 --> 00:23:48,400 COME UP. 696 00:23:48,400 --> 00:23:48,720 THANK YOU. 697 00:23:48,720 --> 00:23:50,560 THANK YOU FOR GIVING ME THE 698 00:23:50,560 --> 00:23:53,440 OPPORTUNITY TO HIGHLIGHT THE ARS 699 00:23:53,440 --> 00:23:54,480 NATIONAL PROGRAM IN HUMAN 700 00:23:54,480 --> 00:23:56,360 NUTRITION, AND OUR INTEREST IN 701 00:23:56,360 --> 00:23:58,120 THE INTERSECTION OF CLIMATE, 702 00:23:58,120 --> 00:23:59,320 ENVIRONMENTAL CHANGE, FOOD 703 00:23:59,320 --> 00:24:02,280 SYSTEMS, DIET, NUTRITION AND 704 00:24:02,280 --> 00:24:02,680 HEALTH. 705 00:24:02,680 --> 00:24:03,360 NEXT SLIDE PLEASE. 706 00:24:03,360 --> 00:24:05,560 THE MISSION OF OUR PROGRAM IS TO 707 00:24:05,560 --> 00:24:07,880 DEFINE THE ROLE OF FOOD AND 708 00:24:07,880 --> 00:24:09,040 COMPONENTS AND OPTIMIZING HEALTH 709 00:24:09,040 --> 00:24:10,800 THROUGHOUT THE LIFE CYCLE FOR 710 00:24:10,800 --> 00:24:14,640 ALL AMERICANS BY CONDUCTING HIGH 711 00:24:14,640 --> 00:24:15,960 NATIONAL PRIORITY RESEARCH AND 712 00:24:15,960 --> 00:24:18,160 EMPHASIS IS ON RESEARCH. 713 00:24:18,160 --> 00:24:19,360 THAT'S HOW WE INTERSECT WITH 714 00:24:19,360 --> 00:24:19,600 ADVANTAGE. 715 00:24:19,600 --> 00:24:23,720 OUR VISION IS A WELL NOURISHED 716 00:24:23,720 --> 00:24:25,680 AMERICAN MAKE HEALTH PROMOTING 717 00:24:25,680 --> 00:24:28,000 DIETARY CHOICES BASED ON 718 00:24:28,000 --> 00:24:28,760 SCIENTIFIC EVIDENCE, FIVE 719 00:24:28,760 --> 00:24:29,960 PROGRAMMATIC PRIORITIES IN THE 720 00:24:29,960 --> 00:24:31,280 NEXT FIVE YEARS. 721 00:24:31,280 --> 00:24:33,160 BRIDGING THE GAP BETWEEN FOOD 722 00:24:33,160 --> 00:24:35,240 PRODUCTION AND HUMAN HEALTH. 723 00:24:35,240 --> 00:24:42,000 MONITORING FOOD COMPOSITION 724 00:24:42,000 --> 00:24:43,320 NUTRIENT INTAKE, SCIENTIFIC 725 00:24:43,320 --> 00:24:45,600 BASIS FOR DIETARY GUIDANCE, 726 00:24:45,600 --> 00:24:48,160 PRE-VEHICLES OF DIET-RELATED 727 00:24:48,160 --> 00:24:52,280 CHRONIC DECEMBER DISEASE LIFE 728 00:24:52,280 --> 00:24:53,280 STAINING NUTRITION. 729 00:24:53,280 --> 00:24:56,880 ARS STUDIES WHAT PEOPLE CONSUME, 730 00:24:56,880 --> 00:24:58,760 METHODS TO IMPROVE ACCESS, 731 00:24:58,760 --> 00:24:59,720 NUTRIENT REQUIREMENTS FOR ALL 732 00:24:59,720 --> 00:25:10,280 AGE GROUPS AND HOW NUTRITION CAN 733 00:25:13,040 --> 00:25:13,600 MAINTAIN HEALTH IN THE LIFESPAN 734 00:25:13,600 --> 00:25:18,640 AND PREVENT UNIQUE AS DETERMINE 735 00:25:18,640 --> 00:25:20,600 HOW CHANGES AFFECT THE NUTRIENT 736 00:25:20,600 --> 00:25:23,600 CONTENT OF THE AMERICAN DIET, 737 00:25:23,600 --> 00:25:25,440 COMPILATION OF FOOD COMPOSITION 738 00:25:25,440 --> 00:25:27,960 ANALYSIS AND DISSEMINATION AND 739 00:25:27,960 --> 00:25:31,080 DATABASES, AND CONDUCT OF 740 00:25:31,080 --> 00:25:31,840 NATIONALLY REPRESENTED SURVEY OF 741 00:25:31,840 --> 00:25:35,480 HOW MUCH AND WHAT AMERICANS EAT. 742 00:25:35,480 --> 00:25:36,920 NEXT SLIDE PLEASE. 743 00:25:36,920 --> 00:25:38,680 AS I MENTIONED, THE FIRST 744 00:25:38,680 --> 00:25:40,520 COMPONENT IS BRIDGING THE GAP 745 00:25:40,520 --> 00:25:43,160 BETWEEN FOOD PRODUCTION AND 746 00:25:43,160 --> 00:25:45,720 HUMAN HEALTH. 747 00:25:45,720 --> 00:25:46,840 ACCESSIBLE, AFFORDABLE FOODS ARE 748 00:25:46,840 --> 00:25:47,440 THE FOUNDATION. 749 00:25:47,440 --> 00:25:49,960 AGRICULTURE IS THE SOURCE OF 750 00:25:49,960 --> 00:25:50,960 FOOD IN OUR DIETS. 751 00:25:50,960 --> 00:25:54,000 AGRICULTURE IS THE BASIS FOR OUR 752 00:25:54,000 --> 00:25:55,360 NUTRITIONAL STATUS AND 753 00:25:55,360 --> 00:25:57,960 NUTRITIONALLY RELATED HEALTH 754 00:25:57,960 --> 00:25:58,400 STATUS. 755 00:25:58,400 --> 00:25:59,040 AGRICULTURAL POLICIES, 756 00:25:59,040 --> 00:26:00,680 DECISIONS, PROCEDURES AS WELL AS 757 00:26:00,680 --> 00:26:04,280 POST HARVEST PRACTICES AND FOOD 758 00:26:04,280 --> 00:26:09,440 PROCESSING DETERMINE THE TYPES 759 00:26:09,440 --> 00:26:10,960 AND AMOUNTS -- CAN YOU PUT MY 760 00:26:10,960 --> 00:26:19,720 SLIDES BACK UP PLEASE? 761 00:26:19,720 --> 00:26:22,680 762 00:26:22,680 --> 00:26:25,080 I'M NOT SURE -- THE FIRST 763 00:26:25,080 --> 00:26:27,360 PROBLEM THIS COMPONENT ADDRESSES 764 00:26:27,360 --> 00:26:28,920 IS DETERMINING AGRICULTURAL 765 00:26:28,920 --> 00:26:30,320 PRACTICES THAT INFLUENCE 766 00:26:30,320 --> 00:26:31,320 NUTRITIONAL QUALITY AND 767 00:26:31,320 --> 00:26:33,080 COMPOSITION OF FOOD. 768 00:26:33,080 --> 00:26:35,040 ARS SCIENTISTS ARE EXAMINING 769 00:26:35,040 --> 00:26:38,000 EFFECT OF GENETICS, AGRICULTURAL 770 00:26:38,000 --> 00:26:38,760 PRODUCTION, MANAGEMENT, 771 00:26:38,760 --> 00:26:40,520 ENVIRONMENT, PROCESSING ON BOTH 772 00:26:40,520 --> 00:26:42,400 MAGNITUDE AND VARIABILITY OF 773 00:26:42,400 --> 00:26:42,960 NUTRITIONAL COMPOSITION AND 774 00:26:42,960 --> 00:26:45,320 QUALITY OF THE U.S. FOOD SUPPLY. 775 00:26:45,320 --> 00:26:47,280 MANY FACTORS HAVE THE POTENTIAL 776 00:26:47,280 --> 00:26:49,280 TO ALTER FOOD COMPOSITION BUT 777 00:26:49,280 --> 00:26:50,400 THE MAGNITUDE AND VARIABILITY OF 778 00:26:50,400 --> 00:26:52,640 CHANGES NEED TO BE PLACED IN THE 779 00:26:52,640 --> 00:26:55,040 CONTEXT OF AN INTEGRATED AND 780 00:26:55,040 --> 00:26:56,960 COMPLEX FOOD SUPPLY TO DETERMINE 781 00:26:56,960 --> 00:26:59,200 IF AND HOW THEY HAVE MEANINGFUL 782 00:26:59,200 --> 00:27:01,840 EFFECTS ON HUMAN HEALTH. 783 00:27:01,840 --> 00:27:03,040 CHEMICAL AND BIOCHEMICAL 784 00:27:03,040 --> 00:27:06,120 ANALYSIS OF CROPS GROWN UNDER 785 00:27:06,120 --> 00:27:11,160 DIFFERENT GENETIC SOURCES IS 786 00:27:11,160 --> 00:27:14,920 NEEDED AND ANIMAL SOURCES. 787 00:27:14,920 --> 00:27:17,280 STUDIES ARE REQUIRED TO ASSESS 788 00:27:17,280 --> 00:27:18,600 EFFECTS OF ENVIRONMENTAL 789 00:27:18,600 --> 00:27:19,240 VARIABLES INCLUDING CLIMATE, 790 00:27:19,240 --> 00:27:21,680 SOIL, WATER ON THE QUALITY OF 791 00:27:21,680 --> 00:27:21,880 FOODS. 792 00:27:21,880 --> 00:27:26,320 THE SECOND PROBLEM STATEMENT IS 793 00:27:26,320 --> 00:27:28,640 TO CONDUCT MULTI-RESEARCH TO 794 00:27:28,640 --> 00:27:29,640 UNDERSTAND COMPLEX INTERACTIONS 795 00:27:29,640 --> 00:27:31,840 AND IMPACTS ON HUMAN HEALTH. 796 00:27:31,840 --> 00:27:33,800 CONSENSUS IS EMERGING FOOD 797 00:27:33,800 --> 00:27:36,000 SYSTEMS CONTAIN FOUR PRIMARY 798 00:27:36,000 --> 00:27:37,320 INTERACTING AND INTERDEPENDENT 799 00:27:37,320 --> 00:27:38,960 COMPONENTS. 800 00:27:38,960 --> 00:27:41,360 HUMAN NUTRITION AND HEALTH, 801 00:27:41,360 --> 00:27:43,040 PRODUCTION AGRICULTURE AND FOOD 802 00:27:43,040 --> 00:27:44,880 TECHNOLOGY, EFFECTS ON AND BY 803 00:27:44,880 --> 00:27:46,640 THE ENVIRONMENT, AND CONSUMER 804 00:27:46,640 --> 00:27:47,920 CHOICES AND ATTITUDES. 805 00:27:47,920 --> 00:27:49,680 MOREOVER IT IS RECOGNIZED WITHIN 806 00:27:49,680 --> 00:27:51,760 A FOOD SYSTEM ALL COMPONENTS 807 00:27:51,760 --> 00:27:54,520 INTERACT WITH AND HAVE INTENDED 808 00:27:54,520 --> 00:27:56,360 AND UNINTENDED CONSEQUENCES FOR 809 00:27:56,360 --> 00:27:58,560 OTHER COMPONENTS OF THE SYSTEM. 810 00:27:58,560 --> 00:27:59,040 UNDERSTANDING COMPLEX 811 00:27:59,040 --> 00:28:00,840 INTERACTIONS WITHIN THE FOOD 812 00:28:00,840 --> 00:28:03,240 SYSTEMS RELATED TO HUMAN HEALTH 813 00:28:03,240 --> 00:28:07,960 REQUIRES DEVELOPMENT OF 814 00:28:07,960 --> 00:28:09,600 MULTI-DISCIPLINARY TEAMS FROM 815 00:28:09,600 --> 00:28:10,360 ALL SECTORS. 816 00:28:10,360 --> 00:28:11,800 NUTRITION SCIENTISTS NEED TO 817 00:28:11,800 --> 00:28:14,280 DEVELOP PARTNERSHIPS WITH OTHER 818 00:28:14,280 --> 00:28:15,720 SCIENTIFIC DISCIPLINES INCLUDING 819 00:28:15,720 --> 00:28:17,720 ANIMAL, PLANT, SOIL, WATER, 820 00:28:17,720 --> 00:28:19,760 CLIMATE, FOOD TECHNOLOGY, FOOD 821 00:28:19,760 --> 00:28:20,640 SAFETY, SOCIAL SCIENTISTS. 822 00:28:20,640 --> 00:28:22,520 'EM TAMPA 823 00:28:22,520 --> 00:28:25,680 EMPHASIS NEEDS TO BE ON 824 00:28:25,680 --> 00:28:26,320 UNDERSTANDING CONSTRAINS ACROSS 825 00:28:26,320 --> 00:28:28,960 THE SYSTEM FOR EXAMPLE BENEFITS 826 00:28:28,960 --> 00:28:31,360 AND DETRIMENTS OF PLANT-BASED 827 00:28:31,360 --> 00:28:33,480 DIET REQUIRES ASSESSMENT OF 828 00:28:33,480 --> 00:28:34,320 MULTIPLE COMPONENTS COLLEAGUE 829 00:28:34,320 --> 00:28:37,160 EFFECT ON WATER, SOIL, LAND, 830 00:28:37,160 --> 00:28:39,240 CONSUMER EXPECTATIONS, CHANGES 831 00:28:39,240 --> 00:28:40,760 IN CROP ROTATIONS, UTILIZATION 832 00:28:40,760 --> 00:28:43,600 OF GRAZING LANDS, AND 833 00:28:43,600 --> 00:28:45,720 NUTRITIONAL CONSEQUENCES OF NOT 834 00:28:45,720 --> 00:28:47,160 CONSUMING NUTRIENTS OR 835 00:28:47,160 --> 00:28:49,560 COMPONENTS ENRICHED WITH ANIMAL 836 00:28:49,560 --> 00:28:50,240 PRODUCTS. 837 00:28:50,240 --> 00:28:55,880 PRODUCTION PRACTICES THAT MAY 838 00:28:55,880 --> 00:28:59,600 ALTER AVAILABILITY AND INFLUENTS 839 00:28:59,600 --> 00:29:00,520 DIET SELECTION AND QUALITY, 840 00:29:00,520 --> 00:29:02,320 THERE'S A NEED TO DETERMINE 841 00:29:02,320 --> 00:29:04,320 WHETHER THESE INTERACTIONS 842 00:29:04,320 --> 00:29:05,640 RESULT IN ALTERED HUMAN BODY 843 00:29:05,640 --> 00:29:07,360 STORES OR CHANGES IN 844 00:29:07,360 --> 00:29:07,920 PHYSIOLOGICAL VARIABLES. 845 00:29:07,920 --> 00:29:10,680 THERE'S A NEED TO UNDERSTAND HOW 846 00:29:10,680 --> 00:29:12,760 ALTERING AGRICULTURE TO PROMOTE 847 00:29:12,760 --> 00:29:14,960 OPTIMAL HUMAN HEALTH AFFECTS 848 00:29:14,960 --> 00:29:17,680 ECONOMIC AND ENVIRONMENTAL 849 00:29:17,680 --> 00:29:18,480 SUSTAINABILITY. 850 00:29:18,480 --> 00:29:20,520 NEXT SLIDE PLEASE. 851 00:29:20,520 --> 00:29:27,000 FOUNDATIONAL TO CHARACTERIZING 852 00:29:27,000 --> 00:29:29,720 NUTRIENT INTAKE IS A FOCUS OF 853 00:29:29,720 --> 00:29:35,840 THE FDA SINCE THE 19th 854 00:29:35,840 --> 00:29:36,080 CENTURY. 855 00:29:36,080 --> 00:29:38,040 FOODDATA CENTRAL INCLUDES IMPACT 856 00:29:38,040 --> 00:29:39,440 OF PRODUCTION MANAGEMENT, 857 00:29:39,440 --> 00:29:40,440 ENVIRONMENT, PROCESSING ON FOOD 858 00:29:40,440 --> 00:29:41,960 COMPOSITION OF THE FOOD SUPPLY, 859 00:29:41,960 --> 00:29:44,160 THIS IS A FOCUS AREA OF THE 860 00:29:44,160 --> 00:29:45,720 HUMAN NUTRITION PROGRAM WHERE 861 00:29:45,720 --> 00:29:47,440 MORE DATA IS NEEDED. 862 00:29:47,440 --> 00:29:48,760 HOPEFULLY ADVANTAGE WILL 863 00:29:48,760 --> 00:29:50,000 STIMULATE RESEARCH TO FILL THIS 864 00:29:50,000 --> 00:29:50,200 GAP. 865 00:29:50,200 --> 00:29:53,040 THANK YOU FOR GIVING ME THE 866 00:29:53,040 --> 00:29:57,720 OPPORTUNITY TO HIGHLIGHT HOW THE 867 00:29:57,720 --> 00:30:00,240 RESEARCH WITHIN THE PROGRAM FITS 868 00:30:00,240 --> 00:30:03,440 WITHIN ADVANTAGE. 869 00:30:03,440 --> 00:30:03,680 THANK YOU. 870 00:30:03,680 --> 00:30:04,280 >> TREMENDOUS. 871 00:30:04,280 --> 00:30:07,560 THANK YOU AND YOUR ARS 872 00:30:07,560 --> 00:30:09,000 COLLEAGUES AND USDA COLLEAGUES 873 00:30:09,000 --> 00:30:10,720 FOR BEING PART OF THIS PROCESS. 874 00:30:10,720 --> 00:30:12,280 WE TRULY APPRECIATE IT. 875 00:30:12,280 --> 00:30:16,120 NOW I'D LIKE TO TURN THE BATON 876 00:30:16,120 --> 00:30:20,160 OVER TO REAR ADMIRAL PAUL REID, 877 00:30:20,160 --> 00:30:21,840 OFFICE OF ASSISTANT SECRETARY 878 00:30:21,840 --> 00:30:22,160 FOR HEALTH. 879 00:30:22,160 --> 00:30:23,320 >> APPRECIATE THE OPPORTUNITY 880 00:30:23,320 --> 00:30:26,600 TO SHARE OUR THOUGHTS ON THIS 881 00:30:26,600 --> 00:30:27,600 EFFORT FROM PERSPECTIVE OF 882 00:30:27,600 --> 00:30:28,800 OFFICE OF ASSISTANT SECRETARY 883 00:30:28,800 --> 00:30:30,440 FOR HEALTH AND OFFICE OF DISEASE 884 00:30:30,440 --> 00:30:32,640 PREVENTION AND HEALTH PROMOTION 885 00:30:32,640 --> 00:30:34,360 WHICH I OVERSEE. 886 00:30:34,360 --> 00:30:36,000 WE UNDERSTAND THAT 887 00:30:36,000 --> 00:30:36,760 SUSTAINABILITY AND COMPLEX 888 00:30:36,760 --> 00:30:38,080 RELATIONSHIP BETWEEN NUTRITION 889 00:30:38,080 --> 00:30:40,840 AND CLIMATE CHANGE REQUIRES 890 00:30:40,840 --> 00:30:42,760 SPECIFIC EXPERTISE AND DEDICATED 891 00:30:42,760 --> 00:30:44,440 EFFORT TO EVALUATING SCIENCE AND 892 00:30:44,440 --> 00:30:45,520 APPRECIATE THAT NICHD AND THE 893 00:30:45,520 --> 00:30:46,840 ACADEMY ARE LEADING THE EFFORT 894 00:30:46,840 --> 00:30:49,480 TO EXAMINE THIS IMPORTANT 895 00:30:49,480 --> 00:30:50,480 EVIDENCE BASE. 896 00:30:50,480 --> 00:30:51,760 IT GOES WITHOUT SAYING THAT IT 897 00:30:51,760 --> 00:30:56,240 IS A HIGH PRIORITY OF HHS 898 00:30:56,240 --> 00:30:56,920 LEADERSHIP TO ADDRESS CLIMATE 899 00:30:56,920 --> 00:30:58,120 CHANGE ON HEALTH OF AMERICANS 900 00:30:58,120 --> 00:31:00,960 AND ISSUES ARE ALL OBVIOUSLY 901 00:31:00,960 --> 00:31:02,480 CRITICAL, IMPORTANT, BEING 902 00:31:02,480 --> 00:31:05,240 ADDRESSED IN MANY INITIATIVES 903 00:31:05,240 --> 00:31:08,760 ACROSS THE ADMINISTRATION. 904 00:31:08,760 --> 00:31:10,840 IMPORTANT WORK IS ONGOING ON 905 00:31:10,840 --> 00:31:11,800 SUSTAINABLE AGRICULTURE, FOOD 906 00:31:11,800 --> 00:31:13,120 WASTE AND EFFORTS RELATED TO 907 00:31:13,120 --> 00:31:14,960 CLIMATE CHANGE AND INTERSECTION 908 00:31:14,960 --> 00:31:15,440 OF POPULATION HEALTH. 909 00:31:15,440 --> 00:31:16,520 WITHIN THE OFFICE OF THE 910 00:31:16,520 --> 00:31:17,920 ASSISTANT SECRETARY FOR HEALTH 911 00:31:17,920 --> 00:31:19,800 AT HHS, THE NEWLY ESTABLISHED 912 00:31:19,800 --> 00:31:23,960 OFFICE OF CLIMATE CHANGE AND 913 00:31:23,960 --> 00:31:26,080 HEALTH EQUITY IS SPECIFICALLY 914 00:31:26,080 --> 00:31:34,840 FOCUSED ON CLIMATE CHANGE ON 915 00:31:34,840 --> 00:31:38,040 HEALTH OF THE AMERICAN PEOPLE 916 00:31:38,040 --> 00:31:40,320 OUR OFFICE'S RESPONSIBILITY IN 917 00:31:40,320 --> 00:31:41,880 THE LANDSCAPE, AT THE WHITE 918 00:31:41,880 --> 00:31:42,840 HOUSE CONFERENCE ON HUNGER, 919 00:31:42,840 --> 00:31:45,240 NUTRITION AND HEALTH HELD THIS 920 00:31:45,240 --> 00:31:46,080 LAST SEPTEMBER, THE PRESIDENT 921 00:31:46,080 --> 00:31:49,920 SET A GOAL TO END HUNGER, 922 00:31:49,920 --> 00:31:52,920 INCREASE HEALTHY EATING BY 2030 923 00:31:52,920 --> 00:31:54,520 SO FEWER AMERICANS EXPERIENCE 924 00:31:54,520 --> 00:31:56,440 DIET-RELATED DISEASES. 925 00:31:56,440 --> 00:31:57,960 AT THAT CONFERENCE, THE WHITE 926 00:31:57,960 --> 00:31:59,760 HOUSE RELEASED NATIONAL STRATEGY 927 00:31:59,760 --> 00:32:00,400 THAT OUTLINES NUMEROUS ACTIONS 928 00:32:00,400 --> 00:32:01,880 THE FEDERAL GOVERNMENT WILL TAKE 929 00:32:01,880 --> 00:32:03,520 TO ACHIEVE THIS GOAL INCLUDING 930 00:32:03,520 --> 00:32:04,800 ACTIONS TO ENABLE THE 931 00:32:04,800 --> 00:32:06,360 OPPORTUNITIES FOR AMERICANS TO 932 00:32:06,360 --> 00:32:08,840 INCREASE HEALTHY EATING AND 933 00:32:08,840 --> 00:32:09,760 PHYSICAL ACTIVITY. 934 00:32:09,760 --> 00:32:10,520 ROUTINELY WITH INPUT FROM 935 00:32:10,520 --> 00:32:14,880 EXPERTS IN THE FIELD AND PUBLIC 936 00:32:14,880 --> 00:32:18,280 FEEDBACK OUR OFFICE SETS FEDERAL 937 00:32:18,280 --> 00:32:19,880 GUIDELINES ON NUTRITION AND 938 00:32:19,880 --> 00:32:22,760 PHYSICAL ACTIVITY INFORMING 939 00:32:22,760 --> 00:32:24,600 FEDERAL POLICIES AND PROGRAMS TO 940 00:32:24,600 --> 00:32:25,320 PROMOTE HEALTH. 941 00:32:25,320 --> 00:32:26,920 SPECIFICALLY, OUR OFFICE OF 942 00:32:26,920 --> 00:32:28,360 DISEASE PREVENTION AND HEALTH 943 00:32:28,360 --> 00:32:31,160 PROMOTION SERVES AS LEAD FOR 944 00:32:31,160 --> 00:32:33,560 DEVELOPMENT OF THE PHYSICAL 945 00:32:33,560 --> 00:32:37,200 ACTIVITY GUIDELINES FOR UPDATES 946 00:32:37,200 --> 00:32:38,600 TO DIETARY GUIDELINES IN 947 00:32:38,600 --> 00:32:40,240 PARTNERSHIP WITH USDA. 948 00:32:40,240 --> 00:32:42,160 THE NATIONAL STRATEGY ON HUNGER, 949 00:32:42,160 --> 00:32:44,760 NUTRITION AND HEALTH THERE ARE 950 00:32:44,760 --> 00:32:45,320 FIVE PILLARS. 951 00:32:45,320 --> 00:32:47,600 MOST RELEVANT TO THE WORK OF 952 00:32:47,600 --> 00:32:50,320 THIS INITIATIVE IS PILLAR FIVE, 953 00:32:50,320 --> 00:32:53,520 ADDRESSING ENHANCING NUTRITION 954 00:32:53,520 --> 00:32:56,120 AND FOOD SECURITY RESEARCH TO 955 00:32:56,120 --> 00:32:57,320 IMPROVE NUTRITION METRICS, DATA 956 00:32:57,320 --> 00:32:58,520 COLLECTION AND RESEARCH TO 957 00:32:58,520 --> 00:32:59,960 INFORM NUTRITION AND FOOD 958 00:32:59,960 --> 00:33:01,720 SECURITY POLICY PARTICULARLY ON 959 00:33:01,720 --> 00:33:04,680 ISSUES OF EQUITY, ACCESS, 960 00:33:04,680 --> 00:33:05,080 DISPARITIES. 961 00:33:05,080 --> 00:33:08,280 I'LL QUICKLY ADD THE SECOND 962 00:33:08,280 --> 00:33:11,440 PILLAR FOCUSES ON INTEGRATING 963 00:33:11,440 --> 00:33:13,760 NUTRITION AND HEALTH, A LINES 964 00:33:13,760 --> 00:33:15,840 CAN THE KEY STRATEGY. 965 00:33:15,840 --> 00:33:17,360 OUR OFFICE WILL LEAD STRATEGY 966 00:33:17,360 --> 00:33:20,000 REGARDING FOOD AS MEDICINE AS 967 00:33:20,000 --> 00:33:22,080 CALLED FOR IN THE 2023 968 00:33:22,080 --> 00:33:22,840 CONSOLIDATED APPROPRIATIONS ACT 969 00:33:22,840 --> 00:33:24,360 SEEKING TO UNDERSTAND THE 970 00:33:24,360 --> 00:33:26,320 BREADTH, FULL BREADTH OF 971 00:33:26,320 --> 00:33:27,480 EXISTING FOOD AS MEDICINE 972 00:33:27,480 --> 00:33:29,080 STRATEGIES AND DEFINE BEST 973 00:33:29,080 --> 00:33:31,800 PRACTICES TO INFORM FUTURE 974 00:33:31,800 --> 00:33:34,400 FEDERAL POLICY AND INVESTMENTS. 975 00:33:34,400 --> 00:33:36,360 THE THIRD PILLAR OF THE NATIONAL 976 00:33:36,360 --> 00:33:37,920 STRATEGY IS ABOUT EMPOWERING ALL 977 00:33:37,920 --> 00:33:42,520 CONSUMERS TO HAVE ACCESS TO AND 978 00:33:42,520 --> 00:33:43,800 MAKE HEALTHY CHOICES. 979 00:33:43,800 --> 00:33:45,480 WE ALSO SUPPORT THIS IMPORTANT 980 00:33:45,480 --> 00:33:47,520 GOAL THROUGH OUR WORK IN 981 00:33:47,520 --> 00:33:48,880 CO-LEADING ONGOING UPDATE OF 982 00:33:48,880 --> 00:33:52,240 DIETARY GUIDELINES FOR AMERICANS 983 00:33:52,240 --> 00:33:52,920 WITH OUR USDA COLLEAGUES. 984 00:33:52,920 --> 00:33:55,680 AS MANY OF YOU KNOW THE DIETARY 985 00:33:55,680 --> 00:33:56,760 GUIDELINES UPDATED AND RELEASED 986 00:33:56,760 --> 00:33:58,840 EVERY FIVE YEARS SERVE AS 987 00:33:58,840 --> 00:34:00,280 CORNERSTONE OF FEDERAL NUTRITION 988 00:34:00,280 --> 00:34:02,600 POLICY AND NUTRITION EDUCATION 989 00:34:02,600 --> 00:34:02,920 ACTIVITIES. 990 00:34:02,920 --> 00:34:05,280 THEY ARE FOOD-BASED NUTRITION 991 00:34:05,280 --> 00:34:07,040 GUIDELINES DESIGNED TO SUPPORT 992 00:34:07,040 --> 00:34:08,800 DEVELOPMENT OF HEALTHY EATING 993 00:34:08,800 --> 00:34:09,080 PATTERNS. 994 00:34:09,080 --> 00:34:10,880 THE CURRENT EDITION OF THE 995 00:34:10,880 --> 00:34:11,960 DIETARY GUIDELINES PROVIDES 996 00:34:11,960 --> 00:34:14,160 GUIDANCE BY LIFE STAGE FROM 997 00:34:14,160 --> 00:34:15,720 BIRTH THROUGH OLDER ADULTHOOD 998 00:34:15,720 --> 00:34:17,120 INCLUDING RECOMMENDATIONS FOR 999 00:34:17,120 --> 00:34:18,680 PREGNANT AND LACTATING WOMEN. 1000 00:34:18,680 --> 00:34:20,280 THE PROCESS TO UPDATE THE NEXT 1001 00:34:20,280 --> 00:34:21,960 EDITION OF THE GUIDELINES IS 1002 00:34:21,960 --> 00:34:23,600 UNDERWAY AS WE SPEAK. 1003 00:34:23,600 --> 00:34:28,400 AS I MENTIONED CO-LED BY ODPHD 1004 00:34:28,400 --> 00:34:30,880 AND CENTER FOR NUTRITION AT 1005 00:34:30,880 --> 00:34:31,080 USDA. 1006 00:34:31,080 --> 00:34:32,520 THE 2025 ADVISORY COMMITTEE WAS 1007 00:34:32,520 --> 00:34:34,720 ANNOUNCED IN JANUARY OF THIS 1008 00:34:34,720 --> 00:34:35,640 YEAR, TASKED WITH REVIEWING 1009 00:34:35,640 --> 00:34:37,440 CURRENT BODY OF EVIDENCE ON DIET 1010 00:34:37,440 --> 00:34:39,320 AND HEALTH OUTCOMES ACROSS THE 1011 00:34:39,320 --> 00:34:39,760 LIFESPAN. 1012 00:34:39,760 --> 00:34:41,320 ALL THE SCIENTIFIC QUESTIONS 1013 00:34:41,320 --> 00:34:43,360 DELIBERATED ON WILL BE REVIEWED 1014 00:34:43,360 --> 00:34:44,560 WITH HEALTH EQUITY LENS TO 1015 00:34:44,560 --> 00:34:46,200 ENSURE THE NEXT EDITION OF THE 1016 00:34:46,200 --> 00:34:48,480 DIETARY GUIDELINES IS RELEVANT 1017 00:34:48,480 --> 00:34:49,160 TO ALL AMERICANS. 1018 00:34:49,160 --> 00:34:50,920 SECOND MEETING OF THE COMMITTEE 1019 00:34:50,920 --> 00:34:52,360 IS COMING UP ON MAY 10, 1020 00:34:52,360 --> 00:34:54,600 REGISTRATION IS NOW OPEN ON 1021 00:34:54,600 --> 00:34:57,040 DIETARY GUIDELINES.GOV AS OF 1022 00:34:57,040 --> 00:34:57,840 TODAY I BELIEVE. 1023 00:34:57,840 --> 00:35:00,000 IN PARALLEL WITH THE WORK OF THE 1024 00:35:00,000 --> 00:35:00,600 SCIENTIFIC ADVISORY COMMITTEE 1025 00:35:00,600 --> 00:35:03,400 AND FEDERAL PARTNERS TO DEVELOP 1026 00:35:03,400 --> 00:35:06,240 THE NET ITERATION OF GUIDELINES 1027 00:35:06,240 --> 00:35:08,320 IS THIS IMPORTANT WORK ON 1028 00:35:08,320 --> 00:35:08,920 SUSTAINABILITY. 1029 00:35:08,920 --> 00:35:10,600 HHS WILL BE FORMING A SEPARATE 1030 00:35:10,600 --> 00:35:12,120 COMMITTEE TO EXAMINE A PROCESS 1031 00:35:12,120 --> 00:35:13,480 FRAMEWORK FOR CONSIDERING 1032 00:35:13,480 --> 00:35:14,120 INCORPORATING ISSUES OF 1033 00:35:14,120 --> 00:35:15,760 SUSTAINABILITY LIKE WHAT WE HOPE 1034 00:35:15,760 --> 00:35:17,840 TO LEARN FROM ADVANTAGE INTO THE 1035 00:35:17,840 --> 00:35:19,280 DIETARY GUIDELINES PROCESS AS 1036 00:35:19,280 --> 00:35:21,360 WELL AS POTENTIALLY HELP INFORM 1037 00:35:21,360 --> 00:35:25,000 OTHER FEDERAL NUTRITION POLICIES 1038 00:35:25,000 --> 00:35:25,720 AND PROGRAMS. 1039 00:35:25,720 --> 00:35:27,360 FINALLY I'D BE REMISS IF I 1040 00:35:27,360 --> 00:35:29,120 DIDN'T MENTION THE HALLMARK 1041 00:35:29,120 --> 00:35:30,080 PROGRAM, HEALTHY PEOPLE AND ITS 1042 00:35:30,080 --> 00:35:32,160 RELEVANCE TO THE WORK WE'RE 1043 00:35:32,160 --> 00:35:34,040 DISCUSSING TODAY. 1044 00:35:34,040 --> 00:35:36,000 THROUGH HEALTHY PEOPLE ODPHP 1045 00:35:36,000 --> 00:35:37,960 WORKS WITH PARTNERS ACROSS THE 1046 00:35:37,960 --> 00:35:40,160 FEDERAL GOVERNMENT TO SET 1047 00:35:40,160 --> 00:35:41,040 NATIONAL DISEASE PREVENTION 1048 00:35:41,040 --> 00:35:43,000 PRIORITIES, SHARE THE LATEST 1049 00:35:43,000 --> 00:35:43,680 HEALTH PROMOTION RESEARCH, 1050 00:35:43,680 --> 00:35:44,960 COLLABORATE ON STRATEGIES TO 1051 00:35:44,960 --> 00:35:47,160 FURTHER THE NATION'S HEALTH 1052 00:35:47,160 --> 00:35:47,400 AGENDA. 1053 00:35:47,400 --> 00:35:48,920 WE CO-CREATE HEALTHY PEOPLE 1054 00:35:48,920 --> 00:35:52,520 EVERY TEN YEARS, HEALTHY PEOPLE 1055 00:35:52,520 --> 00:35:54,200 2030 CURRENT ITERATION INCLUDES 1056 00:35:54,200 --> 00:35:55,840 MORE THAN 350 EVIDENCE-BASED 1057 00:35:55,840 --> 00:35:56,400 MEASURABLE OBJECTIVES WHICH 1058 00:35:56,400 --> 00:35:59,520 COVER A WIDE RANGE OF TOPICS IN 1059 00:35:59,520 --> 00:36:02,400 WHICH HELP US MEASURE AND TRACK 1060 00:36:02,400 --> 00:36:03,880 FACTORS THAT INFLUENCE OUTCOMES. 1061 00:36:03,880 --> 00:36:04,880 I'M QUITE CONFIDENT WHAT WE 1062 00:36:04,880 --> 00:36:06,680 LEARN FROM THE WORK OF ADVANTAGE 1063 00:36:06,680 --> 00:36:08,400 WILL HELP INFORM ALL OF THESE 1064 00:36:08,400 --> 00:36:08,640 EFFORTS. 1065 00:36:08,640 --> 00:36:11,360 I WANT TO THANK YOU, EVERYBODY 1066 00:36:11,360 --> 00:36:13,680 COMMITTED TO THIS EFFORT. 1067 00:36:13,680 --> 00:36:14,720 THANK YOU VERY MUCH. 1068 00:36:14,720 --> 00:36:16,840 >> PAUL, THANK YOU. 1069 00:36:16,840 --> 00:36:18,360 AGAIN, CINDY AND PAUL, WE REALLY 1070 00:36:18,360 --> 00:36:19,560 APPRECIATE NOT ONLY YOU 1071 00:36:19,560 --> 00:36:20,520 PERSONALLY, WHAT YOU BRING TO 1072 00:36:20,520 --> 00:36:22,520 THE TABLE, BUT WHAT YOU BRING 1073 00:36:22,520 --> 00:36:24,360 FROM YOUR AGENCIES. 1074 00:36:24,360 --> 00:36:27,960 AGAIN, VERY GRATEFUL. 1075 00:36:27,960 --> 00:36:33,000 WE'RE GOING GREAT ON TIME. 1076 00:36:33,000 --> 00:36:35,440 WE'LL PIVOT WORKING 1 GROUP 1077 00:36:35,440 --> 00:36:38,800 CO-CHAIRS AND LET'S LAUNCH 1078 00:36:38,800 --> 00:36:39,040 ADVANTAGE. 1079 00:36:39,040 --> 00:36:40,520 KRISTIE AND NANCY, TAKE IT AWAY. 1080 00:36:40,520 --> 00:36:43,960 >> WE REALLY APPRECIATE ALL THE 1081 00:36:43,960 --> 00:36:47,320 COMMENTS FROM EVERYONE, THE 1082 00:36:47,320 --> 00:36:48,280 FRAMING WAS VERY HELPFUL. 1083 00:36:48,280 --> 00:36:51,600 I'M A PREFER AT THE CENTER FOR 1084 00:36:51,600 --> 00:36:53,240 HEALTH AND GLOBAL ENVIRONMENT, 1085 00:36:53,240 --> 00:36:55,640 CO-CHAIR WITH NANCY KREBS, 1086 00:36:55,640 --> 00:36:56,760 WORKING GROUP 1. 1087 00:36:56,760 --> 00:36:56,960 NANCY? 1088 00:36:56,960 --> 00:36:57,680 >>GOOD MORNING. 1089 00:36:57,680 --> 00:36:59,920 GOOD DAY TO THOSE IN OTHER TIME 1090 00:36:59,920 --> 00:37:00,600 ZONES. 1091 00:37:00,600 --> 00:37:04,080 IT'S A DELIGHT TO BE HERE. 1092 00:37:04,080 --> 00:37:06,360 I WANT TO JUST ADD MY THANKS. 1093 00:37:06,360 --> 00:37:11,000 IN THE INTEREST OF TIME I THINK 1094 00:37:11,000 --> 00:37:13,040 THE SLIDES THAT DR. EBI IS GOING 1095 00:37:13,040 --> 00:37:14,240 TO GO THROUGH WILL REALLY LAY 1096 00:37:14,240 --> 00:37:17,000 THE GROUND WORK FOR TODAY'S 1097 00:37:17,000 --> 00:37:18,400 SESSION. 1098 00:37:18,400 --> 00:37:20,520 BUT JUST TO TAKE A MOMENT TO SAY 1099 00:37:20,520 --> 00:37:22,760 WE'LL BE WORKING ON THE 1100 00:37:22,760 --> 00:37:26,920 INTERSECTION OF CLIMATE AND 1101 00:37:26,920 --> 00:37:29,680 ENVIRONMENT CHANGE WITH EMPHASIS 1102 00:37:29,680 --> 00:37:30,960 ON NUTRITION, AND OVERLYING THAT 1103 00:37:30,960 --> 00:37:32,600 IS A LIFE COURSE APPROACH. 1104 00:37:32,600 --> 00:37:37,120 SO OUR PROGRAM FOR TODAY WILL 1105 00:37:37,120 --> 00:37:47,280 HOPEFULLY REFLECT THAT 1106 00:37:47,280 --> 00:37:47,840 MULTI-FACTORIAL SECTORAL 1107 00:37:47,840 --> 00:37:48,080 APPROACH. 1108 00:37:48,080 --> 00:37:49,400 >>I'LL START WITH OUR AGENDA 1109 00:37:49,400 --> 00:37:51,320 LAYING OUT WHAT WE'LL COVER IN 1110 00:37:51,320 --> 00:37:53,200 THE NEXT COUPLE HOURS SO YOU 1111 00:37:53,200 --> 00:37:55,840 HAVE A VISION OF WHERE WE'RE 1112 00:37:55,840 --> 00:37:56,040 GOING. 1113 00:37:56,040 --> 00:37:58,880 AND WE'RE GOING TO START BY 1114 00:37:58,880 --> 00:38:01,280 TALKING ABOUT OUR OBJECTIVES AND 1115 00:38:01,280 --> 00:38:01,960 OUR FRAMEWORK. 1116 00:38:01,960 --> 00:38:03,920 AND THEN WE'RE GOING TO LAUNCH 1117 00:38:03,920 --> 00:38:07,400 INTO A SESSION ON CLIMATE, 1118 00:38:07,400 --> 00:38:07,960 HEALTH, NUTRITION. 1119 00:38:07,960 --> 00:38:10,960 EACH OF THESE SESSIONS WILL HAVE 1120 00:38:10,960 --> 00:38:12,800 A BRIEF DISCUSSION PERIOD. 1121 00:38:12,800 --> 00:38:14,200 WE'LL HAVE SOME PRESENTATIONS 1122 00:38:14,200 --> 00:38:15,560 AND A BRIEF DISCUSSION PERIOD. 1123 00:38:15,560 --> 00:38:16,960 AND WE'LL HAVE A LONGER 1124 00:38:16,960 --> 00:38:18,920 DISCUSSION AT THE END THAT WE 1125 00:38:18,920 --> 00:38:22,200 REALLY LOOK FORWARD TO YOUR 1126 00:38:22,200 --> 00:38:23,400 CONTRIBUTIONS TO. 1127 00:38:23,400 --> 00:38:25,280 THIS IS THE WORKING GROUP. 1128 00:38:25,280 --> 00:38:30,960 YOU ALREADY SAW NANCY AND ME. 1129 00:38:30,960 --> 00:38:41,400 WE'VE GOT RONALD, CARTEEK, 1130 00:38:46,440 --> 00:38:47,560 ANDREW, ALEXANDRA. 1131 00:38:47,560 --> 00:38:49,240 THESE ARE OBJECTIVES. 1132 00:38:49,240 --> 00:38:50,320 WE WANT TO DESCRIBE CURRENT 1133 00:38:50,320 --> 00:38:51,840 STATE OF KNOWLEDGE OF IMPACT OF 1134 00:38:51,840 --> 00:38:55,160 WEATHER AND CLIMATE ON HEALTH 1135 00:38:55,160 --> 00:38:57,080 OUTCOMES OVER THE LIFESPAN. 1136 00:38:57,080 --> 00:39:01,080 THINKING IN PARTICULAR ABOUT 1137 00:39:01,080 --> 00:39:01,920 PARTICULARLY VULNERABLE GROUPS, 1138 00:39:01,920 --> 00:39:07,440 FOR VULNERABILITY FROM THE 1139 00:39:07,440 --> 00:39:11,680 HEALTH PERSPECTIVE WE MEAN 1140 00:39:11,680 --> 00:39:12,920 SUSCEPTIBILITY, MORE SUSCEPTIBLE 1141 00:39:12,920 --> 00:39:16,160 FOR EXAMPLE TO HEAT STRESS AND 1142 00:39:16,160 --> 00:39:17,960 THINKING ABOUT PHYSIOLOGIC 1143 00:39:17,960 --> 00:39:20,080 FUNCTIONS. 1144 00:39:20,080 --> 00:39:26,560 WE'LL COVER THE EVIDENCE BETWEEN 1145 00:39:26,560 --> 00:39:34,120 CLIMATE, MALNUTRITION FOR EACH 1146 00:39:34,120 --> 00:39:35,680 STAGE, KNOWLEDGE GAPS AND 1147 00:39:35,680 --> 00:39:36,440 RESEARCH PRIORITIES. 1148 00:39:36,440 --> 00:39:38,280 NONE OF US HAVE DISCLOSURES. 1149 00:39:38,280 --> 00:39:39,240 PERHAPS WHEN THERE'S MORE 1150 00:39:39,240 --> 00:39:45,080 FUNDING WE MIGHT HAVE SOME 1151 00:39:45,080 --> 00:39:46,360 DISCLOSURES BUT WE PROBABLY 1152 00:39:46,360 --> 00:39:47,880 WON'T FOR THE FORESEEABLE TIME. 1153 00:39:47,880 --> 00:39:51,520 WITH THAT I WANT TO START WITH A 1154 00:39:51,520 --> 00:39:54,160 FEW SLIDES ABOUT CLIMATE CHANGE 1155 00:39:54,160 --> 00:39:57,520 AND HOW IT IS AFFECTING HEALTH. 1156 00:39:57,520 --> 00:40:01,560 THIS AND THE NEXT SLIDE ARE FROM 1157 00:40:01,560 --> 00:40:03,000 THE JUST-RELEASED SYNTHESIS 1158 00:40:03,000 --> 00:40:04,440 REPORT FROM INTERGOVERNMENTAL 1159 00:40:04,440 --> 00:40:05,720 PANEL ON CLIMATE CHANGE. 1160 00:40:05,720 --> 00:40:07,120 IT JUST CAME OUT A FEW WEEKS 1161 00:40:07,120 --> 00:40:08,000 AGO. 1162 00:40:08,000 --> 00:40:11,320 THERE'S A COUPLE HELPFUL 1163 00:40:11,320 --> 00:40:13,640 GRAPHICS THAT CAN HELP FRAME HOW 1164 00:40:13,640 --> 00:40:17,160 WE'RE GOING TO APPROACH OUR 1165 00:40:17,160 --> 00:40:18,840 PARTICULAR CHALLENGE. 1166 00:40:18,840 --> 00:40:21,600 THE PANEL A SHOWS OBSERVED 1167 00:40:21,600 --> 00:40:22,080 IMPACTS. 1168 00:40:22,080 --> 00:40:23,400 CLIMATE CHANGE IS ALREADY 1169 00:40:23,400 --> 00:40:26,880 AFFECTING HUMAN HEALTH AND 1170 00:40:26,880 --> 00:40:27,200 WELL-BEING. 1171 00:40:27,200 --> 00:40:29,160 WE NOW HAVE SPECIFIC STUDIES 1172 00:40:29,160 --> 00:40:31,680 THAT SHOW PEOPLE ARE DYING FROM 1173 00:40:31,680 --> 00:40:32,560 CLIMATE CHANGE. 1174 00:40:32,560 --> 00:40:35,000 THE FOCUS OF THE STUDIES IS ON 1175 00:40:35,000 --> 00:40:37,920 HEAT BUT INCREASINGLY THERE WILL 1176 00:40:37,920 --> 00:40:42,520 BE MORE STUDIES DOCUMENTING HARM 1177 00:40:42,520 --> 00:40:44,840 TODAY FROM MALNUTRITION AND FROM 1178 00:40:44,840 --> 00:40:46,080 WILDFIRES IN PARTICULAR. 1179 00:40:46,080 --> 00:40:47,480 ALTHOUGH THERE ARE SOME 1180 00:40:47,480 --> 00:40:50,560 SUGGESTIONS THAT NOT ONLY DO WE 1181 00:40:50,560 --> 00:40:53,040 KNOW THERE'S ASSOCIATIONS 1182 00:40:53,040 --> 00:40:54,760 BETWEEN OUR CHANGING CLIMATE, 1183 00:40:54,760 --> 00:40:55,680 INCREASES IN FLOODING FOR 1184 00:40:55,680 --> 00:40:58,000 EXAMPLE AND MENTAL HEALTH, AND 1185 00:40:58,000 --> 00:41:00,800 ONCE IT'S DOCUMENTED FLOODING 1186 00:41:00,800 --> 00:41:01,800 EVENTS ARE INDEED ATTRIBUTABLE 1187 00:41:01,800 --> 00:41:05,360 TO SOME DEGREE TO CLIMATE CHANGE 1188 00:41:05,360 --> 00:41:07,320 WE'LL BE ABLE TO ATTRIBUTE 1189 00:41:07,320 --> 00:41:09,280 MENTAL HEALTH OUTCOMES. 1190 00:41:09,280 --> 00:41:10,720 YOU'LL HEAR TODAY MORE ABOUT 1191 00:41:10,720 --> 00:41:12,560 INFECTIOUS DISEASES. 1192 00:41:12,560 --> 00:41:15,080 WE WON'T REALLY TALK MUCH ABOUT 1193 00:41:15,080 --> 00:41:15,400 DISPLACEMENT. 1194 00:41:15,400 --> 00:41:18,120 WHEN YOU LOOK AT THE OTHER PARTS 1195 00:41:18,120 --> 00:41:22,320 OF PANEL A, YOU CAN SEE WATER 1196 00:41:22,320 --> 00:41:24,480 AVAILABILITY, FOOD PRODUCTION, 1197 00:41:24,480 --> 00:41:27,000 CITY SETTLEMENTS AND 1198 00:41:27,000 --> 00:41:29,200 INFRASTRUCTURE, BIODIVERSITY AND 1199 00:41:29,200 --> 00:41:29,520 ECOSYSTEMS. 1200 00:41:29,520 --> 00:41:32,160 THESE ARE CATEGORIZED IN TERMS 1201 00:41:32,160 --> 00:41:35,000 OF WAY MINISTRIES ARE ORGANIZED 1202 00:41:35,000 --> 00:41:36,320 WITHIN GOVERNMENT. 1203 00:41:36,320 --> 00:41:38,040 OR WHERE YOU HAVE SUBNATIONAL 1204 00:41:38,040 --> 00:41:40,040 ELEMENTS LIKE CITIES AND WHAT 1205 00:41:40,040 --> 00:41:40,720 HAPPENS WITHIN CITIES. 1206 00:41:40,720 --> 00:41:44,080 BUT OF COURSE THESE ARE NOT 1207 00:41:44,080 --> 00:41:44,720 INDEPENDENT. 1208 00:41:44,720 --> 00:41:46,160 THESE ALL INTERACTION. 1209 00:41:46,160 --> 00:41:50,920 AND SO AS DR. RAITEN EMPHASIZED 1210 00:41:50,920 --> 00:41:51,960 WE'RE TAKING A SYSTEMS-BASED 1211 00:41:51,960 --> 00:41:54,680 APPROACH, WE NEED TO LOOK AT 1212 00:41:54,680 --> 00:41:56,360 INTERSECTIONS BETWEEN WATER 1213 00:41:56,360 --> 00:41:58,760 AVAILABILITY, WHAT HAPPENS WITH 1214 00:41:58,760 --> 00:42:00,280 AGRICULTURE, WHAT THAT MEANS FOR 1215 00:42:00,280 --> 00:42:05,000 DIETS AND FINALLY WHAT IT MEANS 1216 00:42:05,000 --> 00:42:05,520 FOR NUTRITION. 1217 00:42:05,520 --> 00:42:08,120 PANEL B COVERS THE OBSERVED 1218 00:42:08,120 --> 00:42:09,320 PHYSICAL CLIMATE CHANGES, AND 1219 00:42:09,320 --> 00:42:12,200 EXTENT TO WHICH THERE HAS BEEN 1220 00:42:12,200 --> 00:42:13,000 ATTRIBUTION TO CLIMATE CHANGE. 1221 00:42:13,000 --> 00:42:15,680 YOU CAN SEE IN THE BOTTOM RIGHT 1222 00:42:15,680 --> 00:42:17,880 IT'S VIRTUALLY CERTAIN CLIMATE 1223 00:42:17,880 --> 00:42:19,520 CHANGE HAS INCREASED FREQUENCY, 1224 00:42:19,520 --> 00:42:22,120 INTENSITY, AND DURATION OF HEAT 1225 00:42:22,120 --> 00:42:22,840 EXTREMES. 1226 00:42:22,840 --> 00:42:24,560 WE ALSO KNOW VIRTUALLY CERTAIN 1227 00:42:24,560 --> 00:42:26,560 THAT CLIMATE CHANGE HAS 1228 00:42:26,560 --> 00:42:29,960 AFFECTED pH IN THE UPPER OCEAN 1229 00:42:29,960 --> 00:42:31,960 LEADING TO OCEAN ACIDIFICATION. 1230 00:42:31,960 --> 00:42:34,080 THERE'S BEEN LOTS OF DISCUSSION 1231 00:42:34,080 --> 00:42:36,600 IN THE MEDIA ABOUT SEA LEVEL 1232 00:42:36,600 --> 00:42:38,600 RISE, STORM SURGE, WHAT THAT 1233 00:42:38,600 --> 00:42:39,240 MEANS FOR COASTAL ZONES. 1234 00:42:39,240 --> 00:42:43,440 IN THE U.S. WE'VE SEEN SOME 1235 00:42:43,440 --> 00:42:45,280 MASSIVE PRECIPITATION EVENTS 1236 00:42:45,280 --> 00:42:47,360 RESULTING IN EXTENSIVE FLOODING. 1237 00:42:47,360 --> 00:42:49,000 AND THE FLOODING HAS TO DO NOT 1238 00:42:49,000 --> 00:42:50,720 JUST WITH THE CHANGES IN THE 1239 00:42:50,720 --> 00:42:53,400 PHYSICAL CLIMATE BUT ALSO OUR 1240 00:42:53,400 --> 00:42:53,760 INFRASTRUCTURE. 1241 00:42:53,760 --> 00:42:55,360 CHOICES THAT WE'VE MADE IN OUR 1242 00:42:55,360 --> 00:42:57,880 CITIES AND HOW OUR CITIES ARE 1243 00:42:57,880 --> 00:43:00,520 PLANNED, WHICH IS WHY YOU SEE A 1244 00:43:00,520 --> 00:43:04,200 MEDIUM CONFIDENCE IN ISSUES SUCH 1245 00:43:04,200 --> 00:43:05,480 AS INCREASES IN COMPOUND 1246 00:43:05,480 --> 00:43:07,040 FLOODING. 1247 00:43:07,040 --> 00:43:08,360 AGAIN, ON THE SYSTEMS-BASED 1248 00:43:08,360 --> 00:43:10,600 APPROACH, ALL OF THESE ISSUES 1249 00:43:10,600 --> 00:43:14,280 THEN GO BACK TO THE OBSERVED 1250 00:43:14,280 --> 00:43:21,280 IMPACTS LISTED ABOVE, THE 1251 00:43:21,280 --> 00:43:23,400 FLOODING AFFECT, AGRICULTURE, 1252 00:43:23,400 --> 00:43:23,880 LIVESTOCKS, FISHERIES, 1253 00:43:23,880 --> 00:43:24,520 INFECTIOUS DISEASES, ET CETERA. 1254 00:43:24,520 --> 00:43:26,680 WE HAVE TO TAKE THE BROADEST 1255 00:43:26,680 --> 00:43:28,080 POSSIBLE PICTURE, UNDERSTANDING 1256 00:43:28,080 --> 00:43:33,000 THESE UPSTREAM DRIVERS OF HEALTH 1257 00:43:33,000 --> 00:43:34,520 AND WELL-BEING. 1258 00:43:34,520 --> 00:43:36,360 THE REPORT INCLUDED THIS FIGURE 1259 00:43:36,360 --> 00:43:37,800 WHICH VERY MUCH SPEAKS TO THE 1260 00:43:37,800 --> 00:43:39,360 THEME OF WHAT WE'RE DOING IN 1261 00:43:39,360 --> 00:43:40,200 ADVANTAGE AND WHAT WE'RE GOING 1262 00:43:40,200 --> 00:43:43,160 TO BE TALKING ABOUT IN OUR 1263 00:43:43,160 --> 00:43:44,280 SPECIFIC WORKING GROUP. 1264 00:43:44,280 --> 00:43:45,360 IF YOU'RE NOT FAMILIAR WITH 1265 00:43:45,360 --> 00:43:48,640 THESE, THESE ARE THE WARMING 1266 00:43:48,640 --> 00:43:50,280 STRIPES, CLIMATE STRIPES THAT 1267 00:43:50,280 --> 00:43:52,240 SHOW GLOBAL TEMPERATURE CHANGE 1268 00:43:52,240 --> 00:43:56,640 ABOVE WHAT WAS OBSERVED IN 1850 1269 00:43:56,640 --> 00:43:57,680 TO 1900. 1270 00:43:57,680 --> 00:44:00,480 DARKER THE COLOR, HIGHER THE 1271 00:44:00,480 --> 00:44:01,440 TEMPERATURE CHANGE. 1272 00:44:01,440 --> 00:44:03,640 FROM 2020 GOING FORWARD, THESE 1273 00:44:03,640 --> 00:44:05,960 ARE PROJECTIONS BASED ON 1274 00:44:05,960 --> 00:44:07,880 EMISSION SCENARIOS, HOW MUCH 1275 00:44:07,880 --> 00:44:10,960 GREENHOUSE GASES WILL BE OH OF 1276 00:44:10,960 --> 00:44:13,480 ADMITTED INTO THE ATMOSPHERE 1277 00:44:13,480 --> 00:44:15,000 WITH FIVE SCENARIOS USED TO 1278 00:44:15,000 --> 00:44:18,560 BRACKE THE RANGE OF FUTURE 1279 00:44:18,560 --> 00:44:18,880 UNCERTAINTIES. 1280 00:44:18,880 --> 00:44:21,400 LOW EMISSIONS IS A WORLD AIMING 1281 00:44:21,400 --> 00:44:22,680 TO SUSTAINABLE DEVELOPMENT. 1282 00:44:22,680 --> 00:44:27,480 TRYING TO KEEP WARMING BELOW 2 1283 00:44:27,480 --> 00:44:28,920 DEGREES CELSIUS, AIMING TO 1.5 1284 00:44:28,920 --> 00:44:30,880 DEGREES UP TO VERY HIGH 1285 00:44:30,880 --> 00:44:32,960 EMISSIONS, THIS IS A WORLD WHERE 1286 00:44:32,960 --> 00:44:35,800 THERE ARE VERY HIGH CHALLENGES 1287 00:44:35,800 --> 00:44:37,440 TO ADAPTATION AND MITIGATION, 1288 00:44:37,440 --> 00:44:39,880 AND SO YOU CAN SEE QUITE EXTREME 1289 00:44:39,880 --> 00:44:43,240 WARMING UP TO 4 DEGREES C ABOVE 1290 00:44:43,240 --> 00:44:45,440 PRE-INDUSTRIAL IN THE VERY HIGH. 1291 00:44:45,440 --> 00:44:47,600 THE SLIDE SHOWS YOU WHAT IT 1292 00:44:47,600 --> 00:44:50,920 MEANS FOR US, WHAT IT MEANS FOR 1293 00:44:50,920 --> 00:44:51,880 THE HUMAN POPULATIONS. 1294 00:44:51,880 --> 00:44:55,480 AT THE BOTTOM YOU SEE PEOPLE 1295 00:44:55,480 --> 00:44:57,920 BORN IN 1950, EXPERIENCED A 1296 00:44:57,920 --> 00:44:59,240 SMALL AMOUNT OF TEMPERATURE 1297 00:44:59,240 --> 00:45:00,760 CHANGE BUT NOT MUCH. 1298 00:45:00,760 --> 00:45:03,480 AND AS THEY ARE NOW GETTING INTO 1299 00:45:03,480 --> 00:45:06,320 THE PERIOD OF BEING OLDER 1300 00:45:06,320 --> 00:45:09,920 ADULTS, THEY ARE STARTING TO 1301 00:45:09,920 --> 00:45:11,720 EXPERIENCE HIGHER TEMPERATURES. 1302 00:45:11,720 --> 00:45:14,120 BUT CHILDREN BORN IN 1980 ARE 1303 00:45:14,120 --> 00:45:15,760 STARTING TO EXPERIENCE THESE 1304 00:45:15,760 --> 00:45:16,640 TEMPERATURES IN THEIR MIDDLE 1305 00:45:16,640 --> 00:45:17,120 YEARS. 1306 00:45:17,120 --> 00:45:18,920 AND THIS IS GOING TO AFFECT 1307 00:45:18,920 --> 00:45:19,760 THEIR LIFE COURSE BECAUSE THEY 1308 00:45:19,760 --> 00:45:22,680 ARE GOING TO HAVE MORE 1309 00:45:22,680 --> 00:45:25,400 SIGNIFICANT EXPOSURES TO HIGH 1310 00:45:25,400 --> 00:45:26,720 TEMPERATURES, MORE FLOODING 1311 00:45:26,720 --> 00:45:27,960 EVENTS, THE KINDS OF CLIMATE 1312 00:45:27,960 --> 00:45:30,360 IMPACTS I MENTIONED ON THE 1313 00:45:30,360 --> 00:45:31,680 PREVIOUS SLIDE. 1314 00:45:31,680 --> 00:45:33,520 AND THEN CHILDREN BORN TODAY 1315 00:45:33,520 --> 00:45:35,840 WILL HAVE MUCH MORE EXTREME 1316 00:45:35,840 --> 00:45:36,200 EXPOSURES. 1317 00:45:36,200 --> 00:45:38,560 AND SO WHEN WE THINK ABOUT LIFE 1318 00:45:38,560 --> 00:45:39,960 SOURCE AND HEALTH, WE THINK 1319 00:45:39,960 --> 00:45:41,960 ABOUT WHAT HAPPENS OVER THE 1320 00:45:41,960 --> 00:45:43,720 COURSE OF OUR LIFETIMES, AND WE 1321 00:45:43,720 --> 00:45:49,640 HAVE TO ADD INTO THIS, AS DR. 1322 00:45:49,640 --> 00:45:50,960 RAITEN SET, THINKING ABOUT OUR 1323 00:45:50,960 --> 00:45:52,240 GLOBAL ENVIRONMENT, WHAT IS THE 1324 00:45:52,240 --> 00:45:53,920 EXPERIENCE OF US INDIVIDUALLY 1325 00:45:53,920 --> 00:45:55,440 AND COLLECTIVELY, AS WE GO INTO 1326 00:45:55,440 --> 00:46:00,480 A MUCH WARMER AND VERY DIFFERENT 1327 00:46:00,480 --> 00:46:01,880 FUTURE. 1328 00:46:01,880 --> 00:46:04,320 IN TERMS OF HEALTH, AN IMPORTANT 1329 00:46:04,320 --> 00:46:05,200 FRAMING FROM THE 1330 00:46:05,200 --> 00:46:06,280 INTERGOVERNMENTAL PANEL ON 1331 00:46:06,280 --> 00:46:08,440 CLIMATE CHANGE, WE THINK NOT 1332 00:46:08,440 --> 00:46:10,360 JUST ABOUT THE CLIMATE. 1333 00:46:10,360 --> 00:46:16,120 THE TOP ROW SHOWS CHANGES THAT 1334 00:46:16,120 --> 00:46:17,880 ARE OCCURRING WITH INCREASING 1335 00:46:17,880 --> 00:46:18,720 GREEN HOUSE GAS EMISSIONS, 1336 00:46:18,720 --> 00:46:19,840 INCREASE IN TEMPERATURE, SEA 1337 00:46:19,840 --> 00:46:21,040 LEVEL RISE. 1338 00:46:21,040 --> 00:46:23,360 THOSE INTERACT WITH A BROAD 1339 00:46:23,360 --> 00:46:24,000 RANGE OF DEMOGRAPHIC, 1340 00:46:24,000 --> 00:46:25,880 SOCIOENVIRONMENT, ENVIRONMENTAL 1341 00:46:25,880 --> 00:46:27,360 AND OTHER FACTORS. 1342 00:46:27,360 --> 00:46:28,680 TOGETHER THAT INTERACTION 1343 00:46:28,680 --> 00:46:31,560 DETERMINES THE MAGNITUDE AND 1344 00:46:31,560 --> 00:46:32,760 PATTERN OF RISKS. 1345 00:46:32,760 --> 00:46:34,280 THE SLIDE LISTS A SHORT LIST OF 1346 00:46:34,280 --> 00:46:37,040 SOME OF THESE OTHER FACTORS, AND 1347 00:46:37,040 --> 00:46:38,800 WE NEED TO UNDERSTAND THESE 1348 00:46:38,800 --> 00:46:41,000 BECAUSE CLIMATE CHANGE IS 1349 00:46:41,000 --> 00:46:41,240 UNEVEN. 1350 00:46:41,240 --> 00:46:44,160 WE DO HAVE THE CHANGE AND GLOBAL 1351 00:46:44,160 --> 00:46:45,040 MEAN SURFACE TEMPERATURE BUT 1352 00:46:45,040 --> 00:46:46,800 WHAT HAPPENS AT LOCAL SCALE 1353 00:46:46,800 --> 00:46:48,760 DIFFERS QUITE A BIT. 1354 00:46:48,760 --> 00:46:52,280 AND SO EXPOSURES VARY FROM PLACE 1355 00:46:52,280 --> 00:46:53,240 TO PLACE. 1356 00:46:53,240 --> 00:46:55,320 ALSO, BECAUSE OF THE 1357 00:46:55,320 --> 00:46:55,960 INTERACTIONS THAT ULTIMATELY 1358 00:46:55,960 --> 00:46:58,200 DETERMINE WHAT WE'RE GOING TO 1359 00:46:58,200 --> 00:47:01,880 OBSERVE, WE NEED TO UNDERSTAND 1360 00:47:01,880 --> 00:47:03,600 THE UNDERLYING SUSCEPTIBILITY OF 1361 00:47:03,600 --> 00:47:05,040 POPULATIONS AND WE NEED TO 1362 00:47:05,040 --> 00:47:07,920 UNDERSTAND THE CAPACITY OF OUR 1363 00:47:07,920 --> 00:47:09,560 SYSTEMS TO MANAGE THESE SHIFTS 1364 00:47:09,560 --> 00:47:13,840 IN THE MAGNITUDE AND PATTERN OF 1365 00:47:13,840 --> 00:47:14,040 RISKS. 1366 00:47:14,040 --> 00:47:15,880 AND TOGETHER THOSE THEN 1367 00:47:15,880 --> 00:47:17,320 INFLUENCE EXPOSURE PATHWAYS THAT 1368 00:47:17,320 --> 00:47:18,440 ARE WHAT ARE TYPICALLY STUDIED 1369 00:47:18,440 --> 00:47:19,480 IN HEALTH. 1370 00:47:19,480 --> 00:47:20,280 ON THE LEFT EXTREME WEATHER 1371 00:47:20,280 --> 00:47:22,760 EVENT TO THE RIGHT WHETHER WE'VE 1372 00:47:22,760 --> 00:47:24,200 GOT SOCIAL FACTORS THAT 1373 00:47:24,200 --> 00:47:26,280 INFLUENCE, FOR EXAMPLE, 1374 00:47:26,280 --> 00:47:27,480 MIGRATION AND CONFLICT. 1375 00:47:27,480 --> 00:47:29,120 THE EXAMPLES OF HEALTH OUTCOMES 1376 00:47:29,120 --> 00:47:31,080 ARE INDEED THAT. 1377 00:47:31,080 --> 00:47:33,720 JUST EXAMPLES. 1378 00:47:33,720 --> 00:47:37,560 THERE ARE LITERALLY HUNDREDS OF 1379 00:47:37,560 --> 00:47:40,160 CLIMATE SENSITIVE HEALTH 1380 00:47:40,160 --> 00:47:40,800 OUTCOMES. 1381 00:47:40,800 --> 00:47:42,440 WE CATEGORIZE THINGS FOR 1382 00:47:42,440 --> 00:47:44,440 PARTICULAR REASONS. 1383 00:47:44,440 --> 00:47:46,960 SO THE LIST OF HEALTH OUTCOMES 1384 00:47:46,960 --> 00:47:48,480 IS CATEGORIZED BY EXPOSURE 1385 00:47:48,480 --> 00:47:50,680 PATHWAYS, BUT AGAIN THESE ARE 1386 00:47:50,680 --> 00:47:52,960 NOT INDEPENDENT OF EACH OTHER. 1387 00:47:52,960 --> 00:47:56,600 WE KNOW THAT UNDER NUTRITION IN 1388 00:47:56,600 --> 00:47:59,760 CHILDREN MAKES CHILDREN 1389 00:47:59,760 --> 00:48:03,480 SUSCEPTIBLE TO MALARIA AND TO 1390 00:48:03,480 --> 00:48:06,560 DIARRHEAL DISEASE, MAKING 1391 00:48:06,560 --> 00:48:08,760 CHILDREN MORE SUSCEPTIBLE TO 1392 00:48:08,760 --> 00:48:09,440 ADVERSE CONSEQUENCES OF 1393 00:48:09,440 --> 00:48:11,240 UNDERNUTRITION SO THERE ARE 1394 00:48:11,240 --> 00:48:12,920 INTENSE INTERACTIONS ACROSS 1395 00:48:12,920 --> 00:48:14,120 THESE EXPOSURE PATHWAYS. 1396 00:48:14,120 --> 00:48:16,640 AND WE'RE GOING TOUCH ON SOME OF 1397 00:48:16,640 --> 00:48:19,240 THOSE IN ADVANTAGE JUST TO MAKE 1398 00:48:19,240 --> 00:48:22,680 SURE THAT THE READERS TAKE INTO 1399 00:48:22,680 --> 00:48:23,880 ACCOUNT THE SYSTEMS-BASED 1400 00:48:23,880 --> 00:48:28,480 THINKING, SO THAT WE DON'T 1401 00:48:28,480 --> 00:48:30,880 UNINTENTIONALLY MISINFORM BY 1402 00:48:30,880 --> 00:48:32,200 STOVE PIPING ISSUES WHEN THEY 1403 00:48:32,200 --> 00:48:33,720 ARE IN FACT NOT INDEPENDENT. 1404 00:48:33,720 --> 00:48:36,800 THANK YOU VERY MUCH FOR 1405 00:48:36,800 --> 00:48:37,080 LISTENING. 1406 00:48:37,080 --> 00:48:43,600 AND ALEXA, ON TO YOU. 1407 00:48:43,600 --> 00:48:45,760 DO YOU WANT TO CONTROL THE 1408 00:48:45,760 --> 00:48:46,000 SLIDES? 1409 00:48:46,000 --> 00:48:49,720 >>I CAN SHARE THE SLIDES. 1410 00:48:49,720 --> 00:48:50,040 >> PERFECT. 1411 00:48:50,040 --> 00:48:52,120 >>OKAY. 1412 00:48:52,120 --> 00:48:54,760 ARE YOU SEEING MY SLIDES? 1413 00:48:54,760 --> 00:48:55,280 AWESOME. 1414 00:48:55,280 --> 00:48:57,160 THANK YOU, DR. EBI, FOR THE 1415 00:48:57,160 --> 00:48:59,440 OVERVIEW ON CLIMATE CHANGE AND 1416 00:48:59,440 --> 00:49:00,320 HEALTH. 1417 00:49:00,320 --> 00:49:01,840 I'M ALEXA BELLOWS, DOING A BRIEF 1418 00:49:01,840 --> 00:49:03,520 OVERVIEW ON NUTRITION AND HEALTH 1419 00:49:03,520 --> 00:49:05,360 AS I'M SURE MANY OF YOU ARE 1420 00:49:05,360 --> 00:49:09,520 FAMILIAR WITH THIS TOPIC 1421 00:49:09,520 --> 00:49:09,960 ALREADY. 1422 00:49:09,960 --> 00:49:12,160 SO GLOBALLY THE PREVALENCE OF 1423 00:49:12,160 --> 00:49:14,440 MALNUTRITION IS CONTINUING TO 1424 00:49:14,440 --> 00:49:14,720 INCREASE. 1425 00:49:14,720 --> 00:49:17,000 AND I WANT TO SAY GLOBAL AND 1426 00:49:17,000 --> 00:49:19,400 NATIONAL ESTIMATES DO HIDE 1427 00:49:19,400 --> 00:49:20,920 SIGNIFICANT DISPARITIES IN 1428 00:49:20,920 --> 00:49:22,000 NUTRITIONAL STATUS ACROSS 1429 00:49:22,000 --> 00:49:23,200 POPULATIONS. 1430 00:49:23,200 --> 00:49:24,720 BUT WE KNOW PREVALENCE CONTINUES 1431 00:49:24,720 --> 00:49:28,320 TO BE HIGH PARTICULARLY IN RURAL 1432 00:49:28,320 --> 00:49:30,640 AREAS OF SUB-SAHARAN AFRICA AND 1433 00:49:30,640 --> 00:49:32,320 SOUTH ASIA, OVERWEIGHT AND 1434 00:49:32,320 --> 00:49:34,920 OBESITY PREVALENCE RISING IN ALL 1435 00:49:34,920 --> 00:49:38,240 REGIONS OF THE WORLD. 1436 00:49:38,240 --> 00:49:41,200 YOU CAN SEE 150 MILLION CHILDREN 1437 00:49:41,200 --> 00:49:43,280 ARE STUNTED, 45 MILLION CHILDREN 1438 00:49:43,280 --> 00:49:52,760 WASTED, 35 MILLION OVERWEIGHT, 1439 00:49:52,760 --> 00:49:57,120 700 MILLION AFFECTED BY OBESITY. 1440 00:49:57,120 --> 00:50:00,400 WE'RE NOT A TRACK TO MEET 1441 00:50:00,400 --> 00:50:10,680 TARGETS BY 2025. 1442 00:50:11,320 --> 00:50:13,520 WE'RE OFF COURSE. 1443 00:50:13,520 --> 00:50:16,600 WE'RE OFF COURSE RELATED TO 1444 00:50:16,600 --> 00:50:20,680 REDUCING DIET RELATED 1445 00:50:20,680 --> 00:50:22,200 NON-COMMUNICABLE DISEASES. 1446 00:50:22,200 --> 00:50:27,680 AND FOR THE WORKING GROUP AS 1447 00:50:27,680 --> 00:50:29,000 KRISTI AND NANCY MENTIONED WE'LL 1448 00:50:29,000 --> 00:50:35,560 TAKE A LIFE COURSE PERSPECTIVE, 1449 00:50:35,560 --> 00:50:36,480 IMPACTING IMMEDIATE AND 1450 00:50:36,480 --> 00:50:37,680 LONG-TERM HEALTH OUTCOMES. 1451 00:50:37,680 --> 00:50:40,600 THIS GRAPHIC DOES A NICE JOB OF 1452 00:50:40,600 --> 00:50:42,920 HIGHLIGHTING HOW THE 1453 00:50:42,920 --> 00:50:43,760 UNDERNUTRITION AND OVERNUTRITION 1454 00:50:43,760 --> 00:50:45,320 AT LIFE STAGES CAN IMPACT 1455 00:50:45,320 --> 00:50:46,200 HEALTH. 1456 00:50:46,200 --> 00:50:48,120 FOR EXAMPLE IN INFANCY, CHRONIC 1457 00:50:48,120 --> 00:50:50,520 UNDERNUTRITION CAN LEAD TO 1458 00:50:50,520 --> 00:50:51,640 HIGHER MORTALITY, IMPAIRED 1459 00:50:51,640 --> 00:50:54,280 MENTAL HEALTH, INCREASED RISK OF 1460 00:50:54,280 --> 00:50:55,720 POOR HEALTH OUTCOMES DURING 1461 00:50:55,720 --> 00:50:56,000 ADULTHOOD. 1462 00:50:56,000 --> 00:50:58,000 AND ANOTHER EXAMPLE WOULD BE 1463 00:50:58,000 --> 00:51:00,200 MALNUTRITION AND PREGNANCY WHICH 1464 00:51:00,200 --> 00:51:01,400 CAN RESULT IN INCREASED HEALTH 1465 00:51:01,400 --> 00:51:03,480 RISK FOR MOTHER AND CHILD 1466 00:51:03,480 --> 00:51:05,040 HIGHLIGHTING THIS 1467 00:51:05,040 --> 00:51:05,640 INTERGENERATIONAL EFFECT OF 1468 00:51:05,640 --> 00:51:06,400 NUTRITION. 1469 00:51:06,400 --> 00:51:08,280 THE GOAL FOR WORKING GROUP 1 IS 1470 00:51:08,280 --> 00:51:10,160 TO INCORPORATE THE EFFECT OF 1471 00:51:10,160 --> 00:51:12,000 CLIMATE CHANGE INTO THIS LIFE 1472 00:51:12,000 --> 00:51:16,720 COURSE PERSPECTIVE FOR NUTRITION 1473 00:51:16,720 --> 00:51:17,280 AS WELL. 1474 00:51:17,280 --> 00:51:20,880 AND AT THE MOMENT MOST 1475 00:51:20,880 --> 00:51:21,320 CONCEPTUAL FRAMEWORKS 1476 00:51:21,320 --> 00:51:23,040 INCORPORATE CLIMATE CHANGE AS A 1477 00:51:23,040 --> 00:51:23,840 DISTAL CAUSE FOR MALNUTRITION, 1478 00:51:23,840 --> 00:51:26,200 SO ON THIS SLIDE WE HAVE THE 1479 00:51:26,200 --> 00:51:27,360 W.H.O. CONCEPTUAL FRAMEWORK FOR 1480 00:51:27,360 --> 00:51:29,200 THE DOUBLE BURDEN OF 1481 00:51:29,200 --> 00:51:31,480 MALNUTRITION, WHICH WAS UPDATED 1482 00:51:31,480 --> 00:51:32,240 FROM UNICEF FRAMEWORK FOR 1483 00:51:32,240 --> 00:51:32,680 UNDERNUTRITION. 1484 00:51:32,680 --> 00:51:35,600 WE SEE AT THE BOTTOM IN BLUE 1485 00:51:35,600 --> 00:51:36,800 THAT CLIMATE CHANGE IS INCLUDED 1486 00:51:36,800 --> 00:51:41,880 HERE AS ONE OF THE BASIC CAUSES 1487 00:51:41,880 --> 00:51:44,120 AT THE SOCIETAL LEVEL. 1488 00:51:44,120 --> 00:51:46,400 SO FOR WORKING GROUP 1 WE'RE 1489 00:51:46,400 --> 00:51:50,560 WORKING ON A CONCEPTUAL 1490 00:51:50,560 --> 00:51:56,160 FRAMEWORK, A DRAFT TO HIGHLIGHT 1491 00:51:56,160 --> 00:52:01,960 PATHWAYS THEY INTERACT. 1492 00:52:01,960 --> 00:52:04,480 PATHWAY 1 IN BLUE SHOWS CLIMATE 1493 00:52:04,480 --> 00:52:05,400 AND ENVIRONMENTAL CHANGE 1494 00:52:05,400 --> 00:52:06,360 IMPACTING FOOD SYSTEMS RESULTING 1495 00:52:06,360 --> 00:52:09,000 IN CHANGES IN DIETARY INTAKE, 1496 00:52:09,000 --> 00:52:11,400 NUTRITIONAL STATUS, AND HEALTH. 1497 00:52:11,400 --> 00:52:14,240 IN THE SECOND PATHWAY, THE 1498 00:52:14,240 --> 00:52:17,080 PURPLE ARROW, SHOWS CLIMATE AND 1499 00:52:17,080 --> 00:52:17,720 ENVIRONMENTAL CHANGE DIRECTLY 1500 00:52:17,720 --> 00:52:19,680 IMPACTING HEALTH AND SEVERITY OF 1501 00:52:19,680 --> 00:52:24,600 IMPACTS MAY BE MODIFIED BY 1502 00:52:24,600 --> 00:52:25,400 INDIVIDUALS' STATUS. 1503 00:52:25,400 --> 00:52:26,920 EXAMPLE MIGHT BE IMPACTING 1504 00:52:26,920 --> 00:52:28,320 HEALTH EFFECTS OF EXTREME HEAT. 1505 00:52:28,320 --> 00:52:30,760 AND I ALSO WANT TO POINT OUT WE 1506 00:52:30,760 --> 00:52:33,480 HAVE A DOUBLE ARROW HIGHLIGHTING 1507 00:52:33,480 --> 00:52:35,000 THAT HEALTH ALSO IMPACTS 1508 00:52:35,000 --> 00:52:36,120 NUTRITIONAL STATUS AS WELL. 1509 00:52:36,120 --> 00:52:38,960 AND SO THIS IS A VERY BASIC 1510 00:52:38,960 --> 00:52:40,200 CONCEPTUAL FRAMEWORK WE PUT 1511 00:52:40,200 --> 00:52:41,600 TOGETHER TO HELP US START 1512 00:52:41,600 --> 00:52:43,040 THINKING THROUGH THE DIFFERENT 1513 00:52:43,040 --> 00:52:47,200 PATHWAYS THAT CLIMATE AND 1514 00:52:47,200 --> 00:52:48,840 ENVIRONMENTAL CHANGE IMPACT 1515 00:52:48,840 --> 00:52:49,040 HEALTH. 1516 00:52:49,040 --> 00:52:51,040 AND WORKING GROUPS 2 AND 3 WILL 1517 00:52:51,040 --> 00:52:51,920 FOCUS ON CLIMATE AND 1518 00:52:51,920 --> 00:52:53,200 ENVIRONMENTAL CHANGES IMPACT ON 1519 00:52:53,200 --> 00:52:55,280 THE FOOD SYSTEMS AND DIETS. 1520 00:52:55,280 --> 00:52:56,600 FOR WORKING GROUP 1 WE'RE GOING 1521 00:52:56,600 --> 00:52:58,480 TO FOCUS ON THE DOWNSTREAM END 1522 00:52:58,480 --> 00:52:59,520 OF THIS FRAMEWORK. 1523 00:52:59,520 --> 00:53:01,000 WE PLAN TO LOOK AT HOW CHANGES 1524 00:53:01,000 --> 00:53:03,360 IN DIET ESTIMATED FROM WORKING 1525 00:53:03,360 --> 00:53:04,840 GROUP 2 WILL IMPACT NUTRITIONAL 1526 00:53:04,840 --> 00:53:06,680 STATUS AND THEREFORE HEALTH. 1527 00:53:06,680 --> 00:53:09,840 BUT ALSO HOW NUTRITIONAL STATUS 1528 00:53:09,840 --> 00:53:11,280 MODIFIES DIRECT IMPACT OF 1529 00:53:11,280 --> 00:53:12,680 CLIMATE CHANGE ON LET. 1530 00:53:12,680 --> 00:53:15,600 THAT'S ALL THAT WE HAVE PREPARED 1531 00:53:15,600 --> 00:53:16,520 FOR THIS SESSION. 1532 00:53:16,520 --> 00:53:20,880 DO WE WANT TO LEAVE OUT THIS 1533 00:53:20,880 --> 00:53:22,880 CONCEPTUAL FRAMEWORK FOR THE 1534 00:53:22,880 --> 00:53:23,280 DISCUSSION PART? 1535 00:53:23,280 --> 00:53:25,400 >> THANK YOU, DR. BELLOWS. 1536 00:53:25,400 --> 00:53:27,920 SURE, WE CAN LEAVE THAT UP. 1537 00:53:27,920 --> 00:53:28,320 >> OKAY. 1538 00:53:28,320 --> 00:53:31,120 >> NANCY, DID YOU WANT TO 1539 00:53:31,120 --> 00:53:31,600 MODERATE THE DISCUSSION? 1540 00:53:31,600 --> 00:53:32,160 >> WELL, YES. 1541 00:53:32,160 --> 00:53:34,120 THAT WOULD BE GREAT. 1542 00:53:34,120 --> 00:53:37,760 I WONDER IF ANYONE HAS ANY 1543 00:53:37,760 --> 00:53:40,360 KICKOFF QUESTIONS FOR OUR 1544 00:53:40,360 --> 00:53:42,160 PROPOSED FRAMEWORK HERE, 1545 00:53:42,160 --> 00:53:43,680 ANYTHING COMES TO MIND FROM OUR 1546 00:53:43,680 --> 00:53:46,200 WORKING GROUP OR OTHER WORKING 1547 00:53:46,200 --> 00:53:53,640 GROUP MEMBERS IN ATTENDANCE? 1548 00:53:53,640 --> 00:53:55,520 >> I CAN START WITH A 1549 00:53:55,520 --> 00:53:57,680 DISCUSSION POINT AS PART OF THE 1550 00:53:57,680 --> 00:53:58,000 WORKING GROUP. 1551 00:53:58,000 --> 00:53:58,280 >> GREAT. 1552 00:53:58,280 --> 00:54:00,240 >> ONE OF THE THINGS I THINK 1553 00:54:00,240 --> 00:54:02,280 WHEN I WAS FIRST WORKING WITH 1554 00:54:02,280 --> 00:54:03,840 SOME OTHER MEMBERS OF OUR 1555 00:54:03,840 --> 00:54:05,920 WORKING GROUP IS WE WERE 1556 00:54:05,920 --> 00:54:08,760 FOCUSING ON PATHWAY 1, THAT WAS 1557 00:54:08,760 --> 00:54:10,080 THROUGH MY OWN BIAS, I'VE 1558 00:54:10,080 --> 00:54:11,920 THOUGHT OF NUTRITION AND FOOD 1559 00:54:11,920 --> 00:54:16,200 SYSTEMS, WHERE THE FOCUS OF MY 1560 00:54:16,200 --> 00:54:16,920 WORK HAS BEEN. 1561 00:54:16,920 --> 00:54:18,400 LEARNING FROM OTHERS IN THE 1562 00:54:18,400 --> 00:54:19,800 WORKING GROUP. 1563 00:54:19,800 --> 00:54:22,960 SECOND PATHWAY OF NUTRITIONAL 1564 00:54:22,960 --> 00:54:23,960 STATUS MODIFYING, DIRECT IMPACTS 1565 00:54:23,960 --> 00:54:26,480 OF CLIMATE CHANGE ON HEALTH, 1566 00:54:26,480 --> 00:54:28,440 SOMETHING THAT WAS NEW TO THINK 1567 00:54:28,440 --> 00:54:29,320 ABOUT, REALLY INTERESTING AND 1568 00:54:29,320 --> 00:54:34,240 JUST THE LOOP THAT GOES BACK AS 1569 00:54:34,240 --> 00:54:35,560 WELL. 1570 00:54:35,560 --> 00:54:36,840 THAT WE'LL BE EXPERIENCING. 1571 00:54:36,840 --> 00:54:37,880 >> YES. 1572 00:54:37,880 --> 00:54:38,720 THANK YOU. 1573 00:54:38,720 --> 00:54:42,440 AND I'LL JUST ADD TO THAT THAT I 1574 00:54:42,440 --> 00:54:47,160 WANT TO SORT OF REHIGHLIGHT WHAT 1575 00:54:47,160 --> 00:54:50,920 DR. EBI SAID ABOUT THE 1576 00:54:50,920 --> 00:54:52,760 POPULATION STATISTICS ARE SO 1577 00:54:52,760 --> 00:54:55,480 HIGH LEVEL THAT THEY REALLY 1578 00:54:55,480 --> 00:54:59,440 DON'T GET AT SOME OF THE 1579 00:54:59,440 --> 00:55:01,720 SUBQUESTIONS AND VULNERABILITIES 1580 00:55:01,720 --> 00:55:04,880 AND INEQUALITIES IN HOW THESE 1581 00:55:04,880 --> 00:55:09,080 SYSTEM CHANGES AFFECT 1582 00:55:09,080 --> 00:55:09,920 INDIVIDUALS AND SUBGROUPS 1583 00:55:09,920 --> 00:55:11,320 DIFFERENTLY, THAT ADDRESSES YOUR 1584 00:55:11,320 --> 00:55:14,120 POINT THERE, ALEXA, IN TERMS OF 1585 00:55:14,120 --> 00:55:17,160 NUTRITIONAL STATUS, IT'S NOT AN 1586 00:55:17,160 --> 00:55:19,680 EQUAL PLAYING FIELD. 1587 00:55:19,680 --> 00:55:22,280 >> THERE'S AN ESTIMATE FROM 1588 00:55:22,280 --> 00:55:24,040 UNICEF THAT ABOUT 1 BILLION 1589 00:55:24,040 --> 00:55:25,240 CHILDREN ARE BEING AFFECTED BY 1590 00:55:25,240 --> 00:55:26,000 CLIMATE CHANGE. 1591 00:55:26,000 --> 00:55:28,200 WE KNOW CHILDREN ARE 1592 00:55:28,200 --> 00:55:31,720 PARTICULARLY AFFECTED BY THE 1593 00:55:31,720 --> 00:55:33,440 KINDS OF CHANGES ONGOING. 1594 00:55:33,440 --> 00:55:34,120 AN ESTIMATE FROM THE WORLD 1595 00:55:34,120 --> 00:55:37,080 HEALTH ORGANIZATION A FEW YEARS 1596 00:55:37,080 --> 00:55:39,120 AGO WAS 85% OF HEALTH RISKS IN 1597 00:55:39,120 --> 00:55:40,480 CLIMATE CHANGE ARE IN CHILDREN. 1598 00:55:40,480 --> 00:55:42,480 BUT AS YOU HEARD FROM BOTH OF 1599 00:55:42,480 --> 00:55:43,520 OUR PRESENTATIONS THIS IS GOING 1600 00:55:43,520 --> 00:55:48,200 TO SHIFT OVER THE LIFE COURSE, 1601 00:55:48,200 --> 00:55:49,760 THAT CHILDREN WILL CONTINUE TO 1602 00:55:49,760 --> 00:55:50,520 BE PARTICULARLY AFFECTED BUT ALL 1603 00:55:50,520 --> 00:55:52,600 OF US ARE BEING AFFECTED BY 1604 00:55:52,600 --> 00:55:54,560 CHANGING CLIMATE. 1605 00:55:54,560 --> 00:55:56,320 AS WE'RE SEEING SHIFTS IN, FOR 1606 00:55:56,320 --> 00:55:58,600 EXAMPLE, EXPOSURE TO HEAT 1607 00:55:58,600 --> 00:56:00,480 STRESS, THERE'S GOING TO BE 1608 00:56:00,480 --> 00:56:04,440 CONSEQUENCES FOR OLDER ADULTS AS 1609 00:56:04,440 --> 00:56:08,240 WELL BECAUSE HEAT STRESS IS -- 1610 00:56:08,240 --> 00:56:10,440 PRIMARILY AFFECTS CHILDREN, 1611 00:56:10,440 --> 00:56:11,600 OLDER ADULTS, OUTDOOR WORKERS, 1612 00:56:11,600 --> 00:56:12,720 PREGNANT WOMEN. 1613 00:56:12,720 --> 00:56:13,600 THERE ARE POSSIBILITIES THEN 1614 00:56:13,600 --> 00:56:16,240 THAT THERE COULD BE BROADER 1615 00:56:16,240 --> 00:56:21,160 CONSEQUENCES ACROSS THE LIFE 1616 00:56:21,160 --> 00:56:21,560 COURSE. 1617 00:56:21,560 --> 00:56:26,160 WE'VE GOT SOMETHING IN CHAT. 1618 00:56:26,160 --> 00:56:32,160 >>DO YOU WANT TO VERBALIZE YOUR 1619 00:56:32,160 --> 00:56:32,400 MESSAGE? 1620 00:56:32,400 --> 00:56:34,400 >> I'M A MEMBER OF WORKING 1621 00:56:34,400 --> 00:56:36,920 GROUP 5, FOCUSING ON METHODS AND 1622 00:56:36,920 --> 00:56:38,000 METRICS. 1623 00:56:38,000 --> 00:56:40,760 LOTS OF TIE-INS BETWEEN THE 1624 00:56:40,760 --> 00:56:41,320 DIFFERENT GROUPS. 1625 00:56:41,320 --> 00:56:43,000 GREAT TO HEAR FROM YOU AND SEE 1626 00:56:43,000 --> 00:56:46,800 THIS FRAMEWORK . 1627 00:56:46,800 --> 00:56:48,520 I SUPPOSE WITH EVERY FRAMEWORK 1628 00:56:48,520 --> 00:56:50,880 THERE'S MORE ARROWS THAT COULD 1629 00:56:50,880 --> 00:56:56,400 BE ADDED, INFINITE NUMBER OF 1630 00:56:56,400 --> 00:56:56,880 ARROWS. 1631 00:56:56,880 --> 00:56:58,280 THERE'S IMPACTS OF FOOD SECURITY 1632 00:56:58,280 --> 00:57:00,240 ON HEALTH AS WELL AS IMPACTS OF 1633 00:57:00,240 --> 00:57:06,720 FOOD SYSTEMS ON HEALTH THAT 1634 00:57:06,720 --> 00:57:09,440 AREN'T NECESSARILY MEDIATED. 1635 00:57:09,440 --> 00:57:10,640 FOOD INSECURITY CAN IMPACT 1636 00:57:10,640 --> 00:57:12,840 MENTAL HEALTH, ORAL HEALTH AMONG 1637 00:57:12,840 --> 00:57:16,320 CHILDREN, OR FOR FOOD SYSTEMS, 1638 00:57:16,320 --> 00:57:17,760 OCCUPATIONAL HEALTH RISKS, FARM 1639 00:57:17,760 --> 00:57:20,160 WORKERS THAT DIRECTLY IMPACT 1640 00:57:20,160 --> 00:57:22,320 HEALTH, NOT NECESSARILY MEDIATED 1641 00:57:22,320 --> 00:57:23,520 BY NUTRITIONAL STATUS, THINGS TO 1642 00:57:23,520 --> 00:57:23,800 CONSIDER. 1643 00:57:23,800 --> 00:57:25,440 I KNOW THERE'S ALWAYS AN 1644 00:57:25,440 --> 00:57:29,600 INFINITE NUMBER OF ARROWS THAT 1645 00:57:29,600 --> 00:57:30,520 COULD BE ADDED. 1646 00:57:30,520 --> 00:57:33,840 >> YES. 1647 00:57:33,840 --> 00:57:34,160 THANK YOU. 1648 00:57:34,160 --> 00:57:36,920 >> ANY OTHER THOUGHTS OR 1649 00:57:36,920 --> 00:57:37,200 REACTIONS? 1650 00:57:37,200 --> 00:57:39,800 >> I'LL ADD TO THAT I AGREE 1651 00:57:39,800 --> 00:57:42,080 THERE CAN BE AN INFINITE NUMBER 1652 00:57:42,080 --> 00:57:43,040 OF ARROWS. 1653 00:57:43,040 --> 00:57:44,600 IT DOES BECOME A CHALLENGE HOW 1654 00:57:44,600 --> 00:57:47,440 YOU DO ANY KIND OF GRAPHIC WHEN 1655 00:57:47,440 --> 00:57:50,640 YOU'RE TALKING ABOUT SYSTEMS 1656 00:57:50,640 --> 00:57:52,040 THAT ARE FUNDAMENTALLY 1657 00:57:52,040 --> 00:57:52,480 INTERCONNECTED. 1658 00:57:52,480 --> 00:57:54,080 WE'RE ALSO GOING TO ACROSS ALL 1659 00:57:54,080 --> 00:57:55,440 OF THE WORKING GROUPS HAVE 1660 00:57:55,440 --> 00:57:57,400 EXTENSIVE COVERAGE ABOUT HOW 1661 00:57:57,400 --> 00:57:58,840 LIMITED OUR KNOWLEDGE IS. 1662 00:57:58,840 --> 00:58:02,440 AND NOTE THAT THERE'S LOTS OF 1663 00:58:02,440 --> 00:58:03,880 CONNECTIONS THAT WE UNDERSTAND 1664 00:58:03,880 --> 00:58:07,040 FROM FIRST PRINCIPLES BUT WE MAY 1665 00:58:07,040 --> 00:58:09,040 NOT UNDERSTAND HOW CLIMATE AND 1666 00:58:09,040 --> 00:58:10,200 GLOBAL ENVIRONMENTAL CHANGE 1667 00:58:10,200 --> 00:58:12,320 COULD INTERACT WITH THOSE. 1668 00:58:12,320 --> 00:58:14,160 THERE'S BEEN RELATIVELY LITTLE 1669 00:58:14,160 --> 00:58:15,800 RESEARCH IN THE SPACE, AND SO 1670 00:58:15,800 --> 00:58:20,240 WE'LL BE FINDING LOTS OF 1671 00:58:20,240 --> 00:58:21,480 OPPORTUNITIES FOR FURTHER 1672 00:58:21,480 --> 00:58:23,680 RESEARCH TO IDENTIFY KEY ISSUES 1673 00:58:23,680 --> 00:58:28,480 THAT ARE IMPORTANT FOR POLICY 1674 00:58:28,480 --> 00:58:28,720 MAKING. 1675 00:58:28,720 --> 00:58:29,000 >> YES. 1676 00:58:29,000 --> 00:58:29,360 >> CHRIS? 1677 00:58:29,360 --> 00:58:30,120 >>YES? 1678 00:58:30,120 --> 00:58:34,600 >> I RAISED MY HAND. 1679 00:58:34,600 --> 00:58:38,480 SO, I JUST WANT TO REEMPHASIZE 1680 00:58:38,480 --> 00:58:41,400 THE POINT WITH REGARD TO THE 1681 00:58:41,400 --> 00:58:42,760 VERNACULAR WE'RE USING. 1682 00:58:42,760 --> 00:58:45,800 NUTRITION IS THE GLUE THAT TIES 1683 00:58:45,800 --> 00:58:48,200 FOOD SYSTEMS TO HEALTH. 1684 00:58:48,200 --> 00:58:51,040 SO YOU HAVE FOOD, A DELIVERY 1685 00:58:51,040 --> 00:58:51,800 VEHICLE. 1686 00:58:51,800 --> 00:58:53,360 FOOD SYSTEMS PROVIDE FOOD. 1687 00:58:53,360 --> 00:58:55,240 BUT NUTRITION IS A BIOLOGICAL 1688 00:58:55,240 --> 00:58:56,440 VARIABLE THAT CONNECTS TO 1689 00:58:56,440 --> 00:58:56,680 HEALTH. 1690 00:58:56,680 --> 00:58:58,920 I THINK IT'S REALLY IMPORTANT 1691 00:58:58,920 --> 00:59:00,800 FOR US TO MAINTAIN VIGILANCE 1692 00:59:00,800 --> 00:59:02,480 ABOUT THAT BECAUSE OTHERWISE 1693 00:59:02,480 --> 00:59:04,720 WE'RE MISSING A CRITICAL PIECE 1694 00:59:04,720 --> 00:59:04,920 HERE. 1695 00:59:04,920 --> 00:59:06,720 FOOD IS NOT NUTRITION. 1696 00:59:06,720 --> 00:59:08,160 NUTRITION IS NOT FOOD. 1697 00:59:08,160 --> 00:59:10,880 THEY ARE OBVIOUSLY RELATED. 1698 00:59:10,880 --> 00:59:13,800 AND ALONG THOSE LINES IN YOUR 1699 00:59:13,800 --> 00:59:16,000 EFFORTS WE HAVEN'T TALKED ABOUT 1700 00:59:16,000 --> 00:59:18,240 THIS YET, BUT HOW MIGHT YOU 1701 00:59:18,240 --> 00:59:21,040 INTEGRATE AND MAYBE THIS IS 1702 00:59:21,040 --> 00:59:22,000 SOMETHING THAT WORKING GROUP 4 1703 00:59:22,000 --> 00:59:24,640 COULD CHIME IN ON AS WELL, 1704 00:59:24,640 --> 00:59:28,360 INTEGRATE ASSESSMENT OF 1705 00:59:28,360 --> 00:59:30,240 NUTRITIONAL STATUS, BOTH 1706 00:59:30,240 --> 00:59:33,080 SURVEILLANCE AND CLINICAL 1707 00:59:33,080 --> 00:59:38,040 ASSESSMENT, INDIVIDUAL CARE, TO 1708 00:59:38,040 --> 00:59:39,120 ADDRESS THIS INTERSECTION. 1709 00:59:39,120 --> 00:59:40,320 >> THANK YOU, DAN. 1710 00:59:40,320 --> 00:59:41,720 THAT'S REALLY HELPFUL. 1711 00:59:41,720 --> 00:59:42,960 I'LL ADD THAT OF COURSE 1712 00:59:42,960 --> 00:59:45,160 AGRICULTURE IS NOT FOOD SECURITY 1713 00:59:45,160 --> 00:59:45,360 EITHER. 1714 00:59:45,360 --> 00:59:49,960 AND SO WE DO HAVE TO BE MINDFUL 1715 00:59:49,960 --> 00:59:53,120 OF HOW WE FRAME THE QUESTIONS 1716 00:59:53,120 --> 00:59:54,440 THAT WE'RE ADDRESSING. 1717 00:59:54,440 --> 00:59:55,200 AND YOU'RE ABSOLUTELY RIGHT. 1718 00:59:55,200 --> 00:59:56,640 ONE OF THE OTHER WORKING GROUPS 1719 00:59:56,640 --> 01:00:00,360 IS GOING TO BE TALKING ABOUT THE 1720 01:00:00,360 --> 01:00:06,840 CONSEQUENCES OF HIGHER 1721 01:00:06,840 --> 01:00:07,480 CONCENTRATIONS OF CARBON DIOXIDE 1722 01:00:07,480 --> 01:00:14,120 IN THE ATMOSPHERE AND NUTRIENTAL 1723 01:00:14,120 --> 01:00:15,560 DENSITY OF FOOD, THINKING ABOUT 1724 01:00:15,560 --> 01:00:16,760 HOW WE MEASURE NUTRITIONAL 1725 01:00:16,760 --> 01:00:18,120 STATUS AND THINK ABOUT WHAT 1726 01:00:18,120 --> 01:00:22,160 KINDS OF SURVEYS WE NEED GOING 1727 01:00:22,160 --> 01:00:24,200 FORWARD AS WE -- FROM WHAT WE 1728 01:00:24,200 --> 01:00:28,600 KNOW FROM EXPERIMENTS, THE 1729 01:00:28,600 --> 01:00:31,760 NUTRIENT DENSITY IS ALTERING OUR 1730 01:00:31,760 --> 01:00:34,400 FOOD, HOW THAT AFFECTS 1731 01:00:34,400 --> 01:00:34,680 WELL-BEING. 1732 01:00:34,680 --> 01:00:37,320 >> I'D LIKE TO JUST ADD TO THIS 1733 01:00:37,320 --> 01:00:39,200 AND NOT NECESSARILY ADD ARROWS 1734 01:00:39,200 --> 01:00:42,600 BUT I THINK THAT THE WAY THE 1735 01:00:42,600 --> 01:00:46,320 CURRENT FRAMEWORK IS SET UP SORT 1736 01:00:46,320 --> 01:00:47,840 OF DOES REINFORCE WHAT I THINK 1737 01:00:47,840 --> 01:00:49,560 DAN WAS TRYING TO COUNTER OR 1738 01:00:49,560 --> 01:00:51,160 BROADEN OUR THINKING ABOUT IS 1739 01:00:51,160 --> 01:00:53,880 THAT NUTRITIONAL STATUS IS NOT 1740 01:00:53,880 --> 01:00:55,280 ONLY SUPPLY SIDE ECONOMICS, IF 1741 01:00:55,280 --> 01:00:56,800 YOU WILL, THE ENVIRONMENT IS 1742 01:00:56,800 --> 01:00:58,600 DEFINITELY GOING TO BE AFFECTS 1743 01:00:58,600 --> 01:01:01,000 HOW FOOD IS UTILIZED, 1744 01:01:01,000 --> 01:01:01,520 NUTRITIONAL AND METABOLIC 1745 01:01:01,520 --> 01:01:03,240 STATUS, ALL OF THAT. 1746 01:01:03,240 --> 01:01:06,440 AND THEN THAT THEN THEREFORE 1747 01:01:06,440 --> 01:01:08,200 INTERACTS WITH REQUIREMENTS AND 1748 01:01:08,200 --> 01:01:10,280 HEALTH STATUS AND SO ON. 1749 01:01:10,280 --> 01:01:12,480 SO WE QUICKLY GET INTO THE 1750 01:01:12,480 --> 01:01:13,720 COMPLEXITY BUT THIS IS WHAT 1751 01:01:13,720 --> 01:01:16,200 WE'RE HERE FOR. 1752 01:01:16,200 --> 01:01:24,280 >> EXACTLY RIGHT. 1753 01:01:24,280 --> 01:01:25,160 1754 01:01:25,160 --> 01:01:26,960 >> WE HAVE TIME FOR ANOTHER 1755 01:01:26,960 --> 01:01:27,760 COMMENT OR QUESTION. 1756 01:01:27,760 --> 01:01:29,760 THIS IS GREAT TO HAVE THIS 1757 01:01:29,760 --> 01:01:31,560 INTERACTION, ESPECIALLY FROM THE 1758 01:01:31,560 --> 01:01:37,080 OTHER WORKING GROUPS. 1759 01:01:37,080 --> 01:01:40,040 >> ANYBODY FROM WORKING GROUP 4 1760 01:01:40,040 --> 01:01:47,280 HERE? 1761 01:01:47,280 --> 01:01:48,480 I DON'T THINK SO. 1762 01:01:48,480 --> 01:01:52,320 I KNOW THE CHAIRS ARE CONFLICTED 1763 01:01:52,320 --> 01:01:54,600 TODAY. 1764 01:01:54,600 --> 01:01:58,440 WORKING GROUP 5? 1765 01:01:58,440 --> 01:02:01,040 GOING ONCE? 1766 01:02:01,040 --> 01:02:04,560 1767 01:02:04,560 --> 01:02:06,640 >> WE CAN ALWAYS MOVE TO THE 1768 01:02:06,640 --> 01:02:08,280 NEXT SET OF -- 1769 01:02:08,280 --> 01:02:11,360 >> I WAS GOING TO SAY WE'RE 1770 01:02:11,360 --> 01:02:15,520 ALWAYS HAPPY TO HAVE EXTRA TIME. 1771 01:02:15,520 --> 01:02:17,920 DR. KLEINMAN IS NEXT TO TALK 1772 01:02:17,920 --> 01:02:21,440 ABOUT NUCLEAR ENERGY, WAS THAT 1773 01:02:21,440 --> 01:02:23,440 IT, RON? 1774 01:02:23,440 --> 01:02:28,320 INFECTIOUS DISEASE. 1775 01:02:28,320 --> 01:02:29,280 RON KLEINMAN, WELCOME. 1776 01:02:29,280 --> 01:02:30,640 >> THANK YOU, NANCY. 1777 01:02:30,640 --> 01:02:33,280 YES, I'M NOT -- YES, I'M NOT 1778 01:02:33,280 --> 01:02:35,000 GOING TO TALK ABOUT NUCLEAR 1779 01:02:35,000 --> 01:02:35,240 ENERGY. 1780 01:02:35,240 --> 01:02:39,960 BUT WHAT I HELP TO DO IN THE 1781 01:02:39,960 --> 01:02:42,000 SHORT PRESENTATION IS ADD A FEW 1782 01:02:42,000 --> 01:02:45,960 MORE ARROWS AND BUILD ON WHAT 1783 01:02:45,960 --> 01:02:48,680 NANCY, KRIS, AND ALEXA HAVE JUST 1784 01:02:48,680 --> 01:02:51,440 TALKED ABOUT BY RELATING 1785 01:02:51,440 --> 01:02:52,160 INFECTIOUS DISEASE, NUTRITION 1786 01:02:52,160 --> 01:02:56,320 AND CLIMATE TO ONE ANOTHER. 1787 01:02:56,320 --> 01:02:56,920 NEXT SLIDE PLEASE. 1788 01:02:56,920 --> 01:03:00,160 I'D LIKE TO START WITH THIS 1789 01:03:00,160 --> 01:03:03,040 FRAMEWORK THAT DAN RAITEN 1790 01:03:03,040 --> 01:03:05,120 PRESENTED IN HIS INTRODUCTION TO 1791 01:03:05,120 --> 01:03:10,000 THE ADVANTAGE PROJECT WITH A FEW 1792 01:03:10,000 --> 01:03:10,880 MODIFICATIONS. 1793 01:03:10,880 --> 01:03:12,880 IT'S QUITE CLEAR THAT INFECTIOUS 1794 01:03:12,880 --> 01:03:15,080 IMPACTS ON HEALTH ARE 1795 01:03:15,080 --> 01:03:17,240 INTERRELATED WITH THE IMPACTS ON 1796 01:03:17,240 --> 01:03:19,000 HEALTH OF NUTRITIONAL STATUS. 1797 01:03:19,000 --> 01:03:23,480 AND THAT BOTH OF THESE ARE 1798 01:03:23,480 --> 01:03:25,360 SIGNIFICANTLY INFLUENCED BY 1799 01:03:25,360 --> 01:03:27,240 WEATHER, CLIMATE, CLIMATE 1800 01:03:27,240 --> 01:03:29,280 CHANGE, AND ENVIRONMENT OVER THE 1801 01:03:29,280 --> 01:03:35,160 COURSE OF A LIFETIME. 1802 01:03:35,160 --> 01:03:35,840 NEXT SLIDE PLEASE. 1803 01:03:35,840 --> 01:03:39,040 THIS IS FURTHER DESCRIBED IN 1804 01:03:39,040 --> 01:03:41,240 THIS NEXT GRAPHIC IN WHICH I 1805 01:03:41,240 --> 01:03:45,920 PRESENTED SOME OF THE OTHER 1806 01:03:45,920 --> 01:03:47,920 MEDIATORS IMPACTED BY CLIMATE ON 1807 01:03:47,920 --> 01:03:49,120 HEALTH ULTIMATELY. 1808 01:03:49,120 --> 01:03:51,960 AND THIS INCLUDES FOOD AND 1809 01:03:51,960 --> 01:03:53,040 NUTRITION SECURITY, AND FOOD 1810 01:03:53,040 --> 01:03:56,080 SAFETY, AND OVER THE COURSE OF A 1811 01:03:56,080 --> 01:03:58,080 LIFETIME PHYSIOLOGY AND THE 1812 01:03:58,080 --> 01:03:59,480 CHANGES IN PHYSIOLOGY THAT 1813 01:03:59,480 --> 01:04:02,000 OCCUR, CHANGES IN DIETS AND 1814 01:04:02,000 --> 01:04:06,080 DIETARY PATTERNS, AS WELL AS 1815 01:04:06,080 --> 01:04:09,240 FOOD -- DEVELOPING FOOD AND 1816 01:04:09,240 --> 01:04:10,880 AGRICULTURAL SYSTEMS. 1817 01:04:10,880 --> 01:04:12,840 SO, IN THIS NEXT FEW MINUTES, 1818 01:04:12,840 --> 01:04:18,000 I'M GOING TO BRIEFLY TOUCH ON 1819 01:04:18,000 --> 01:04:21,760 WEATHER AND CLIMATE IMPACTS ON 1820 01:04:21,760 --> 01:04:22,600 INFECTIONS. 1821 01:04:22,600 --> 01:04:27,640 THEN BRIEFLY MOVE ON TO 1822 01:04:27,640 --> 01:04:28,520 NUTRITION, NUTRITIONAL STATUS 1823 01:04:28,520 --> 01:04:32,120 AND HOST DEFENSE. 1824 01:04:32,120 --> 01:04:33,680 AND THEN END WITH A BRIEF 1825 01:04:33,680 --> 01:04:36,640 DISCUSSION OF A CASE AND ITS 1826 01:04:36,640 --> 01:04:38,600 IMPACT WITH REGARD TO CHOLERA. 1827 01:04:38,600 --> 01:04:41,480 SO THE NEXT SLIDE PLEASE. 1828 01:04:41,480 --> 01:04:44,760 IT'S BEEN KNOWN FOR SOME TIME 1829 01:04:44,760 --> 01:04:47,080 THAT WEATHER PATTERNS INFLUENCE 1830 01:04:47,080 --> 01:04:49,360 THE PATHWAYS OF INFECTIOUS 1831 01:04:49,360 --> 01:04:51,000 DISEASE TRANSMISSION. 1832 01:04:51,000 --> 01:04:52,120 THESE PATTERNS INCLUDE ALL OF 1833 01:04:52,120 --> 01:04:55,680 THOSE ON THE LEFT SIDE OF THE 1834 01:04:55,680 --> 01:04:58,120 SLIDE FROM WARMING DOWN TO SEA 1835 01:04:58,120 --> 01:05:00,040 LEVEL CHANGES. 1836 01:05:00,040 --> 01:05:02,760 ALL OF THESE IMPACT ALL OF THE 1837 01:05:02,760 --> 01:05:05,880 PATHWAYS OF INFECTIOUS DISEASE 1838 01:05:05,880 --> 01:05:07,840 TRANSMISSION, INCLUDING VECTOR, 1839 01:05:07,840 --> 01:05:12,120 WATER, AIR, AND FOOD, ALONG WITH 1840 01:05:12,120 --> 01:05:15,120 DIRECT CONTACT. 1841 01:05:15,120 --> 01:05:17,560 AND THESE PATHWAYS OF 1842 01:05:17,560 --> 01:05:18,920 TRANSMISSION IMPACT INFECTIONS 1843 01:05:18,920 --> 01:05:22,360 FROM HUNDREDS OF DIFFERENT 1844 01:05:22,360 --> 01:05:26,520 DISEASES, IN ALL CATEGORIES OF 1845 01:05:26,520 --> 01:05:27,520 INFECTION, AFFECTING HUMANS, 1846 01:05:27,520 --> 01:05:33,080 PLANTS, AS WELL AS ANIMALS. 1847 01:05:33,080 --> 01:05:35,280 NEXT SLIDE PLEASE. 1848 01:05:35,280 --> 01:05:39,080 THE CDC POINTED OUT THE INCREASE 1849 01:05:39,080 --> 01:05:40,880 TO DISEASE THREATS THAT OCCURRED 1850 01:05:40,880 --> 01:05:45,880 OVER THE PAST TWO DECADES FROM 1851 01:05:45,880 --> 01:05:47,840 VECTOR-BORNE DISEASE, FOR 1852 01:05:47,840 --> 01:05:49,320 EXAMPLE ILLNESS FROM MOSQUITOES, 1853 01:05:49,320 --> 01:05:51,240 TICK, FLEA BITES MORE THAN 1854 01:05:51,240 --> 01:05:53,320 DOUBLED OVER THE PAST TWO 1855 01:05:53,320 --> 01:05:57,920 DECADES, WITH A NUMBER OF NEW 1856 01:05:57,920 --> 01:06:00,120 DISORDERS, DISEASES, SPREAD BY 1857 01:06:00,120 --> 01:06:01,960 MOSQUITOES AND TICKS THAT WERE 1858 01:06:01,960 --> 01:06:04,600 INTRODUCED INTO THE U.S. DURING 1859 01:06:04,600 --> 01:06:06,440 THIS PERIOD. 1860 01:06:06,440 --> 01:06:09,200 FURTHERMORE THE GEOGRAPHIC RANGE 1861 01:06:09,200 --> 01:06:14,040 OF THESE VECTOR-BORNE DISEASES 1862 01:06:14,040 --> 01:06:15,200 LAST EXPANDED SIGNIFICANTLY 1863 01:06:15,200 --> 01:06:18,920 INCLUDING LYME DISEASE AND OTHER 1864 01:06:18,920 --> 01:06:26,520 TICK-BORNE ILLNESSES SUCH A 1865 01:06:26,520 --> 01:06:29,680 SAPLASMOSIS AND SPOTTED FEVER. 1866 01:06:29,680 --> 01:06:36,120 LONGER AND WARMER SUMMERS HAVE 1867 01:06:36,120 --> 01:06:37,000 FAVORED MOSQUITOS IN A 1868 01:06:37,000 --> 01:06:45,520 SIGNIFICANT WAY WITH HOTTER 1869 01:06:45,520 --> 01:06:46,840 SUMMERS, FOR EXAMPLE, WEST NILE 1870 01:06:46,840 --> 01:06:49,560 VIRUS, AND THE LIST OF THESE 1871 01:06:49,560 --> 01:06:50,760 CONDITIONS OBSERVED TO INCREASE 1872 01:06:50,760 --> 01:06:52,280 OVER THE PAST TWO DECADES IS ON 1873 01:06:52,280 --> 01:06:55,600 THE RIGHT SIDE OF THE SLIDE, AND 1874 01:06:55,600 --> 01:06:57,560 IT GOES FROM A-W, IF WE WANTED 1875 01:06:57,560 --> 01:07:01,160 TO INCLUDE ZIKA IN IT IT WOULD 1876 01:07:01,160 --> 01:07:04,440 GO FROM A-Z. 1877 01:07:04,440 --> 01:07:05,440 NEXT SLIDE PLEASE. 1878 01:07:05,440 --> 01:07:09,040 IN ADDITION TO THE INFECTIONS 1879 01:07:09,040 --> 01:07:15,080 THEMSELVES, THERE ARE SOME 1880 01:07:15,080 --> 01:07:15,640 UNEXPECTED MANIFESTATIONS AS 1881 01:07:15,640 --> 01:07:17,080 MCFADDEN ET AL. POINT YOU HAD 1882 01:07:17,080 --> 01:07:18,680 OUT IN THIS PAPER, INCREASE IN 1883 01:07:18,680 --> 01:07:22,080 TEMPERATURE OF 10 DEGREES 1884 01:07:22,080 --> 01:07:23,640 CENTIGRADE ACROSS REGIONS OF THE 1885 01:07:23,640 --> 01:07:25,480 UNITED STATES WAS SIGNIFICANTLY 1886 01:07:25,480 --> 01:07:29,440 ASSOCIATED WITH INCREASE IN 1887 01:07:29,440 --> 01:07:32,720 ANTIBIOTIC RESISTANCE TO SEVERAL 1888 01:07:32,720 --> 01:07:37,400 VERY IMPORTANT PATHOGENS, 1889 01:07:37,400 --> 01:07:38,200 INCLUDING E. COLI, KLEBSIELLA, 1890 01:07:38,200 --> 01:07:41,000 STAPH AUREUS. 1891 01:07:41,000 --> 01:07:42,400 NEXT SLIDE PLEASE. 1892 01:07:42,400 --> 01:07:45,280 IN ADDITION TO THE INFECTIONS 1893 01:07:45,280 --> 01:07:47,600 THEMSELVES, CLIMATE CHANGE HAS A 1894 01:07:47,600 --> 01:07:50,440 PROFOUND EFFECT AND CAN HAVE A 1895 01:07:50,440 --> 01:07:52,280 PROFOUND EFFECT ON FOOD SAFETY. 1896 01:07:52,280 --> 01:07:55,240 IN PART AS A RESULT OF CHANGES 1897 01:07:55,240 --> 01:07:57,880 IN THE GROWTH PATTERN OF 1898 01:07:57,880 --> 01:07:59,600 PATHOGENS, THEIR ABILITY TO 1899 01:07:59,600 --> 01:08:02,280 SURVIVE AND THEIR CHANGES IN 1900 01:08:02,280 --> 01:08:05,000 THEIR VIRULENCE OVER TIME, IN 1901 01:08:05,000 --> 01:08:08,280 RESPONSE TO CLIMATE, AND CLIMATE 1902 01:08:08,280 --> 01:08:10,440 CHANGE, AND WORKING THROUGH 1903 01:08:10,440 --> 01:08:13,080 CONTAMINATION OF CROPS BY FECES 1904 01:08:13,080 --> 01:08:15,840 DUE TO FLOODING OR HIGH LEVELS 1905 01:08:15,840 --> 01:08:19,240 OF RAINFALL, AND ON THE OPPOSITE 1906 01:08:19,240 --> 01:08:21,000 RIGHT-HAND SIDE OF THE SLIDE 1907 01:08:21,000 --> 01:08:23,920 LIKELY ALSO DUE TO WATER 1908 01:08:23,920 --> 01:08:25,880 SCARCITY DURING DROUGHTS WHICH 1909 01:08:25,880 --> 01:08:29,720 CAN ADVERSELY AFFECT HYGIENE AND 1910 01:08:29,720 --> 01:08:30,040 SANITATION. 1911 01:08:30,040 --> 01:08:33,200 AND ALL OF THIS LEADING TO FOOD 1912 01:08:33,200 --> 01:08:36,720 SCARCITY CAN CAUSE DIETARY 1913 01:08:36,720 --> 01:08:39,680 SHIFTS TOWARDS MORE UNSAFE 1914 01:08:39,680 --> 01:08:42,160 FOODS. 1915 01:08:42,160 --> 01:08:43,920 NEXT SLIDE PLEASE. 1916 01:08:43,920 --> 01:08:47,200 IN THIS PAPER FROM CANADA, THEY 1917 01:08:47,200 --> 01:08:49,000 HAVE POINTED OUT POTENTIAL 1918 01:08:49,000 --> 01:08:53,680 IMPACT OF ALMOST ALL OF THE 1919 01:08:53,680 --> 01:08:55,440 COMMON FOOD-BORNE DISEASES OVER 1920 01:08:55,440 --> 01:08:59,200 THE COMING YEARS, AS A RESULT OF 1921 01:08:59,200 --> 01:08:59,920 CLIMATE CHANGES. 1922 01:08:59,920 --> 01:09:05,000 THE LIST IS QUITE EXTENSIVE. 1923 01:09:05,000 --> 01:09:08,320 AND VIRTUALLY ALL OF THEM 1924 01:09:08,320 --> 01:09:10,280 POTENTIALLY HAVE SOME IMPACT 1925 01:09:10,280 --> 01:09:13,080 OCCURRING AS A RESULT -- ON THE 1926 01:09:13,080 --> 01:09:15,240 ILLNESSES THEMSELVES, AS A 1927 01:09:15,240 --> 01:09:20,800 RESULT OF CLIMATE AND CLIMATE 1928 01:09:20,800 --> 01:09:21,040 CHANGE. 1929 01:09:21,040 --> 01:09:22,600 NEXT SLIDE. 1930 01:09:22,600 --> 01:09:26,080 THE RELATIONSHIP THEN BETWEEN 1931 01:09:26,080 --> 01:09:27,280 INFECTION AND MALNUTRITION, THE 1932 01:09:27,280 --> 01:09:29,800 SYNERGY DESCRIBED MORE THAN 50 1933 01:09:29,800 --> 01:09:32,640 YEARS AGO, ESSENTIALLY SAYS THAT 1934 01:09:32,640 --> 01:09:35,600 INFECTION LEADS TO MALNUTRITION 1935 01:09:35,600 --> 01:09:38,760 IN MANY CASES, PARTICULARLY IN 1936 01:09:38,760 --> 01:09:39,680 VULNERABLE POPULATIONS, AND 1937 01:09:39,680 --> 01:09:42,080 MALNUTRITION INCREASES THE RISK 1938 01:09:42,080 --> 01:09:44,720 OF AND FROM INFECTIONS. 1939 01:09:44,720 --> 01:09:46,560 AND SO INFECTIONS POTENTIALLY 1940 01:09:46,560 --> 01:09:52,680 LEAD TO DECREASED NUTRIENT 1941 01:09:52,680 --> 01:09:56,720 INTAKE, MALABSORPTION, INCREASED 1942 01:09:56,720 --> 01:09:58,800 CATABOLISM, AND MALNUTRITION 1943 01:09:58,800 --> 01:10:00,240 THEN LEADS TO DEFICIENCIES IN 1944 01:10:00,240 --> 01:10:02,280 HOST RESPONSE TO INFECTION 1945 01:10:02,280 --> 01:10:05,360 THROUGH IMPAIRED IMMUNE FUNCTION 1946 01:10:05,360 --> 01:10:08,080 AND IMPAIRED BARRIER PROTECTION 1947 01:10:08,080 --> 01:10:12,240 AGAINST THOSE INFECTIONS. 1948 01:10:12,240 --> 01:10:14,960 NEXT SLIDE PLEASE. 1949 01:10:14,960 --> 01:10:18,160 SOME OF THE SPECIFIC NUTRITIONAL 1950 01:10:18,160 --> 01:10:19,480 DEFICIENCIES THAT AFFECT IMMUNE 1951 01:10:19,480 --> 01:10:21,360 RESPONSE HAVE ALSO BEEN WELL 1952 01:10:21,360 --> 01:10:23,400 DESCRIBED OVER THE PAST SEVERAL 1953 01:10:23,400 --> 01:10:23,760 DECADES. 1954 01:10:23,760 --> 01:10:27,600 AND I THINK MOST OF US ARE 1955 01:10:27,600 --> 01:10:28,800 FAMILIAR WITH THESE PATHWAYS. 1956 01:10:28,800 --> 01:10:33,680 VITAMIN A IS PERHAPS ONE OF THE 1957 01:10:33,680 --> 01:10:35,440 MOST WELL-KNOWN DEFICIENCIES 1958 01:10:35,440 --> 01:10:38,200 RELATED TO RESISTANCE TO MEASLES 1959 01:10:38,200 --> 01:10:40,840 AND MORTALITY AS WELL AS 1960 01:10:40,840 --> 01:10:42,800 MORBIDITY FROM MEASLES, AND IN 1961 01:10:42,800 --> 01:10:43,840 ADDITION TO ACUTE DIARRHEA. 1962 01:10:43,840 --> 01:10:46,720 BUT ALL OF THESE HAVE BEEN 1963 01:10:46,720 --> 01:10:50,560 LINKED TO SERIOUS AND 1964 01:10:50,560 --> 01:10:52,680 COMPROMISED RESPONSES TO 1965 01:10:52,680 --> 01:10:54,160 INFECTIONS. 1966 01:10:54,160 --> 01:10:55,480 NEXT SLIDE PLEASE. 1967 01:10:55,480 --> 01:11:00,320 AS HAS BEEN POINTED OUT, THE 1968 01:11:00,320 --> 01:11:01,960 VULNERABLE POPULATIONS ARE THOSE 1969 01:11:01,960 --> 01:11:06,440 AT THE PRESENT TIME IN LOW -- 1970 01:11:06,440 --> 01:11:07,640 MOST VULNERABLE POPULATIONS ARE 1971 01:11:07,640 --> 01:11:15,400 CURRENTLY THOSE WHO LIVE IN LOW 1972 01:11:15,400 --> 01:11:16,920 AND MIDDLE INCOME COUNTRIES, 1973 01:11:16,920 --> 01:11:18,240 EXPANDING OVER TIME TO AFFECT 1974 01:11:18,240 --> 01:11:19,240 THE ENTIRE GLOBE. 1975 01:11:19,240 --> 01:11:23,360 WE KNOW THE PREVALENCE OF 1976 01:11:23,360 --> 01:11:25,240 STUNTING IN CHILDREN HAS 1977 01:11:25,240 --> 01:11:28,200 SIGNIFICANTLY DECREASED OVER THE 1978 01:11:28,200 --> 01:11:32,920 PAST DECADE, GLOBALLY, BUT 1979 01:11:32,920 --> 01:11:34,200 REMAINS STUBBORNLY HIGHLY 1980 01:11:34,200 --> 01:11:36,640 PREVALENT IN AFRICA, 1981 01:11:36,640 --> 01:11:38,840 PARTICULARLY SUB-SAHARAN AFRICA, 1982 01:11:38,840 --> 01:11:41,120 AND ASIA, SOUTHEAST ASIA, WITH 1983 01:11:41,120 --> 01:11:45,960 LEVELS BETWEEN 20 AND 60%. 1984 01:11:45,960 --> 01:11:49,560 AND NEXT SLIDE. 1985 01:11:49,560 --> 01:11:51,960 ONE CAN COMPLETELY OVERLAY THIS 1986 01:11:51,960 --> 01:11:55,480 MAP OF PREVALENCE OF VITAMIN A 1987 01:11:55,480 --> 01:11:57,000 DEFICIENCY IN YOUNG CHILDREN 1988 01:11:57,000 --> 01:11:59,760 WITH THAT MAP OF STUNTING, AND 1989 01:11:59,760 --> 01:12:05,200 THE SAME THING WITH MAPS FOR 1990 01:12:05,200 --> 01:12:06,640 ZINC DEFICIENCY, IODINE 1991 01:12:06,640 --> 01:12:08,520 DEFICIENCY, IRON, AND OTHER 1992 01:12:08,520 --> 01:12:13,120 MACRO AND MICRO NUTRIENT 1993 01:12:13,120 --> 01:12:13,440 DEFICIENCIES. 1994 01:12:13,440 --> 01:12:14,560 NEXT SLIDE. 1995 01:12:14,560 --> 01:12:20,120 AND SO I WANT TO CONCLUDE THEN 1996 01:12:20,120 --> 01:12:22,880 BY TALKING ABOUT -- BRIEFLY 1997 01:12:22,880 --> 01:12:25,160 ABOUT CHOLERA, A BELLWETHER FOR 1998 01:12:25,160 --> 01:12:29,440 THE IMPACT OF CLIMATE CHANGE ON 1999 01:12:29,440 --> 01:12:29,680 HEALTH. 2000 01:12:29,680 --> 01:12:33,680 CURRENTLY, THERE 3 MILLION CASES 2001 01:12:33,680 --> 01:12:40,280 OF DIARRHEA AND 100,000 DEATHS 2002 01:12:40,280 --> 01:12:42,120 ANNUALLY CAUSED BY VIBRIO 2003 01:12:42,120 --> 01:12:44,320 CHOLERA. 2004 01:12:44,320 --> 01:12:50,000 IT OCCURS IN SPORADIC FORM, 2005 01:12:50,000 --> 01:12:52,520 ENDEMIC AREAS, PRIMARILY IN 2006 01:12:52,520 --> 01:12:55,400 YOUNG CHILDREN WHO LACK IMMUNITY 2007 01:12:55,400 --> 01:13:00,600 AND THEN IN THE EPIDEMICKING I 2008 01:13:00,600 --> 01:13:02,640 N -- EPIDEMICS IN MAN-MADE AND 2009 01:13:02,640 --> 01:13:04,000 NATURAL DISASTERS, FOR EXAMPLE 2010 01:13:04,000 --> 01:13:07,600 IN YEMEN AND SYRIA OVER THE PAST 2011 01:13:07,600 --> 01:13:09,000 SEVERAL YEARS. 2012 01:13:09,000 --> 01:13:11,200 IN 2017 THE W.H.O. INITIATED A 2013 01:13:11,200 --> 01:13:17,240 CAMPAIGN TO REDUCE CHOLERA 2014 01:13:17,240 --> 01:13:21,280 DEATHS BY 90%, BY 2030. 2015 01:13:21,280 --> 01:13:23,360 WITH IMPROVED SANITATION AND 2016 01:13:23,360 --> 01:13:24,760 VACCINES. 2017 01:13:24,760 --> 01:13:27,200 BUT CLIMATE CHANGE POSES A VERY 2018 01:13:27,200 --> 01:13:28,160 SIGNIFICANT EXISTENTIAL THREAT 2019 01:13:28,160 --> 01:13:30,920 TO THIS GOAL. 2020 01:13:30,920 --> 01:13:32,200 NEXT SLIDE. 2021 01:13:32,200 --> 01:13:37,800 THE REASON FOR THIS IS THAT 2022 01:13:37,800 --> 01:13:39,320 VIBRIOS THRIVE UNDER THE 2023 01:13:39,320 --> 01:13:41,200 CONDITIONS OF CLIMATE CHANGE 2024 01:13:41,200 --> 01:13:43,480 THAT WE ARE EXPERIENCING NOW AND 2025 01:13:43,480 --> 01:13:47,200 WILL CONTINUE TO EXPERIENCE 2026 01:13:47,200 --> 01:13:50,400 GOING FORWARD, DEPENDING ON OUR 2027 01:13:50,400 --> 01:13:53,640 RESPONSE TO THESE CHANGES. 2028 01:13:53,640 --> 01:13:56,720 INCREASED OCEAN SURFACE 2029 01:13:56,720 --> 01:13:57,840 TEMPERATURE, ACIDITY, SEA LEVEL 2030 01:13:57,840 --> 01:14:02,080 RISE, CHANGES IN SALINITY AND 2031 01:14:02,080 --> 01:14:06,560 CHANGES IN PRECIPITATION ALL 2032 01:14:06,560 --> 01:14:10,840 INCREASE THE GROWTH OF VIBRIOS 2033 01:14:10,840 --> 01:14:12,160 SPECIES AND HORIZONTAL GENE 2034 01:14:12,160 --> 01:14:15,120 TRANSFER IN THESE SPECIES, 2035 01:14:15,120 --> 01:14:18,480 LEADING TO NOT ONLY INCREASED 2036 01:14:18,480 --> 01:14:26,720 RISK FOR CHOLERA FROM VIBRIOS, 2037 01:14:26,720 --> 01:14:32,840 BUT AS WELL NON-VIBRIO SPECIES 2038 01:14:32,840 --> 01:14:35,360 SUCH AS VULNIFICANS AND 2039 01:14:35,360 --> 01:14:41,920 INCREASED ANTIBIOTIC RESISTANCE 2040 01:14:41,920 --> 01:14:44,680 WHICH I MENTIONED BEFORE. 2041 01:14:44,680 --> 01:14:46,520 BANGLADESH REPRESENTS AN AREA OF 2042 01:14:46,520 --> 01:14:50,000 THE GLOBE WHERE THIS 2043 01:14:50,000 --> 01:14:50,680 RELATIONSHIP BETWEEN CLIMATE, 2044 01:14:50,680 --> 01:14:53,520 HEALTH, AND ENDEMIC CHOLERA IS 2045 01:14:53,520 --> 01:14:57,360 MOST ACTIVELY DEMONSTRATED, EVEN 2046 01:14:57,360 --> 01:15:00,000 RIGHT NOW. 2047 01:15:00,000 --> 01:15:01,960 AND IN ENDEMIC AREAS, CLIMATE 2048 01:15:01,960 --> 01:15:07,520 DATA PREDICTS INCIDENCE OF 2049 01:15:07,520 --> 01:15:09,160 CHOLERA, AND THIS INCLUDES 2050 01:15:09,160 --> 01:15:10,360 RAINFALL, WATER SURFACE 2051 01:15:10,360 --> 01:15:12,400 TEMPERATURE, AND SALINITY. 2052 01:15:12,400 --> 01:15:14,960 AND MODELING THE IMPACT OF 2053 01:15:14,960 --> 01:15:17,800 CHANGE IN THESE PREDICTORS IN 2054 01:15:17,800 --> 01:15:19,880 BANGLADESH SUGGESTS A COUNTRY 2055 01:15:19,880 --> 01:15:22,840 THAT IS UNDER ENORMOUS THREAT 2056 01:15:22,840 --> 01:15:24,680 FROM CHOLERA. 2057 01:15:24,680 --> 01:15:25,800 AND WITHOUT INTERVENTION, A 2058 01:15:25,800 --> 01:15:27,600 SUBSTANTIAL INCREASE IN CHOLERA 2059 01:15:27,600 --> 01:15:30,120 IS PREDICTED IN EVERY DISTRICT 2060 01:15:30,120 --> 01:15:34,120 IN BANGLADESH OVER THE NEXT 30 2061 01:15:34,120 --> 01:15:35,440 YEARS, ESPECIALLY IN LOW-LYING 2062 01:15:35,440 --> 01:15:36,200 COASTAL AREAS. 2063 01:15:36,200 --> 01:15:38,840 SO, WITH THAT I'M GOING TO 2064 01:15:38,840 --> 01:15:42,520 CONCLUDE WITH THE NEXT SLIDE. 2065 01:15:42,520 --> 01:15:45,520 WHICH RETURNS TO THE FRAMEWORK 2066 01:15:45,520 --> 01:15:52,080 THAT I BEGAN WITH. 2067 01:15:52,080 --> 01:15:53,160 AND REEMPHASIZES THE 2068 01:15:53,160 --> 01:15:55,280 INTERRELATIONSHIP BETWEEN 2069 01:15:55,280 --> 01:15:58,320 CLIMATE, CLIMATE CHANGE, AND 2070 01:15:58,320 --> 01:15:59,200 ENVIRONMENTAL CHANGE ON 2071 01:15:59,200 --> 01:16:07,080 NUTRITIONAL STATUS AND THE RISK 2072 01:16:07,080 --> 01:16:08,480 FROM UNDER AND OVERNUTRITION AND 2073 01:16:08,480 --> 01:16:10,880 INFECTIOUS DISEASES OVER THE 2074 01:16:10,880 --> 01:16:13,320 LIFE COURSE, AND I LOOK FORWARD 2075 01:16:13,320 --> 01:16:16,080 TO WORKING WITH COLLEAGUES ON 2076 01:16:16,080 --> 01:16:18,320 WORK GROUP 1, IDENTIFYING THE 2077 01:16:18,320 --> 01:16:21,520 EVIDENCE THAT CURRENTLY EXISTS 2078 01:16:21,520 --> 01:16:22,520 TO ESTABLISH THESE 2079 01:16:22,520 --> 01:16:25,000 INTERRELATIONSHIPS AS WELL AS TO 2080 01:16:25,000 --> 01:16:26,440 IDENTIFYING THE RESEARCH GAPS 2081 01:16:26,440 --> 01:16:29,960 FOR STUDIES THAT STILL NEED TO 2082 01:16:29,960 --> 01:16:33,640 BE CONDUCTED TO FURTHER 2083 01:16:33,640 --> 01:16:35,440 DEMONSTRATE CAUSAL RELATIONSHIPS 2084 01:16:35,440 --> 01:16:37,440 BETWEEN THESE OUTCOMES. 2085 01:16:37,440 --> 01:16:38,480 WITH THAT, I'LL END. 2086 01:16:38,480 --> 01:16:41,640 THANK YOU. 2087 01:16:41,640 --> 01:16:47,200 >> THANK YOU FOR AN EXCELLENT 2088 01:16:47,200 --> 01:16:49,520 OVERVIEW, VERY COMPLEX TOPIC. 2089 01:16:49,520 --> 01:16:51,400 IN ADDITION TO COMMENTS YOU MADE 2090 01:16:51,400 --> 01:16:53,080 I'D LIKE TO UNDERSCORE SOMETHING 2091 01:16:53,080 --> 01:16:55,440 THAT'S INCREASING CONCERN IN THE 2092 01:16:55,440 --> 01:16:56,400 CLIMATE CHANGE COMMUNITY, WHAT 2093 01:16:56,400 --> 01:16:58,960 WE CALL COMPOUNDING AND 2094 01:16:58,960 --> 01:17:00,720 CASCADING RISKS. 2095 01:17:00,720 --> 01:17:01,680 YOU ILLUSTRATED THAT THROUGHOUT 2096 01:17:01,680 --> 01:17:03,200 THAT WE NEED TO STOP THINKING 2097 01:17:03,200 --> 01:17:04,360 ABOUT JUST THE FLOODING EVENT 2098 01:17:04,360 --> 01:17:06,280 BUT NEED TO MOVE ON TO THINKING 2099 01:17:06,280 --> 01:17:12,320 ABOUT THE CONSEQUENCES OF 2100 01:17:12,320 --> 01:17:16,120 FLOODING FOR MENTAL HEALTH, 2101 01:17:16,120 --> 01:17:18,200 INFECTIOUS DISEASE, TO THINK 2102 01:17:18,200 --> 01:17:19,960 ACROSS COMPLEXITY OF WHAT 2103 01:17:19,960 --> 01:17:23,760 HAPPENS WHEN OUR ENVIRONMENT 2104 01:17:23,760 --> 01:17:27,080 FURTHER CHANGES SO WE'RE BETTER 2105 01:17:27,080 --> 01:17:27,560 PREPARED. 2106 01:17:27,560 --> 01:17:30,240 IT'S NOT JUST TO UNDERSTAND FOR 2107 01:17:30,240 --> 01:17:31,360 UNDERSTANDING'S SAKE BUT 2108 01:17:31,360 --> 01:17:33,640 UNDERSTAND TO TAKE EFFECTIVE 2109 01:17:33,640 --> 01:17:33,880 ACTION. 2110 01:17:33,880 --> 01:17:34,240 >> ABSOLUTELY. 2111 01:17:34,240 --> 01:17:34,520 >> NANCY? 2112 01:17:34,520 --> 01:17:36,800 >>I WOULD POINT OUT THAT MY 2113 01:17:36,800 --> 01:17:38,840 BACKGROUND HERE IS THE VIEW FROM 2114 01:17:38,840 --> 01:17:43,720 OUR HOUSE TO THE COAST OF MAINE, 2115 01:17:43,720 --> 01:17:45,440 AND SO WE ACTUALLY -- AND THE 2116 01:17:45,440 --> 01:17:50,040 GULF OF MAINE IS THE 2117 01:17:50,040 --> 01:17:52,560 FASTEST-WARMING OCEAN IN THE 2118 01:17:52,560 --> 01:17:53,480 WORLD I BELIEVE. 2119 01:17:53,480 --> 01:17:56,400 AND WHILE THE TIDE IS OUT IN 2120 01:17:56,400 --> 01:17:59,720 THIS SLIDE, WHEN IT COMES IN WE 2121 01:17:59,720 --> 01:18:02,200 APPRECIATE EXACTLY WHAT'S MEANT 2122 01:18:02,200 --> 01:18:03,960 BY RISING TIDES AND THREATS. 2123 01:18:03,960 --> 01:18:08,880 SO JUST WANTED TO ADD THAT IN. 2124 01:18:08,880 --> 01:18:09,760 NANCY? 2125 01:18:09,760 --> 01:18:10,000 THANKS. 2126 01:18:10,000 --> 01:18:15,000 THAT . 2127 01:18:15,000 --> 01:18:17,640 >> I HABIT HEARD THOSE FIGURES 2128 01:18:17,640 --> 01:18:20,680 FOR THE CHOLERA IN -- HADN'T 2129 01:18:20,680 --> 01:18:22,640 HEARD THAT FOR CHOLERA AND 2130 01:18:22,640 --> 01:18:23,080 BANGLADESH. 2131 01:18:23,080 --> 01:18:27,280 HAVE YOU RUN INTO EXAMPLES OF 2132 01:18:27,280 --> 01:18:29,120 HOW NUTRITIONAL STATUS INTERACTS 2133 01:18:29,120 --> 01:18:31,880 WITH THE -- YOU KNOW, RESPONSE 2134 01:18:31,880 --> 01:18:34,160 TO CHOLERA INFECTIONS, EITHER IN 2135 01:18:34,160 --> 01:18:36,280 BANGLADESH, BUT ELSEWHERE AS 2136 01:18:36,280 --> 01:18:36,520 WELL. 2137 01:18:36,520 --> 01:18:39,000 BANGLADESH HAS BEEN ONE OF THE 2138 01:18:39,000 --> 01:18:41,520 LEADING COUNTRIES IN REALLY 2139 01:18:41,520 --> 01:18:42,000 ADDRESSING MICRONUTRIENT 2140 01:18:42,000 --> 01:18:45,120 DEFICIENCY, ESPECIALLY IN YOUNG 2141 01:18:45,120 --> 01:18:45,400 CHILDREN. 2142 01:18:45,400 --> 01:18:48,720 AND SO ARE THERE ANY DATA TO 2143 01:18:48,720 --> 01:18:50,800 SUGGEST THIS COULD ALTER THE 2144 01:18:50,800 --> 01:18:55,520 RESPONSE OR RESILIENCE OF 2145 01:18:55,520 --> 01:18:55,840 POPULATIONS? 2146 01:18:55,840 --> 01:19:01,520 >> YEAH, I MEAN, THE IDDRB IN 2147 01:19:01,520 --> 01:19:03,520 BANGLADESH HAS CERTAINLY TAKEN 2148 01:19:03,520 --> 01:19:05,400 THE LEAD IN IDENTIFYING THE -- 2149 01:19:05,400 --> 01:19:13,720 WHAT HAPPENS WHEN YOU ARE 2150 01:19:13,720 --> 01:19:16,120 MALNOURISHED AND TRYING TO 2151 01:19:16,120 --> 01:19:17,200 RECOVER FROM CHOLERA. 2152 01:19:17,200 --> 01:19:18,320 THAT'S WELL ESTABLISHED. 2153 01:19:18,320 --> 01:19:25,520 WHAT'S LESS WELL ESTABLISHED IS 2154 01:19:25,520 --> 01:19:26,960 NUTRITIONAL MITIGATION. 2155 01:19:26,960 --> 01:19:30,480 FRANKLY, THAT IS AN AREA THAT IS 2156 01:19:30,480 --> 01:19:32,000 BEING ACTIVELY PURSUED, BUT THE 2157 01:19:32,000 --> 01:19:37,160 BIGGEST IMPACT IS GOING TO COME 2158 01:19:37,160 --> 01:19:38,240 WITH VACCINES, EFFECTIVE 2159 01:19:38,240 --> 01:19:40,240 VACCINES, AND BEING ABLE TO 2160 01:19:40,240 --> 01:19:43,600 DISTRIBUTE THOSE IN A WAY THAT 2161 01:19:43,600 --> 01:19:46,480 REACHES ALL OF THOSE VULNERABLE 2162 01:19:46,480 --> 01:19:48,360 CHILDREN AND ADULTS. 2163 01:19:48,360 --> 01:19:48,760 >> ADULTS, RIGHT. 2164 01:19:48,760 --> 01:19:49,040 >> YEAH. 2165 01:19:49,040 --> 01:19:52,160 >> I THINK THAT'S WHERE THE 2166 01:19:52,160 --> 01:19:52,880 PAYLOAD IS ACTUALLY. 2167 01:19:52,880 --> 01:19:55,400 >> YEAH. 2168 01:19:55,400 --> 01:19:57,840 THANKS. 2169 01:19:57,840 --> 01:19:58,960 >> THAT WAS EXCELLENT. 2170 01:19:58,960 --> 01:20:01,080 WE'LL HAVE MORE TIME AT THE END 2171 01:20:01,080 --> 01:20:01,880 FOR DISCUSSION. 2172 01:20:01,880 --> 01:20:06,680 SHOULD WE MOVE ON TO DR. BUNDY? 2173 01:20:06,680 --> 01:20:09,120 THANK YOU FOR JOINING FROM THE 2174 01:20:09,120 --> 01:20:11,200 U.K. 2175 01:20:11,200 --> 01:20:13,520 2176 01:20:13,520 --> 01:20:18,960 >> THANK YOU VERY MUCH, 2177 01:20:18,960 --> 01:20:19,160 KRISTIE. 2178 01:20:19,160 --> 01:20:20,040 WE'VE SPOKEN BUT WE HAVEN'T MET. 2179 01:20:20,040 --> 01:20:24,200 THIS IS PART OF THE LEGACY OF 2180 01:20:24,200 --> 01:20:24,880 THE PANDEMIC. 2181 01:20:24,880 --> 01:20:28,480 SO THANK YOU FOR THIS 2182 01:20:28,480 --> 01:20:30,640 OPPORTUNITY TO SPEAK ON CLIMATE 2183 01:20:30,640 --> 01:20:33,040 CHANGE IN THE NEXT 7,000 DAYS OF 2184 01:20:33,040 --> 01:20:34,280 CHILD DEVELOPMENT. 2185 01:20:34,280 --> 01:20:38,880 I WAS ASKED TO SPEAK REALLY ON 2186 01:20:38,880 --> 01:20:40,400 BEHALF OF ANOTHER GROUP WITHIN 2187 01:20:40,400 --> 01:20:43,920 THE NIH THAT'S LOOKING AT THESE 2188 01:20:43,920 --> 01:20:47,880 MODERN DAY ISSUES, AND THIS IS A 2189 01:20:47,880 --> 01:20:49,720 GROUP CALLED BOND-KIDS, 2190 01:20:49,720 --> 01:20:51,920 BIOMARKERS OF NUTRITIONAL 2191 01:20:51,920 --> 01:20:54,200 DEVELOPMENT, FOCUSING ON 2192 01:20:54,200 --> 01:20:56,280 SCHOOL-AGE CHILDREN AND 2193 01:20:56,280 --> 01:20:56,600 ADOLESCENTS. 2194 01:20:56,600 --> 01:20:59,800 I'M GOING TO BE -- I REALLY 2195 01:20:59,800 --> 01:21:00,560 ENJOYED DR. KLEINMAN'S 2196 01:21:00,560 --> 01:21:01,200 PRESENTATION. 2197 01:21:01,200 --> 01:21:02,720 I'M GOING TO BE MUCH MORE 2198 01:21:02,720 --> 01:21:05,240 TALKING ABOUT SOME ACTIONS THAT 2199 01:21:05,240 --> 01:21:08,480 ARE ONGOING AND SOME LEVELS OF 2200 01:21:08,480 --> 01:21:11,280 UNDERSTANDING THAT ARE PERHAPS 2201 01:21:11,280 --> 01:21:12,800 DIFFERENT ABOUT SCHOOL-AGE 2202 01:21:12,800 --> 01:21:13,080 CHILDREN. 2203 01:21:13,080 --> 01:21:15,960 SO, I'M GOING TO TALK ABOUT THE 2204 01:21:15,960 --> 01:21:18,920 FIRST 8,000 DAYS OF LIFE, UP TO 2205 01:21:18,920 --> 01:21:20,120 SORT OF THE EARLY 20s. 2206 01:21:20,120 --> 01:21:22,320 I'M GOING TO TALK ABOUT WHAT 2207 01:21:22,320 --> 01:21:26,360 GOVERNMENTS ARE DOING TO ACT ON 2208 01:21:26,360 --> 01:21:28,320 THIS, WHAT RESEARCH IS BEING 2209 01:21:28,320 --> 01:21:30,400 INITIATED, HOW THAT'S NOW 2210 01:21:30,400 --> 01:21:32,600 LOOKING AT CLIMATE, AND REALLY 2211 01:21:32,600 --> 01:21:34,600 HOW OUR GOVERNMENT'S REACTING. 2212 01:21:34,600 --> 01:21:36,320 WHAT IS THEIR LEVEL OF INTEREST. 2213 01:21:36,320 --> 01:21:37,600 ARE THEY GOING TO TAKE UP THESE 2214 01:21:37,600 --> 01:21:39,920 IDEAS AND MOVE WITH THEM? 2215 01:21:39,920 --> 01:21:44,400 SO, HERE'S -- LET'S START WITH A 2216 01:21:44,400 --> 01:21:47,120 FOCUS ON THE FIRST 8,000 DAYS OF 2217 01:21:47,120 --> 01:21:49,000 LIFE, THE THOUSAND DAYS WE'RE SO 2218 01:21:49,000 --> 01:21:51,080 USED TO TALKING ABOUT FOR 2219 01:21:51,080 --> 01:21:52,280 NUTRITIONAL PERSPECTIVE, ALSO 2220 01:21:52,280 --> 01:21:54,280 THE NEXT 7,000 DAYS THROUGH 2221 01:21:54,280 --> 01:21:57,320 SCHOOL AGE AND INTO ADOLESCENCE. 2222 01:21:57,320 --> 01:21:59,960 MANY OF US DURING THE FIRST DAYS 2223 01:21:59,960 --> 01:22:01,800 OF THE COVID EPIDEMIC WERE 2224 01:22:01,800 --> 01:22:02,800 SUFFICIENTLY DISTRACTED NOT TO 2225 01:22:02,800 --> 01:22:03,920 NOTICE ONE STRANGE THING THAT 2226 01:22:03,920 --> 01:22:08,080 HAPPENED TO THE WORLD IN 2020 2227 01:22:08,080 --> 01:22:10,200 WAS THE AVERAGE AGE OF A PERSON 2228 01:22:10,200 --> 01:22:12,800 IN THE WORLD NOW EXCEEDED FOR 2229 01:22:12,800 --> 01:22:16,600 THE FIRST TIME 30 YEARS OF AGE. 2230 01:22:16,600 --> 01:22:19,720 IN SOME PARTS OF THE WORLD AS WE 2231 01:22:19,720 --> 01:22:22,080 RECOGNIZE, THAT'S A MUCH HIGHER 2232 01:22:22,080 --> 01:22:22,400 AGE. 2233 01:22:22,400 --> 01:22:25,720 IN BRITAIN AND THE STATES, THE 2234 01:22:25,720 --> 01:22:30,600 AVERAGE AGE OF A PERSON IS NOW 2235 01:22:30,600 --> 01:22:31,360 IN THEIR 40s. 2236 01:22:31,360 --> 01:22:36,160 IN OTHER PARTS OF THE WORLD, 2237 01:22:36,160 --> 01:22:39,040 THINKING, THE AVERAGE AGE OF 2238 01:22:39,040 --> 01:22:42,320 SOME POPULATIONS, NIGER OR CHAD, 2239 01:22:42,320 --> 01:22:44,200 IS AROUND 15 OR 16 YEARS OF AGE. 2240 01:22:44,200 --> 01:22:46,240 IN OTHER WORDS, HALF THE 2241 01:22:46,240 --> 01:22:48,640 POPULATION ARE CHILDREN. 2242 01:22:48,640 --> 01:22:50,760 AND THESE TWO DEMOGRAPHIC 2243 01:22:50,760 --> 01:22:52,480 PYRAMIDS ARE JUST TO REEMPHASIZE 2244 01:22:52,480 --> 01:22:54,680 THE POINT, WHAT IS THE GROUP WE 2245 01:22:54,680 --> 01:22:55,560 ARE TALKING ABOUT? 2246 01:22:55,560 --> 01:23:03,880 ON THE LEFT WE'VE GOT THE 2247 01:23:03,880 --> 01:23:05,000 SUB-SAHARAN AFRICAN POPULATION, 2248 01:23:05,000 --> 01:23:08,600 ON THE RIGHT EUROPEAN AND NORTH 2249 01:23:08,600 --> 01:23:12,360 AMERICAN POPULATION BY AGE AND 2250 01:23:12,360 --> 01:23:13,560 SEX, STRIKINGLY DIFFERENT 2251 01:23:13,560 --> 01:23:13,880 DISTRIBUTIONS. 2252 01:23:13,880 --> 01:23:17,160 IF WE LOOK AT THE RIGHT, WE CAN 2253 01:23:17,160 --> 01:23:20,120 SEE IN THOSE RICH NORTHERN 2254 01:23:20,120 --> 01:23:21,520 COUNTRIES SOMETHING LIKE LESS 2255 01:23:21,520 --> 01:23:24,640 THAN 7% OF THE COUNTRY, OF THE 2256 01:23:24,640 --> 01:23:26,160 POPULATION, ARE THOSE SCHOOL-AGE 2257 01:23:26,160 --> 01:23:28,320 CHILDREN AND ADOLESCENTS. 2258 01:23:28,320 --> 01:23:30,080 BUT WE ALSO RECOGNIZE THAT THAT 2259 01:23:30,080 --> 01:23:34,760 7% IS GOING TO HAVE TO BE THE 2260 01:23:34,760 --> 01:23:35,720 EARNERS OF TOMORROW. 2261 01:23:35,720 --> 01:23:36,880 THOSE ARE OUR FUTURE. 2262 01:23:36,880 --> 01:23:40,160 THAT'S THE HUMAN CAPITAL WE'LL 2263 01:23:40,160 --> 01:23:43,120 TAKE FORWARD TO SUPPORT THE VERY 2264 01:23:43,120 --> 01:23:45,760 LARGE BURDEN OF DEPENDENT 2265 01:23:45,760 --> 01:23:47,200 POPULATIONS THAT ARE GROWING 2266 01:23:47,200 --> 01:23:48,720 THERE, WHEREAS IF WE LOOK AT THE 2267 01:23:48,720 --> 01:23:51,400 AFRICAN SITUATION WE CAN SEE 2268 01:23:51,400 --> 01:23:53,520 VERY DIFFERENT. 2269 01:23:53,520 --> 01:23:56,560 THERE ARE VERY LARGE VERY 2270 01:23:56,560 --> 01:23:57,440 SUBSTANTIAL PROPORTIONS OF THE 2271 01:23:57,440 --> 01:23:59,200 POPULATION SCHOOL AGE CHILDREN 2272 01:23:59,200 --> 01:24:02,840 AND ADOLESCENTS AND CARRY FOR 2273 01:24:02,840 --> 01:24:03,680 THEM, ALSO VITALLY IMPORTANT, 2274 01:24:03,680 --> 01:24:05,320 PRETTY WELL THE TOTAL OF THE 2275 01:24:05,320 --> 01:24:06,120 POPULATION. 2276 01:24:06,120 --> 01:24:09,920 SO WE'RE SEEING A VERY DIFFERENT 2277 01:24:09,920 --> 01:24:12,560 BUT EQUALLY IMPORTANT REASONS 2278 01:24:12,560 --> 01:24:15,320 FOR FOCUSING ON THOSE NEXT 7,000 2279 01:24:15,320 --> 01:24:15,720 DAYS. 2280 01:24:15,720 --> 01:24:20,800 AND WHEN THE NEXT SLIDE PLEASE, 2281 01:24:20,800 --> 01:24:23,200 WHEN THE BOND-KIDS INITIATIVE OF 2282 01:24:23,200 --> 01:24:25,160 NIH WAS LAUNCHED AND STARTED 2283 01:24:25,160 --> 01:24:27,120 LOOKING AT THE DATA, THEIR 2284 01:24:27,120 --> 01:24:28,560 WORKING GROUP 1 FOCUSED ON 2285 01:24:28,560 --> 01:24:34,000 BIOLOGY CAME UP WITH SOME OF 2286 01:24:34,000 --> 01:24:35,200 THESE RESULTS, ASSEMBLED SOME 2287 01:24:35,200 --> 01:24:36,480 IMPORTANT INDICATORS HERE. 2288 01:24:36,480 --> 01:24:41,320 SO, LET'S LOOK AT THIS GRAPH, 2289 01:24:41,320 --> 01:24:45,000 TOTAL ENERGY EXPENDITURE BY AGE, 2290 01:24:45,000 --> 01:24:45,800 ISOTOPIC MEASURES, SO THAT'S THE 2291 01:24:45,800 --> 01:24:47,760 FIRST TIME WE'VE BEEN ABLE TO 2292 01:24:47,760 --> 01:24:50,760 LOOK AT HUNDREDS OF THOUSANDS OF 2293 01:24:50,760 --> 01:24:52,480 PEOPLE IN TERMS OF ENERGY 2294 01:24:52,480 --> 01:24:53,200 EXPENDITURE. 2295 01:24:53,200 --> 01:24:55,120 REALLY LOOK ACROSS AN AGE RANGE. 2296 01:24:55,120 --> 01:24:57,840 WHAT WE SEE, WE SEE BETWEEN 20 2297 01:24:57,840 --> 01:25:02,880 AND 60 YEARS OF AGE, NOMINAL 2298 01:25:02,880 --> 01:25:06,960 WORKING ADULT AGE RANGE, STABLE 2299 01:25:06,960 --> 01:25:08,360 LEVELS OF ENERGY EXPENDITURE. 2300 01:25:08,360 --> 01:25:11,760 THEY CONTINUE PRETTY WELL AFTER 2301 01:25:11,760 --> 01:25:12,400 62. 2302 01:25:12,400 --> 01:25:15,160 UP TO THAT 20, WE CAN SEE THE 2303 01:25:15,160 --> 01:25:17,320 PICTURE IS NOT HOW WE TENDED TO 2304 01:25:17,320 --> 01:25:18,560 THINK OF IT IN NUTRITION. 2305 01:25:18,560 --> 01:25:20,760 WE SEE THIS PEAK VERY EARLY ON 2306 01:25:20,760 --> 01:25:22,600 IN THE FIRST THOUSAND DAYS BUT 2307 01:25:22,600 --> 01:25:26,200 WE CAN ALSO SEE THAT ENERGY 2308 01:25:26,200 --> 01:25:28,000 DEMANDS REMAINED HIGH THROUGHOUT 2309 01:25:28,000 --> 01:25:30,040 INTO THE 20s. 2310 01:25:30,040 --> 01:25:31,880 SO, MESSAGE THEN, THE FIRST 2311 01:25:31,880 --> 01:25:33,120 THOUSAND DAYS VERY IMPORTANT 2312 01:25:33,120 --> 01:25:33,440 NUTRITIONALLY. 2313 01:25:33,440 --> 01:25:35,200 WE KNOW ALL THAT. 2314 01:25:35,200 --> 01:25:36,600 THAT'S AN OLD STORY. 2315 01:25:36,600 --> 01:25:38,280 BUT NOW WE'RE SEEING SOMETHING 2316 01:25:38,280 --> 01:25:40,840 MORE IMPORTANT HAPPENING THAT WE 2317 01:25:40,840 --> 01:25:43,080 SEE THE NEXT 7,000 DAYS, SCHOOL 2318 01:25:43,080 --> 01:25:47,520 AGE AND ADOLESCENTS, ALSO 2319 01:25:47,520 --> 01:25:49,920 IMPORTANT NUTRITIONALLY. 2320 01:25:49,920 --> 01:25:54,440 THE BOND-KIDS PROJECT IN FACT IS 2321 01:25:54,440 --> 01:25:57,080 MAKING THAT A SPECIFIC MESSAGE 2322 01:25:57,080 --> 01:25:59,800 OF A DIFFERENT WAY OF THINKING 2323 01:25:59,800 --> 01:26:02,120 OF THE DEMOGRAPHICS OF 2324 01:26:02,120 --> 01:26:02,840 POPULATIONS FROM A NUTRITIONAL 2325 01:26:02,840 --> 01:26:03,240 PERSPECTIVE. 2326 01:26:03,240 --> 01:26:07,120 AND IF I HAVE THE NEXT SLIDE 2327 01:26:07,120 --> 01:26:08,880 PLEASE, THIS IMPLIES THINKING IN 2328 01:26:08,880 --> 01:26:09,840 TERMS OF INTERVENTIONS FIRST 2329 01:26:09,840 --> 01:26:17,440 THOUSAND DAYS WE'RE USED TO THAT 2330 01:26:17,440 --> 01:26:18,960 MATERNAL INTRAUTERINE, INFANT 2331 01:26:18,960 --> 01:26:19,720 DEVELOPMENT, ALL INTERVENTIONS 2332 01:26:19,720 --> 01:26:21,920 REQUIRED THERE, BUT WE'RE ALSO 2333 01:26:21,920 --> 01:26:23,480 NOW SAYING THAT THOSE 2334 01:26:23,480 --> 01:26:26,400 INVESTMENTS NEED TO ALSO 2335 01:26:26,400 --> 01:26:28,600 CONTINUE THROUGH THE NEXT 7,000 2336 01:26:28,600 --> 01:26:30,360 DAYS, TO MAINTAIN THOSE EARLY 2337 01:26:30,360 --> 01:26:33,400 GAINS, TO ALLOW FOR CATCH-UP, 2338 01:26:33,400 --> 01:26:37,000 ALSO TO SUPPORT CHILDREN DURING 2339 01:26:37,000 --> 01:26:38,800 VULNERABLE PHASES OF, FOR 2340 01:26:38,800 --> 01:26:39,960 EXAMPLE, BRAIN DEVELOPMENT 2341 01:26:39,960 --> 01:26:40,960 DURING ADOLESCENCE. 2342 01:26:40,960 --> 01:26:43,880 CERTAINLY ALSO THE VULNERABLE 2343 01:26:43,880 --> 01:26:45,560 PHASES DURING PUBERTY. 2344 01:26:45,560 --> 01:26:48,080 BUT THE BIG MESSAGE, THE BIG 2345 01:26:48,080 --> 01:26:50,560 MESSAGE HERE IS THE NEED TO 2346 01:26:50,560 --> 01:26:52,880 SUPPORT CHILDREN THROUGHOUT THE 2347 01:26:52,880 --> 01:26:57,720 FIRST 8,000 DAYS OF THEIR LIFE. 2348 01:26:57,720 --> 01:26:59,480 AND WE RECOGNIZE, IF WE TAKE A 2349 01:26:59,480 --> 01:27:03,320 STAND BACK AND TAKE A VIEW 2350 01:27:03,320 --> 01:27:04,040 BEYOND NUTRITION, THOSE NEXT 2351 01:27:04,040 --> 01:27:06,600 7,000 DAYS OF SCHOOL AGE AND 2352 01:27:06,600 --> 01:27:09,400 ADOLESCENT DAYS ARE AGES WHEN WE 2353 01:27:09,400 --> 01:27:12,040 TEACH OUR CHILDREN. 2354 01:27:12,040 --> 01:27:14,560 THAT'S WHEN CHILDREN, WE INVEST 2355 01:27:14,560 --> 01:27:17,520 IN THE EDUCATION OF SCHOOL AGE 2356 01:27:17,520 --> 01:27:18,920 CHILDREN AND ADOLESCENTS, 2357 01:27:18,920 --> 01:27:22,520 LEADING INTO ADULTHOOD. 2358 01:27:22,520 --> 01:27:23,960 WHEN COUNTRY CREATES HUMAN 2359 01:27:23,960 --> 01:27:25,160 CAPITAL IT'S INVESTING HEAVILY 2360 01:27:25,160 --> 01:27:26,920 IN EDUCATION DURING THAT PHASE 2361 01:27:26,920 --> 01:27:28,680 AND WHAT WE'RE ARGUING NOW THAT 2362 01:27:28,680 --> 01:27:31,120 THERE NEEDS TO BE EQUIVALENT 2363 01:27:31,120 --> 01:27:32,760 INVESTMENT IN THE WELL-BEING OF 2364 01:27:32,760 --> 01:27:36,280 CHILDREN DURING THOSE AGES WHEN 2365 01:27:36,280 --> 01:27:36,760 THEY ARE BEING EDUCATED. 2366 01:27:36,760 --> 01:27:40,200 SO IF I COULD HAVE THE NEXT 2367 01:27:40,200 --> 01:27:45,400 SLIDE AND THE NEXT ONE PLEASE. 2368 01:27:45,400 --> 01:27:46,440 NEXT SLIDE. 2369 01:27:46,440 --> 01:27:48,320 AND THE MESSAGE THAT I 2370 01:27:48,320 --> 01:27:49,760 PARTICULARLY THEN WANT TO TALK 2371 01:27:49,760 --> 01:27:53,960 ABOUT IS WHAT ARE COUNTRIES 2372 01:27:53,960 --> 01:27:55,280 DOING DURING THOSE 7,000 DAYS, 2373 01:27:55,280 --> 01:27:57,080 THE NEXT 7,000 DAYS. 2374 01:27:57,080 --> 01:28:00,280 THE ANSWER IS THAT SCHOOL HEALTH 2375 01:28:00,280 --> 01:28:02,320 AND NUTRITION PROGRAMS ARE IN 2376 01:28:02,320 --> 01:28:04,400 PLACE, AND IN PARTICULAR SCHOOL 2377 01:28:04,400 --> 01:28:05,760 MEALS PROGRAMS ARE IN PLACE. 2378 01:28:05,760 --> 01:28:10,680 IF WE LOOK AT THE GRAPH ON THE 2379 01:28:10,680 --> 01:28:12,400 LEFT HERE, JANUARY 2020, THIS IS 2380 01:28:12,400 --> 01:28:14,520 JUST -- THESE ARE DATA FROM 2381 01:28:14,520 --> 01:28:16,920 BEFORE THE COVID PANDEMIC, SOME 2382 01:28:16,920 --> 01:28:19,760 388 MILLION SCHOOL CHILDREN WERE 2383 01:28:19,760 --> 01:28:22,960 BEING FED EVERY DAY, AT SCHOOL. 2384 01:28:22,960 --> 01:28:25,360 THAT'S APPROXIMATELY 1 IN 2 OF 2385 01:28:25,360 --> 01:28:26,760 ALL PRIMARY SCHOOL CHILDREN WERE 2386 01:28:26,760 --> 01:28:28,840 BEING FED. 2387 01:28:28,840 --> 01:28:31,560 AND SOMEWHERE OVER 95% OF THOSE 2388 01:28:31,560 --> 01:28:34,000 CHILDREN WERE ALSO RECEIVING 2389 01:28:34,000 --> 01:28:34,920 HEALTH INTERVENTIONS, MANY OF 2390 01:28:34,920 --> 01:28:37,520 THEM WERE OF COURSE 2391 01:28:37,520 --> 01:28:38,360 NUTRITIONALLY SENSITIVE LIKE 2392 01:28:38,360 --> 01:28:41,560 DEWORMING, FOR EXAMPLE. 2393 01:28:41,560 --> 01:28:45,160 SO, A VERY SUBSTANTIAL COVERAGE 2394 01:28:45,160 --> 01:28:47,680 WORLDWIDE OF INVESTMENT IN 2395 01:28:47,680 --> 01:28:49,720 CHILDREN IN THOSE EARLY -- IN 2396 01:28:49,720 --> 01:28:50,960 THE NEXT 7,000 DAYS. 2397 01:28:50,960 --> 01:28:55,560 AND IF I CAN GO TO THE PREVIOUS 2398 01:28:55,560 --> 01:28:57,640 SLIDE PLEASE, WHAT WE SEE HERE 2399 01:28:57,640 --> 01:28:59,840 IS WHO IS PAYING FOR THESE 2400 01:28:59,840 --> 01:29:00,400 INTERVENTIONS. 2401 01:29:00,400 --> 01:29:02,040 THIS IS QUITE STRIKING. 2402 01:29:02,040 --> 01:29:04,440 SO THAT IN HISTOGRAM ON THE LEFT 2403 01:29:04,440 --> 01:29:07,840 WE CAN SEE THAT OVER THE LAST 10 2404 01:29:07,840 --> 01:29:09,720 YEARS THERE'S BEEN ACTUALLY A 2405 01:29:09,720 --> 01:29:11,240 SUSTAINED GROWTH IN THESE 2406 01:29:11,240 --> 01:29:11,760 PROGRAMS. 2407 01:29:11,760 --> 01:29:13,840 BUT THROUGHOUT THAT PERIOD, MORE 2408 01:29:13,840 --> 01:29:17,480 THAN 98% OF THE COSTS HAVE BEEN 2409 01:29:17,480 --> 01:29:19,680 MET FROM DOMESTIC FUNDS. 2410 01:29:19,680 --> 01:29:21,000 THE OTHER HISTOGRAMS SHOW IT'S 2411 01:29:21,000 --> 01:29:23,400 ONLY REALLY IN THE LOWEST INCOME 2412 01:29:23,400 --> 01:29:24,400 COUNTRIES THAT THERE'S RELIANCE 2413 01:29:24,400 --> 01:29:25,920 ON EXTERNAL FUNDS FOR THESE 2414 01:29:25,920 --> 01:29:26,200 PROGRAMS. 2415 01:29:26,200 --> 01:29:29,000 MOST OF THE SCHOOL MEALS AND 2416 01:29:29,000 --> 01:29:31,920 SCHOOL HEALTH PROGRAMS ARE 2417 01:29:31,920 --> 01:29:33,280 DOMESTICALLY FUNDED. 2418 01:29:33,280 --> 01:29:35,880 AND THE HISTOGRAM -- SORRY, THE 2419 01:29:35,880 --> 01:29:38,400 PIECHART ON THE RIGHT SHOWS IT'S 2420 01:29:38,400 --> 01:29:41,120 AN INDUSTRY THAT'S WORTH 2421 01:29:41,120 --> 01:29:44,960 SOMETHING LIKE $40 BILLION A 2422 01:29:44,960 --> 01:29:47,360 YEAR, BUT ONLY ABOUT .$3 BILLION 2423 01:29:47,360 --> 01:29:48,560 COMES FROM EXTERNAL SOURCES. 2424 01:29:48,560 --> 01:29:50,560 THIS IS OFTEN A SURPRISE TO HOW 2425 01:29:50,560 --> 01:29:53,080 PEOPLE THINK THAT SCHOOL MEALS 2426 01:29:53,080 --> 01:29:56,160 PROGRAMS WORK GLOBALLY. 2427 01:29:56,160 --> 01:29:57,800 THEIR ESSENTIALLY DOMESTICALLY 2428 01:29:57,800 --> 01:29:59,640 FUNDED GOVERNMENT-LED PROGRAMS. 2429 01:29:59,640 --> 01:30:02,840 GO BACK TO THE -- THANK YOU VERY 2430 01:30:02,840 --> 01:30:03,280 MUCH. 2431 01:30:03,280 --> 01:30:04,600 JANUARY 2020, MORE CHILDREN 2432 01:30:04,600 --> 01:30:08,000 LOOKED AFTER THROUGH THEIR 2433 01:30:08,000 --> 01:30:09,400 SCHOOL SYSTEMS MORE CHILDREN IN 2434 01:30:09,400 --> 01:30:11,680 THE 7,000 DAYS AREA THAN EVER IN 2435 01:30:11,680 --> 01:30:15,240 THE HISTORY OF THE WORLD. 2436 01:30:15,240 --> 01:30:17,120 THEN BY APRIL 2020, WITH THE 2437 01:30:17,120 --> 01:30:18,960 ARRIVAL OF COVID, THE DECISION 2438 01:30:18,960 --> 01:30:23,560 WAS MADE TO CLOSE SCHOOLS 2439 01:30:23,560 --> 01:30:26,520 WORLDWIDE. 2440 01:30:26,520 --> 01:30:28,960 SO 199 COUNTRIES CLOSED SCHOOLS 2441 01:30:28,960 --> 01:30:29,840 WITH CATASTROPHIC CONSEQUENCES 2442 01:30:29,840 --> 01:30:30,720 FOR THE CHILDREN. 2443 01:30:30,720 --> 01:30:34,400 OVERNIGHT OF COURSE THEY LOST 2444 01:30:34,400 --> 01:30:37,240 THE ACCESS TO EDUCATION IN SOME 2445 01:30:37,240 --> 01:30:37,920 COUNTRIES, RICHER COUNTRIES THAT 2446 01:30:37,920 --> 01:30:40,200 WASN'T MUCH OF A CHALLENGE 2447 01:30:40,200 --> 01:30:41,280 BECAUSE THERE WERE OPPORTUNITIES 2448 01:30:41,280 --> 01:30:41,520 ONLINE. 2449 01:30:41,520 --> 01:30:43,160 NOT TOO MUCH OF A CHALLENGE, BUT 2450 01:30:43,160 --> 01:30:48,960 OF COURSE IN OUR RICH COUNTRIES 2451 01:30:48,960 --> 01:30:52,160 WE'VE HEARD NOTHING -- ABOUT 2452 01:30:52,160 --> 01:30:55,320 NOTHING MORE THAN DAMAGE DOWN TO 2453 01:30:55,320 --> 01:30:56,760 OUR -- DONE TO OUR CHILDREN 2454 01:30:56,760 --> 01:30:57,920 DAMAGED BY THAT PROCESS. 2455 01:30:57,920 --> 01:31:01,800 IMAGINE THE REST OF THE WORLD, 2456 01:31:01,800 --> 01:31:04,560 FOR EXAMPLE IN AFRICA 10% OF 2457 01:31:04,560 --> 01:31:06,080 CHILDREN HAVE ACCESS TO ONLINE 2458 01:31:06,080 --> 01:31:07,080 EDUCATION. 2459 01:31:07,080 --> 01:31:09,000 IN SOME COUNTRIES WE'RE SEEING 2460 01:31:09,000 --> 01:31:11,360 THE SCHOOLS REMAINED CLOSED FOR 2461 01:31:11,360 --> 01:31:12,880 3 YEARS, ONLY JUST NOW BEGINNING 2462 01:31:12,880 --> 01:31:16,360 TO OPEN. 2463 01:31:16,360 --> 01:31:18,760 SO WE'VE SEEN DISASTROUS 2464 01:31:18,760 --> 01:31:20,520 CONSEQUENCES OF PARTICULARLY 2465 01:31:20,520 --> 01:31:22,720 SCHOOL GIRLS, BECOMING FIRST 2466 01:31:22,720 --> 01:31:24,040 WIVES, SCHOOL GIRLS ALSO 2467 01:31:24,040 --> 01:31:27,000 BECOMING MOTHERS, SCHOOL BOYS 2468 01:31:27,000 --> 01:31:30,960 BECOMING LABOR, SO ON. 2469 01:31:30,960 --> 01:31:33,040 IT'S BEEN -- ALL THE LAST THREE 2470 01:31:33,040 --> 01:31:34,800 SOCIAL CONSEQUENCES HAVE PROVEN 2471 01:31:34,800 --> 01:31:36,640 LARGELY IRREVERSIBLE, MOST OF 2472 01:31:36,640 --> 01:31:38,040 THOSE CHILDREN HAVE NEVER GONE 2473 01:31:38,040 --> 01:31:41,800 BACK TO SCHOOL. 2474 01:31:41,800 --> 01:31:43,320 SO, WE SEE THIS CONSEQUENCE. 2475 01:31:43,320 --> 01:31:45,840 WE THEN SAW A VERY STRONG 2476 01:31:45,840 --> 01:31:46,720 REACTION FROM THE COUNTRIES. 2477 01:31:46,720 --> 01:31:49,120 NEXT SLIDE PLEASE. 2478 01:31:49,120 --> 01:31:50,680 WE SAW COUNTRIES COMING FORWARD 2479 01:31:50,680 --> 01:31:52,960 TO REACT TO THIS. 2480 01:31:52,960 --> 01:31:55,040 SO JUST SOME EXAMPLES HERE, 2481 01:31:55,040 --> 01:31:57,040 FINLAND, WHICH DIDN'T CLOSE ITS 2482 01:31:57,040 --> 01:32:00,320 SCHOOLS, AND WHICH HAS RELIED ON 2483 01:32:00,320 --> 01:32:01,600 UNIVERSAL SCHOOL FEEDING 2484 01:32:01,600 --> 01:32:02,720 PROGRAMS FOR THE LAST 75 YEARS 2485 01:32:02,720 --> 01:32:04,240 SINCE THE SECOND WORLD WAR AND 2486 01:32:04,240 --> 01:32:08,520 SEES THEM AS THE KEY FACTOR IN 2487 01:32:08,520 --> 01:32:11,040 ITS INTERNATIONAL DEVELOPMENT, 2488 01:32:11,040 --> 01:32:13,240 HAS LOBBIED STRONGLY FOR 2489 01:32:13,240 --> 01:32:15,600 REBUILDING OF THESE PROGRAMS. 2490 01:32:15,600 --> 01:32:19,520 BUT TWO EXAMPLES FURTHER OVER, 2491 01:32:19,520 --> 01:32:23,040 EMMANUEL MACRON FROM FRANCE AND 2492 01:32:23,040 --> 01:32:25,760 PRESIDENT PAUL KAGAMA FROM 2493 01:32:25,760 --> 01:32:26,800 RWANDA, ESSENTIALLY TWEETING THE 2494 01:32:26,800 --> 01:32:28,720 SAME MESSAGE THAT THIS IS A 2495 01:32:28,720 --> 01:32:30,520 REALLY IMPORTANT ISSUE THAT 2496 01:32:30,520 --> 01:32:32,720 LOOKING A OUR SCHOOL CHILDREN, 2497 01:32:32,720 --> 01:32:34,680 THE WELL-BEING OF OUR SCHOOL 2498 01:32:34,680 --> 01:32:37,600 CHILDREN IS CRUCIAL TO THE 2499 01:32:37,600 --> 01:32:38,600 DEVELOPMENT OF THE NATIONS. 2500 01:32:38,600 --> 01:32:41,840 IF I HAVE THE NEXT SLIDE PLEASE, 2501 01:32:41,840 --> 01:32:44,200 THE REACTION TO THIS HAS BEEN 2502 01:32:44,200 --> 01:32:46,680 CREATION OF A SCHOOL MEALS 2503 01:32:46,680 --> 01:32:47,880 COALITION, SCHOOL MEALS 2504 01:32:47,880 --> 01:32:49,240 COALITION BUT REALLY ABOUT 2505 01:32:49,240 --> 01:32:51,400 SCHOOL HEALTH AND NUTRITION. 2506 01:32:51,400 --> 01:32:53,680 BUT MEALS THE MOST VISIBLE 2507 01:32:53,680 --> 01:32:56,760 ASPECT OF THIS. 2508 01:32:56,760 --> 01:32:58,720 78 COUNTRIES REPRESENTING 55% OF 2509 01:32:58,720 --> 01:33:00,840 GLOBAL POPULATION HAVE JOINED 2510 01:33:00,840 --> 01:33:01,720 THE SCHOOL MEALS COALITION AT 2511 01:33:01,720 --> 01:33:04,160 THE LEVEL OF HEAD OF STATE OR 2512 01:33:04,160 --> 01:33:06,960 PRIME MINISTER, SO HAS BEEN A 2513 01:33:06,960 --> 01:33:08,720 STRONG DRIVING FORCE. 2514 01:33:08,720 --> 01:33:12,120 NEXT SLIDE PLEASE. 2515 01:33:12,120 --> 01:33:13,400 AND THIS AGGREGATION OF 78 2516 01:33:13,400 --> 01:33:14,520 COUNTRIES HAS HAPPENED IN LESS 2517 01:33:14,520 --> 01:33:15,520 THAN A YEAR. 2518 01:33:15,520 --> 01:33:19,880 I JUST WANT TO CONTRAST THAT 2519 01:33:19,880 --> 01:33:23,680 WITH SCALING UP NUTRITION, SUN, 2520 01:33:23,680 --> 01:33:27,760 SUPPORTING 65 COUNTRIES AFTER 12 2521 01:33:27,760 --> 01:33:29,280 YEARS, OR GLOBAL FINANCING 75 2522 01:33:29,280 --> 01:33:32,000 COUNTRIES OVER SEVEN YEARS. 2523 01:33:32,000 --> 01:33:37,160 THE COALITION DEVELOPED ITS OWN 2524 01:33:37,160 --> 01:33:38,680 INTERNAL MOMENTUM. 2525 01:33:38,680 --> 01:33:40,760 IT'S ALSO STAKEHOLDERS THAT HAVE 2526 01:33:40,760 --> 01:33:43,360 GOT BEHIND THIS AND ARE 2527 01:33:43,360 --> 01:33:44,480 SUPPORTING THIS AGENDA. 2528 01:33:44,480 --> 01:33:47,560 IF I COULD -- YES, THE GOALS OF 2529 01:33:47,560 --> 01:33:49,840 THE COALITION ARE VERY CLEAR. 2530 01:33:49,840 --> 01:33:51,920 FIRST GOAL IS TO RESTORE THE 2531 01:33:51,920 --> 01:33:55,440 COVERAGE THAT THERE WAS IN 2020 2532 01:33:55,440 --> 01:33:57,840 TO RESTORE IT BEFORE 2023. 2533 01:33:57,840 --> 01:33:58,720 SECONDLY, REACH THE 73 MILLION 2534 01:33:58,720 --> 01:34:00,480 CHILDREN WHO WERE NOT EVEN 2535 01:34:00,480 --> 01:34:02,240 REACHED IN 2020. 2536 01:34:02,240 --> 01:34:03,920 AND FINALLY, TO RAISE THE 2537 01:34:03,920 --> 01:34:05,640 QUALITY OF SCHOOL HEALTH AND 2538 01:34:05,640 --> 01:34:06,720 NUTRITION PROGRAMS. 2539 01:34:06,720 --> 01:34:09,320 HERE'S THE ISSUE WHERE BOND-KIDS 2540 01:34:09,320 --> 01:34:11,400 AND I WOULD SUGGEST ADVANTAGE 2541 01:34:11,400 --> 01:34:15,400 CAN REALLY PLAY AN IMPORTANT 2542 01:34:15,400 --> 01:34:17,960 ROLE IN ADDRESSING WHAT ARE THE 2543 01:34:17,960 --> 01:34:19,880 KEY COMPONENTS. 2544 01:34:19,880 --> 01:34:23,240 WELL, THE NEXT DEVELOPMENT FROM 2545 01:34:23,240 --> 01:34:25,200 THE SCHOOL MEALS COALITION WAS 2546 01:34:25,200 --> 01:34:26,960 TO DEVELOP A RESEARCH CONSORTIUM 2547 01:34:26,960 --> 01:34:28,480 TO TAKE THESE IDEAS FORWARD. 2548 01:34:28,480 --> 01:34:31,440 SO LET'S HEAR FROM GORDON BROWN 2549 01:34:31,440 --> 01:34:37,680 ABOUT THIS ONE. 2550 01:34:37,680 --> 01:34:44,360 WE'RE NOT HEARING SOUND I THINK. 2551 01:34:44,360 --> 01:34:47,080 THE RESEARCH CONSORTIUM -- 2552 01:34:47,080 --> 01:34:48,080 SORRY, RESEARCH COALITION, 2553 01:34:48,080 --> 01:34:48,960 SCHOOL MEALS COALITION, 2554 01:34:48,960 --> 01:34:52,400 DETERMINED ITS FIRST ACTION 2555 01:34:52,400 --> 01:34:55,000 SHOULD BE TO INITIATE A RESEARCH 2556 01:34:55,000 --> 01:34:55,400 CONSORTIUM. 2557 01:34:55,400 --> 01:35:00,680 IS THE SOUND WORKING NOW? 2558 01:35:00,680 --> 01:35:01,880 >>A SACRED INJUNCTION IN EVERY 2559 01:35:01,880 --> 01:35:02,440 RELIGIOUS FAITH. 2560 01:35:02,440 --> 01:35:03,840 IF WE'RE TO BE THE FIRST 2561 01:35:03,840 --> 01:35:06,160 GENERATION IN HISTORY TO ACHIEVE 2562 01:35:06,160 --> 01:35:08,880 TWO GREAT HUMANITARIAN GOALS, 2563 01:35:08,880 --> 01:35:09,560 ENDING EXTREME POVERTY, GETTING 2564 01:35:09,560 --> 01:35:12,400 EVERY CHILD INTO SCHOOL AND 2565 01:35:12,400 --> 01:35:13,840 LEARNING, THEN EVERY SINGLE 2566 01:35:13,840 --> 01:35:15,720 CHILD MUST HAVE THE OPPORTUNITY 2567 01:35:15,720 --> 01:35:17,040 TO ACCESS WHAT IS PERHAPS THE 2568 01:35:17,040 --> 01:35:18,440 MOST IMPACTFUL AND EFFECTIVE 2569 01:35:18,440 --> 01:35:20,960 SAFETY NET TO SUPPORT CHILDREN, 2570 01:35:20,960 --> 01:35:25,440 HEALTHY MEALS EVERY DAY IN 2571 01:35:25,440 --> 01:35:28,600 SCHOOL. 2572 01:35:28,600 --> 01:35:31,640 IN LOW- AND MIDDLE-INCOME 2573 01:35:31,640 --> 01:35:33,200 COUNTRIES EVERY DOLLAR YIELDS 2574 01:35:33,200 --> 01:35:34,240 NINE DOLLARS IN RETURNS. 2575 01:35:34,240 --> 01:35:36,840 SINCE THE START OF THE PANDEMIC, 2576 01:35:36,840 --> 01:35:41,720 MORE THAN 39 BILLION IN-SCHOOL 2577 01:35:41,720 --> 01:35:43,800 MEALS HAVE BEEN MISSED, 379 2578 01:35:43,800 --> 01:35:45,240 MILLION CHILDREN HAVE BEEN 2579 01:35:45,240 --> 01:35:46,520 SUDDENLY DEPRIVED OF THE MAIN 2580 01:35:46,520 --> 01:35:48,600 AND SOMETIMES ONLY MEAL OF THE 2581 01:35:48,600 --> 01:35:50,720 DAY, A SILENT TRAGEDY FOR 2582 01:35:50,720 --> 01:35:51,680 CHILDREN'S NUTRITION THAT WILL 2583 01:35:51,680 --> 01:35:53,960 COME BACK TO HAUNT US. 2584 01:35:53,960 --> 01:35:56,320 EVEN BEFORE THE PANDEMIC, 2585 01:35:56,320 --> 01:35:58,400 DESPITE 388 MILLION STUDENTS 2586 01:35:58,400 --> 01:36:00,560 RECEIVING MEALS IN 161 2587 01:36:00,560 --> 01:36:01,760 COUNTRIES, 73 MILLION OF THE 2588 01:36:01,760 --> 01:36:05,480 MOST VULNERABLE GIRLS AND BOYS 2589 01:36:05,480 --> 01:36:07,680 IN 60 LOWER INCOME COUNTRIES 2590 01:36:07,680 --> 01:36:09,320 WERE NOT REACHED. 2591 01:36:09,320 --> 01:36:12,280 TO REPAIR THIS WE NEED TO 2592 01:36:12,280 --> 01:36:15,000 MOBILIZE $2 BILLION IN AID, 2593 01:36:15,000 --> 01:36:17,640 RESTORE PROGRAMS FOR CHILDREN BY 2594 01:36:17,640 --> 01:36:19,800 2022 AND ENSURE THE 73 MILLION 2595 01:36:19,800 --> 01:36:21,480 ADDITIONAL CHILDREN LEFT OUT ARE 2596 01:36:21,480 --> 01:36:22,320 NOW FED. 2597 01:36:22,320 --> 01:36:25,160 WE WILL NEED THE SUPPORT OF THE 2598 01:36:25,160 --> 01:36:26,400 GLOBAL COALITION FOR SCHOOL 2599 01:36:26,400 --> 01:36:28,040 FEEDING AS IT BRINGS TOGETHER 2600 01:36:28,040 --> 01:36:34,520 ALL WHO CAN CONTRIBUTE AND NEW 2601 01:36:34,520 --> 01:36:36,680 RESEARCH CONSORTIUM WILL BE 2602 01:36:36,680 --> 01:36:37,880 WORKING WITH DEDICATED TASK 2603 01:36:37,880 --> 01:36:39,440 FORCE UNDER THE EDUCATION FORUM 2604 01:36:39,440 --> 01:36:42,920 I CO-CHAIR, AND IT WILL MAP THE 2605 01:36:42,920 --> 01:36:44,040 AVAILABLE GLOBAL FINANCING FOR 2606 01:36:44,040 --> 01:36:46,080 HEALTH PROGRAMS AND WILL DEVELOP 2607 01:36:46,080 --> 01:36:48,720 A FINANCING AND DELIVERY PLAN SO 2608 01:36:48,720 --> 01:36:50,480 THAT INSTEAD OF DEVELOPING ONLY 2609 01:36:50,480 --> 01:36:52,600 SOME POTENTIAL OF SOME CHILDREN 2610 01:36:52,600 --> 01:36:54,320 IN SOME COUNTRIES, WE NURTURE 2611 01:36:54,320 --> 01:36:57,120 AND FEED ALL OF THE POTENTIAL OF 2612 01:36:57,120 --> 01:37:02,880 ALL CHILDREN IN ALL COUNTRIES. 2613 01:37:02,880 --> 01:37:05,400 >>SO THAT'S GORDON BROWN, 2614 01:37:05,400 --> 01:37:07,000 EX-PRIME MINISTER OF THE U.K. 2615 01:37:07,000 --> 01:37:12,040 ALSO SPEAKING THERE AS THE 2616 01:37:12,040 --> 01:37:13,800 CO-CHAIR OF THE GLOBAL EDUCATION 2617 01:37:13,800 --> 01:37:14,080 COMMISSION. 2618 01:37:14,080 --> 01:37:16,960 THE POINT I WANT TO EMPHASIZE 2619 01:37:16,960 --> 01:37:19,480 HERE, THIS IS THE EDUCATION 2620 01:37:19,480 --> 01:37:23,440 WORLD ALSO RECOGNIZING THE 2621 01:37:23,440 --> 01:37:25,160 IMPORTANCE OF WELL-BEING IN 2622 01:37:25,160 --> 01:37:28,920 SCHOOL AGE CHILDREN AND 2623 01:37:28,920 --> 01:37:30,480 ADOLESCENTS, CRITICALITY FOR 2624 01:37:30,480 --> 01:37:30,760 DEVELOPMENT. 2625 01:37:30,760 --> 01:37:33,560 AS HE SAID, THE PURPOSE OF THIS 2626 01:37:33,560 --> 01:37:35,000 LAUNCH THAT HE WAS DISCUSSING 2627 01:37:35,000 --> 01:37:39,760 WAS THE CREATION OF THE RESEARCH 2628 01:37:39,760 --> 01:37:40,080 SIDE. 2629 01:37:40,080 --> 01:37:44,200 AND THE AFRICAN UNION 2630 01:37:44,200 --> 01:37:47,000 DEVELOPMENT AGENCY WORKED WITH 2631 01:37:47,000 --> 01:37:52,120 US TO CREATE THIS NEW RESEARCH 2632 01:37:52,120 --> 01:37:52,440 CONSORTIUM. 2633 01:37:52,440 --> 01:37:53,240 NEXT SLIDE PLEASE. 2634 01:37:53,240 --> 01:37:54,720 AND THE GOAL OF THE CONSORTIUM, 2635 01:37:54,720 --> 01:37:56,640 THIS IS WHERE WE START TO COME 2636 01:37:56,640 --> 01:38:00,200 BACK TO OUR CLIMATE ISSUES, WAS 2637 01:38:00,200 --> 01:38:02,200 TO GENERATE EVIDENCE ON THE 2638 01:38:02,200 --> 01:38:04,280 VALUE OF SCHOOL MEALS, SCHOOL 2639 01:38:04,280 --> 01:38:08,440 HEALTH AND NUTRITION, AND TO DO 2640 01:38:08,440 --> 01:38:11,120 THAT FOR THE POLICYMAKERS AND 2641 01:38:11,120 --> 01:38:13,480 PARLIAMENTARIANS FROM THE 78 2642 01:38:13,480 --> 01:38:14,880 COUNTRIES THAT SUPPORT THE 2643 01:38:14,880 --> 01:38:16,200 SCHOOL MEALS COALITION. 2644 01:38:16,200 --> 01:38:21,040 SO THIS IS VERY MUCH RESEARCH 2645 01:38:21,040 --> 01:38:23,560 FOR A PURPOSE, MISSION-DRIVEN 2646 01:38:23,560 --> 01:38:25,320 RESEARCH. 2647 01:38:25,320 --> 01:38:26,520 NEXT SLIDE PLEASE. 2648 01:38:26,520 --> 01:38:29,680 THIS IS THE STRUCTURE OF THE 2649 01:38:29,680 --> 01:38:30,760 RESEARCH CONSORTIUM. 2650 01:38:30,760 --> 01:38:32,120 SO THE BOSS , THE LEADERSHIP OF 2651 01:38:32,120 --> 01:38:35,920 ALL OF THIS, IS THE 78 NATIONAL 2652 01:38:35,920 --> 01:38:36,200 GOVERNMENTS. 2653 01:38:36,200 --> 01:38:38,480 A SMALL SECRETARIAT SET UP IN 2654 01:38:38,480 --> 01:38:42,760 LONDON AT THE LONDON SCHOOL OF 2655 01:38:42,760 --> 01:38:44,680 HYGIENE AND TROPICAL MEDICINE, 2656 01:38:44,680 --> 01:38:47,280 HELPS COORDINATE THE REAL POWER 2657 01:38:47,280 --> 01:38:49,280 IN THE RESEARCH CONSORTIUM, A 2658 01:38:49,280 --> 01:38:51,160 SERIES OF COMMUNITIES OF 2659 01:38:51,160 --> 01:38:54,880 PRACTICE ADDRESSING A RANGE OF 2660 01:38:54,880 --> 01:38:56,440 TOPICS, SIX OF THEM LINED UP 2661 01:38:56,440 --> 01:38:56,720 THERE. 2662 01:38:56,720 --> 01:38:59,480 LET ME BRIEFLY MENTION THE NEXT 2663 01:38:59,480 --> 01:39:02,960 SLIDE WHAT THOSE CONSORTIA -- 2664 01:39:02,960 --> 01:39:03,920 WHAT THOSE RESEARCH GROUPS ARE 2665 01:39:03,920 --> 01:39:05,720 CONCERNED ARE. 2666 01:39:05,720 --> 01:39:09,640 THESE ARE THE COMMUNITIES OF 2667 01:39:09,640 --> 01:39:11,280 PRACTICE. 2668 01:39:11,280 --> 01:39:12,480 IMPACTING EVIDENCE, UNDERTAKING 2669 01:39:12,480 --> 01:39:14,760 SYSTEMATIC REVIEWS OF THIS 2670 01:39:14,760 --> 01:39:15,400 PROCESS, IT'S WORTH EMPHASIZING 2671 01:39:15,400 --> 01:39:17,000 EACH OF THE COMMUNITIES OF 2672 01:39:17,000 --> 01:39:19,480 PRACTICE IS GLOBAL IN ITS 2673 01:39:19,480 --> 01:39:20,240 MEMBERSHIP AND SPECIFICALLY 2674 01:39:20,240 --> 01:39:24,520 GLOBAL IN ITS THOUGHT 2675 01:39:24,520 --> 01:39:24,800 LEADERSHIP. 2676 01:39:24,800 --> 01:39:27,160 ANALYTICS AND METRICS, VALUE FOR 2677 01:39:27,160 --> 01:39:30,440 MONEY, ALSO LOOKING AT SOME 2678 01:39:30,440 --> 01:39:32,040 IMPACTS SPECIFICALLY ON 2679 01:39:32,040 --> 01:39:32,280 LEARNING. 2680 01:39:32,280 --> 01:39:34,920 THE GOOD EXAMPLES WHICH CREATES 2681 01:39:34,920 --> 01:39:36,480 CASE STUDIES, PURSUING CASE 2682 01:39:36,480 --> 01:39:38,280 STUDIES FOR ALL 78 COUNTRIES, SO 2683 01:39:38,280 --> 01:39:41,720 TO LEARN WHAT ARE THE BEST 2684 01:39:41,720 --> 01:39:42,520 PRACTICES, NUTRITION MEASUREMENT 2685 01:39:42,520 --> 01:39:45,120 GROUP WHICH IS WHERE BOND-KIDS 2686 01:39:45,120 --> 01:39:47,760 CAME INTO THE PICTURE. 2687 01:39:47,760 --> 01:39:50,640 AND LED ON NUTRITION. 2688 01:39:50,640 --> 01:39:53,200 AND SO IMPORTANTLY SHOWED THE 2689 01:39:53,200 --> 01:39:55,600 WAY FORWARD IN THAT AREA, 2690 01:39:55,600 --> 01:39:57,600 IMPORTANCE OF THE NEXT 7,000 2691 01:39:57,600 --> 01:39:58,240 DAYS. 2692 01:39:58,240 --> 01:40:00,120 I'M GOING TO TALK ABOUT THE DIET 2693 01:40:00,120 --> 01:40:01,640 AND FOOD SYSTEMS SPECIFICALLY 2694 01:40:01,640 --> 01:40:02,960 NOW JUST TO MENTION AT THE END 2695 01:40:02,960 --> 01:40:07,680 WE ALSO HAVE AN EARLY CAREER 2696 01:40:07,680 --> 01:40:11,360 RESEARCH GROUP, VERY KEEN TO 2697 01:40:11,360 --> 01:40:12,360 ENCOURAGE YOUNGER SCIENTISTS 2698 01:40:12,360 --> 01:40:15,560 INTO LOOKING AT SCHOOL AGE 2699 01:40:15,560 --> 01:40:16,320 CHILDREN AND ADOLESCENT 2700 01:40:16,320 --> 01:40:16,800 NUTRITION. 2701 01:40:16,800 --> 01:40:19,680 LET'S TALK ABOUT THE DIET AND 2702 01:40:19,680 --> 01:40:20,520 FOOD SYSTEMS. 2703 01:40:20,520 --> 01:40:23,000 IN THIS A THIS IS A COMMUNITY OF 2704 01:40:23,000 --> 01:40:27,920 PRACTICE ESTABLISHED IN RESPONSE 2705 01:40:27,920 --> 01:40:29,560 TO COUNTRY DEMAND GOING ON FOR A 2706 01:40:29,560 --> 01:40:30,360 YEAR NOW. 2707 01:40:30,360 --> 01:40:33,040 WHAT BECAME APPARENT THROUGH THE 2708 01:40:33,040 --> 01:40:34,880 WORK OF BOND-KIDS WAS NOT ONLY 2709 01:40:34,880 --> 01:40:36,640 DO WE NEED TO THINK ABOUT 2710 01:40:36,640 --> 01:40:39,400 NUTRITION, WE NEED TO THINK 2711 01:40:39,400 --> 01:40:43,680 ABOUT THE MENUS IN SCHOOLS, DIET 2712 01:40:43,680 --> 01:40:46,120 THAT SUPPORTS, AND HOW THAT'S 2713 01:40:46,120 --> 01:40:48,080 SUPPORTED BY FOOD SYSTEMS. 2714 01:40:48,080 --> 01:40:53,560 SO, WITH A FOCUS ON DIET, ON 2715 01:40:53,560 --> 01:40:54,760 FOOD SOVEREIGNTY, AGRO 2716 01:40:54,760 --> 01:40:56,280 BIODIVERSITY AND CLIMATE 2717 01:40:56,280 --> 01:40:57,680 RESPONSIVENESS IN ADDRESSING 2718 01:40:57,680 --> 01:41:00,680 SCHOOL MEALS, PARTICULARLY 2719 01:41:00,680 --> 01:41:01,880 THROUGH THE HOMEGROWN SCHOOL 2720 01:41:01,880 --> 01:41:04,480 MEALS ACTIVITIES THAT ARE BEING 2721 01:41:04,480 --> 01:41:08,240 ADOPTED SO STRONGLY IN AFRICA. 2722 01:41:08,240 --> 01:41:10,200 AND FOOD SYSTEMS, THIS IS THE 2723 01:41:10,200 --> 01:41:13,880 YELLOW BOX HERE, WHY FOOD 2724 01:41:13,880 --> 01:41:14,920 SYSTEMS? 2725 01:41:14,920 --> 01:41:19,520 BECAUSE WE SEE THESE AS -- 2726 01:41:19,520 --> 01:41:22,360 COUNTRIES SEE THESE AS A FAST 2727 01:41:22,360 --> 01:41:24,760 TRACK TO SUBSTANTIAL CHANGE. 2728 01:41:24,760 --> 01:41:27,160 OPERATING AT SCHOOL, OVER $40 2729 01:41:27,160 --> 01:41:30,160 BILLION WORTH OF BUSINESS A 2730 01:41:30,160 --> 01:41:31,760 YEAR, FEEDING SOME 400 MILLION 2731 01:41:31,760 --> 01:41:32,720 CHILDREN. 2732 01:41:32,720 --> 01:41:34,960 AND THEY HAVE LIFELONG AND 2733 01:41:34,960 --> 01:41:37,440 COMMUNITY-WIDE INFLUENCES, THEY 2734 01:41:37,440 --> 01:41:39,240 CAN ESTABLISH DIETARY 2735 01:41:39,240 --> 01:41:39,880 PREFERENCES, AND MOST 2736 01:41:39,880 --> 01:41:43,840 IMPORTANTLY BECAUSE THESE ARE 2737 01:41:43,840 --> 01:41:45,240 GENERALLY GOVERNMENT LED, LEVERS 2738 01:41:45,240 --> 01:41:47,720 OF POLICY CHANGE ARE RELATIVELY 2739 01:41:47,720 --> 01:41:51,120 IN HAND, THERE TO BE MOVED. 2740 01:41:51,120 --> 01:41:53,320 SO, ALL OF THAT SUGGESTED STRONG 2741 01:41:53,320 --> 01:41:55,640 NEED TO LOOK AT NEW COMMUNITY OF 2742 01:41:55,640 --> 01:41:59,680 PRACTICE IN FOOD SYSTEMS, AND 2743 01:41:59,680 --> 01:42:02,120 WITHIN THAT, NEXT SLIDE PLEASE, 2744 01:42:02,120 --> 01:42:05,640 TO THINK ABOUT FOOD SYSTEMS AND 2745 01:42:05,640 --> 01:42:06,160 THE ENVIRONMENT. 2746 01:42:06,160 --> 01:42:09,080 AND SO ONE OF THE ISSUES THE 2747 01:42:09,080 --> 01:42:11,800 CURRENT FOOD SYSTEMS ARE 2748 01:42:11,800 --> 01:42:12,840 ENVIRONMENTALLY UNSUSTAINABLE. 2749 01:42:12,840 --> 01:42:14,000 THEY ARE MAJOR DRIVERS OF 2750 01:42:14,000 --> 01:42:15,040 CLIMATE CHANGE. 2751 01:42:15,040 --> 01:42:18,440 THEY ARE MAJOR DRIVERS OF 2752 01:42:18,440 --> 01:42:19,960 ENVIRONMENTAL DEGRADATION. 2753 01:42:19,960 --> 01:42:22,400 AND THAT THE FOOD SYSTEMS BY AND 2754 01:42:22,400 --> 01:42:24,560 LARGE FAILED TO DELIVER HEALTHY 2755 01:42:24,560 --> 01:42:26,000 AND NUTRITIOUS DIETS. 2756 01:42:26,000 --> 01:42:28,080 AND WE SEE DIETARY RISKS ARE A 2757 01:42:28,080 --> 01:42:32,360 LEADING RISK FACTOR FOR 2758 01:42:32,360 --> 01:42:34,080 PREMATURE MORTALITY GLOBALLY. 2759 01:42:34,080 --> 01:42:35,600 PREVALENCE OF OVERWEIGHT AND 2760 01:42:35,600 --> 01:42:37,560 OBESITY IN PARTICULAR, WHICH ARE 2761 01:42:37,560 --> 01:42:43,840 ON THE INCREASE, EVEN WHILE 2762 01:42:43,840 --> 01:42:46,440 UNDERNUTRITION IS A PROBLEM. 2763 01:42:46,440 --> 01:42:47,440 HEALTHY DIETS ARE UNAFFORDABLE 2764 01:42:47,440 --> 01:42:48,800 FOR THE WORLD'S POOR. 2765 01:42:48,800 --> 01:42:50,080 WE SEE FOOD SYSTEMS AS VITALLY 2766 01:42:50,080 --> 01:42:53,680 IMPORTANT FOR ALL OF THOSE 2767 01:42:53,680 --> 01:42:54,240 REASONS. 2768 01:42:54,240 --> 01:42:55,560 NEXT SLIDE PLEASE. 2769 01:42:55,560 --> 01:42:58,080 AT THE SAME TIME WE SEE SCHOOL 2770 01:42:58,080 --> 01:43:01,120 MEALS CAN BE PART OF THE 2771 01:43:01,120 --> 01:43:01,520 SOLUTION. 2772 01:43:01,520 --> 01:43:03,720 SO, SCHOOL MEALS IF WELL PLANNED 2773 01:43:03,720 --> 01:43:08,480 CAN PROVIDE THE HEALTH AND DIET 2774 01:43:08,480 --> 01:43:10,360 AT AFFORDABLE COST. 2775 01:43:10,360 --> 01:43:12,640 AND THEY ACT AT DIFFERENT LEVELS 2776 01:43:12,640 --> 01:43:15,160 OF IMPACT ON HEALTH AND 2777 01:43:15,160 --> 01:43:16,600 NUTRITIONAL IMPACTS FOR THE 2778 01:43:16,600 --> 01:43:19,320 PUPIL, SUSTAINABLE IMPACTS TO 2779 01:43:19,320 --> 01:43:20,840 SOCIETY, AND COST IMPACTS FOR 2780 01:43:20,840 --> 01:43:24,680 SCHOOLS AND PARENTS AND TO 2781 01:43:24,680 --> 01:43:24,920 SOCIETY. 2782 01:43:24,920 --> 01:43:27,640 AND HERE WE'RE TALKING ABOUT IN 2783 01:43:27,640 --> 01:43:29,680 TERMS OF FOOD SYSTEMS IMPROVED 2784 01:43:29,680 --> 01:43:31,880 FOOD SOVEREIGNTY, AND THE 2785 01:43:31,880 --> 01:43:35,920 EXAMPLE I THINK OF NEPAL, FROM 2786 01:43:35,920 --> 01:43:37,480 HAVING THREE MAIN CROPS 2787 01:43:37,480 --> 01:43:39,560 SUPPLYING ITS SCHOOL MEALS 2788 01:43:39,560 --> 01:43:42,640 PROGRAMS TO 18 I THINK IS A 2789 01:43:42,640 --> 01:43:45,280 GREAT EXAMPLE, CREATION OF 2790 01:43:45,280 --> 01:43:46,800 SHORTER FOOD CHAINS AND 2791 01:43:46,800 --> 01:43:51,400 HOMEGROWN SCHOOL FOOD. 2792 01:43:51,400 --> 01:43:54,240 AND HOW THESE IMPACTS ARE 2793 01:43:54,240 --> 01:43:55,120 SUSTAINABLE, CONTINUING HOME 2794 01:43:55,120 --> 01:43:57,000 SUSTAINED DURING THE LIFE COURSE 2795 01:43:57,000 --> 01:43:59,080 AND TAKEN UP PIE PARENTS AND 2796 01:43:59,080 --> 01:44:00,080 TEACHERS AND OTHERS. 2797 01:44:00,080 --> 01:44:04,480 ALREADY WE KNOW THE CHILDREN 2798 01:44:04,480 --> 01:44:05,760 ALONE REPRESENT SOMETHING LIKE 2799 01:44:05,760 --> 01:44:08,840 400 MILLION DAILY. 2800 01:44:08,840 --> 01:44:09,240 NEXT SLIDE PLEASE. 2801 01:44:09,240 --> 01:44:12,120 AS A RESULT OF THIS, WE'RE 2802 01:44:12,120 --> 01:44:13,960 EMBARKING ON CREATING A WHITE 2803 01:44:13,960 --> 01:44:15,400 PAPER ON CLIMATE SMART SCHOOL 2804 01:44:15,400 --> 01:44:15,600 MEALS. 2805 01:44:15,600 --> 01:44:19,800 THIS IS BEING LED BY SYLVIA 2806 01:44:19,800 --> 01:44:21,200 PASTORENO FROM OUR SIDE FROM, 2807 01:44:21,200 --> 01:44:24,240 SIDE OF THE RESEARCH CONSORTIUM. 2808 01:44:24,240 --> 01:44:26,200 WE'VE INVITED BY ONE OF THE 2809 01:44:26,200 --> 01:44:28,520 MEMBER STATES OF THE COALITION, 2810 01:44:28,520 --> 01:44:32,360 UAE, TO DEVELOP A WHITE PAPER ON 2811 01:44:32,360 --> 01:44:33,880 CLIMATE SMART SCHOOL MEALS, 2812 01:44:33,880 --> 01:44:36,640 WE'RE TAKING THAT PAPER TO OUR 2813 01:44:36,640 --> 01:44:39,120 MINISTERIAL MEETING IN PARIS 2814 01:44:39,120 --> 01:44:43,160 THIS YEAR, CHAIRED BY PRESIDENT 2815 01:44:43,160 --> 01:44:44,600 MACRON, TO WHICH THE 78 2816 01:44:44,600 --> 01:44:45,800 MINISTERS WILL BE INVITED. 2817 01:44:45,800 --> 01:44:48,200 AND ON THE BASIS OF THEIR 2818 01:44:48,200 --> 01:44:52,800 DECISION, TO MOVE THAT PAPER 2819 01:44:52,800 --> 01:44:58,760 THEN ON TO COP 28 IN DUBAI IN 2820 01:44:58,760 --> 01:45:00,400 NOVEMBER, ENSURING SOME OF THE 2821 01:45:00,400 --> 01:45:04,400 COUNTRIES, SOME OF THE SCHOOL 2822 01:45:04,400 --> 01:45:05,640 MEAL COALITION COUNTRIES 2823 01:45:05,640 --> 01:45:07,240 FORMALLY ADOPT THESE PERHAPS AND 2824 01:45:07,240 --> 01:45:11,600 ALLOW FOR TRACKING OF WHAT ARE 2825 01:45:11,600 --> 01:45:12,800 THE REALTIME BENEFITS. 2826 01:45:12,800 --> 01:45:17,720 TO GET TO THIS WE'RE UNDERTAKING 2827 01:45:17,720 --> 01:45:21,040 AN ANALYSIS LED BY MARCO 2828 01:45:21,040 --> 01:45:23,320 SPRINGMAN ON ACTIONABLE POLICY 2829 01:45:23,320 --> 01:45:25,960 RECOMMENDATION ALSO BASED ON 2830 01:45:25,960 --> 01:45:29,360 MODELING INDICATIONS FROM 2831 01:45:29,360 --> 01:45:31,400 NUTRITIONAL ANALYSIS AND COST OF 2832 01:45:31,400 --> 01:45:33,040 DIET. 2833 01:45:33,040 --> 01:45:35,120 SO ALL OF THOSE PIECES ARE IN 2834 01:45:35,120 --> 01:45:40,640 PLACE AS WE ARE NOW MOVING 2835 01:45:40,640 --> 01:45:43,560 FORWARD DRAFT THAT WHITE PAPER. 2836 01:45:43,560 --> 01:45:46,640 SO THAT'S WHERE WE'VE GOT TO. 2837 01:45:46,640 --> 01:45:48,400 IN FINISHING, I WANT TO SAY ONE 2838 01:45:48,400 --> 01:45:51,920 OF THE QUESTIONS WE ALL ASK, WE 2839 01:45:51,920 --> 01:45:53,400 ASK OURSELVES, IS WILL 2840 01:45:53,400 --> 01:45:54,960 GOVERNMENTS ACTUALLY TAKE THIS 2841 01:45:54,960 --> 01:45:55,160 ON? 2842 01:45:55,160 --> 01:45:56,800 WILL GOVERNMENTS MOVE ON THIS? 2843 01:45:56,800 --> 01:45:58,360 HOW INTERESTED ARE THE 2844 01:45:58,360 --> 01:45:58,880 GOVERNMENTS? 2845 01:45:58,880 --> 01:46:00,320 I WANTED TO FINISH ON TWO 2846 01:46:00,320 --> 01:46:03,720 EXAMPLES THAT I THINK ARE QUITE 2847 01:46:03,720 --> 01:46:05,000 ENCOURAGING. 2848 01:46:05,000 --> 01:46:06,440 THE FIRST IS THREE COUNTRIES 2849 01:46:06,440 --> 01:46:09,520 WHICH HAVE MADE A DECISION SINCE 2850 01:46:09,520 --> 01:46:13,280 2020 TO GO AHEAD WITH 2851 01:46:13,280 --> 01:46:15,360 SIGNIFICANT INVESTMENT IN THE 2852 01:46:15,360 --> 01:46:17,240 NUTRITION AND SUPPORT AND HEALTH 2853 01:46:17,240 --> 01:46:20,160 OF THEIR SCHOOL AGE CHILDREN AND 2854 01:46:20,160 --> 01:46:20,480 ADOLESCENTS. 2855 01:46:20,480 --> 01:46:22,360 THESE ARE NOT THE RICHEST 2856 01:46:22,360 --> 01:46:26,640 COUNTRIES IN THE WORLD. 2857 01:46:26,640 --> 01:46:27,360 BENIN DECIDED TO INVEST $270 2858 01:46:27,360 --> 01:46:30,560 MILLION OVER THE NEXT FIVE 2859 01:46:30,560 --> 01:46:30,960 YEARS. 2860 01:46:30,960 --> 01:46:34,160 THEIR COVERAGE HAS RISEN FROM 2861 01:46:34,160 --> 01:46:39,000 30% IN 2020 TO 75% NOW WITH 100% 2862 01:46:39,000 --> 01:46:43,600 EXPECTED IN TWO YEARS' TIME. 2863 01:46:43,600 --> 01:46:47,720 KENYA EMBARKING ON SIMILAR 2864 01:46:47,720 --> 01:46:48,200 PROGRAM. 2865 01:46:48,200 --> 01:46:50,480 RWANDA ALSO HAS INCREASED ITS 2866 01:46:50,480 --> 01:46:52,080 NATIONAL BUDGET. 2867 01:46:52,080 --> 01:46:55,920 IT'S MOVING UP TO $8 IN 2020 TO 2868 01:46:55,920 --> 01:47:00,040 $80 MILLION IN 2022, INCREASED 2869 01:47:00,040 --> 01:47:03,400 COVERAGE FROM 660,000 CHILDREN 2870 01:47:03,400 --> 01:47:08,000 TO 3.8 MILLION PUPILS THIS YEAR. 2871 01:47:08,000 --> 01:47:12,240 IT'S ALREADY VERY DRAMATICALLY 2872 01:47:12,240 --> 01:47:13,240 INCREASED ITS COVERAGE. 2873 01:47:13,240 --> 01:47:15,840 FINALLY THIS IS NOT JUST A FEW 2874 01:47:15,840 --> 01:47:18,680 COUNTRIES, HERE IS THE LATEST 2875 01:47:18,680 --> 01:47:21,040 DATA ON THE NUMBERS OF CHILDREN 2876 01:47:21,040 --> 01:47:24,280 BEING SUPPORTED BY SCHOOL MEALS 2877 01:47:24,280 --> 01:47:24,600 PROGRAMS. 2878 01:47:24,600 --> 01:47:29,000 THIS IS FROM WORLD FOOD PROGRAMS 2879 01:47:29,000 --> 01:47:31,120 2022 DATA ANALYSIS, DATA I 2880 01:47:31,120 --> 01:47:33,160 SHOWED BEFORE FROM THE 2020 2881 01:47:33,160 --> 01:47:33,720 ANALYSIS. 2882 01:47:33,720 --> 01:47:35,760 AND WHAT THIS SHOWS IS THE 2883 01:47:35,760 --> 01:47:39,760 NUMBER OF CHILDREN NOW BEING FED 2884 01:47:39,760 --> 01:47:43,920 IS AROUND 418 MILLION, WHICH IS 2885 01:47:43,920 --> 01:47:48,920 UP FROM 388 MILLION TWO YEARS 2886 01:47:48,920 --> 01:47:49,080 AGO. 2887 01:47:49,080 --> 01:47:50,560 SO, IN ONE SENSE, THE GOAL, 2888 01:47:50,560 --> 01:47:53,000 FIRST GOAL OF THE SCHOOL MEALS 2889 01:47:53,000 --> 01:47:55,920 COALITION IS BEING MET. 2890 01:47:55,920 --> 01:47:57,480 COUNTRIES REOPENED SCHOOLS, PUT 2891 01:47:57,480 --> 01:47:59,760 IN PLACE PROGRAMS THAT ACHIEVED 2892 01:47:59,760 --> 01:48:02,520 WHAT THEY ACHIEVED IN 2020 BUT 2893 01:48:02,520 --> 01:48:03,480 ACTUALLY EXCEEDED. 2894 01:48:03,480 --> 01:48:04,680 OF COURSE, THERE'S A DOWN SIDE 2895 01:48:04,680 --> 01:48:05,680 TO THIS STORY. 2896 01:48:05,680 --> 01:48:07,080 THAT OF COURSE IS THE COUNTRIES 2897 01:48:07,080 --> 01:48:08,400 THAT NEED TO DO THIS THE MOST 2898 01:48:08,400 --> 01:48:13,360 ARE THE ONES THAT HAVE BEEN 2899 01:48:13,360 --> 01:48:15,200 LEAST ABLE TO RESPOND. 2900 01:48:15,200 --> 01:48:17,400 THIS IS VERY ENCOURAGING. 2901 01:48:17,400 --> 01:48:18,480 OVER JUST A TWO-YEAR PERIOD 2902 01:48:18,480 --> 01:48:20,440 WE'RE SEEING A REAL REACTION 2903 01:48:20,440 --> 01:48:22,760 FROM THE COUNTRIES, A REAL 2904 01:48:22,760 --> 01:48:25,240 INTEREST, AND THIS IS A REAL 2905 01:48:25,240 --> 01:48:26,880 INTEREST THAT EXTENDS TO 2906 01:48:26,880 --> 01:48:28,240 HOMEGROWN SCHOOL FEEDING AS A 2907 01:48:28,240 --> 01:48:30,080 SOURCE OF FOOD FOR THESE 2908 01:48:30,080 --> 01:48:30,640 PROGRAMS. 2909 01:48:30,640 --> 01:48:35,040 HOW CAN WE LEARN BETTER TO MAKE 2910 01:48:35,040 --> 01:48:37,000 THESE HOMEGROWN SCHOOL MEALS 2911 01:48:37,000 --> 01:48:38,720 MUCH MORE CLIMATE RESPONSIVE IS 2912 01:48:38,720 --> 01:48:40,160 EXACTLY WHERE WE'RE GOING WITH 2913 01:48:40,160 --> 01:48:41,240 THE WHITE PAPER. 2914 01:48:41,240 --> 01:48:42,160 SO THANK YOU. 2915 01:48:42,160 --> 01:48:43,240 THAT'S THE MESSAGE THAT I WANTED 2916 01:48:43,240 --> 01:48:53,680 TO SHARE WITH YOU TODAY. 2917 01:48:56,840 --> 01:48:58,080 >> THANK YOU. 2918 01:48:58,080 --> 01:49:04,440 THAT WAS PERFECT, AS USUAL. 2919 01:49:04,440 --> 01:49:07,520 DON IS AN INSPIRATIONAL PARTNER. 2920 01:49:07,520 --> 01:49:08,080 THE EXPANSIVE PRESENTATION 2921 01:49:08,080 --> 01:49:08,840 COVERED A LOT OF ISSUES THAT ARE 2922 01:49:08,840 --> 01:49:12,960 GOING TO BE COVERED BY THE 2923 01:49:12,960 --> 01:49:16,800 LARGER COMMUNITY, IT IS -- WHAT 2924 01:49:16,800 --> 01:49:17,960 HE'S PRESENTED EXEMPLIFIES 2925 01:49:17,960 --> 01:49:21,000 IMPORTANCE OF ECOLOGICAL 2926 01:49:21,000 --> 01:49:21,520 APPROACH. 2927 01:49:21,520 --> 01:49:23,360 HE MENTIONED THE BOND-KIDS 2928 01:49:23,360 --> 01:49:23,600 PROJECT. 2929 01:49:23,600 --> 01:49:26,720 THERE MAY BE A WAY TO INTEGRATE 2930 01:49:26,720 --> 01:49:28,520 THE 7,000 DAYS INTO WHAT WORKING 2931 01:49:28,520 --> 01:49:30,360 GROUP 1 IS DOING, SPECIFICALLY 2932 01:49:30,360 --> 01:49:31,800 AS RELATES TO THE INTERSECTION 2933 01:49:31,800 --> 01:49:35,520 OF CLIMATE AND FOOD SYSTEMS. 2934 01:49:35,520 --> 01:49:36,720 THE ECOLOGY IS CLEARLY 2935 01:49:36,720 --> 01:49:37,760 REPRESENTING WHAT DON PRESENTED 2936 01:49:37,760 --> 01:49:40,840 HERE TODAY IN TERMS OF THE 2937 01:49:40,840 --> 01:49:42,440 BIOLOGY, INTERSECTION OF THE 2938 01:49:42,440 --> 01:49:44,520 FOOD SYSTEMS, IMPACT ON 2939 01:49:44,520 --> 01:49:44,760 PROGRAMS. 2940 01:49:44,760 --> 01:49:46,080 FUNDAMENTALLY THE REASON WE NEED 2941 01:49:46,080 --> 01:49:48,760 SCHOOL MEAL PROGRAMS IS BECAUSE 2942 01:49:48,760 --> 01:49:51,760 KIDS ARE IN FACT FOOD INSECURE, 2943 01:49:51,760 --> 01:49:56,560 NUTRITION INSECURE. 2944 01:49:56,560 --> 01:49:59,720 AND MALNOURISHED AND THESE 2945 01:49:59,720 --> 01:50:04,080 PROGRAMS ARE HELPING AMELIORATE 2946 01:50:04,080 --> 01:50:06,480 BUT BEING IMPACTED BY CHANGING 2947 01:50:06,480 --> 01:50:06,720 CLIMATE. 2948 01:50:06,720 --> 01:50:08,080 WE'LL WORK TOGETHER TO MAKE SURE 2949 01:50:08,080 --> 01:50:11,280 THIS IS INTEGRATED, THE TWO 2950 01:50:11,280 --> 01:50:12,280 PROJECTS. 2951 01:50:12,280 --> 01:50:13,840 >> THANK YOU. 2952 01:50:13,840 --> 01:50:15,600 >> I WANT ECHO MY THANKS, DON. 2953 01:50:15,600 --> 01:50:17,120 ALWAYS GREAT TO SEE YOU. 2954 01:50:17,120 --> 01:50:17,760 THANK YOU. 2955 01:50:17,760 --> 01:50:18,880 >> THANK YOU, DREW. 2956 01:50:18,880 --> 01:50:21,600 MUCH APPRECIATED. 2957 01:50:21,600 --> 01:50:22,920 2958 01:50:22,920 --> 01:50:23,800 >> YES, THANK YOU. 2959 01:50:23,800 --> 01:50:25,680 I'M NOT SURE IF I'M MODERATING 2960 01:50:25,680 --> 01:50:28,280 BUT I'LL JUMP IN AND ASK IF 2961 01:50:28,280 --> 01:50:30,240 ANYONE HAS QUESTIONS, BUT I WANT 2962 01:50:30,240 --> 01:50:32,000 TO -- YOU TOUCHED ON SO MANY 2963 01:50:32,000 --> 01:50:33,640 ASPECTS OF WHAT WE'VE BEEN 2964 01:50:33,640 --> 01:50:35,720 THINKING ABOUT AND REALLY HOW 2965 01:50:35,720 --> 01:50:37,040 IMPORTANT SCHOOL PROGRAMS ARE, 2966 01:50:37,040 --> 01:50:38,360 EVEN THOUGH A SMALLER PERCENTAGE 2967 01:50:38,360 --> 01:50:41,400 OF YOUNG CHILDREN IN OUR 2968 01:50:41,400 --> 01:50:42,400 COUNTRY, THE SCHOOL PROGRAM IN 2969 01:50:42,400 --> 01:50:45,480 THE U.S. IS CLEARLY AN IMPORTANT 2970 01:50:45,480 --> 01:50:48,320 DRIVER OF LOTS OF DIFFERENT 2971 01:50:48,320 --> 01:50:48,680 IMPLICATIONS. 2972 01:50:48,680 --> 01:50:52,160 HEALTH AND OTHERWISE. 2973 01:50:52,160 --> 01:50:53,680 DOES ANYONE HAVE QUESTIONS? 2974 01:50:53,680 --> 01:50:58,480 COMMENTS? 2975 01:50:58,480 --> 01:51:04,400 >> IF I MAY, THANK YOU FOR THIS 2976 01:51:04,400 --> 01:51:08,880 PROMISING AND GOOD NEWS TALK. 2977 01:51:08,880 --> 01:51:12,200 I WONDERED, HOW LONG STAYING IN 2978 01:51:12,200 --> 01:51:14,280 SCHOOL INFLUENCES NUTRITIONAL 2979 01:51:14,280 --> 01:51:18,000 ACCESS AND HOW THAT IS ACROSS 2980 01:51:18,000 --> 01:51:24,760 SOCIAL STRATA AND FIT INTO THIS 2981 01:51:24,760 --> 01:51:25,040 APPROACH? 2982 01:51:25,040 --> 01:51:27,520 >> SURE, THAT'S A VERY 2983 01:51:27,520 --> 01:51:28,960 IMPORTANT QUESTION. 2984 01:51:28,960 --> 01:51:30,560 AND A SLIGHTLY COMPLICATED ONE. 2985 01:51:30,560 --> 01:51:33,840 LET ME SAY WHAT WAS THE GREAT 2986 01:51:33,840 --> 01:51:34,680 ACHIEVEMENT OF THE MILLENIUM 2987 01:51:34,680 --> 01:51:35,400 DEVELOPMENT GOALS? 2988 01:51:35,400 --> 01:51:37,160 IT WAS GETTING KIDS TO GO TO 2989 01:51:37,160 --> 01:51:38,160 SCHOOL. 2990 01:51:38,160 --> 01:51:39,440 THAT WAS THE NUMBER ONE SUCCESS 2991 01:51:39,440 --> 01:51:42,480 STORY THAT CAME FROM THE 2992 01:51:42,480 --> 01:51:44,120 MILLENIUM DEVELOPMENT GOALS. 2993 01:51:44,120 --> 01:51:45,960 NOW, WHAT DID THEY DO WHEN THEY 2994 01:51:45,960 --> 01:51:46,760 GOT TO SCHOOL? 2995 01:51:46,760 --> 01:51:49,360 THAT'S STILL A PROBLEM BECAUSE 2996 01:51:49,360 --> 01:51:51,360 THE LEARNING DIDN'T NECESSARILY 2997 01:51:51,360 --> 01:51:53,200 RISE WITH THE ATTENDANCE. 2998 01:51:53,200 --> 01:51:56,600 SO, BUT THE IDEA THAT CHILDREN 2999 01:51:56,600 --> 01:52:01,320 GO TO PRIMARY SCHOOL IS NOW WELL 3000 01:52:01,320 --> 01:52:01,560 EMBEDDED. 3001 01:52:01,560 --> 01:52:03,720 THAT'S NOW -- FOR THOSE WHO HAVE 3002 01:52:03,720 --> 01:52:05,960 NOT BEEN FOLLOWING THE EDUCATION 3003 01:52:05,960 --> 01:52:07,400 STORY CLOSELY, THAT'S THE GOOD 3004 01:52:07,400 --> 01:52:11,680 NEWS FROM THE EDUCATION STORY. 3005 01:52:11,680 --> 01:52:14,200 CHILDREN DO NOW BY AND LARGE 3006 01:52:14,200 --> 01:52:15,760 ATTEND PRIMARY SCHOOL THROUGHOUT 3007 01:52:15,760 --> 01:52:17,240 THE WORLD. 3008 01:52:17,240 --> 01:52:18,120 THEY DON'T NECESSARILY LEARN 3009 01:52:18,120 --> 01:52:20,680 WELL WHILE THERE. 3010 01:52:20,680 --> 01:52:22,080 THAT'S ANOTHER CHALLENGE. 3011 01:52:22,080 --> 01:52:25,040 AND SO THE PUSH NOW IS TO GET 3012 01:52:25,040 --> 01:52:26,240 CHILDREN TO ATTEND SECONDARY 3013 01:52:26,240 --> 01:52:28,680 SCHOOL, BECAUSE THAT'S THE 3014 01:52:28,680 --> 01:52:29,640 ADOLESCENT AREA. 3015 01:52:29,640 --> 01:52:32,160 VITALLY IMPORTANT IN TERMS OF 3016 01:52:32,160 --> 01:52:34,480 ACHIEVING A FULL EDUCATION 3017 01:52:34,480 --> 01:52:36,880 OUTCOME AND ACHIEVING REAL HUMAN 3018 01:52:36,880 --> 01:52:37,400 CAPITAL, HEALTHY CHILDREN 3019 01:52:37,400 --> 01:52:40,400 ACHIEVE WHAT THEY CAN IN THEIR 3020 01:52:40,400 --> 01:52:40,600 LIVES. 3021 01:52:40,600 --> 01:52:41,960 SO THAT'S A DYNAMIC. 3022 01:52:41,960 --> 01:52:43,880 AND ACTUALLY ONE OF THE REASONS 3023 01:52:43,880 --> 01:52:45,800 WHY SCHOOL MEALS AND PROGRAMS 3024 01:52:45,800 --> 01:52:48,160 LIKE THAT ARE SO SUPPORTED BY 3025 01:52:48,160 --> 01:52:49,440 COUNTRIES AND LET'S REALIZE IT'S 3026 01:52:49,440 --> 01:52:50,560 THE COUNTRIES THAT ARE 3027 01:52:50,560 --> 01:52:52,200 SUPPORTING THEM. 3028 01:52:52,200 --> 01:52:55,680 THAT'S THE MOST STRIKING FINDING 3029 01:52:55,680 --> 01:52:55,920 I THINK. 3030 01:52:55,920 --> 01:52:57,560 THE COUNTRIES, WHY ARE THEY 3031 01:52:57,560 --> 01:52:58,040 SUPPORTING THEM? 3032 01:52:58,040 --> 01:52:59,320 BECAUSE THEY KNOW IF THEY 3033 01:52:59,320 --> 01:53:00,440 PROVIDE SUPPORTS AT SCHOOL 3034 01:53:00,440 --> 01:53:02,320 CHILDREN GO TO SCHOOL. 3035 01:53:02,320 --> 01:53:03,920 THIS IS PART OF -- IN OTHER 3036 01:53:03,920 --> 01:53:05,560 WORDS YOUR QUESTION, A GREAT 3037 01:53:05,560 --> 01:53:08,960 ONE, IS ACTUALLY AN INTERACTIVE 3038 01:53:08,960 --> 01:53:09,240 QUESTION. 3039 01:53:09,240 --> 01:53:10,800 DOESN'T SCHOOL -- DON'T SCHOOL 3040 01:53:10,800 --> 01:53:12,520 MEALS ALSO ENSURE THAT CHILDREN 3041 01:53:12,520 --> 01:53:16,320 GO TO SCHOOL, GET AN EDUCATION, 3042 01:53:16,320 --> 01:53:17,600 AND CONTRIBUTE TO THEIR 3043 01:53:17,600 --> 01:53:18,480 COUNTRY'S HUMAN CAPITAL. 3044 01:53:18,480 --> 01:53:20,440 THE ANSWER IS YES. 3045 01:53:20,440 --> 01:53:22,840 THESE PARTS OF NEED TO COME 3046 01:53:22,840 --> 01:53:23,440 TOGETHER. 3047 01:53:23,440 --> 01:53:24,240 SO YOU'RE ABSOLUTELY RIGHT THERE 3048 01:53:24,240 --> 01:53:26,040 ARE CERTAINLY AREAS IN THE WORLD 3049 01:53:26,040 --> 01:53:28,760 WHERE NOT ENOUGH CHILDREN GO TO 3050 01:53:28,760 --> 01:53:30,280 SCHOOL, PARTICULARLY NOT ENOUGH 3051 01:53:30,280 --> 01:53:36,440 GIRLS, BUT FIXING THAT SHOULD BE 3052 01:53:36,440 --> 01:53:38,000 PART OF THE SOLUTION. 3053 01:53:38,000 --> 01:53:39,840 I WASN'T SUGGESTING THAT THIS 3054 01:53:39,840 --> 01:53:41,800 WAS THE SOLUTION TO NUTRITION IN 3055 01:53:41,800 --> 01:53:43,360 THESE GROUPS BUT I DO THINK IT'S 3056 01:53:43,360 --> 01:53:44,880 PART OF THE SOLUTION TO 3057 01:53:44,880 --> 01:53:53,160 NUTRITION IN THESE GROUPS. 3058 01:53:53,160 --> 01:53:53,440 >> ALEXA? 3059 01:53:53,440 --> 01:53:53,840 >> HI. 3060 01:53:53,840 --> 01:53:55,600 THANK YOU FOR THAT GREAT 3061 01:53:55,600 --> 01:53:56,680 PRESENTATION. 3062 01:53:56,680 --> 01:53:58,840 I HAD A QUESTION ABOUT SCHOOL 3063 01:53:58,840 --> 01:54:01,920 MEALS AND WE SAW DURING COVID 3064 01:54:01,920 --> 01:54:03,880 WHEN SCHOOLS SHUT DOWN THAT IT 3065 01:54:03,880 --> 01:54:05,960 HIGHLIGHTED HOW IMPORTANT THESE 3066 01:54:05,960 --> 01:54:07,600 SCHOOL MEALS WERE TO NUTRITION 3067 01:54:07,600 --> 01:54:09,120 AND FOOD SECURITY STATUS FOR SO 3068 01:54:09,120 --> 01:54:11,960 MANY CHILDREN ESPECIALLY IN THE 3069 01:54:11,960 --> 01:54:14,960 U.S. WHERE I LIVED DURING THE 3070 01:54:14,960 --> 01:54:15,200 LOCKDOWNS. 3071 01:54:15,200 --> 01:54:16,920 WE HAVE CLIMATE CHANGE. 3072 01:54:16,920 --> 01:54:19,560 WE'RE GOING TO EXPECT IN MANY 3073 01:54:19,560 --> 01:54:23,480 PARTS OF THE WORLD GREATER 3074 01:54:23,480 --> 01:54:25,440 DISRUPTION, PARTICULARLY AROUND 3075 01:54:25,440 --> 01:54:27,080 WEATHER, THAT MIGHT AFFECT THE 3076 01:54:27,080 --> 01:54:28,840 STUDENTS' ABILITY TO GO TO 3077 01:54:28,840 --> 01:54:29,240 SCHOOL. 3078 01:54:29,240 --> 01:54:31,040 HAS THERE BEEN TALK ABOUT HOW TO 3079 01:54:31,040 --> 01:54:36,640 STILL PROVIDE MEALS WHEN SCHOOLS 3080 01:54:36,640 --> 01:54:37,120 CAN'T OPEN? 3081 01:54:37,120 --> 01:54:38,760 >> SO GREAT QUESTION. 3082 01:54:38,760 --> 01:54:40,760 I THINK IT'S ALMOST THE REVERSE 3083 01:54:40,760 --> 01:54:43,360 IS THE DISCUSSION, THE 3084 01:54:43,360 --> 01:54:45,120 DISCUSSION IS SHOULD WE AS 3085 01:54:45,120 --> 01:54:46,000 COUNTRIES HAVE CLOSED THESE 3086 01:54:46,000 --> 01:54:50,840 SCHOOLS IN THE FIRST PLACE? 3087 01:54:50,840 --> 01:54:52,560 WAS THAT ACTUALLY RATIONAL? 3088 01:54:52,560 --> 01:54:55,400 IT HAS BEEN DISASTROUS. 3089 01:54:55,400 --> 01:54:56,480 IT'S BEEN REALLY DESTRUCTIVE. 3090 01:54:56,480 --> 01:54:59,600 AND I THINK THE GENERAL VIEW IS 3091 01:54:59,600 --> 01:55:01,240 THAT ARE THIS SHOULD REALLY ONLY 3092 01:55:01,240 --> 01:55:03,760 BE THE LAST RESORT, THAT KEEPING 3093 01:55:03,760 --> 01:55:06,040 SCHOOLS OPEN, MAKING THE SCHOOLS 3094 01:55:06,040 --> 01:55:07,680 KEY TO SUPPORTING CHILDREN IN 3095 01:55:07,680 --> 01:55:09,560 THOSE AGE GROUPS, BECAUSE 3096 01:55:09,560 --> 01:55:11,200 FRANKLY IN MANY SOCIETIES IT IS 3097 01:55:11,200 --> 01:55:15,680 THE SCHOOL -- THE SCHOOL IS THE 3098 01:55:15,680 --> 01:55:16,240 ONLY INSTITUTION SUPPORTING 3099 01:55:16,240 --> 01:55:18,120 THOSE AGE GROUPS, THAT THAT'S 3100 01:55:18,120 --> 01:55:20,960 SOMETHING WE ACTUALLY NEED TO 3101 01:55:20,960 --> 01:55:22,800 GIVE FAR MORE EMPHASIS TO. 3102 01:55:22,800 --> 01:55:26,280 I TRAINED AS AN EPIDEMIOLOGIST. 3103 01:55:26,280 --> 01:55:26,960 EPIDEMIOLOGISTS SAID SHUTTING 3104 01:55:26,960 --> 01:55:28,920 SCHOOLS SEEMED LIKE A CHEAP WAY 3105 01:55:28,920 --> 01:55:30,200 OF REDUCING TRANSMISSION. 3106 01:55:30,200 --> 01:55:33,520 IT'S WHAT WE'VE DONE FOR YEARS 3107 01:55:33,520 --> 01:55:36,240 WITH MANY EARLY CHILDHOOD 3108 01:55:36,240 --> 01:55:37,040 INFECTIONS, RIGHT? 3109 01:55:37,040 --> 01:55:39,640 THAT SEEMED LIKE A SIMPLE AND 3110 01:55:39,640 --> 01:55:41,200 LOW IMPACT, LOW COST THING TO 3111 01:55:41,200 --> 01:55:41,360 DO. 3112 01:55:41,360 --> 01:55:48,240 IT TURNED OUT TO BE A 3113 01:55:48,240 --> 01:55:52,480 DISASTROUSLY BAD THING TO DO. 3114 01:55:52,480 --> 01:55:54,760 THE WORLD BANK IS ANALYZING THE 3115 01:55:54,760 --> 01:55:56,840 2008 FOOD AND FINANCIAL CRISIS 3116 01:55:56,840 --> 01:56:01,080 THAT BECAME A RECESSION IN2010. 3117 01:56:01,080 --> 01:56:05,480 AND SHOWING THAT THEN 3118 01:56:05,480 --> 01:56:06,920 GOVERNMENTS LOOKED TO AIDS 3119 01:56:06,920 --> 01:56:10,440 PROGRAMS TO EXPAND SCHOOL MEALS 3120 01:56:10,440 --> 01:56:10,840 PROGRAMS. 3121 01:56:10,840 --> 01:56:11,760 THEIR REACTION, GOVERNMENT 3122 01:56:11,760 --> 01:56:13,480 REACTION IN 2008, WAS NOT TO 3123 01:56:13,480 --> 01:56:14,720 CLOSE SCHOOLS BUT TO ACTUALLY 3124 01:56:14,720 --> 01:56:18,240 EXPAND THE ROLE OF THEIR SCHOOLS 3125 01:56:18,240 --> 01:56:21,680 IN SUPPORTING CHILDREN. 3126 01:56:21,680 --> 01:56:23,560 AND MAYBE IN 2020 WE SHOULD HAVE 3127 01:56:23,560 --> 01:56:24,480 PAID MORE ATTENTION TO DOING 3128 01:56:24,480 --> 01:56:29,160 THAT RATHER THAN THE COMPLETE 3129 01:56:29,160 --> 01:56:29,440 OPPOSITE. 3130 01:56:29,440 --> 01:56:31,360 I DON'T KNOW IF THAT ANSWERS 3131 01:56:31,360 --> 01:56:31,800 YOUR ACTUAL QUESTION. 3132 01:56:31,800 --> 01:56:32,680 >> YES, THAT MAKES SENSE. 3133 01:56:32,680 --> 01:56:38,360 I WAS MORE THINKING ABOUT 3134 01:56:38,360 --> 01:56:39,880 WEATHER DISRUPTION, I'M FROM 3135 01:56:39,880 --> 01:56:41,520 FLORIDA, FORT LAUDERDALE, WHICH 3136 01:56:41,520 --> 01:56:42,840 CLOSED ITS SCHOOLS TODAY AND 3137 01:56:42,840 --> 01:56:43,680 GREW UP WITH HURRICANES. 3138 01:56:43,680 --> 01:56:45,160 WE WERE OUT OF SCHOOL FOR 3139 01:56:45,160 --> 01:56:46,360 SOMETIMES A COUPLE WEEKS. 3140 01:56:46,360 --> 01:56:47,960 I HAD THE PRIVILEGE OF NOT 3141 01:56:47,960 --> 01:56:49,640 NEEDING TO WORRY ABOUT WHERE MY 3142 01:56:49,640 --> 01:56:51,920 MEALS CAME FROM DURING THAT TIME 3143 01:56:51,920 --> 01:56:53,600 BUT WITH MY KNOWLEDGE OF FOOD 3144 01:56:53,600 --> 01:56:55,440 SECURITY I'M NOW THINKING MORE 3145 01:56:55,440 --> 01:56:57,960 ABOUT WHEN WE DO HAVE THESE 3146 01:56:57,960 --> 01:56:59,960 DISRUPTIONS, WE'RE SEEING MORE 3147 01:56:59,960 --> 01:57:03,880 FREQUENTLY, SCHOOLS CLOSE FOR 3148 01:57:03,880 --> 01:57:05,320 SAFETY AS WELL. 3149 01:57:05,320 --> 01:57:06,600 YEAH, I'VE BEEN THINKING ABOUT 3150 01:57:06,600 --> 01:57:08,880 THAT A LITTLE BIT. 3151 01:57:08,880 --> 01:57:09,280 >> INTERESTING. 3152 01:57:09,280 --> 01:57:12,720 >> DAN, HOW ABOUT WE GIVE YOU 3153 01:57:12,720 --> 01:57:14,920 THE LAST QUESTION? 3154 01:57:14,920 --> 01:57:16,400 >> THANK YOU. 3155 01:57:16,400 --> 01:57:19,240 I JUST THINK IT'S -- GETTING 3156 01:57:19,240 --> 01:57:20,520 BACK TO THE BOND-KIDS PROJECT 3157 01:57:20,520 --> 01:57:23,360 AND OUR MOTIVATION FOR DOING 3158 01:57:23,360 --> 01:57:25,800 THAT, THE RELEVANCE TO THE 3159 01:57:25,800 --> 01:57:26,560 ADVANTAGE PROJECT, SCHOOL MEALS 3160 01:57:26,560 --> 01:57:28,200 PROGRAMS ARE MORE THAN JUST AN 3161 01:57:28,200 --> 01:57:30,720 INCENTIVE TO GET KIDS TO GO TO 3162 01:57:30,720 --> 01:57:30,920 SCHOOL. 3163 01:57:30,920 --> 01:57:32,480 THEY REALLY ARE, AS DON 3164 01:57:32,480 --> 01:57:35,200 HIGHLIGHTED, OVER AND OVER 3165 01:57:35,200 --> 01:57:37,080 AGAIN, ABOUT THE CHILD'S HEALTH. 3166 01:57:37,080 --> 01:57:38,720 AND HOW DO YOU MEASURE THAT? 3167 01:57:38,720 --> 01:57:41,400 HOW DO YOU MEASURE THE IMPACT OF 3168 01:57:41,400 --> 01:57:43,320 THESE PROGRAMS ON THE CHILD'S 3169 01:57:43,320 --> 01:57:44,480 HEALTH AND WHAT DOMAINS SHOULD 3170 01:57:44,480 --> 01:57:46,040 WE LOOK AT, WHAT SYSTEMS SHOULD 3171 01:57:46,040 --> 01:57:51,200 WE BE LOOKING AT? ? 3172 01:57:51,200 --> 01:57:52,680 HOW DO YOU ASSESS THE IMPACT OF 3173 01:57:52,680 --> 01:57:55,680 THESE PROGRAMS? 3174 01:57:55,680 --> 01:57:57,840 IT'S MORE THAN KIDS NOT BEING 3175 01:57:57,840 --> 01:57:59,880 ABLE TO LEARN, NOT HAVING ACCESS 3176 01:57:59,880 --> 01:58:00,480 TO LEARN. 3177 01:58:00,480 --> 01:58:02,880 ITS HAD AN IMPACT ON THEIR 3178 01:58:02,880 --> 01:58:04,320 HEALTH AND PERHAPS SOME OF THE 3179 01:58:04,320 --> 01:58:08,160 DATA THAT WILL BE EMERGING WILL 3180 01:58:08,160 --> 01:58:09,440 START LOOKING AT INCREASE IN 3181 01:58:09,440 --> 01:58:10,200 PREVALENCE OF INFECTIOUS 3182 01:58:10,200 --> 01:58:12,280 DISEASE, IS THERE AN INCREASE IN 3183 01:58:12,280 --> 01:58:14,360 OTHER AT VERSE HEALTH OUTCOMES? 3184 01:58:14,360 --> 01:58:17,200 I THINK THAT BRINGS IT BACK TO 3185 01:58:17,200 --> 01:58:20,160 THE ISSUE HERE OF WHAT IS THE 3186 01:58:20,160 --> 01:58:21,600 HEALTH IMPACT OF THIS 3187 01:58:21,600 --> 01:58:23,000 INTERSECTION OF CLIMATE, 3188 01:58:23,000 --> 01:58:27,280 NUTRITION, FOOD SYSTEMS AND 3189 01:58:27,280 --> 01:58:28,680 PROGRAMS LIKE SCHOOL MEAL 3190 01:58:28,680 --> 01:58:32,080 PROGRAMS. 3191 01:58:32,080 --> 01:58:32,480 THANKS AGAIN, DON. 3192 01:58:32,480 --> 01:58:33,920 >> YES. 3193 01:58:33,920 --> 01:58:35,320 THANK YOU. 3194 01:58:35,320 --> 01:58:37,000 I SAW DREW PROPOSED KEEPING OUR 3195 01:58:37,000 --> 01:58:37,440 20-MINUTE BREAK. 3196 01:58:37,440 --> 01:58:38,920 I WAS GOING TO SPLIT THE 3197 01:58:38,920 --> 01:58:40,520 DIFFERENCE AND SAY 15. 3198 01:58:40,520 --> 01:58:43,560 LET'S GO WITH THE 20 AND WE'LL 3199 01:58:43,560 --> 01:58:43,920 TAKE THAT. 3200 01:58:43,920 --> 01:58:45,360 DON, I DON'T KNOW IF YOU CAN 3201 01:58:45,360 --> 01:58:46,160 CONTINUE WITH US. 3202 01:58:46,160 --> 01:58:47,880 IT'S LATE WHERE YOU ARE. 3203 01:58:47,880 --> 01:58:49,200 I'M GUESSING IT IS. 3204 01:58:49,200 --> 01:58:50,280 YOU'RE WELCOME TO CONTINUE TO 3205 01:58:50,280 --> 01:58:51,040 JOIN OUR GROUP. 3206 01:58:51,040 --> 01:58:53,600 BUT THANK YOU SO MUCH FOR YOUR 3207 01:58:53,600 --> 01:58:54,280 TALK. 3208 01:58:54,280 --> 01:58:54,960 IT WAS WONDERFUL. 3209 01:58:54,960 --> 01:58:57,200 >> WELL, THANK YOU, NANCY. 3210 01:58:57,200 --> 01:58:58,960 >>EVERYONE, LET'S TAKE A 3211 01:58:58,960 --> 01:58:59,600 20-MINUTE BREAK. 3212 01:58:59,600 --> 01:59:03,000 SO THAT GETS US BACK HERE AT 10 3213 01:59:03,000 --> 01:59:05,480 MINUTES TO THE HOUR. 3214 01:59:05,480 --> 01:59:05,880 THANK YOU. 3215 01:59:05,880 --> 01:59:08,960 >> SOUND GREAT. 3216 01:59:08,960 --> 01:59:09,120 THANKS. 3217 01:59:09,120 --> 01:59:11,000 >> THANK YOU FOR COMING BACK. 3218 01:59:11,000 --> 01:59:14,600 WE HAVE A FEW MORE MOMENTS 3219 01:59:14,600 --> 01:59:16,920 BEFORE MY CLOCK SAYS IT'S TEN 3220 01:59:16,920 --> 01:59:18,680 TO. 3221 01:59:18,680 --> 01:59:19,680 LOOKS LIKE EVERYBODY'S BACK 3222 01:59:19,680 --> 01:59:20,160 ONLINE. 3223 01:59:20,160 --> 01:59:25,680 WE MIGHT AS WELL GET STARTED. 3224 01:59:25,680 --> 01:59:31,160 I'M DELIGHTED TO INTRODUCE DR. 3225 01:59:31,160 --> 01:59:31,840 SHANKAR, MATERNAL HEALTH, 3226 01:59:31,840 --> 01:59:33,480 LACTATION, CLIMATE AND HEALTH. 3227 01:59:33,480 --> 01:59:34,560 LOOK FORWARD TO YOUR 3228 01:59:34,560 --> 01:59:42,640 PRESENTATION. 3229 01:59:42,640 --> 01:59:45,280 3230 01:59:45,280 --> 01:59:52,720 >> THANK YOU, DR. EBI. 3231 01:59:52,720 --> 01:59:56,000 THANK YOU TO DREW, DAN, ALISON 3232 01:59:56,000 --> 01:59:57,120 AND CO-CHAIRS FOR ABLY LEADING 3233 01:59:57,120 --> 02:00:00,040 THIS GROUP. 3234 02:00:00,040 --> 02:00:07,600 3235 02:00:07,600 --> 02:00:09,240 I'M GOING TO GO BACK AFTER THE 3236 02:00:09,240 --> 02:00:11,640 WONDERFUL TALK FROM DR. BUNDY 3237 02:00:11,640 --> 02:00:15,240 AND REWIND TO THE FIRST THOUSAND 3238 02:00:15,240 --> 02:00:15,680 DAYS. 3239 02:00:15,680 --> 02:00:19,880 AND TALK ABOUT WHAT WE KNOW 3240 02:00:19,880 --> 02:00:24,000 ABOUT CLIMATE IMPACTS DURING THE 3241 02:00:24,000 --> 02:00:26,320 PREGNANCY AND EARLY LIFE. 3242 02:00:26,320 --> 02:00:31,320 WE'VE SEEN THIS SCHEMATIC IN 3243 02:00:31,320 --> 02:00:34,040 SEVERAL VERSIONS, IN MANY 3244 02:00:34,040 --> 02:00:35,160 PREVIOUS TALKS. 3245 02:00:35,160 --> 02:00:40,200 THE FEW OF US WHO MAYBE JOINED 3246 02:00:40,200 --> 02:00:41,880 LATER, WE'RE IN WORKING GROUP 1 3247 02:00:41,880 --> 02:00:44,640 INTERESTED IN THIS INTERACTION 3248 02:00:44,640 --> 02:00:46,120 OF THE HEALTH OUTCOMES BETWEEN 3249 02:00:46,120 --> 02:00:49,400 CLIMATE CHANGE AND NUTRITION, 3250 02:00:49,400 --> 02:00:52,360 I'LL FOCUS ON PREGNANCY AND 3251 02:00:52,360 --> 02:00:53,560 EARLY LIFE. 3252 02:00:53,560 --> 02:00:57,080 BROADLY AS WE'VE HEARD DR. EBI 3253 02:00:57,080 --> 02:01:00,480 DISCUSS THIS, EFFECTS OF CLIMATE 3254 02:01:00,480 --> 02:01:07,480 ARE DIRECT AND INDIRECT, AND 3255 02:01:07,480 --> 02:01:10,440 DATA, PRECIPITATION EVENTS, 3256 02:01:10,440 --> 02:01:12,520 FLOODING ARE THE PREDOMINANT 3257 02:01:12,520 --> 02:01:13,080 ONES. 3258 02:01:13,080 --> 02:01:17,000 I'M TRYING TO IN THIS GRAPHIC 3259 02:01:17,000 --> 02:01:19,520 SUMMARIZE THE EXISTING EVIDENCE 3260 02:01:19,520 --> 02:01:21,600 FROM THESE EXPOSURES, 3261 02:01:21,600 --> 02:01:25,560 CLIMATE-RELATED EXPOSURES, 3262 02:01:25,560 --> 02:01:27,200 ESPECIALLY IN PREGNANCY AND 3263 02:01:27,200 --> 02:01:28,520 OUTCOMES STUDIED. 3264 02:01:28,520 --> 02:01:31,680 SIZE OF THE ARROWS REPRESENTS 3265 02:01:31,680 --> 02:01:37,840 PREDOMINANCE OF LIMIT -- 3266 02:01:37,840 --> 02:01:41,760 LITERATURE IN EACH AREA, 3267 02:01:41,760 --> 02:01:47,000 DOMINATED BY HEAT AND AIR 3268 02:01:47,000 --> 02:01:47,760 POLLUTION. 3269 02:01:47,760 --> 02:01:51,600 MOST OF THE OUTCOMES THAT HAVE 3270 02:01:51,600 --> 02:01:55,400 BEEN STUDIED IN GESTATIONAL 3271 02:01:55,400 --> 02:01:57,600 LENGTH, PREECLAMPSIA, OUTCOMES 3272 02:01:57,600 --> 02:01:59,840 SUCH AS PRE-TERM BIRTH AND 3273 02:01:59,840 --> 02:02:01,320 STILLBIRTH, MOSTLY STUDIED IN 3274 02:02:01,320 --> 02:02:03,400 THE LITERATURE. 3275 02:02:03,400 --> 02:02:05,600 IT'S GOING TO BE HARD TO 3276 02:02:05,600 --> 02:02:08,960 SUMMARIZE A LOT OF THIS DATA, IN 3277 02:02:08,960 --> 02:02:10,960 THE SHORT TEN MINUTES. 3278 02:02:10,960 --> 02:02:13,880 THERE HAVE BEEN SEVERAL 3279 02:02:13,880 --> 02:02:16,360 META-ANALYSES AND SYSTEMATIC 3280 02:02:16,360 --> 02:02:22,000 ANNUAL -- ANALYSES IN THE 3281 02:02:22,000 --> 02:02:23,720 CONTEXT OF PREGNANCY, STRONG 3282 02:02:23,720 --> 02:02:28,520 EVIDENCE FOR EFFECTS OF HEAT TO 3283 02:02:28,520 --> 02:02:30,080 HAVE DETRIMENTAL EFFECTS ON 3284 02:02:30,080 --> 02:02:31,160 SEVERAL OUTCOMES, NOTED IN MANY 3285 02:02:31,160 --> 02:02:34,240 PARTS OF THE WORLD INCLUDING THE 3286 02:02:34,240 --> 02:02:38,320 U.S., IN LARGE SCHEMATIC 3287 02:02:38,320 --> 02:02:39,200 ANALYSES, PROJECTION STUDIES 3288 02:02:39,200 --> 02:02:41,280 SUGGESTED THAT BOTH SOUTH ASIA 3289 02:02:41,280 --> 02:02:43,040 AND MIDDLE EAST AND NORTH AFRICA 3290 02:02:43,040 --> 02:02:47,280 REGION ARE GOING TO BE 3291 02:02:47,280 --> 02:02:49,840 ESPECIALLY SUSCEPTIBLE IN FUTURE 3292 02:02:49,840 --> 02:02:53,080 TO EFFECTS OF HEAT ON PREGNANCY 3293 02:02:53,080 --> 02:02:53,440 OUTCOMES. 3294 02:02:53,440 --> 02:02:55,280 HERE IS MORE SPECIFIC 3295 02:02:55,280 --> 02:03:01,200 INFORMATION IN THIS CONTEXT. 3296 02:03:01,200 --> 02:03:03,920 LARGE META ANALYSES A COUPLE 3297 02:03:03,920 --> 02:03:06,000 YEARS AGO IN THE U.S. INCLUDING 3298 02:03:06,000 --> 02:03:08,640 32 MILLION BIRTHS SHOWED RISK OF 3299 02:03:08,640 --> 02:03:10,280 BOTH PRE-TERM BIRTH, LOW BIRTH 3300 02:03:10,280 --> 02:03:11,760 WEIGHT AND STILLBIRTH WAS 3301 02:03:11,760 --> 02:03:13,240 INCREASED IN 9 OUT OF 10 STUDIES 3302 02:03:13,240 --> 02:03:17,280 IN A LOOKED AT HEAT, ALMOST 85% 3303 02:03:17,280 --> 02:03:19,680 LOOKED AT AIR POLLUTION. 3304 02:03:19,680 --> 02:03:21,560 AND SPECIFIC METRIC OF AIR 3305 02:03:21,560 --> 02:03:25,400 QUALITY, THIS IS THE ABUNDANCE 3306 02:03:25,400 --> 02:03:29,880 OF PARTICULATE MATTER AROUND 3307 02:03:29,880 --> 02:03:34,480 2.5-MICRON RANGE,ING PM2.5 IN 3308 02:03:34,480 --> 02:03:38,640 LITERATURE, ABUNDANCE OF AIR 3309 02:03:38,640 --> 02:03:40,440 POLLUTANT IS ASSOCIATED WITH A 3310 02:03:40,440 --> 02:03:45,600 LOT OF NEGATIVE OUTCOMES. 3311 02:03:45,600 --> 02:03:46,880 MUCH MORE COMPREHENSIVE 3312 02:03:46,880 --> 02:03:47,640 META-ANALYSIS WORLDWIDE LOOKING 3313 02:03:47,640 --> 02:03:50,480 AT HEAT STRESS AND EXTREME HEAT 3314 02:03:50,480 --> 02:03:58,160 EXPOSURE IN PREGNANCY WAS DONE, 3315 02:03:58,160 --> 02:04:03,080 CLEARLY SHOWED 70 STUDIES OUT OF 3316 02:04:03,080 --> 02:04:05,280 WHICH 7 WERE IN LOW- AND 3317 02:04:05,280 --> 02:04:06,800 MIDDLE-INCOME COUNTRIES, 3318 02:04:06,800 --> 02:04:08,880 DOMINANCE OF DATA CAME FROM 3319 02:04:08,880 --> 02:04:11,960 HIGH-INCOME COUNTRIES, SHOWED 3320 02:04:11,960 --> 02:04:14,800 RISK OF PRE-TERM BIRTH AND 3321 02:04:14,800 --> 02:04:17,560 STILLBIRTH, LOW BIRTH WEIGHT 3322 02:04:17,560 --> 02:04:19,120 INCREASES AS TEMPERATURE 3323 02:04:19,120 --> 02:04:20,520 EXPOSURE IN PREGNANCY INCREASES. 3324 02:04:20,520 --> 02:04:27,160 THERE WERE LOTS OF CAVEATS TO 3325 02:04:27,160 --> 02:04:28,080 OBSERVATIONS, PRIMARILY 3326 02:04:28,080 --> 02:04:30,400 HETEROGENEITY IN DEFINING 3327 02:04:30,400 --> 02:04:32,880 TEMPERATURES, METHODS USED TO 3328 02:04:32,880 --> 02:04:34,880 DEVELOP, WINDOWS TO EXAMINE, AND 3329 02:04:34,880 --> 02:04:37,720 ONLY 7 OUT OF THE 70 STUDIES 3330 02:04:37,720 --> 02:04:38,920 WERE DONE IN LOW- AND 3331 02:04:38,920 --> 02:04:40,520 MIDDLE-INCOME COUNTRIES AND EVEN 3332 02:04:40,520 --> 02:04:43,720 MANY OF THESE WERE IN MIDDLE 3333 02:04:43,720 --> 02:04:46,360 INCOME COUNTRIES. 3334 02:04:46,360 --> 02:04:48,000 SO REALLY WE'RE MISSING A LOT OF 3335 02:04:48,000 --> 02:04:49,440 DATA WHERE EXPOSURE IS LARGEST. 3336 02:04:49,440 --> 02:04:52,040 THERE WAS VERY ALSO INCLUSION OF 3337 02:04:52,040 --> 02:04:56,000 MATERNAL NUTRITIONAL STATUS AND 3338 02:04:56,000 --> 02:04:57,840 FEW ANALYSES THAT INCLUDED 3339 02:04:57,840 --> 02:05:00,280 SUBANALYSES BASED ON MATERNAL 3340 02:05:00,280 --> 02:05:00,600 NUTRITION. 3341 02:05:00,600 --> 02:05:02,040 THIS IS AN IMPORTANT COMPONENT 3342 02:05:02,040 --> 02:05:04,000 OF WHAT WE'RE TRYING TO 3343 02:05:04,000 --> 02:05:04,320 UNDERSTAND. 3344 02:05:04,320 --> 02:05:07,600 WE'VE BEEN TRYING TO 3345 02:05:07,600 --> 02:05:11,600 UNDERSTAND -- IMPLICIT AMONG THE 3346 02:05:11,600 --> 02:05:12,200 PREDISPOSITION AMONG LOW- AND 3347 02:05:12,200 --> 02:05:15,800 MIDDLE-INCOME COUNTRIES WE HEARD 3348 02:05:15,800 --> 02:05:18,320 SEVERAL SPEAKERS TALK ABOUT 3349 02:05:18,320 --> 02:05:19,200 MATERNAL NUTRITION STATUS 3350 02:05:19,200 --> 02:05:21,720 PERHAPS PLAYS AN IMPORTANT ROLE 3351 02:05:21,720 --> 02:05:23,440 IN MODIFYING THIS RELATIONSHIP 3352 02:05:23,440 --> 02:05:24,680 BETWEEN ENVIRONMENTAL STRESSORS 3353 02:05:24,680 --> 02:05:25,320 AND OUTCOMES. 3354 02:05:25,320 --> 02:05:28,400 WE'VE BEEN INTERESTED IN THIS 3355 02:05:28,400 --> 02:05:32,440 QUESTION, WE'VE LEVERAGED ONE 3356 02:05:32,440 --> 02:05:35,480 DATASET FROM PAKISTAN, WHICH 3357 02:05:35,480 --> 02:05:41,160 RANKS HIGHLY IN THE CLIMATE -- 3358 02:05:41,160 --> 02:05:46,320 CHILDREN'S CLIMATE RISK INDEX, 3359 02:05:46,320 --> 02:05:53,120 LOOKING AT WOMEN WHO WERE FROM A 3360 02:05:53,120 --> 02:05:54,960 STUDY CALLED WOMEN FIRST FROM 3361 02:05:54,960 --> 02:05:57,480 NICHD AND GATES FOUNDATION, 3362 02:05:57,480 --> 02:06:00,600 WOMEN WERE RANDOMIZED TO 3363 02:06:00,600 --> 02:06:02,000 MULTIPLE MICRONUTRIENT 3364 02:06:02,000 --> 02:06:03,640 SUPPLEMENTATION, BEFORE 3365 02:06:03,640 --> 02:06:06,480 CONCEPTION, DURING PREGNANCY, OR 3366 02:06:06,480 --> 02:06:08,120 RECEIVED CONTROL OR NO 3367 02:06:08,120 --> 02:06:08,440 INTERVENTION. 3368 02:06:08,440 --> 02:06:10,080 COMPARING EFFECTS OF HEAT AMONG 3369 02:06:10,080 --> 02:06:13,360 THE THREE GROUPS PROVIDED US THE 3370 02:06:13,360 --> 02:06:15,760 BALANCE BETWEEN UNDERSTANDING 3371 02:06:15,760 --> 02:06:17,880 INTERACTIONS BETWEEN 3372 02:06:17,880 --> 02:06:18,520 PRE-CONCEPTION MATERNAL 3373 02:06:18,520 --> 02:06:22,200 NUTRITION AND EFFECTS OF HEAT 3374 02:06:22,200 --> 02:06:22,440 STRESS. 3375 02:06:22,440 --> 02:06:26,360 IN THIS ANALYSIS IT WAS OBVIOUS 3376 02:06:26,360 --> 02:06:29,400 THAT THE CHILD'S BIRTH LENGTH 3377 02:06:29,400 --> 02:06:30,560 WAS NEGATIVELY ASSOCIATED WITH 3378 02:06:30,560 --> 02:06:32,840 HEAT EXPOSURE IN FIRST 3379 02:06:32,840 --> 02:06:35,680 TRIMESTER, WHETHER HEAT EXPOSURE 3380 02:06:35,680 --> 02:06:39,000 WAS CONTINUOUS OUTCOME EXPOSURE 3381 02:06:39,000 --> 02:06:40,640 OR A CATEGORICAL EXPOSURE. 3382 02:06:40,640 --> 02:06:42,480 HIGH DAYS OF HEAT STRESS LET TO 3383 02:06:42,480 --> 02:06:45,120 SMALLER LENGTH BABIES AT BIRTH. 3384 02:06:45,120 --> 02:06:46,880 WHAT WAS NOTABLE WAS THAT THIS 3385 02:06:46,880 --> 02:06:50,160 EFFECT OF HEAT STRESS WAS 3386 02:06:50,160 --> 02:06:51,400 ACTUALLY OBSERVED ONLY IN THE 3387 02:06:51,400 --> 02:06:56,120 WOMEN WHO DID NOT RECEIVE 3388 02:06:56,120 --> 02:06:56,880 NUTRITIONAL SUPPLEMENTATION 3389 02:06:56,880 --> 02:06:58,160 SUGGESTING PROVIDING OR 3390 02:06:58,160 --> 02:06:59,040 IMPROVING MATERNAL NUTRITION 3391 02:06:59,040 --> 02:07:00,920 PRIOR TO PREGNANCY OR PRIOR TO 3392 02:07:00,920 --> 02:07:07,920 THE HEAT EXPOSURE PERIOD 3393 02:07:07,920 --> 02:07:08,400 ACTUALLY MITIGATED. 3394 02:07:08,400 --> 02:07:11,440 THIS IS ONE OF THE FEW STUDIES 3395 02:07:11,440 --> 02:07:15,160 MATERNAL NUTRITION HAS BEEN 3396 02:07:15,160 --> 02:07:16,360 EXAMINED AS A FACTOR. 3397 02:07:16,360 --> 02:07:20,080 WE SAW THAT AS AN EXAMPLE WHERE 3398 02:07:20,080 --> 02:07:22,040 NUTRITION WAS A MODIFIER FOR 3399 02:07:22,040 --> 02:07:25,760 CLIMATE STRESSORS BUT THERE 3400 02:07:25,760 --> 02:07:28,600 EXISTS EVIDENCE WHERE NUTRITION 3401 02:07:28,600 --> 02:07:30,800 ITSELF IS AN OUTPUT, MATERNAL 3402 02:07:30,800 --> 02:07:32,320 NUTRITION ITSELF IS AFFECTED BY 3403 02:07:32,320 --> 02:07:35,280 CLIMATE STRESSORS AND IN THIS 3404 02:07:35,280 --> 02:07:39,560 CASE IT'S ANEMIA AND PM2.5 3405 02:07:39,560 --> 02:07:42,400 LEVELS IN INDIA WITH A HIGH 3406 02:07:42,400 --> 02:07:44,000 PREVALENCE OF ANEMIA, HALF WOMEN 3407 02:07:44,000 --> 02:07:46,640 OF PRODUCTION AGE HAVE SOME 3408 02:07:46,640 --> 02:07:47,480 LEVEL OF ANEMIA, ONE OF THE 3409 02:07:47,480 --> 02:07:49,440 WORST AIR QUALITIES IN THE WORLD 3410 02:07:49,440 --> 02:07:59,040 WHERE LEVELS OF PM2.5 EXCEEDS BY 3411 02:07:59,040 --> 02:08:01,120 SEVERAL LEVELS OF MAGNITUDE. 3412 02:08:01,120 --> 02:08:03,920 THIS IS 80% OF WOMEN IN DARK 3413 02:08:03,920 --> 02:08:07,560 SHADES OF BROWN. 3414 02:08:07,560 --> 02:08:10,320 THIS GRAPH AT THE BOTTOM SHOWS 3415 02:08:10,320 --> 02:08:13,120 PROBABILITY OF HAVING ANEMIA AS 3416 02:08:13,120 --> 02:08:15,200 AIR QUALITY DECREASES. 3417 02:08:15,200 --> 02:08:19,120 AS PM2.5 INCREASES, PROBABILITY 3418 02:08:19,120 --> 02:08:22,680 OF A PERSON BEING DIAGNOSED WITH 3419 02:08:22,680 --> 02:08:25,760 ANEMIA CHANGES SUBSTANTIALLY. 3420 02:08:25,760 --> 02:08:26,880 THIS ANALYSIS DID PROJECTIONS, 3421 02:08:26,880 --> 02:08:28,600 LOOKING AT WHAT WOULD HAPPEN IF 3422 02:08:28,600 --> 02:08:31,520 INDIA STARTED TO MEET SOME OF 3423 02:08:31,520 --> 02:08:33,600 ITS AIR QUALITY TARGETS OR CLEAN 3424 02:08:33,600 --> 02:08:37,000 AIR TARGETS. 3425 02:08:37,000 --> 02:08:41,360 IF IT REALLY MET THE WORLD 3426 02:08:41,360 --> 02:08:42,920 HEALTH ORGANIZATION GUIDELINE 3427 02:08:42,920 --> 02:08:45,200 FOR QUALITY WOULD SIGNIFICANTLY 3428 02:08:45,200 --> 02:08:49,400 DECREASE ANEMIA PREVALENCE, OVER 3429 02:08:49,400 --> 02:08:51,000 186 DISTRICTS WOULD FALL BELOW 3430 02:08:51,000 --> 02:08:54,000 THE TARGET OF 35% SUGGESTING 3431 02:08:54,000 --> 02:08:58,480 NEXUS OF MATERNAL NUTRITION, 3432 02:08:58,480 --> 02:08:59,760 RESPONSE TO NUTRITIONAL 3433 02:08:59,760 --> 02:09:01,760 INTERVENTIONS AND HEALTH 3434 02:09:01,760 --> 02:09:04,720 OUTCOMES IS ACTUALLY STRONG. 3435 02:09:04,720 --> 02:09:07,320 WE KNOW PREGNANCY HAS A LOT OF 3436 02:09:07,320 --> 02:09:11,160 CHANGES AND TO REALLY UNDERSTAND 3437 02:09:11,160 --> 02:09:15,000 THE NUTS AND BOLTS OF VARIABLES, 3438 02:09:15,000 --> 02:09:17,520 WE NEED PHYSIOLOGICAL 3439 02:09:17,520 --> 02:09:18,240 UNDERSTANDING. 3440 02:09:18,240 --> 02:09:20,560 WE KNOW THAT HEAT HAS IMPACT ON 3441 02:09:20,560 --> 02:09:21,440 PHYSIOLOGY ESPECIALLY IN 3442 02:09:21,440 --> 02:09:23,320 PREGNANCY, AND PREGNANCY IS 3443 02:09:23,320 --> 02:09:27,040 ASSOCIATED WITH ITS OWN SET OF 3444 02:09:27,040 --> 02:09:28,560 PHYSIOLOGICAL CHANGES INCLUDING 3445 02:09:28,560 --> 02:09:29,640 LOWERING OF CORE BODY 3446 02:09:29,640 --> 02:09:33,480 TEMPERATURE, INCREASE IN PLASMA 3447 02:09:33,480 --> 02:09:35,760 VOLUME DEFENDING AGAINST EFFECTS 3448 02:09:35,760 --> 02:09:38,640 OF HEAT, NICELY SUMMARIZED IN 3449 02:09:38,640 --> 02:09:39,840 THIS SCHEMATIC PUBLISHED IN "THE 3450 02:09:39,840 --> 02:09:46,960 LANCET" A FEW YEARS AGO. 3451 02:09:46,960 --> 02:09:50,680 AND EFFECTS ARE SYSTEMIC. 3452 02:09:50,680 --> 02:09:55,680 CHANGE CARDIO OUTPUT, BLOOD 3453 02:09:55,680 --> 02:10:00,760 PERFUSION TO THE TRUNK, MANY 3454 02:10:00,760 --> 02:10:01,840 ENDOCRINE CHANGES INCLUDING 3455 02:10:01,840 --> 02:10:04,120 ENDOTOXEMIA DUE TO CHANGES IN 3456 02:10:04,120 --> 02:10:08,280 GUT PERMEABILITY, LEADING TO 3457 02:10:08,280 --> 02:10:12,920 CHANGES IN BLOOD FLOW, OXIDATIVE 3458 02:10:12,920 --> 02:10:16,520 STRESS, ENDOTOXEMIA, IMPACTING 3459 02:10:16,520 --> 02:10:20,480 HEALTH OUTCOMES IN PREGNANCY. 3460 02:10:20,480 --> 02:10:24,600 ONE GAP HAS BEEN MEASURING IN 3461 02:10:24,600 --> 02:10:26,200 PHYSIOLOGICAL STATES EFFECTS OF 3462 02:10:26,200 --> 02:10:30,000 HEAT STRESS ON THE PLACENTA AND 3463 02:10:30,000 --> 02:10:31,520 PLACENTAL FUNCTION. 3464 02:10:31,520 --> 02:10:34,280 I WANT TO HIGHLIGHT THESE PAPERS 3465 02:10:34,280 --> 02:10:36,560 FROM THE LONDON SCHOOL OF 3466 02:10:36,560 --> 02:10:39,920 HYGIENE AND TROPICAL MEDICINE 3467 02:10:39,920 --> 02:10:42,600 WHERE WOMEN IN GAMBIA HAD 3468 02:10:42,600 --> 02:10:43,720 BEEN -- PHYSIOLOGIC OUTCOMES IN 3469 02:10:43,720 --> 02:10:48,040 THIS COHORT HAS BEEN MEASURED 3470 02:10:48,040 --> 02:10:49,560 USING DOPPLER UMBILICAL THAT CAN 3471 02:10:49,560 --> 02:10:56,280 MEASURE TRUE CORD BLOOD VELOCITY 3472 02:10:56,280 --> 02:10:58,560 AND UTERINE HEART RESISTANCE, 3473 02:10:58,560 --> 02:10:59,880 IMPORTANT MEASURES OF PLACEBO 3474 02:10:59,880 --> 02:11:07,760 CERTAINLY BLOOD FLOW AND DELIVER 3475 02:11:07,760 --> 02:11:07,960 Y 3476 02:11:07,960 --> 02:11:10,480 TO THE FETUS. 3477 02:11:10,480 --> 02:11:12,040 A PHYSIOLOGICAL MEASURE OF 3478 02:11:12,040 --> 02:11:13,760 THERMAL STRESS WAS MEASURED, 3479 02:11:13,760 --> 02:11:19,480 PRETTY EVIDENT AS TEMPERATURES 3480 02:11:19,480 --> 02:11:21,320 GO UP, THE ARTERY RESISTANCE 3481 02:11:21,320 --> 02:11:22,640 GOES UP. 3482 02:11:22,640 --> 02:11:29,200 AND FETAL STRESS MEASURED BY 3483 02:11:29,200 --> 02:11:30,520 HEART RATE GOES UP. 3484 02:11:30,520 --> 02:11:31,720 EVEN IN CONDITIONS IN NOT 3485 02:11:31,720 --> 02:11:35,000 EXTREME HEAT STRESS THERE'S A 3486 02:11:35,000 --> 02:11:35,920 STRONG PHYSIOLOGIC RESPONSE IN 3487 02:11:35,920 --> 02:11:37,520 PREGNANCY OF THE MOTHER AND 3488 02:11:37,520 --> 02:11:37,720 FETUS. 3489 02:11:37,720 --> 02:11:42,800 WE KNOW THIS IS RELEVANT BECAUSE 3490 02:11:42,800 --> 02:11:44,760 ALMOST 750 MILLION KIDS LIVE IN 3491 02:11:44,760 --> 02:11:45,960 AREAS THROUGHOUT THE WORLD THAT 3492 02:11:45,960 --> 02:11:50,560 HAVE VERY HIGH NUMBER OF HEAT 3493 02:11:50,560 --> 02:11:51,760 DAYS. 3494 02:11:51,760 --> 02:11:52,320 THIS WAS REALLY ELEGANTLY 3495 02:11:52,320 --> 02:11:56,040 HIGHLIGHTED IN THE REPORT BY THE 3496 02:11:56,040 --> 02:11:58,320 UNICEF WHICH WAS APTLY NAMED 3497 02:11:58,320 --> 02:12:00,760 COLDEST YEAR OF THE REST OF 3498 02:12:00,760 --> 02:12:01,520 THEIR LIVES. 3499 02:12:01,520 --> 02:12:03,800 BY 2050 IT'S PROJECTED UNDER ANY 3500 02:12:03,800 --> 02:12:05,040 WARMING SCENARIO ALMOST ALL KIDS 3501 02:12:05,040 --> 02:12:08,320 ON THE PLANET ARE GOING TO BE 3502 02:12:08,320 --> 02:12:11,240 EXPOSED TO GREATER HEAT STRESS 3503 02:12:11,240 --> 02:12:11,520 THAN NOW. 3504 02:12:11,520 --> 02:12:15,640 THIS IS CERTAINLY AN URGENT 3505 02:12:15,640 --> 02:12:16,640 ISSUE. 3506 02:12:16,640 --> 02:12:19,360 THERE ARE LONG-TERM IMPACTS OF 3507 02:12:19,360 --> 02:12:22,200 BOTH HEAT AND OTHER 3508 02:12:22,200 --> 02:12:22,920 ENVIRONMENTAL EXPOSURES ON 3509 02:12:22,920 --> 02:12:23,840 INFANTS AND CHILDREN. 3510 02:12:23,840 --> 02:12:27,800 THE MOST STUDY AMONG THESE IS 3511 02:12:27,800 --> 02:12:29,520 HIGH AMBIENT TEMPERATURE, 3512 02:12:29,520 --> 02:12:32,600 ASSOCIATED WITH GROWTH ALTERING, 3513 02:12:32,600 --> 02:12:34,360 STUNTING, OCCURRENCE OF WASTING 3514 02:12:34,360 --> 02:12:38,200 AND STUNTING, SHOWN TO HAPPEN IN 3515 02:12:38,200 --> 02:12:39,280 SUB-SAHARAN AFRICA AND SOUTH 3516 02:12:39,280 --> 02:12:41,000 ASIAN CONTINENT IN LARGE STUDIES 3517 02:12:41,000 --> 02:12:44,640 INVOLVING HUNDREDS OF THOUSANDS 3518 02:12:44,640 --> 02:12:46,040 OF CHILDREN IN THE FIVE YEAR 3519 02:12:46,040 --> 02:12:50,080 RANGE AND THEN OTHER STUDIES OUT 3520 02:12:50,080 --> 02:12:51,440 OF CHINA HAVE SUGGESTED THAT 3521 02:12:51,440 --> 02:12:52,200 EXTREME TEMPERATURES IN 3522 02:12:52,200 --> 02:12:55,280 PREGNANCY AND MEASURES OF AIR 3523 02:12:55,280 --> 02:12:58,000 POLLUTION CAN CAUSE LONG-TERM 3524 02:12:58,000 --> 02:12:59,000 NEURODEVELOPMENTAL AND OTHER 3525 02:12:59,000 --> 02:13:02,920 IMMUNOLOGIC CHANGES. 3526 02:13:02,920 --> 02:13:04,480 ONE IMPORTANT STUDY POINTED TO 3527 02:13:04,480 --> 02:13:06,640 THE CHANGES IN PRECIPITATION 3528 02:13:06,640 --> 02:13:11,800 PATTERNS AS MEASURED BY THIS 3529 02:13:11,800 --> 02:13:12,000 INDEX. 3530 02:13:12,000 --> 02:13:14,400 WHAT YOU SEE IN THE GRAPH AS 3531 02:13:14,400 --> 02:13:19,480 PRECIPITATION BECOMES TOO WET OR 3532 02:13:19,480 --> 02:13:21,040 TOO DRY, IT CHANGES THE HEIGHT Z 3533 02:13:21,040 --> 02:13:23,240 SCORES OF THE CHILDREN 3534 02:13:23,240 --> 02:13:25,440 SUGGESTING THAT OBVIOUSLY 3535 02:13:25,440 --> 02:13:26,160 PRECIPITATION PATTERNS STILL 3536 02:13:26,160 --> 02:13:28,240 HAVE AN IMPACT ON THE GROWTH OF 3537 02:13:28,240 --> 02:13:29,000 CHILDREN. 3538 02:13:29,000 --> 02:13:32,400 AND THIS COULD BE MEDIATED 3539 02:13:32,400 --> 02:13:34,920 THROUGH MANY FACTORS AND TWO 3540 02:13:34,920 --> 02:13:37,160 IMPORTANT FACTORS RELEVANT FOR 3541 02:13:37,160 --> 02:13:39,960 ADVANTAGE WERE NUTRITIONAL 3542 02:13:39,960 --> 02:13:42,240 DIVERSITY OF AGRICULTURE AND 3543 02:13:42,240 --> 02:13:44,120 RELATED FACTORS THAT MODERATED 3544 02:13:44,120 --> 02:13:45,400 THE ASSOCIATION. 3545 02:13:45,400 --> 02:13:47,400 SUGGESTING AGAIN THE NEXUS 3546 02:13:47,400 --> 02:13:48,480 BETWEEN CLIMATE VARIABLES SUCH 3547 02:13:48,480 --> 02:13:51,760 AS PRECIPITATION AND THEN HEALTH 3548 02:13:51,760 --> 02:13:54,040 OUTCOMES IN CHILDREN. 3549 02:13:54,040 --> 02:13:55,640 THERE'S ALSO RELATIONSHIP 3550 02:13:55,640 --> 02:14:00,520 OBSERVED BETWEEN PM 2.5 LEVELS 3551 02:14:00,520 --> 02:14:01,360 AND ANEMIA, AND HEMOGLOBIN 3552 02:14:01,360 --> 02:14:03,360 VALUES IN CHILDREN, SEEN WITH 3553 02:14:03,360 --> 02:14:06,880 PREGNANT WOMEN, AND SHE'S -- 3554 02:14:06,880 --> 02:14:09,120 THESE DATA COME FROM INDIA, 3555 02:14:09,120 --> 02:14:10,720 NATIONAL HEALTH SURVEY, DISTRICT 3556 02:14:10,720 --> 02:14:12,440 LEVEL AND INDIVIDUAL LEVEL DATA. 3557 02:14:12,440 --> 02:14:16,800 THESE GRAPHS ARE TELLING FOR 3558 02:14:16,800 --> 02:14:18,040 THEMSELVES, HEMOGLOBIN VALUES 3559 02:14:18,040 --> 02:14:20,640 PLUMMET AS AIR QUALITY 3560 02:14:20,640 --> 02:14:26,120 DECREASES, INCREASING THE ODDS 3561 02:14:26,120 --> 02:14:28,080 OF HAVING ANEMIA. 3562 02:14:28,080 --> 02:14:30,400 THE PHASE DURING LACTATION IS 3563 02:14:30,400 --> 02:14:31,920 ANOTHER IMPORTANT COMPONENT 3564 02:14:31,920 --> 02:14:34,080 WHERE CLIMATE VARIABLES COULD 3565 02:14:34,080 --> 02:14:36,520 AFFECT CONTINUUM OF MATERNAL 3566 02:14:36,520 --> 02:14:38,520 CHILD NUTRITION, AND FROM THE 3567 02:14:38,520 --> 02:14:42,640 WOMEN FIRST TRIAL SUGGEST THERE 3568 02:14:42,640 --> 02:14:47,560 SEASONAL VARIATIONS IN MILK 3569 02:14:47,560 --> 02:14:50,640 ENERGY ACKNOWLEDGE MILK FAT, 3570 02:14:50,640 --> 02:14:56,760 ASSOCIATE THE WITH TEMPERATURE 3571 02:14:56,760 --> 02:14:57,080 FLUCTUATIONS. 3572 02:14:57,080 --> 02:14:58,800 AND FINALLY, IT'S IMPORTANT TO 3573 02:14:58,800 --> 02:15:01,480 KNOW THAT FOR A LONG TIME WE'VE 3574 02:15:01,480 --> 02:15:04,640 KNOWN LACTATION IS SUSCEPTIBLE 3575 02:15:04,640 --> 02:15:07,600 TO HEAT STRESS FROM BOTH ANIMALS 3576 02:15:07,600 --> 02:15:08,840 AND AGRICULTURAL ANIMALS, AND 3577 02:15:08,840 --> 02:15:09,880 THERE'S A REALLY INTERESTING 3578 02:15:09,880 --> 02:15:14,080 ANALYSIS OUT OF COLORADO 3579 02:15:14,080 --> 02:15:17,560 SUGGESTING ANALYSIS OF OVER 3580 02:15:17,560 --> 02:15:19,000 13,000 COWS, MAPPING CLIMATE 3581 02:15:19,000 --> 02:15:20,640 DATA, AND SHOWING THERE IS 3582 02:15:20,640 --> 02:15:23,040 ACTUALLY A HUGE EFFECT OF HEAT 3583 02:15:23,040 --> 02:15:24,560 AND POLLUTION ON MILK 3584 02:15:24,560 --> 02:15:25,120 PRODUCTION. 3585 02:15:25,120 --> 02:15:27,960 BUT MUCH, MUCH LESS IS KNOWN 3586 02:15:27,960 --> 02:15:28,640 ABOUT BREASTFEEDING PRACTICES 3587 02:15:28,640 --> 02:15:31,440 AND MILK QUALITY AND COMPOSITION 3588 02:15:31,440 --> 02:15:32,560 IN HUMANS, CONTINUES TO BE AN 3589 02:15:32,560 --> 02:15:34,880 IMPORTANT AREA. 3590 02:15:34,880 --> 02:15:37,040 THERE'S A NEW PAPER RECENTLY 3591 02:15:37,040 --> 02:15:40,400 PUBLISHED LOOKING AT AROUND 800 3592 02:15:40,400 --> 02:15:42,960 WOMEN IN BURKINA FASO AND 3593 02:15:42,960 --> 02:15:45,920 TEMPERATURES AS EXPOSURE 3594 02:15:45,920 --> 02:15:47,560 VARIABLE SUGGESTING A 3595 02:15:47,560 --> 02:15:49,200 SIGNIFICANT DECREASE IN 3596 02:15:49,200 --> 02:15:50,320 BREASTFEEDING WITH INCREASED 3597 02:15:50,320 --> 02:15:51,280 AMBIENT TEMPERATURE, BUT THIS 3598 02:15:51,280 --> 02:15:53,160 WAS MOST PROMINENT IN OLDER KIDS 3599 02:15:53,160 --> 02:15:54,560 RATHER THAN YOUNGER KIDS. 3600 02:15:54,560 --> 02:15:58,400 SO THIS SEEMS TO BE AN OPEN 3601 02:15:58,400 --> 02:16:01,840 QUESTION ON THE IMPACTS OF THIS. 3602 02:16:01,840 --> 02:16:05,520 SO FINALLY I WANT TO LEAVE US 3603 02:16:05,520 --> 02:16:09,120 WITH SOME SUMMARY QUESTIONS THAT 3604 02:16:09,120 --> 02:16:11,200 EMERGED FROM THIS VIEW, WHICH IS 3605 02:16:11,200 --> 02:16:13,280 IN MOST STUDIES LOOKING AT 3606 02:16:13,280 --> 02:16:16,240 CLIMATE AND HEALTH NUTRITIONAL 3607 02:16:16,240 --> 02:16:17,440 STATUS REMAINS AN UNMEASURED 3608 02:16:17,440 --> 02:16:17,680 VARIABLE. 3609 02:16:17,680 --> 02:16:19,280 HEAT STRESS AND AIR POLLUTIONS 3610 02:16:19,280 --> 02:16:24,080 FORM THE PREDOMINANCE OF 3611 02:16:24,080 --> 02:16:24,720 EVIDENCE LINKING CLIMATE 3612 02:16:24,720 --> 02:16:25,760 VARIABLES AND CLIMATE EXPOSURES 3613 02:16:25,760 --> 02:16:29,120 AND HEALTH. 3614 02:16:29,120 --> 02:16:31,760 AND MOST STUDIES ASSOCIATE AND 3615 02:16:31,760 --> 02:16:34,720 DIRECT ATTRIBUTION TO A SINGLE 3616 02:16:34,720 --> 02:16:35,920 CLIMATE-RELATED EVENT REMAINS 3617 02:16:35,920 --> 02:16:37,000 CHALLENGING AND THIS SHOULD BE 3618 02:16:37,000 --> 02:16:40,640 AN IMPORTANT POINT OF OUR 3619 02:16:40,640 --> 02:16:40,920 DISCUSSION. 3620 02:16:40,920 --> 02:16:42,680 FINALLY, CONTEXT MATTERS A LOT 3621 02:16:42,680 --> 02:16:50,040 BECAUSE IN EVERY CASE WHERE 3622 02:16:50,040 --> 02:16:54,440 CLIMATE IMPACTS HAVE IMPACTED 3623 02:16:54,440 --> 02:16:56,400 HEALTH THERE ARE NICHES. 3624 02:16:56,400 --> 02:17:02,960 AND MOSTLY THE POSTPARTUM PERIOD 3625 02:17:02,960 --> 02:17:04,960 AND PREGNANCY HAVE BEEN 3626 02:17:04,960 --> 02:17:05,280 UNDERSTUDIED. 3627 02:17:05,280 --> 02:17:10,960 I'LL STOP AND LEAVE TIME FOR 3628 02:17:10,960 --> 02:17:11,240 DISCUSSION. 3629 02:17:11,240 --> 02:17:12,480 >> EXCELLENT REVIEW OF THE 3630 02:17:12,480 --> 02:17:19,080 KNOWLEDGE GAPS IN THIS AREA. 3631 02:17:19,080 --> 02:17:20,480 REALLY APPRECIATE THAT. 3632 02:17:20,480 --> 02:17:22,080 WE'RE RUNNING BEHIND SO WE'LL 3633 02:17:22,080 --> 02:17:23,480 MOVE TO DR. CHANG IN A MOMENT 3634 02:17:23,480 --> 02:17:24,320 AND COME BACK. 3635 02:17:24,320 --> 02:17:25,680 FIRST SET OF QUESTIONS WHEN WE 3636 02:17:25,680 --> 02:17:31,080 DID Q&A WILL BE TO YOU. 3637 02:17:31,080 --> 02:17:31,800 REALLY APPRECIATE THAT 3638 02:17:31,800 --> 02:17:33,640 COMPREHENSIVE REVIEW. 3639 02:17:33,640 --> 02:17:34,400 THE COMMENT ON THE ATTRIBUTION 3640 02:17:34,400 --> 02:17:36,160 THERE'S QUITE A BIT OF WORK 3641 02:17:36,160 --> 02:17:38,400 GOING ON IN TERMS OF ATTRIBUTION 3642 02:17:38,400 --> 02:17:40,400 IN THE HEALTH SECTOR AND HOW WE 3643 02:17:40,400 --> 02:17:41,400 DO THAT. 3644 02:17:41,400 --> 02:17:43,160 THERE'S SOME PAPERS THAT ARE 3645 02:17:43,160 --> 02:17:44,400 UNDER REVIEW AT THE MOMENT, 3646 02:17:44,400 --> 02:17:46,400 HOPEFULLY WILL SHED LIGHT ON 3647 02:17:46,400 --> 02:17:46,880 THAT IMPORTANT QUESTION. 3648 02:17:46,880 --> 02:17:49,240 THANK YOU VERY MUCH. 3649 02:17:49,240 --> 02:17:51,080 I'M SURE PEOPLE WILL WANT YOUR 3650 02:17:51,080 --> 02:17:52,000 SLIDES. 3651 02:17:52,000 --> 02:17:53,160 THAT WAS REALLY GREAT. 3652 02:17:53,160 --> 02:17:55,080 ANDY, DO YOU WANT TO COME UP 3653 02:17:55,080 --> 02:17:55,320 NEXT? 3654 02:17:55,320 --> 02:17:55,800 ARE YOU READY? 3655 02:17:55,800 --> 02:17:57,720 ARE YOU GOING TO SHARE YOUR 3656 02:17:57,720 --> 02:17:57,960 SLIDES? 3657 02:17:57,960 --> 02:18:04,000 >> YES. 3658 02:18:04,000 --> 02:18:06,720 I CAN DO THAT. 3659 02:18:06,720 --> 02:18:08,480 THAT WAS INCREDIBLE, I FEEL 3660 02:18:08,480 --> 02:18:11,320 INTIMIDATED GOING AFTER HIM. 3661 02:18:11,320 --> 02:18:12,840 I'LL DO MY BEST. 3662 02:18:12,840 --> 02:18:14,520 ALL RIGHT. 3663 02:18:14,520 --> 02:18:23,240 LET'S DO A QUICK SHARE. 3664 02:18:23,240 --> 02:18:25,240 CAN EVERYBODY SEE THE SLIDES? 3665 02:18:25,240 --> 02:18:25,680 >>YES. 3666 02:18:25,680 --> 02:18:26,440 >> PERFECT. 3667 02:18:26,440 --> 02:18:27,880 WELL, GOOD MORNING, EVERYBODY. 3668 02:18:27,880 --> 02:18:30,280 THANK YOU SO MUCH FOR STAYING 3669 02:18:30,280 --> 02:18:31,800 LONG ENOUGH TO SEE MY PORTION AT 3670 02:18:31,800 --> 02:18:38,040 THE END AND I HOPE I WON'T 3671 02:18:38,040 --> 02:18:38,800 DISAPPOINT. 3672 02:18:38,800 --> 02:18:40,120 ANDY CHANG, CARDIOLOGIST, 3673 02:18:40,120 --> 02:18:41,120 POSTDOCTORAL RESEARCH FELLOW 3674 02:18:41,120 --> 02:18:44,240 WITH CARDIOVASCULAR INSTITUTE AT 3675 02:18:44,240 --> 02:18:44,920 STANFORD. 3676 02:18:44,920 --> 02:18:47,000 ALSO WORKING ON A DOCTORATE 3677 02:18:47,000 --> 02:18:48,800 DEGREE IN EPIDEMIOLOGY AS WELL 3678 02:18:48,800 --> 02:18:49,600 CONCURRENTLY AT STANFORD. 3679 02:18:49,600 --> 02:18:52,240 I'M GOING TO TALK ABOUT THE 3680 02:18:52,240 --> 02:18:53,680 CLIMATE MEDIATED HEALTH CONCERNS 3681 02:18:53,680 --> 02:18:56,080 FOR OUR MIDDLE AGED AND OLDER 3682 02:18:56,080 --> 02:18:57,760 AGED ADULTS, AND AS YOU CAN 3683 02:18:57,760 --> 02:18:59,800 IMAGINE IT'S A BROAD TOPIC. 3684 02:18:59,800 --> 02:19:01,840 I APOLOGIZE I WON'T BE ABLE TO 3685 02:19:01,840 --> 02:19:06,040 GO INTO MUCH GRANULARITY ON SOME 3686 02:19:06,040 --> 02:19:06,320 CONCEPTS. 3687 02:19:06,320 --> 02:19:08,120 BUT ALSO NOTE THAT AS A 3688 02:19:08,120 --> 02:19:09,520 CARDIOLOGIST, AND GIVEN MY 3689 02:19:09,520 --> 02:19:10,200 PATIENT POPULATION, THERE WILL 3690 02:19:10,200 --> 02:19:12,840 BE A LITTLE BIT OF A BIAS 3691 02:19:12,840 --> 02:19:14,120 TOWARDS CARDIOVASCULAR DISEASE 3692 02:19:14,120 --> 02:19:15,560 AND OLDER ADULTS IN THIS TALK. 3693 02:19:15,560 --> 02:19:20,800 I WILL DO MY BEST TO REMAIN AS 3694 02:19:20,800 --> 02:19:22,000 UNBIASED AS POSSIBLE. 3695 02:19:22,000 --> 02:19:24,600 I DID WANT TO MENTION A COUPLE 3696 02:19:24,600 --> 02:19:26,440 DISCLOSURES AS DR. EBI MENTIONED 3697 02:19:26,440 --> 02:19:28,520 AT THE BEGINNING I DON'T HAVE 3698 02:19:28,520 --> 02:19:29,480 COMMERCIAL CONFLICTS OF INTEREST 3699 02:19:29,480 --> 02:19:32,120 BUT PAID BY THE U.S. FEDERAL 3700 02:19:32,120 --> 02:19:34,200 GOVERNMENT FOR MY CLINICAL WORK. 3701 02:19:34,200 --> 02:19:35,640 SO, CONTINUING ON THE LIFE 3702 02:19:35,640 --> 02:19:39,440 COURSE, A LITTLE BIT OF A JUMP 3703 02:19:39,440 --> 02:19:41,320 FROM 18 TO THE 40s, BUT 3704 02:19:41,320 --> 02:19:43,160 THERE'S PHENOMENON IN THE MIDDLE 3705 02:19:43,160 --> 02:19:44,280 AND OLDER AGE GROUPS, WE'RE 3706 02:19:44,280 --> 02:19:48,400 TALKING ABOUT THE 40s TO 60s 3707 02:19:48,400 --> 02:19:56,640 FOR THE MIDDLE AGES, 60s PLUS 3708 02:19:56,640 --> 02:20:00,640 FOR OLD, MOLECULAR, CELLULAR, 3709 02:20:00,640 --> 02:20:02,040 TISSUE-LEVEL CHANGES. 3710 02:20:02,040 --> 02:20:06,360 THERE ARE A LOT OF EXTERNAL AND 3711 02:20:06,360 --> 02:20:07,480 INTERNAL CONTRIBUTIONS, THINGS 3712 02:20:07,480 --> 02:20:10,640 LIKE UV LIGHT, DNA STRESS, 3713 02:20:10,640 --> 02:20:16,000 OXIDATIVE STRESS, WHICH INTERACT 3714 02:20:16,000 --> 02:20:16,680 WITH UNDERLYING GENETIC 3715 02:20:16,680 --> 02:20:17,880 SUSCEPTIBILITIES, INFLUENCING A 3716 02:20:17,880 --> 02:20:20,800 HOST OF GENETIC AND 3717 02:20:20,800 --> 02:20:22,360 CELLULAR-LEVEL PROCESSES THAT 3718 02:20:22,360 --> 02:20:23,840 ULTIMATELY LEAD TO THIS 3719 02:20:23,840 --> 02:20:25,760 PHENOTYPIC PHENOMENON THAT WE 3720 02:20:25,760 --> 02:20:26,920 CALL AGING. 3721 02:20:26,920 --> 02:20:30,120 AND WON'T GO INTO MUCH DEPTH BUT 3722 02:20:30,120 --> 02:20:33,200 THIS REVIEW BY LOPEZ ET AL. IN 3723 02:20:33,200 --> 02:20:37,640 "CELL" IN 2013 DOES A GOOD JOB 3724 02:20:37,640 --> 02:20:38,960 SUMMARIZING NINE DOMAINS, DEBATE 3725 02:20:38,960 --> 02:20:41,800 IF THERE'S A 10th OR 11th, 3726 02:20:41,800 --> 02:20:45,080 LIKE DECREASED ABILITY TO REPAIR 3727 02:20:45,080 --> 02:20:46,160 DNA, LOSS OF TELOMERES, 3728 02:20:46,160 --> 02:20:52,400 EPIGENETIC CHANGES ASSOCIATED 3729 02:20:52,400 --> 02:20:53,520 WITH AGING, CHRONIC 3730 02:20:53,520 --> 02:20:54,520 INFLAMMATION, CELLS THEMSELVES 3731 02:20:54,520 --> 02:20:56,600 IN A VACUUM WILL ALSO GROW OLD 3732 02:20:56,600 --> 02:20:58,120 OVER TIME. 3733 02:20:58,120 --> 02:20:59,120 THAT'S A CELLULAR SENESCENCE. 3734 02:20:59,120 --> 02:21:02,280 WE LOSE ABILITY TO MAINTAIN OUR 3735 02:21:02,280 --> 02:21:03,760 PROTEIN STRUCTURES. 3736 02:21:03,760 --> 02:21:06,040 MITOCHONDRIA WHICH HAVE NO DNA 3737 02:21:06,040 --> 02:21:08,760 REPAIR MECHANISMS OF THEIR OWN 3738 02:21:08,760 --> 02:21:10,160 GRADUALLY ACCUMULATE ADDITIONAL 3739 02:21:10,160 --> 02:21:11,920 MUTATIONS AND WILL EXHIBIT 3740 02:21:11,920 --> 02:21:12,240 DYSFUNCTION. 3741 02:21:12,240 --> 02:21:14,200 CELLS STOP TALKING TO EACH 3742 02:21:14,200 --> 02:21:18,120 OTHER, SO EFFICIENT EFFICIENTLE 3743 02:21:18,120 --> 02:21:20,320 AND WE'RE BORN WITH A RESERVE OF 3744 02:21:20,320 --> 02:21:22,800 STEM CELLS AND BURN THROUGH OR 3745 02:21:22,800 --> 02:21:24,240 USE UP A GOOD CHUNK OF THEM. 3746 02:21:24,240 --> 02:21:26,360 A LOT OF THESE PROCESSES WORK 3747 02:21:26,360 --> 02:21:27,080 TOGETHER, CERTAINLY WITH 3748 02:21:27,080 --> 02:21:28,960 NUTRITION AS WELL AS THE 3749 02:21:28,960 --> 02:21:30,360 ENVIRONMENT, TO INFLUENCE HUMAN 3750 02:21:30,360 --> 02:21:30,920 DISEASE. 3751 02:21:30,920 --> 02:21:31,920 AND WHAT'S INTERESTING IS THAT 3752 02:21:31,920 --> 02:21:34,320 THESE CHANGES ARE ALSO AS I 3753 02:21:34,320 --> 02:21:35,840 MENTIONED ASSOCIATED NOT JUST IN 3754 02:21:35,840 --> 02:21:39,560 VITRO AND ANIMAL MODELS BUT WITH 3755 02:21:39,560 --> 02:21:41,520 POPULATION-LEVEL CHANGES AND 3756 02:21:41,520 --> 02:21:43,160 INCIDENCE AND PREVALENCE, VERY 3757 02:21:43,160 --> 02:21:45,040 IMPORTANT HIGH MORBIDITY, HIGH 3758 02:21:45,040 --> 02:21:46,520 MORTALITY CONDITIONS. 3759 02:21:46,520 --> 02:21:49,680 I LEAK THIS GRAPH FROM THE 3760 02:21:49,680 --> 02:21:51,600 NATIONAL CANCER INSTITUTE'S SEER 3761 02:21:51,600 --> 02:21:52,600 EXPLORER WEBSITE, IF YOU HAVEN'T 3762 02:21:52,600 --> 02:21:54,040 HAD A CHANCE TO LOOK AT THAT 3763 02:21:54,040 --> 02:21:56,880 IT'S A FUN WAY TO PLAY WITH DATA 3764 02:21:56,880 --> 02:21:57,400 VISUALIZATIONS. 3765 02:21:57,400 --> 02:22:00,960 WHAT THIS SHOWS IS FOR ALL 3766 02:22:00,960 --> 02:22:02,360 CANCER SITES COMBINED THE 3767 02:22:02,360 --> 02:22:04,120 INCIDENCE THAT THERE'S THIS 3768 02:22:04,120 --> 02:22:05,760 INFLECTION POINT THAT HAPPENS IN 3769 02:22:05,760 --> 02:22:06,920 THE 40s THAT CONTINUES ON 3770 02:22:06,920 --> 02:22:08,400 THROUGHOUT THE COURSE OF THE 3771 02:22:08,400 --> 02:22:10,680 HUMAN LIFE IN TERMS OF ALL 3772 02:22:10,680 --> 02:22:12,440 CAUSES OF CANCERS. 3773 02:22:12,440 --> 02:22:14,080 INDEED THE SAME SHAPE, YOU CAN 3774 02:22:14,080 --> 02:22:17,240 SEE FOR WHOLE HOST OF CHRONIC 3775 02:22:17,240 --> 02:22:19,760 DISEASES, SUCH AS ARTHRITIS, 3776 02:22:19,760 --> 02:22:21,320 HEART DISEASE, COPD, LUNG 3777 02:22:21,320 --> 02:22:23,160 DISEASES, AS WELL AS DIABETES, I 3778 02:22:23,160 --> 02:22:24,160 REALLY LIKE THIS GRAPH IN 3779 02:22:24,160 --> 02:22:26,000 PARTICULAR BECAUSE IT ALSO SHOWS 3780 02:22:26,000 --> 02:22:28,640 THAT NOT ALL DISEASES ARE 3781 02:22:28,640 --> 02:22:32,360 NECESSARILY DISEASES OF AGING. 3782 02:22:32,360 --> 02:22:34,560 SO HARRIS AND THE AUTHORS AND 3783 02:22:34,560 --> 02:22:37,520 THIS TEXT BOOK CHAPTER INCLUDE 3784 02:22:37,520 --> 02:22:38,800 ASTHMA AS A DISEASE 3785 02:22:38,800 --> 02:22:39,480 DISPROPORTIONATELY AFFECTING 3786 02:22:39,480 --> 02:22:40,240 YOUNGER INDIVIDUALS AND STAYS 3787 02:22:40,240 --> 02:22:41,880 THE SAME OR MAY TAIL OFF INTO 3788 02:22:41,880 --> 02:22:43,520 OLDER AGES. 3789 02:22:43,520 --> 02:22:44,840 AGING IS A UNIQUE PHENOMENON 3790 02:22:44,840 --> 02:22:46,840 THAT SHOULD BE CONSIDERED TO BE 3791 02:22:46,840 --> 02:22:48,240 DISTINCT AND NOT A MAGNIFICATION 3792 02:22:48,240 --> 02:22:50,320 OF DISEASES EARLIER IN LIFE THAT 3793 02:22:50,320 --> 02:22:53,480 CONTINUE ON THROUGHOUT THE LIFE 3794 02:22:53,480 --> 02:22:53,720 COURSE. 3795 02:22:53,720 --> 02:22:56,080 AND WHY IS THIS IMPORTANT? 3796 02:22:56,080 --> 02:22:58,640 WELL, AS OF FOUR YEARS AGO 3797 02:22:58,640 --> 02:22:59,720 ALMOST 3/4 OF A BILLION PEOPLE 3798 02:22:59,720 --> 02:23:06,600 IN THE WORLD WERE OVER 65. 3799 02:23:06,600 --> 02:23:11,160 BY 2050 THAT WILL DOUBLE, 1 IN 6 3800 02:23:11,160 --> 02:23:12,560 PEOPLE GLOBALLY CONSIDERED OLDER 3801 02:23:12,560 --> 02:23:13,400 ADULTS. 3802 02:23:13,400 --> 02:23:14,400 AND THIS IS PARTICULARLY 3803 02:23:14,400 --> 02:23:18,560 RELEVANT AS WE SAW IN DR. EBI'S 3804 02:23:18,560 --> 02:23:19,360 PRESENTATION BEFORE, BY 2050 3805 02:23:19,360 --> 02:23:21,840 THAT'S A LOT OF INDIVIDUALS WHO 3806 02:23:21,840 --> 02:23:23,880 ARE NOT OLDER ADULTS RIGHT NOW 3807 02:23:23,880 --> 02:23:24,840 CONSIDERED TO BE YOUNG AND 3808 02:23:24,840 --> 02:23:26,360 PERHAPS MAY NOT BE THINKING 3809 02:23:26,360 --> 02:23:28,320 ABOUT THESE ISSUES. 3810 02:23:28,320 --> 02:23:30,400 OLDER ADULTS WILL COMPRISE NOT 3811 02:23:30,400 --> 02:23:32,040 JUST A LARGER ABSOLUTE NUMBER OF 3812 02:23:32,040 --> 02:23:33,800 INDIVIDUALS BUT A LARGER 3813 02:23:33,800 --> 02:23:35,200 PROPORTION OF INDIVIDUALS THAN 3814 02:23:35,200 --> 02:23:37,920 WE ARE CURRENTLY HAVING IN OUR 3815 02:23:37,920 --> 02:23:38,280 SOCIETY. 3816 02:23:38,280 --> 02:23:41,360 AND THAT'S NOT JUST A PROBLEM IN 3817 02:23:41,360 --> 02:23:42,960 THE WEALTHY COUNTRIES BUT AN 3818 02:23:42,960 --> 02:23:43,960 ISSUE IN LOW- AND MIDDLE-INCOME 3819 02:23:43,960 --> 02:23:46,000 COUNTRIES TOO AS THEY ARE 3820 02:23:46,000 --> 02:23:49,920 EXPERIENCING A DEMOGRAPHIC 3821 02:23:49,920 --> 02:23:50,440 TRANSITION. 3822 02:23:50,440 --> 02:23:51,640 UNFORTUNATELY, FORTUNATELY THAT 3823 02:23:51,640 --> 02:23:52,640 MEANS LIFE EXPECTANCIES ARE 3824 02:23:52,640 --> 02:23:53,640 INCREASING BUT UNFORTUNATELY 3825 02:23:53,640 --> 02:23:54,960 THAT'S ASSOCIATED WITH A NUMBER 3826 02:23:54,960 --> 02:24:00,520 OF CHANGES THAT ARE LEADING TO 3827 02:24:00,520 --> 02:24:03,480 THIS ATHEROGENIC, OBESOGENIC 3828 02:24:03,480 --> 02:24:04,560 CHRONIC DISEASE-GENERATING 3829 02:24:04,560 --> 02:24:06,880 ENVIRONMENT. 3830 02:24:06,880 --> 02:24:07,960 AND IT SHOULD BE NO -- SHOULDN'T 3831 02:24:07,960 --> 02:24:10,600 BE A SURPRISE TO ANYONE ON THIS 3832 02:24:10,600 --> 02:24:13,200 CALL THAT INCLUDES CHEAP 3833 02:24:13,200 --> 02:24:15,080 PROCESSED FOODS, INCREASE IN 3834 02:24:15,080 --> 02:24:19,560 WHITE COLLAR WORK, URBAN LIVING, 3835 02:24:19,560 --> 02:24:20,080 REDUCED PHYSICAL ACTIVITY, 3836 02:24:20,080 --> 02:24:21,000 OVERALL PER CAPITA INCOME IS 3837 02:24:21,000 --> 02:24:24,040 GREAT BUT UNFORTUNATELY CAN LEAD 3838 02:24:24,040 --> 02:24:24,960 TO INCREASED MALADAPTIVE 3839 02:24:24,960 --> 02:24:27,120 BEHAVIORS LIKE ALCOHOL AND 3840 02:24:27,120 --> 02:24:28,640 TOBACCO USE. 3841 02:24:28,640 --> 02:24:30,440 IN ADDITION THERE'S INCREASED 3842 02:24:30,440 --> 02:24:32,280 LOCAL POLLUTION, WHETHER AIR 3843 02:24:32,280 --> 02:24:34,000 POLLUTION, TOXIC EXPOSURES FROM 3844 02:24:34,000 --> 02:24:34,880 INDUSTRIALIZATION OR SOUND AND 3845 02:24:34,880 --> 02:24:38,600 LIGHT POLLUTION AS WELL TOO. 3846 02:24:38,600 --> 02:24:40,680 THIS GRAPH WAS FROM DR. BELLOWS' 3847 02:24:40,680 --> 02:24:41,840 TALK EARLIER. 3848 02:24:41,840 --> 02:24:44,400 OUR PATHWAY NUMBER 1 ON THE LEFT 3849 02:24:44,400 --> 02:24:46,800 SIDE OF THIS FIGURE I THINK WILL 3850 02:24:46,800 --> 02:24:49,120 ALLOW OUR COLLEAGUES AND WORKING 3851 02:24:49,120 --> 02:24:54,440 GROUP TO FLESH THAT OUT SO WE'L 3852 02:24:54,440 --> 02:24:56,240 FOCUS ON THE RIGHT SIDE, CLIMATE 3853 02:24:56,240 --> 02:24:58,160 AND ENVIRONMENTAL CHANGE EFFECTS 3854 02:24:58,160 --> 02:24:58,960 ON HEALTH AND PERHAPS A FEW 3855 02:24:58,960 --> 02:25:01,880 COMMENTS AT THE END ABOUT HOW 3856 02:25:01,880 --> 02:25:03,040 NUTRITION STATUS SHOULD BE 3857 02:25:03,040 --> 02:25:07,320 EXAMINED AND HOW THIS FITS IN. 3858 02:25:07,320 --> 02:25:08,960 SO MOVING TO OLDER ADULTS A LOT 3859 02:25:08,960 --> 02:25:10,680 OF CLIMATE EFFECTS ARE 3860 02:25:10,680 --> 02:25:13,560 CONCENTRATED HERE, ONE OF THE 3861 02:25:13,560 --> 02:25:16,080 BIGGEST -- TWO BIGGEST ISSUES AS 3862 02:25:16,080 --> 02:25:22,160 WAS MENTIONED EARLIER ARE AIR 3863 02:25:22,160 --> 02:25:23,160 POLLUTION AND HEAT STRESSES. 3864 02:25:23,160 --> 02:25:24,280 AIR POLLUTION, WE'LL HAVE 3865 02:25:24,280 --> 02:25:26,600 INCREASES NOT JUST IN GROUND 3866 02:25:26,600 --> 02:25:28,560 LEVEL AIR POLLUTION IN GENERAL 3867 02:25:28,560 --> 02:25:31,720 BUT ALSO AN INCREASE IN REGIONAL 3868 02:25:31,720 --> 02:25:32,720 WILDFIRE EVENTS, POLLEN SEASONS 3869 02:25:32,720 --> 02:25:35,880 WILL BE LONGER AND MORE SEVERE, 3870 02:25:35,880 --> 02:25:39,280 DUST STORMS IN AREAS THAT ARE 3871 02:25:39,280 --> 02:25:40,400 PRE-DISPOSED. 3872 02:25:40,400 --> 02:25:41,880 AND OVERALL THAT LEADS TO 7 3873 02:25:41,880 --> 02:25:42,760 MILLION PREMATURE DEATHS 3874 02:25:42,760 --> 02:25:43,760 GLOBALLY EACH YEAR, AIR 3875 02:25:43,760 --> 02:25:45,840 POLLUTION IS THE SINGLE LARGEST 3876 02:25:45,840 --> 02:25:47,480 ENVIRONMENTAL CONTRIBUTOR TO 3877 02:25:47,480 --> 02:25:48,800 HUMAN HEALTH. 3878 02:25:48,800 --> 02:25:52,280 AND UNSURPRISINGLY ABOUT HALF OF 3879 02:25:52,280 --> 02:25:53,880 THOSE DEATHS, 7 MILLION DEATHS, 3880 02:25:53,880 --> 02:25:56,120 ARE INDIVIDUALS OVER 65. 3881 02:25:56,120 --> 02:25:57,640 AND HALF ARE ATTRIBUTABLE TO 3882 02:25:57,640 --> 02:25:59,080 CARDIOVASCULAR DISEASES AS WELL 3883 02:25:59,080 --> 02:25:59,960 AS STROKE. 3884 02:25:59,960 --> 02:26:02,600 AND CHRONIC LUNG DISEASE SUCH AS 3885 02:26:02,600 --> 02:26:04,840 COPD ARE NOT FAR BEHIND. 3886 02:26:04,840 --> 02:26:08,400 THERE'S QUITE A FEW 3887 02:26:08,400 --> 02:26:09,720 META-ANALYSES AND SYSTEMATIC 3888 02:26:09,720 --> 02:26:11,440 REVIEWS THAT DISCUSSED THAT, NOT 3889 02:26:11,440 --> 02:26:13,360 JUST SHORT TERM BUT LONG-TERM 3890 02:26:13,360 --> 02:26:14,960 EFFECTS FROM AIR POLLUTION. 3891 02:26:14,960 --> 02:26:16,840 BOTH EXPOSURES HAVE BEEN LINKED 3892 02:26:16,840 --> 02:26:20,000 TO NOT JUST ASTHMA AND COPD 3893 02:26:20,000 --> 02:26:22,320 EXACERBATION BUT HEART ATTACK, 3894 02:26:22,320 --> 02:26:23,080 HEART FAILURE, DECOMPENSATIONS, 3895 02:26:23,080 --> 02:26:24,320 CARDIAC ARREST AS WELL AS STROKE 3896 02:26:24,320 --> 02:26:27,480 FROM A WIDE VARIETY OF DIFFERENT 3897 02:26:27,480 --> 02:26:28,880 AIR POLLUTION EXPOSURES WITH PM 3898 02:26:28,880 --> 02:26:32,160 2.57 OR CARBON MONOXIDE OR 3899 02:26:32,160 --> 02:26:34,800 NITROGEN DIOXIDE, ET CETERA. 3900 02:26:34,800 --> 02:26:37,080 ALSO RELEVANT TO OLDER ADULTS, 3901 02:26:37,080 --> 02:26:38,960 LONG-TERM AIR POLLUTION EXPOSURE 3902 02:26:38,960 --> 02:26:41,240 IS ASSOCIATED WITH MALIGNANCY, 3903 02:26:41,240 --> 02:26:43,160 PARTICULARLY LUNG CANCER, ALSO 3904 02:26:43,160 --> 02:26:45,120 DEMENTIA, OSTEOPOROSIS AND 3905 02:26:45,120 --> 02:26:45,680 FRAILTY. 3906 02:26:45,680 --> 02:26:47,080 THESE CHRONIC CONDITIONS ARE 3907 02:26:47,080 --> 02:26:48,520 ALSO IMPORTANT NOT JUST BECAUSE 3908 02:26:48,520 --> 02:26:50,120 AIR POLLUTION ITSELF CAN BE A 3909 02:26:50,120 --> 02:26:52,000 RISK FACTOR FOR DEVELOPMENT OF 3910 02:26:52,000 --> 02:26:55,400 THESE CONDITIONS BUT HAVING 3911 02:26:55,400 --> 02:26:56,840 PREEXISTING CARDIOVASCULAR 3912 02:26:56,840 --> 02:26:58,360 DISEASE OR FRAILTY STATUS OR 3913 02:26:58,360 --> 02:27:00,000 DEMENTIA ACTUALLY INCREASES RISK 3914 02:27:00,000 --> 02:27:03,600 OF SUFFERING FROM NOT JUST 3915 02:27:03,600 --> 02:27:05,120 EXACERBATION BUT RELATED 3916 02:27:05,120 --> 02:27:06,040 CONDITION FROM AIR POLLUTION 3917 02:27:06,040 --> 02:27:08,200 EXPOSURE AS WELL TOO. 3918 02:27:08,200 --> 02:27:10,400 MOVING TO EXTREME HEAT, HEAT 3919 02:27:10,400 --> 02:27:12,800 WAVES, A NUMBER OF LARGE 3920 02:27:12,800 --> 02:27:17,560 MULTI-NATIONAL ANALYSES SUGGEST 3921 02:27:17,560 --> 02:27:18,760 THAT GLOBAL GENERAL TEMPERATURE 3922 02:27:18,760 --> 02:27:21,280 INCREASES HAVE BEEN LINKED TO 3923 02:27:21,280 --> 02:27:23,440 INCREASE IN CARDIOVASCULAR 3924 02:27:23,440 --> 02:27:23,720 MORTALITIES. 3925 02:27:23,720 --> 02:27:25,080 BUT LOOKING SPECIFICALLY AT 3926 02:27:25,080 --> 02:27:27,080 EXTREME HEAT WAVES, DEPENDING 3927 02:27:27,080 --> 02:27:28,520 HOW YOU DEFINE IT, STILL 3928 02:27:28,520 --> 02:27:30,360 RESPONSIBLE FOR QUITE A FEW 3929 02:27:30,360 --> 02:27:32,280 DEATHS, MAYBE 2,000 OR SO A YEAR 3930 02:27:32,280 --> 02:27:34,320 IN THE UNITED STATES. 3931 02:27:34,320 --> 02:27:36,280 BUT IT DOESN'T CAPTURE THE FACT 3932 02:27:36,280 --> 02:27:38,280 THAT PARTICULARLY SEVERE HEAT 3933 02:27:38,280 --> 02:27:39,400 WAVES CAN REALLY CLAIM QUITE A 3934 02:27:39,400 --> 02:27:41,200 FEW LIVES IN A SHORT AMOUNT OF 3935 02:27:41,200 --> 02:27:41,440 TIME. 3936 02:27:41,440 --> 02:27:42,760 FOR EXAMPLE EUROPEAN HEAT WAVE 3937 02:27:42,760 --> 02:27:45,920 IN 2003 WHICH WAS PARTICULARLY 3938 02:27:45,920 --> 02:27:48,240 BAD FOR FRANCE HAS BEEN 3939 02:27:48,240 --> 02:27:51,160 ASSOCIATED WITH AN ESTIMATED 3940 02:27:51,160 --> 02:27:53,880 70,000 FATALITIES, MAKING THEM 3941 02:27:53,880 --> 02:27:57,080 MORE DANGEROUS THAN OTHER VERY 3942 02:27:57,080 --> 02:27:59,160 HIGH PROFILE NATURAL DISASTERS 3943 02:27:59,160 --> 02:28:00,560 COMBINED. 3944 02:28:00,560 --> 02:28:01,320 UNSURPRISINGLY MAJORITY OF 3945 02:28:01,320 --> 02:28:04,200 DEATHS IN INDIVIDUALS WHO LIVED 3946 02:28:04,200 --> 02:28:06,040 THROUGH THESE EXPERIENCES, 3947 02:28:06,040 --> 02:28:08,560 SUCCUMBED TO THESE EXPERIENCES, 3948 02:28:08,560 --> 02:28:11,200 WERE IN ADULTS OVER 65, AND WHAT 3949 02:28:11,200 --> 02:28:12,400 I FOUND INTERESTING AS A 3950 02:28:12,400 --> 02:28:14,480 CARDIOLOGIST CAUSE OF DEATH 3951 02:28:14,480 --> 02:28:16,000 DURING HEAT WAVES AND SPIKES IS 3952 02:28:16,000 --> 02:28:16,800 LARGELY CARDIOVASCULAR IN 3953 02:28:16,800 --> 02:28:17,000 NATURE. 3954 02:28:17,000 --> 02:28:20,280 AND JUST TO GIVE AN EXAMPLE IN 3955 02:28:20,280 --> 02:28:22,240 THE 1990s WHEN WE HAD MAJOR 3956 02:28:22,240 --> 02:28:24,000 HEAT WAVES GO THROUGH THE U.S. 3957 02:28:24,000 --> 02:28:27,400 MIDWEST, IF YOU LOOK BACK AT THE 3958 02:28:27,400 --> 02:28:28,680 MORTALITY STATISTICS, MINORITY 3959 02:28:28,680 --> 02:28:32,440 OF THEM ARE DIRECTLY ATTRIBUTED 3960 02:28:32,440 --> 02:28:35,640 TO HEAT STROKE OR HEAT 3961 02:28:35,640 --> 02:28:36,680 WAVE-RELATED CODED CAUSES, AND 3962 02:28:36,680 --> 02:28:39,240 THAT QUITE A FEW, MAJORITY IN 3963 02:28:39,240 --> 02:28:42,240 FACT, EITHER LIST CARDIOVASCULAR 3964 02:28:42,240 --> 02:28:43,080 DISEASE AS CONTRIBUTING FACTOR 3965 02:28:43,080 --> 02:28:45,040 OR AS ACTUAL CAUSE OF DEATH 3966 02:28:45,040 --> 02:28:45,280 ITSELF. 3967 02:28:45,280 --> 02:28:46,600 AND I'M SURE PART OF THAT HAS TO 3968 02:28:46,600 --> 02:28:49,440 DO WITH THE WAY WE CODE HEAT 3969 02:28:49,440 --> 02:28:51,400 INJURY THAT THERE'S VERY 3970 02:28:51,400 --> 02:28:52,400 SPECIFIC DEFINITIONS SUCH AS, 3971 02:28:52,400 --> 02:28:54,240 YOU KNOW, A CORE BODY 3972 02:28:54,240 --> 02:28:56,120 TEMPERATURE OVER X, BUT 3973 02:28:56,120 --> 02:28:59,280 NEVERTHELESS I THINK THIS 3974 02:28:59,280 --> 02:29:01,920 SUGGESTS THERE IS INVOLVEMENT OF 3975 02:29:01,920 --> 02:29:03,000 THE HEART AND CARDIOVASCULAR 3976 02:29:03,000 --> 02:29:04,760 SYSTEM IN A LOT OF THESE 3977 02:29:04,760 --> 02:29:05,160 MORTALITIES. 3978 02:29:05,160 --> 02:29:07,280 AND TO GIVE AN EXAMPLE OF SOME 3979 02:29:07,280 --> 02:29:08,160 BIOCHEMICAL EVIDENCE IN SUPPORT 3980 02:29:08,160 --> 02:29:10,520 OF THIS, THERE ARE A NUMBER OF 3981 02:29:10,520 --> 02:29:13,840 ANALYSES THAT SUGGEST THAT 3982 02:29:13,840 --> 02:29:16,680 HIGHER SERUM TROPONIN LEVELS IN 3983 02:29:16,680 --> 02:29:18,760 THE BLOOD TREMENDOUS, A MARKER 3984 02:29:18,760 --> 02:29:21,200 OF CARDIAC INDUSTRY OR STRESS IS 3985 02:29:21,200 --> 02:29:23,920 AN INDEPENDENT RISK FACTOR FOR 3986 02:29:23,920 --> 02:29:26,120 POOR OUTCOME FROM HEAT-RELATED 3987 02:29:26,120 --> 02:29:26,400 INJURIES. 3988 02:29:26,400 --> 02:29:28,320 BRIEFLY, I DID WANT TO MENTION 3989 02:29:28,320 --> 02:29:29,840 NATURAL DISASTER, WHETHER 3990 02:29:29,840 --> 02:29:31,840 HURRICANES, FLOODING, TORNADOES, 3991 02:29:31,840 --> 02:29:33,920 WINTER STORMS, BLIZZARDS. 3992 02:29:33,920 --> 02:29:36,080 AGAIN, THEY ARE TRAGICALLY 3993 02:29:36,080 --> 02:29:38,400 ILLUSTRATIVE OF THE FACT THAT 3994 02:29:38,400 --> 02:29:41,240 WITHIN HURRICANE KATRINA OVER 3995 02:29:41,240 --> 02:29:42,760 HALF -- NEARLY HALF MORTALITIES 3996 02:29:42,760 --> 02:29:44,320 IN ADULTS OVER 75 YEARS OF AGE. 3997 02:29:44,320 --> 02:29:45,760 WHAT'S INTERESTING WHEN WE LOOK 3998 02:29:45,760 --> 02:29:47,880 AT HURRICANES AND HURRICANE 3999 02:29:47,880 --> 02:29:50,120 SEASONS, THERE'S USUALLY A BUMP 4000 02:29:50,120 --> 02:29:51,640 IN MYOCARDIAL INFARCTIONS THAT 4001 02:29:51,640 --> 02:29:53,960 FOLLOW THESE EVENTS, SOMETIMES 4002 02:29:53,960 --> 02:29:55,040 ELEVATIONS PERSIST FOR YEARS, 4003 02:29:55,040 --> 02:29:57,000 THERE HAVE BEEN ANALYSES 4004 02:29:57,000 --> 02:30:02,440 FOLLOWING KATRINA LOOK LOOKING3 4005 02:30:02,440 --> 02:30:04,400 TO 10 YEARS MEDICAL CENTERS 4006 02:30:04,400 --> 02:30:05,840 REPORTING ELEVATED LEVELS, NOT 4007 02:30:05,840 --> 02:30:07,800 JUST EFFECT OF ACUTE HURRICANE 4008 02:30:07,800 --> 02:30:09,960 EVENT BUT PROBABLY THE EMOTIONAL 4009 02:30:09,960 --> 02:30:12,160 AND MENTAL STRESS THAT RESULTS 4010 02:30:12,160 --> 02:30:14,880 FROM SUCH A SEVERE INCIDENT CAN 4011 02:30:14,880 --> 02:30:16,520 REALLY AFFECT YOUR HEALTH GOING 4012 02:30:16,520 --> 02:30:19,280 FOR YEARS AFTER THESE EVENTS. 4013 02:30:19,280 --> 02:30:20,760 AND THEN ADDITIONALLY SOME GREAT 4014 02:30:20,760 --> 02:30:24,000 ANALYSES FROM BACK IN THE 4015 02:30:24,000 --> 02:30:25,640 1970s, SHOWN CLEAR INCREASES 4016 02:30:25,640 --> 02:30:28,240 IN RISK OF ISCHEMIC HEART 4017 02:30:28,240 --> 02:30:31,560 DISEASE RELATED DEATHS AND 4018 02:30:31,560 --> 02:30:33,640 HOSPITALIZATIONS FOLLOWING 4019 02:30:33,640 --> 02:30:33,960 SNOWSTORMS. 4020 02:30:33,960 --> 02:30:35,360 SOMETHING THAT REQUIRES MORE 4021 02:30:35,360 --> 02:30:37,040 ATTENTION COMING TO LIGHT IS 4022 02:30:37,040 --> 02:30:38,880 JUST HOW BAD THE MENTAL HEALTH 4023 02:30:38,880 --> 02:30:40,760 EFFECTS OF THESE NATURAL 4024 02:30:40,760 --> 02:30:41,920 DISASTERS ARE. 4025 02:30:41,920 --> 02:30:45,000 WE DO KNOW OLDER ADULTS ARE 4026 02:30:45,000 --> 02:30:46,640 PARTICULARLY SENSITIVE TO 4027 02:30:46,640 --> 02:30:48,600 AMENDMENT CRISES FROM NOT JUST 4028 02:30:48,600 --> 02:30:50,560 THE DISASTERS BUT EVACUATIONS 4029 02:30:50,560 --> 02:30:52,880 AND CERTAIN GROUPS OF 4030 02:30:52,880 --> 02:30:56,160 INDIVIDUALS SUCH AS INDIGENOUS 4031 02:30:56,160 --> 02:30:58,560 PEOPLES, ELDERS, ARE ESPECIALLY 4032 02:30:58,560 --> 02:30:59,400 DISPROPORTIONATELY AFFECTED BY 4033 02:30:59,400 --> 02:31:04,600 EVACUATIONS AS WELL AS DISASTERS 4034 02:31:04,600 --> 02:31:04,880 THEMSELVES. 4035 02:31:04,880 --> 02:31:06,240 BRIEFLY, SOMETHING EMERGING IS 4036 02:31:06,240 --> 02:31:07,640 DISCUSSION OF SEA LEVEL RISE, 4037 02:31:07,640 --> 02:31:10,040 THERE'S NOT A LOT OF DATA 4038 02:31:10,040 --> 02:31:12,240 CONNECTING ACTUAL HEART HEALTH 4039 02:31:12,240 --> 02:31:14,080 OUTCOMES ASSOCIATED, BUT THERE'S 4040 02:31:14,080 --> 02:31:16,400 A DISTURBING TREND IN COASTAL 4041 02:31:16,400 --> 02:31:17,400 REGIONS THAT SOME PLACES, MOST 4042 02:31:17,400 --> 02:31:21,920 OF THE DATA IS COMING OUT OF 4043 02:31:21,920 --> 02:31:23,840 BANGLADESH, BUT GROUND WATER 4044 02:31:23,840 --> 02:31:26,160 ENCROACHMENT BY SEA WATER FROM 4045 02:31:26,160 --> 02:31:28,240 RISING SEA LEVELS. 4046 02:31:28,240 --> 02:31:30,760 AND THAT WILL INCREASE SALINITY 4047 02:31:30,760 --> 02:31:33,040 WHICH WE'LL HAVE TO WAIT AND SEE 4048 02:31:33,040 --> 02:31:37,000 WHAT THAT HAS IMPLICATIONS ON IN 4049 02:31:37,000 --> 02:31:38,400 TERMS OF HYPERTENSION, OVERALL 4050 02:31:38,400 --> 02:31:43,640 SODIUM INTAKE ON COASTAL 4051 02:31:43,640 --> 02:31:44,120 POPULATIONS. 4052 02:31:44,120 --> 02:31:48,680 FINALLY EPIDEMIC AND PANDEMIC 4053 02:31:48,680 --> 02:31:51,280 DISEASE WILL BE WORSENED, WE 4054 02:31:51,280 --> 02:31:56,520 HEARD FROM DR. KLEINMAN. 4055 02:31:56,520 --> 02:31:57,640 PARTICULARLY NURSING HOMES WERE 4056 02:31:57,640 --> 02:31:59,440 GROUND ZERO IN THE INITIAL 4057 02:31:59,440 --> 02:32:00,400 OUTBREAK OF COVID-19. 4058 02:32:00,400 --> 02:32:01,640 I DON'T THINK IT REQUIRES 4059 02:32:01,640 --> 02:32:02,600 ADDITIONAL DISCUSSION ABOUT HOW 4060 02:32:02,600 --> 02:32:04,960 IMPORTANT IT WILL BE TO CONSIDER 4061 02:32:04,960 --> 02:32:07,680 OLDER ADULTS IN FUTURE PANDEMIC 4062 02:32:07,680 --> 02:32:10,280 OR EPIDEMIC DISEASES THAT MAY 4063 02:32:10,280 --> 02:32:11,200 HAVE CLIMATE CONNECTIONS. 4064 02:32:11,200 --> 02:32:14,240 I WANTED TO DRILL DOWN INTO WHY 4065 02:32:14,240 --> 02:32:16,680 OLDER ADULTS ARE PHYSIOLOGICALLY 4066 02:32:16,680 --> 02:32:18,400 AND SOCIOLOGICALLY VULNERABLE TO 4067 02:32:18,400 --> 02:32:18,760 HAZARDS. 4068 02:32:18,760 --> 02:32:20,800 LOOKING FROM A BODY SYSTEMS 4069 02:32:20,800 --> 02:32:22,080 PERSPECTIVE, AS I MENTIONED 4070 02:32:22,080 --> 02:32:26,720 BEFORE, DEMENTIA IS NOT ONLY A 4071 02:32:26,720 --> 02:32:28,480 RISK FACTOR BUT ALSO END RESULT 4072 02:32:28,480 --> 02:32:31,080 FOR INJURY FROM THINGS LIKE AIR 4073 02:32:31,080 --> 02:32:33,160 POLLUTION EXPOSURE AND TOXIC AIR 4074 02:32:33,160 --> 02:32:34,160 POLLUTION EXPOSURE. 4075 02:32:34,160 --> 02:32:35,920 THE HEART IS INTERESTING BECAUSE 4076 02:32:35,920 --> 02:32:37,680 IT'S SO VERY INVOLVED IN THE 4077 02:32:37,680 --> 02:32:40,200 BODY'S RESPONSE TO EXTREME HEAT. 4078 02:32:40,200 --> 02:32:42,200 AND SO WITH THE AGING PROCESS 4079 02:32:42,200 --> 02:32:48,640 YOU SEE THERE'S A DECREASE IN 4080 02:32:48,640 --> 02:32:50,040 MYOCARDIAL CONTRACTILITY, THE 4081 02:32:50,040 --> 02:32:54,200 HEART DOES NOT PUMP AS IT USED 4082 02:32:54,200 --> 02:32:55,760 TO, ABILITY DECREASES, BUT ALSO 4083 02:32:55,760 --> 02:32:58,160 ABILITY TO INCREASE HEART RATE 4084 02:32:58,160 --> 02:33:04,360 CAN BE HIGHER METABOLIC DEMANDS 4085 02:33:04,360 --> 02:33:05,400 DURING DEHYDRATION, HEAT STRESS, 4086 02:33:05,400 --> 02:33:07,160 ALSO BLUNTED OVER TIME. 4087 02:33:07,160 --> 02:33:09,760 OLDER ADULTS ARE MORE LIKELY TO 4088 02:33:09,760 --> 02:33:11,160 HAVE COMORBIDITIES LIKE RENAL 4089 02:33:11,160 --> 02:33:14,560 DISEASE OR HEART FAILURE 4090 02:33:14,560 --> 02:33:15,640 NECESSITATING BEING ON 4091 02:33:15,640 --> 02:33:18,600 MEDICATIONS LIKE DIURETICS AND 4092 02:33:18,600 --> 02:33:19,920 BETA BLOCKERS PREDISPOSING TO 4093 02:33:19,920 --> 02:33:21,120 DEHYDRATION BUT DESIGNED TO 4094 02:33:21,120 --> 02:33:22,520 BLUNT THE VERY INCREASE IN 4095 02:33:22,520 --> 02:33:23,640 CARDIAC SQUEEZE AS WELL AS HEART 4096 02:33:23,640 --> 02:33:25,400 RATE THAT THE BODY NEEDS TO RELY 4097 02:33:25,400 --> 02:33:27,800 ON IN TIMES OF HEAT STRESS AND 4098 02:33:27,800 --> 02:33:30,680 DEHYDRATION IN ORDER TO MAINTAIN 4099 02:33:30,680 --> 02:33:31,640 ADEQUATE BLOOD PRESSURE. 4100 02:33:31,640 --> 02:33:33,080 AND SO WHAT'S INTERESTING IS 4101 02:33:33,080 --> 02:33:35,600 THAT THERE'S A HOST OF PROCESSES 4102 02:33:35,600 --> 02:33:38,640 THAT LEAD TO INCREASED HEART 4103 02:33:38,640 --> 02:33:40,200 STRESS, BUT ALSO ISCHEMIA, AND 4104 02:33:40,200 --> 02:33:43,480 PUMP FUNCTION THAT CAN SPIRAL 4105 02:33:43,480 --> 02:33:46,000 QUICKLY OUT OF CONTROL INTO 4106 02:33:46,000 --> 02:33:47,280 FRANK CARDIOVASCULAR SHOCK IN 4107 02:33:47,280 --> 02:33:48,280 THESE EVENTS. 4108 02:33:48,280 --> 02:33:51,280 THE LUNGS ARE VERY IMPORTANT 4109 02:33:51,280 --> 02:33:54,400 BECAUSE THE PULMONARY VASCULAR 4110 02:33:54,400 --> 02:33:56,040 INTERFACE IS THE -- INTERFACE 4111 02:33:56,040 --> 02:33:57,160 FOR AIR POLLUTION INHALATION 4112 02:33:57,160 --> 02:34:01,440 EXPOSURE BEFORE IT HAS PASSES 4113 02:34:01,440 --> 02:34:02,720 THROUGH THE BLOODSTREAM INTO 4114 02:34:02,720 --> 02:34:03,000 ORGANS. 4115 02:34:03,000 --> 02:34:06,440 WITH AGING THERE'S A VARIETY OF 4116 02:34:06,440 --> 02:34:09,400 ISSUES THAT IMPAIR THAT 4117 02:34:09,400 --> 02:34:10,920 PULMONARY VASCULAR BARRIER 4118 02:34:10,920 --> 02:34:13,120 FUNCTION LIKE LOSS OF THE 4119 02:34:13,120 --> 02:34:19,360 PROGENITOR CELLS AND LOSS OF THE 4120 02:34:19,360 --> 02:34:20,360 EXTRACELLULAR MATRIX COMPRISING 4121 02:34:20,360 --> 02:34:23,520 THAT BARRIER FUNCTION SO YOU SEE 4122 02:34:23,520 --> 02:34:24,920 THERE'S ADDITIONAL 4123 02:34:24,920 --> 02:34:25,920 SUSCEPTIBILITY TO INHALED TOXINS 4124 02:34:25,920 --> 02:34:29,080 AND DELAYED RECOVERY FROM 4125 02:34:29,080 --> 02:34:31,720 INHALATION EXPOSURE. 4126 02:34:31,720 --> 02:34:35,240 NEXT, SKIN IS IMPORTANT BECAUSE 4127 02:34:35,240 --> 02:34:37,840 THE THERMO RECEPTORS THAT TELL 4128 02:34:37,840 --> 02:34:45,840 THE BODY LET'S KICK COMPENSATORY 4129 02:34:45,840 --> 02:34:46,840 MEASURES ARE DECREASED, 4130 02:34:46,840 --> 02:34:47,600 REDISTRIBUTION OF SWEAT GLANDS 4131 02:34:47,600 --> 02:34:49,560 IN TERMS OF WHERE THEY ARE AND 4132 02:34:49,560 --> 02:34:53,720 HOW ACTIVE THEY ARE, AND THAT 4133 02:34:53,720 --> 02:34:55,600 TENDS TO RELIEVE THE CORE OF THE 4134 02:34:55,600 --> 02:34:57,440 BODY WHERE A LOT OF HEAT 4135 02:34:57,440 --> 02:34:59,520 DISSIPATION NEEDS TO OCCUR SO 4136 02:34:59,520 --> 02:35:04,680 YOU HAVE REDUCE THE EVAPORATIVE 4137 02:35:04,680 --> 02:35:06,320 COOLING EEFFICIENCY. 4138 02:35:06,320 --> 02:35:10,600 NEXT KIDNEYS AND GUT, THE BODY 4139 02:35:10,600 --> 02:35:14,240 ACTUALLY REDIRECTS BLOOD FROM 4140 02:35:14,240 --> 02:35:14,880 THE VASCULATURE, INTERNAL 4141 02:35:14,880 --> 02:35:16,160 STRUCTURES LIKE GUT AND KIDNEYS 4142 02:35:16,160 --> 02:35:20,760 TO THE SKIN IN HEAT STRESS IN 4143 02:35:20,760 --> 02:35:21,960 ORDER TO FACILITATE PASSIVE 4144 02:35:21,960 --> 02:35:23,480 COOLING BY BRINGING BLOOD TO THE 4145 02:35:23,480 --> 02:35:26,680 SURFACE TO ALLOW IT TO COOL. 4146 02:35:26,680 --> 02:35:28,560 WITH AGING DECREASE IN THAT 4147 02:35:28,560 --> 02:35:31,520 ABILITY TO REDIRECT BLOOD FLOW 4148 02:35:31,520 --> 02:35:34,440 AND BASICALLY ACTIVATE OUR HEAT 4149 02:35:34,440 --> 02:35:35,440 SYNC FEATURES. 4150 02:35:35,440 --> 02:35:37,520 FINALLY, DR. KLEINMAN MENTIONED 4151 02:35:37,520 --> 02:35:39,240 IMMUNE SYSTEM AND CLIMATE 4152 02:35:39,240 --> 02:35:41,040 EFFECTS, BUT AGING IS ASSOCIATED 4153 02:35:41,040 --> 02:35:43,120 WITH THIS CONCEPT OF 4154 02:35:43,120 --> 02:35:44,760 IMMUNOSENESCENCE, THAT HAS TWO 4155 02:35:44,760 --> 02:35:45,280 CONSEQUENCES. 4156 02:35:45,280 --> 02:35:46,920 FIRST IS THAT OLDER ADULTS ARE 4157 02:35:46,920 --> 02:35:53,080 LESS LIKELY TO BE ABLE TO MOUNT 4158 02:35:53,080 --> 02:35:55,280 A ROBUST IMMUNE REACTION TO 4159 02:35:55,280 --> 02:35:56,760 INFECTIOUS AGENTS BUT ALSO TO 4160 02:35:56,760 --> 02:36:00,000 VACCINES, AND ON THE FLIP SIDE 4161 02:36:00,000 --> 02:36:00,880 WE HAVE DYSREGULATION AND 4162 02:36:00,880 --> 02:36:02,280 AUTOIMMUNITY ON THE FLIP SIDE 4163 02:36:02,280 --> 02:36:05,160 WHICH LEADS TO THE PHENOMENON I 4164 02:36:05,160 --> 02:36:06,440 MENTIONED CALLED IMMUNE AGING 4165 02:36:06,440 --> 02:36:08,240 AND SO THAT PROCESS OF CHRONIC 4166 02:36:08,240 --> 02:36:09,840 INFLAMMATION IN THE BODY CAN 4167 02:36:09,840 --> 02:36:20,280 ALSO LEAD TO THINGS LIKE 4168 02:36:20,760 --> 02:36:23,440 ATHEROSCLEROSIS, A DOUBLE WHAMMY 4169 02:36:23,440 --> 02:36:27,480 ON THE SPECTRUM. 4170 02:36:27,480 --> 02:36:28,360 SOCIAL VULNERABILITIES, A LOT 4171 02:36:28,360 --> 02:36:30,960 ARE LIVING ON FIXED INCOMES, 4172 02:36:30,960 --> 02:36:32,080 CANNOT DEAL WITH ACUTE FINANCIAL 4173 02:36:32,080 --> 02:36:35,120 STRESS AS WELL AS YOUNGER 4174 02:36:35,120 --> 02:36:36,000 ADULTS. 4175 02:36:36,000 --> 02:36:37,640 SOCIAL ISOLATION, OLDER ADULTS 4176 02:36:37,640 --> 02:36:39,400 IF NOT INSTITUTIONALIZED ARE 4177 02:36:39,400 --> 02:36:41,040 MORE LIKELY TO LIVE BY 4178 02:36:41,040 --> 02:36:43,120 THEMSELVES LEADING TO DECREASE 4179 02:36:43,120 --> 02:36:45,440 IN MOBILITY AND TRANSPORTATION 4180 02:36:45,440 --> 02:36:45,680 RESOURCES. 4181 02:36:45,680 --> 02:36:48,680 I DON'T HAVE TO ELABORATE TO LET 4182 02:36:48,680 --> 02:36:52,080 YOU KNOW INSTITUTIONALIZED 4183 02:36:52,080 --> 02:36:53,920 ELDERS ARE PARTICULARLY 4184 02:36:53,920 --> 02:36:55,600 CONSTRAINED WHETHER DUE TO 4185 02:36:55,600 --> 02:36:56,800 FRAILTY OR NEURODEGENERATIVE 4186 02:36:56,800 --> 02:36:58,640 CONDITIONS BUT EVEN INDEPENDENT 4187 02:36:58,640 --> 02:37:00,400 LIVING OLDER ADULTS ARE LESS 4188 02:37:00,400 --> 02:37:01,360 LIKELY TO DRIVE THEMSELVES, 4189 02:37:01,360 --> 02:37:03,560 WHETHER THEY DON'T OWN A CAR OR 4190 02:37:03,560 --> 02:37:05,440 LOST THEIR LICENSE OR SIMPLY 4191 02:37:05,440 --> 02:37:08,400 DON'T HAVE ACCESS TO THE SOCIAL 4192 02:37:08,400 --> 02:37:10,920 NETWORK NECESSARY FOR RAPID 4193 02:37:10,920 --> 02:37:13,240 TRANSPORTATION RESOURCES. 4194 02:37:13,240 --> 02:37:14,640 AND THEN UNFORTUNATELY OLDER 4195 02:37:14,640 --> 02:37:15,840 ADULTS SOMETIMES LESS ABLE AND 4196 02:37:15,840 --> 02:37:17,920 WILLING TO EVACUATE IN DISASTERS 4197 02:37:17,920 --> 02:37:19,440 WHICH SOME WAS REFLECTED IN THE 4198 02:37:19,440 --> 02:37:22,520 HIGH MORTALITY IN THIS 4199 02:37:22,520 --> 02:37:29,360 POPULATION DURING HURRICANE 4200 02:37:29,360 --> 02:37:32,480 EVENTS, LESS LIKELY TO LIVE IN 4201 02:37:32,480 --> 02:37:34,360 AIR CONDITIONED HOMES, HELPFUL 4202 02:37:34,360 --> 02:37:35,840 IN WILDFIRE EVENTS, HIGH HAIR 4203 02:37:35,840 --> 02:37:38,080 POLLUTION DAYS OR TIMES OF HEAT 4204 02:37:38,080 --> 02:37:39,360 STRESS. 4205 02:37:39,360 --> 02:37:41,440 EVEN INDIVIDUALS WHO DO LIVE IN 4206 02:37:41,440 --> 02:37:42,320 HOMES WITH AIR CONDITIONING 4207 02:37:42,320 --> 02:37:45,600 UNITS, THERE'S A TENDENCY TO BE 4208 02:37:45,600 --> 02:37:48,560 LESS LIKELY TO USE THEM WITH 4209 02:37:48,560 --> 02:37:50,080 ADVANCING AGE, QUALITATIVE 4210 02:37:50,080 --> 02:37:52,400 RESEARCH SUGGESTS THAT'S DUE TO 4211 02:37:52,400 --> 02:37:54,120 FINANCIAL BARRIERS TO THEIR USE, 4212 02:37:54,120 --> 02:37:56,120 WHICH I MENTIONED EARLIER AS 4213 02:37:56,120 --> 02:37:56,880 WELL TOO. 4214 02:37:56,880 --> 02:37:59,920 I DID WANT TO END BY MENTIONING 4215 02:37:59,920 --> 02:38:01,360 THAT NUTRITION DOES PLAY A VERY 4216 02:38:01,360 --> 02:38:02,600 IMPORTANT ROLE IN THIS ACCESS 4217 02:38:02,600 --> 02:38:04,120 AND THINK SOMETHING I'D LOVE TO 4218 02:38:04,120 --> 02:38:05,400 HEAR MORE FROM THE OTHER WORKING 4219 02:38:05,400 --> 02:38:07,080 GROUPS AND WHAT WE WOULD LIKE TO 4220 02:38:07,080 --> 02:38:09,680 FLESH OUT IN WORKING GROUP 1 AS 4221 02:38:09,680 --> 02:38:11,640 A RESULT HOW THESE THREE FACTORS 4222 02:38:11,640 --> 02:38:13,520 NOW INTERSECT AND SO THE FIRST 4223 02:38:13,520 --> 02:38:14,960 BEING HOW CLIMATE AFFECTS 4224 02:38:14,960 --> 02:38:16,600 NUTRITION-RELATED HEALTH 4225 02:38:16,600 --> 02:38:17,560 CONDITIONS IN OLDER ADULTS WHICH 4226 02:38:17,560 --> 02:38:19,840 AGAIN A LOT OF THAT WORK WILL BE 4227 02:38:19,840 --> 02:38:23,040 ASSESSED IT BY WORKING GROUP 2 I 4228 02:38:23,040 --> 02:38:23,240 ASSUME. 4229 02:38:23,240 --> 02:38:26,520 SPECIFICALLY LOOKING AT HOW 4230 02:38:26,520 --> 02:38:27,880 NUTRITION INFLUENCES OUR 4231 02:38:27,880 --> 02:38:30,920 VULNERABILITY TO CLIMATE 4232 02:38:30,920 --> 02:38:32,560 MEDIATED HAZARDS, PARTICULAR 4233 02:38:32,560 --> 02:38:38,040 AREAS ARE BARRIER FUNCTIONS, 4234 02:38:38,040 --> 02:38:38,640 PULMONARY VASCULATURE, 4235 02:38:38,640 --> 02:38:41,880 PHYSIOLOGIC REACTION TO EXTREME 4236 02:38:41,880 --> 02:38:47,000 HEAT, WHAT NUTRITION MEANS 4237 02:38:47,000 --> 02:38:49,120 DEMENTIA IN CLIMATE-MEDIATED 4238 02:38:49,120 --> 02:38:53,560 INSULTS, WHAT NUTRITION AND 4239 02:38:53,560 --> 02:38:55,240 TUMORGENESIS MEANS FOR CANCER, 4240 02:38:55,240 --> 02:38:57,200 BONE HEALTH, IMMUNE SYSTEM, 4241 02:38:57,200 --> 02:38:58,400 FINALLY SPECIFIC DIETARY TOXINS 4242 02:38:58,400 --> 02:39:00,800 THAT ARE KNOWN TO BE TOXIC TO 4243 02:39:00,800 --> 02:39:04,280 THE HEART AND BRAIN AND OTHER 4244 02:39:04,280 --> 02:39:07,800 ORGANS SUCH AS HEAVY METALS, 4245 02:39:07,800 --> 02:39:08,720 ENDOCRINE DISRUPTORS, WHAT THAT 4246 02:39:08,720 --> 02:39:11,400 HAS IN TERMS OF CLIMATE AND 4247 02:39:11,400 --> 02:39:14,680 AGING-RELATED DISEASE 4248 02:39:14,680 --> 02:39:15,000 RELATIONSHIP. 4249 02:39:15,000 --> 02:39:16,560 SO, WITH THAT, I GUESS WE WILL 4250 02:39:16,560 --> 02:39:19,400 OPEN UP FOR QUESTIONS. 4251 02:39:19,400 --> 02:39:19,560 4252 02:39:19,560 --> 02:39:22,160 >> THANK YOU VERY MUCH. 4253 02:39:22,160 --> 02:39:24,320 THAT'S AN IMPRESSIVE RESEARCH 4254 02:39:24,320 --> 02:39:25,320 AGENDA SUGGESTING FUNDERS WILL 4255 02:39:25,320 --> 02:39:26,720 BE BUSY FOR QUITE SOME TIME 4256 02:39:26,720 --> 02:39:33,080 TRYING TO FILL IN THE GAPS THAT 4257 02:39:33,080 --> 02:39:33,720 YOU LISTED. 4258 02:39:33,720 --> 02:39:37,560 THANK YOU, ANDY, AND WAS LISTED 4259 02:39:37,560 --> 02:39:40,520 IN THE EARLIER PRESENTATIONS. 4260 02:39:40,520 --> 02:39:43,360 WEIGH POSTPONED QUESTIONS FOR 4261 02:39:43,360 --> 02:39:44,920 KARTIK AND WE HAVE QUESTIONS FOR 4262 02:39:44,920 --> 02:39:45,320 ANDY. 4263 02:39:45,320 --> 02:39:52,440 NANCY, DID YOU WANT TO MODERATE 4264 02:39:52,440 --> 02:39:52,640 THAT? 4265 02:39:52,640 --> 02:39:57,080 >>I CAN JUST OPEN THE FLOOR. 4266 02:39:57,080 --> 02:39:59,360 WE CAN GO BACK AND FORTH WITH 4267 02:39:59,360 --> 02:40:02,280 QUESTIONS, BUT THANK YOU BOTH. 4268 02:40:02,280 --> 02:40:07,320 4269 02:40:07,320 --> 02:40:13,040 I CAN'T IMAGINE THERE ARE NO 4270 02:40:13,040 --> 02:40:13,320 QUESTIONS. 4271 02:40:13,320 --> 02:40:13,560 >> JEAN? 4272 02:40:13,560 --> 02:40:15,200 >>MICHIGAN STATE UNIVERSITY. 4273 02:40:15,200 --> 02:40:18,360 I'M ALSO A PART OF WORK GROUP 2 4274 02:40:18,360 --> 02:40:20,440 SO I'M REALLY IN AWE OF ALL THAT 4275 02:40:20,440 --> 02:40:24,360 YOU'VE DONE WITH THIS WORK GROUP 4276 02:40:24,360 --> 02:40:26,800 ALREADY. 4277 02:40:26,800 --> 02:40:28,440 AND DR. SHANKA, I WANTED TO 4278 02:40:28,440 --> 02:40:29,960 COMMENT ON YOUR PRESENTATION. 4279 02:40:29,960 --> 02:40:31,200 I'M A PRINCIPAL INVESTIGATOR OF 4280 02:40:31,200 --> 02:40:33,920 ONE OF THE ECHO COHORTS, SO FOR 4281 02:40:33,920 --> 02:40:36,640 PEOPLE WHO MIGHT NOT KNOW, ECHO 4282 02:40:36,640 --> 02:40:38,000 IS NIH'S PROJECT ENVIRONMENTAL 4283 02:40:38,000 --> 02:40:39,880 INFLUENCE ON CHILD HEALTH 4284 02:40:39,880 --> 02:40:40,120 OUTCOMES. 4285 02:40:40,120 --> 02:40:43,760 THEY ARE JUST TO START A SECOND 4286 02:40:43,760 --> 02:40:44,880 FUNDING CYCLE. 4287 02:40:44,880 --> 02:40:46,080 7-YEAR FUNDING CYCLE. 4288 02:40:46,080 --> 02:40:49,800 I FEEL LIKE I HOPE THAT ALL OF 4289 02:40:49,800 --> 02:40:51,200 WHAT YOU SAID WILL GO STRAIGHT 4290 02:40:51,200 --> 02:40:56,160 TO THE ECHO LEADERSHIP BECAUSE 4291 02:40:56,160 --> 02:41:00,600 IT INFORMS SOPPING WE CAN -- 4292 02:41:00,600 --> 02:41:02,040 SOMETHING WE COULD IN THE U.S. 4293 02:41:02,040 --> 02:41:04,360 INFORMED BY THE INSIGHT YOU HAVE 4294 02:41:04,360 --> 02:41:06,640 INTERNATIONALLY THROUGH THE ECHO 4295 02:41:06,640 --> 02:41:08,280 PROGRAM WHICH HAS 69 COHORTS 4296 02:41:08,280 --> 02:41:10,040 ACROSS THE U.S. AT THIS TIME. 4297 02:41:10,040 --> 02:41:13,560 AND I THINK WE CAN REALLY LOOK 4298 02:41:13,560 --> 02:41:16,800 AT SOME IMPORTANT INTERACTIONS 4299 02:41:16,800 --> 02:41:18,040 BETWEEN NUTRITION AND CLIMATE. 4300 02:41:18,040 --> 02:41:20,760 THANK YOU SO MUCH. 4301 02:41:20,760 --> 02:41:23,920 4302 02:41:23,920 --> 02:41:25,240 >> THANK YOU FOR THE COMMENT. 4303 02:41:25,240 --> 02:41:27,640 IN THE SHORT TIME I DIDN'T MAKE 4304 02:41:27,640 --> 02:41:28,760 THESE CONNECTIONS BUT WITHIN THE 4305 02:41:28,760 --> 02:41:31,280 U.S. A LOT OF THE DATA FROM AIR 4306 02:41:31,280 --> 02:41:32,920 POLLUTION AND OTHER 4307 02:41:32,920 --> 02:41:34,000 ENVIRONMENTAL CONTAMINANTS HAS 4308 02:41:34,000 --> 02:41:36,640 COME FROM THE ECHO COHORT FOR 4309 02:41:36,640 --> 02:41:37,240 SUBANALYSES OF SEVERAL STUDIES 4310 02:41:37,240 --> 02:41:42,000 THAT ARE PART OF THE ECHO 4311 02:41:42,000 --> 02:41:45,840 COHORT, BUT AS FAR AS I KNOW A 4312 02:41:45,840 --> 02:41:48,680 LOT OF THE CLIMATE VARIABLES 4313 02:41:48,680 --> 02:41:51,280 SEEM TO BE BEHIND IN TERMS OF 4314 02:41:51,280 --> 02:41:53,840 THE MORE TRADITIONAL 4315 02:41:53,840 --> 02:41:54,360 ENVIRONMENTAL POLLUTANTS, 4316 02:41:54,360 --> 02:41:56,280 METALS, SO ON AND SO FORTH, THE 4317 02:41:56,280 --> 02:41:59,200 ONES THAT HAVE BEEN STUDIED. 4318 02:41:59,200 --> 02:42:00,320 EXPOSURE TO SOME OF THESE IS 4319 02:42:00,320 --> 02:42:03,560 ALSO GOING TO BE INCREASED WITH 4320 02:42:03,560 --> 02:42:04,440 ADVANCING CLIMATE CHANGE. 4321 02:42:04,440 --> 02:42:14,920 THANK YOU FOR THAT COMMENT. 4322 02:42:16,120 --> 02:42:18,000 >> ANDY, I'D LIKE TO ASK YOU, 4323 02:42:18,000 --> 02:42:19,760 YOU SAID THERE WEREN'T MANY 4324 02:42:19,760 --> 02:42:20,880 NUTRITION INTERVENTIONS OR DATA 4325 02:42:20,880 --> 02:42:24,040 GATHERED ON THE COHORTS YOU 4326 02:42:24,040 --> 02:42:24,480 DESCRIBED. 4327 02:42:24,480 --> 02:42:29,360 BUT WHAT'S YOUR GUT FEELING 4328 02:42:29,360 --> 02:42:30,480 ABOUT IF YOU COULD TEST 4329 02:42:30,480 --> 02:42:32,280 SOMETHING IN TERMS OF NUTRITION 4330 02:42:32,280 --> 02:42:35,600 AND RISK FACTORS, AGAIN THE 4331 02:42:35,600 --> 02:42:38,360 MULTI-SYSTEM EFFECTS, WHERE 4332 02:42:38,360 --> 02:42:42,000 WOULD YOU START? 4333 02:42:42,000 --> 02:42:43,160 IMPROVED BMIs, MACRONUTRIENTS, 4334 02:42:43,160 --> 02:42:49,280 OR IMPROVED -- LIKE EVERYBODY ON 4335 02:42:49,280 --> 02:42:50,000 MACRONUTRIENTS OR IMPROVED 4336 02:42:50,000 --> 02:42:52,120 DIETS, WHAT COMES TO MIND? 4337 02:42:52,120 --> 02:42:53,600 >>YOU MENTIONED EXACTLY WHAT IT 4338 02:42:53,600 --> 02:42:56,920 IS I THINK IT'S GOING TO BE 4339 02:42:56,920 --> 02:42:57,280 MACRONUTRIENTS. 4340 02:42:57,280 --> 02:42:59,360 THE BIG THREE THAT I USUALLY 4341 02:42:59,360 --> 02:43:01,320 THINK ABOUT CARDIOVASCULAR RISK 4342 02:43:01,320 --> 02:43:03,520 FACTORS, SO WE'RE TALKING 4343 02:43:03,520 --> 02:43:05,920 HYPERTENSION, BLOOD SUGAR IN 4344 02:43:05,920 --> 02:43:07,680 FORM OF DIABETES AND 4345 02:43:07,680 --> 02:43:08,280 HYPERLIPIDEMIA. 4346 02:43:08,280 --> 02:43:11,080 A LOT HAVE STRONG LINKS TO 4347 02:43:11,080 --> 02:43:12,800 CARBOHYDRATES AS WELL AS 4348 02:43:12,800 --> 02:43:13,920 CONSUMPTION OF CERTAIN PROTEINS 4349 02:43:13,920 --> 02:43:16,000 SUCH AS RED MEAT AND DAIRY. 4350 02:43:16,000 --> 02:43:19,800 WE HAVE LONG KNOWN THESE THINGS. 4351 02:43:19,800 --> 02:43:23,440 UNFORTUNATELY, MAYBE FORTUNATELY 4352 02:43:23,440 --> 02:43:30,960 FOR US, THERE'S BIDIRECTIONAL 4353 02:43:30,960 --> 02:43:32,640 IMPACT, FOR INSTANCE RED MEAT 4354 02:43:32,640 --> 02:43:34,720 FOR THE CLIMATE, CARDIOVASCULAR 4355 02:43:34,720 --> 02:43:34,920 DISEASE. 4356 02:43:34,920 --> 02:43:44,360 REALLY IT'S GOT TO BE THE 4357 02:43:44,360 --> 02:43:45,320 MACROMACROS, SUGAR, PROTEINS, 4358 02:43:45,320 --> 02:43:46,360 FATS REALLY. 4359 02:43:46,360 --> 02:43:50,400 >> I'LL JUST SAY I WOULDN'T 4360 02:43:50,400 --> 02:43:51,680 DISMISS MICRO NUTRIENTS BUT THAT 4361 02:43:51,680 --> 02:43:55,640 SEEMS FAR TO START WITH MACROS. 4362 02:43:55,640 --> 02:43:55,960 GREAT COMMENT. 4363 02:43:55,960 --> 02:43:58,240 >>IF I COULD INTERRUPT I'D LIKE 4364 02:43:58,240 --> 02:44:01,880 TO ADD TO THAT. 4365 02:44:01,880 --> 02:44:10,160 WE KNOW CARBON DIOXIDE IS 4366 02:44:10,160 --> 02:44:11,160 AFFECTING NUTRIENT DENSITY, NOT 4367 02:44:11,160 --> 02:44:16,640 RESEARCH OF WHAT THAT MEANS FOR 4368 02:44:16,640 --> 02:44:17,400 THE OBESITY EPIDEMIC. 4369 02:44:17,400 --> 02:44:19,360 WHEN WE LOOK AT MEAT 4370 02:44:19,360 --> 02:44:21,120 ALTERNATIVES AT THIS MOMENT 4371 02:44:21,120 --> 02:44:24,280 THOSE MEAT ALTERNATIVES ARE 4372 02:44:24,280 --> 02:44:27,800 FOCUSING ON PROTEIN CONTENT BUT 4373 02:44:27,800 --> 02:44:29,480 NOT MICRONUTRIENTS. 4374 02:44:29,480 --> 02:44:32,600 SWITCHING TO THESE ALTERNATIVES 4375 02:44:32,600 --> 02:44:34,120 IN TERMS OF WHAT 1.5 BILLION 4376 02:44:34,120 --> 02:44:38,360 WOMEN WHO HAVE IRON DEFICIENCY 4377 02:44:38,360 --> 02:44:39,720 ANEMIA AND THINKING FORWARD 4378 02:44:39,720 --> 02:44:41,800 ABOUT THE CHALLENGES WE'RE GOING 4379 02:44:41,800 --> 02:44:44,960 TO FACE AS WE TRANSITION TO MORE 4380 02:44:44,960 --> 02:44:46,640 SUSTAINABLE FOOD SYSTEM THAT 4381 02:44:46,640 --> 02:44:48,720 TAKES INTO ACCOUNT ITS 4382 02:44:48,720 --> 02:44:49,560 CONTRIBUTION TO CLIMATE CHANGE, 4383 02:44:49,560 --> 02:44:52,840 BUT THEN ALSO HOW IT COMES BACK 4384 02:44:52,840 --> 02:44:54,720 TO NUTRITION, AND I'M SURE DAN 4385 02:44:54,720 --> 02:44:58,800 HAS HIS HAND UP FOR JUST THAT 4386 02:44:58,800 --> 02:45:05,560 REASON. 4387 02:45:05,560 --> 02:45:08,280 >> YOU'RE STILL ON MUTE. 4388 02:45:08,280 --> 02:45:14,680 THERE WE GO. 4389 02:45:14,680 --> 02:45:18,320 >> THERE IS WORK BEING DONE ON 4390 02:45:18,320 --> 02:45:20,000 MEAT ALTERNATIVES, AND I THINK 4391 02:45:20,000 --> 02:45:21,160 WORKING GROUP 3 WILL FOCUS ON 4392 02:45:21,160 --> 02:45:25,720 SOME OF THAT. 4393 02:45:25,720 --> 02:45:27,360 I THINK THAT'S IMPORTANT. 4394 02:45:27,360 --> 02:45:29,800 THE QUESTION I HAD FOR THE 4395 02:45:29,800 --> 02:45:31,680 GROUP, THE CONTEXT OF THE 4396 02:45:31,680 --> 02:45:34,040 PROJECT, OUR GOAL HERE IS TO 4397 02:45:34,040 --> 02:45:37,520 MAKE A CASE FOR WHY THIS 4398 02:45:37,520 --> 02:45:40,360 INTERSECTION OF HEALTH AND 4399 02:45:40,360 --> 02:45:44,000 NUTRITION NEEDS TO BE INTEGRATED 4400 02:45:44,000 --> 02:45:45,840 INTO THE DELIBERATION OF 4401 02:45:45,840 --> 02:45:46,600 GUIDANCE RECOMMENDATIONS ET 4402 02:45:46,600 --> 02:45:48,040 CETERA, HOW CAN WE POSITION 4403 02:45:48,040 --> 02:45:50,320 THIS, ARE THERE DATA WE CAN 4404 02:45:50,320 --> 02:45:51,840 EXPLORE FOR WHAT HAPPENS WHEN 4405 02:45:51,840 --> 02:45:54,600 YOU DON'T INTEGRATE THESE 4406 02:45:54,600 --> 02:45:54,840 THINGS? 4407 02:45:54,840 --> 02:45:56,320 I'M JUST WONDERING IF WE CAN 4408 02:45:56,320 --> 02:45:59,720 COVER THAT SOMEHOW IN THE GROUP. 4409 02:45:59,720 --> 02:46:01,400 I'M HAPPY TO HEAR FROM OTHER 4410 02:46:01,400 --> 02:46:02,680 WORKING GROUP MEMBERS AS WELL, 4411 02:46:02,680 --> 02:46:04,000 FROM OTHER WORKING GROUPS AS 4412 02:46:04,000 --> 02:46:12,000 WELL AS THIS ONE. 4413 02:46:12,000 --> 02:46:14,960 >> I GUESS I WOULD JUST SAY 4414 02:46:14,960 --> 02:46:17,120 THAT WE HAVE WHAT YOU JUST 4415 02:46:17,120 --> 02:46:20,000 DESCRIBED IS WHAT HAPPENS WHEN 4416 02:46:20,000 --> 02:46:21,640 WE DON'T ACCOUNT FOR IT. 4417 02:46:21,640 --> 02:46:28,760 YOU KNOW, WE HAVE ALL THESE GAPS 4418 02:46:28,760 --> 02:46:33,080 IN KNOWLEDGE, BUT YOU'VE RAISED 4419 02:46:33,080 --> 02:46:35,200 AN IMPORTANT POINT. 4420 02:46:35,200 --> 02:46:41,480 >>AN EXAMPLE, WE HAVE THE W.H. 4421 02:46:41,480 --> 02:46:42,440 TARGETS, ANEMIA, STUNTING, ET 4422 02:46:42,440 --> 02:46:43,560 CETERA, WE'RE NOT DOING A GREAT 4423 02:46:43,560 --> 02:46:45,880 JOB OF MEETING BUT THEY DON'T 4424 02:46:45,880 --> 02:46:46,880 INCLUDE CONSIDERATION OF 4425 02:46:46,880 --> 02:46:47,120 CLIMATE. 4426 02:46:47,120 --> 02:46:49,480 BUT THERE ARE DATA TO INDICATE 4427 02:46:49,480 --> 02:46:52,680 THAT I THINK WE'VE HEARD DATA 4428 02:46:52,680 --> 02:46:55,200 TODAY TO INDICATE WHY THAT'S 4429 02:46:55,200 --> 02:46:56,360 IMPORTANT. 4430 02:46:56,360 --> 02:46:58,240 I WANT TO HIGHLIGHT THAT IS AS A 4431 02:46:58,240 --> 02:47:02,960 POINTS OF EMPHASIS FOR THE 4432 02:47:02,960 --> 02:47:04,480 REPORT, WE HAVE TARGETS THAT 4433 02:47:04,480 --> 02:47:05,640 WE'RE TRYING TO MEET, HERE IS 4434 02:47:05,640 --> 02:47:07,680 WHY THIS NEEDS TO BE INTEGRATED. 4435 02:47:07,680 --> 02:47:09,000 ANEMIA IS A PERFECT CASE IN 4436 02:47:09,000 --> 02:47:09,200 POINT. 4437 02:47:09,200 --> 02:47:11,960 WE HEAR ABOUT IT ALL THE TIME. 4438 02:47:11,960 --> 02:47:16,400 IT'S A MULTI-DIMENSIONAL 4439 02:47:16,400 --> 02:47:22,000 DISEASE, NOT JUST NUTRITIONAL. 4440 02:47:22,000 --> 02:47:26,600 WE DON'T ADDRESS ITS IT AND HAT 4441 02:47:26,600 --> 02:47:27,720 INCLUDE THE THE INTERSECTION OF 4442 02:47:27,720 --> 02:47:28,040 CLIMATE. 4443 02:47:28,040 --> 02:47:30,680 IF WE WANT TO TIE IT TOGETHER, 4444 02:47:30,680 --> 02:47:31,800 TAKE MALARIA, RON DISCUSSED 4445 02:47:31,800 --> 02:47:37,560 INFECTIOUS DISEASES, IF YOU LOOK 4446 02:47:37,560 --> 02:47:38,960 AT MALARIA AND RELATIONSHIP TO 4447 02:47:38,960 --> 02:47:42,960 IRON, A SCENARIO IS CREATED THAT 4448 02:47:42,960 --> 02:47:46,600 MAKES FOR A COMPLICATED SET OF 4449 02:47:46,600 --> 02:47:52,440 ISSUES THAT WE NEED TO HIGHLIGHT 4450 02:47:52,440 --> 02:47:52,640 HERE. 4451 02:47:52,640 --> 02:47:54,760 SO, FOR EXAMPLE, IF WE ASSUME 4452 02:47:54,760 --> 02:47:58,120 MALARIA IS RELATED TO IRON 4453 02:47:58,120 --> 02:47:59,440 STATUS, AND IRON PHYSIOLOGY, 4454 02:47:59,440 --> 02:48:00,960 WHICH IT OBVIOUSLY IS, THERE'S 4455 02:48:00,960 --> 02:48:07,000 ASSUMPTION IT'S RELATED TO IRON 4456 02:48:07,000 --> 02:48:07,880 DEFICIENCY, OR IRON NUTRITION, 4457 02:48:07,880 --> 02:48:11,280 WHICH IT MAY OR MAY NOT BE. 4458 02:48:11,280 --> 02:48:14,800 IN AREAS WHAT MALARIA IS ENDEMIC 4459 02:48:14,800 --> 02:48:21,120 IRON DEFICIENCY IS ALSO ENDEMIC. 4460 02:48:21,120 --> 02:48:23,760 WE'RE LEFT WITH WHAT TO DO IN 4461 02:48:23,760 --> 02:48:29,080 THAT CONTEXT, GIVE IRON 4462 02:48:29,080 --> 02:48:30,200 SUPPLEMENTATION WHERE KRIS IS 4463 02:48:30,200 --> 02:48:33,080 POINTING OUT AND WE'LL HEAR FROM 4464 02:48:33,080 --> 02:48:37,200 WORKING GROUP 2 THAT QUALITY OF 4465 02:48:37,200 --> 02:48:38,720 THE DIETS AND BEING DECREASED AS 4466 02:48:38,720 --> 02:48:41,160 A RESULT OF GREENHOUSE GAS 4467 02:48:41,160 --> 02:48:41,720 EMISSION, EXPECTATIONS ABOUT 4468 02:48:41,720 --> 02:48:45,720 DIET ARE GOING TO BE REDUCED. 4469 02:48:45,720 --> 02:48:46,720 IRON SUPPLEMENTATION MAY NOT BE 4470 02:48:46,720 --> 02:48:52,160 SAFE IN THE CONTEXT OF MALARIA, 4471 02:48:52,160 --> 02:48:54,240 AND INFECTIOUS DISEASES, MAKES 4472 02:48:54,240 --> 02:48:58,640 FOR A CONUNDRUM WITH REGARD TO 4473 02:48:58,640 --> 02:48:59,840 INTERVENTION, TAKING THAT 4474 02:48:59,840 --> 02:49:00,840 APPROACH WILL BE IMPORTANT, NOT 4475 02:49:00,840 --> 02:49:04,280 JUST PRESENTING THE CASE FOR 4476 02:49:04,280 --> 02:49:05,200 NUTRITION BEING IMPORTANT, IN 4477 02:49:05,200 --> 02:49:06,680 THE COURSE OF THE LIFESTYLE 4478 02:49:06,680 --> 02:49:12,440 CYCLE OR ANY DISEASE BUT ALSO 4479 02:49:12,440 --> 02:49:13,240 CHALLENGES ABOUT MAKING 4480 02:49:13,240 --> 02:49:16,040 DECISIONS WHAT INTERVENTION 4481 02:49:16,040 --> 02:49:17,800 MIGHT BE BEST ON A GIVEN 4482 02:49:17,800 --> 02:49:18,160 CIRCUMSTANCE. 4483 02:49:18,160 --> 02:49:21,600 WORKING GROUP 2 WILL BE DEALING 4484 02:49:21,600 --> 02:49:23,280 WITH CHOICE, ISSUES AROUND 4485 02:49:23,280 --> 02:49:24,920 CHOICE, DIETARY PATTERNS, AND 4486 02:49:24,920 --> 02:49:28,040 WORKING GROUP 3 WILL BE DEALING 4487 02:49:28,040 --> 02:49:33,520 WITH CHOICES AS RELATES TO 4488 02:49:33,520 --> 02:49:34,120 PRODUCTION-RELATED ISSUES AND 4489 02:49:34,120 --> 02:49:35,480 WORKING GROUP 5 WILL HAVE TO 4490 02:49:35,480 --> 02:49:39,480 ADDRESS IT IN SOME WAY BUT THIS 4491 02:49:39,480 --> 02:49:41,200 IT WILL BE IMPORTANT FOR THIS 4492 02:49:41,200 --> 02:49:43,600 GROUP TO PUT IT IN CONTEXT. 4493 02:49:43,600 --> 02:49:49,760 I'LL STOP RAMBLING. 4494 02:49:49,760 --> 02:49:51,320 >>YOU RAISED A CASE FOR 4495 02:49:51,320 --> 02:49:52,480 EXAMPLES TO HIGHLIGHT WHAT 4496 02:49:52,480 --> 02:49:53,160 YOU'RE DESCRIBING. 4497 02:49:53,160 --> 02:49:55,600 THERE'S MANY THAT WE COULD DO. 4498 02:49:55,600 --> 02:49:58,960 >> EXACTLY. 4499 02:49:58,960 --> 02:49:59,440 THANK YOU. 4500 02:49:59,440 --> 02:50:05,520 >> ALEXANDRA? 4501 02:50:05,520 --> 02:50:06,560 ALEXA, SORRY. 4502 02:50:06,560 --> 02:50:07,800 >> ANDY, YOUR TALK WAS 4503 02:50:07,800 --> 02:50:08,560 INTERESTING. 4504 02:50:08,560 --> 02:50:09,680 I MYSELF DON'T HAVE A LOT OF 4505 02:50:09,680 --> 02:50:12,080 EXPERIENCE LOOKING AT DATA FOR 4506 02:50:12,080 --> 02:50:12,720 ORDINARY ADULTS BUT WAS 4507 02:50:12,720 --> 02:50:14,040 WONDERING AS WE'RE THINKING 4508 02:50:14,040 --> 02:50:16,120 ABOUT THIS LIFE COURSE 4509 02:50:16,120 --> 02:50:18,320 PERSPECTIVE, WHEN DO YOU THINK 4510 02:50:18,320 --> 02:50:21,920 THE BEST TIME TO INTERVENE TO 4511 02:50:21,920 --> 02:50:26,600 IMPROVE NUTRITIONAL STATUS FOR 4512 02:50:26,600 --> 02:50:28,720 ELDERLY, IS IT BEFORE YOU ENTER 4513 02:50:28,720 --> 02:50:29,480 A CERTAIN AGE? 4514 02:50:29,480 --> 02:50:32,760 OR LIKE CAN WE BE INTERVENING 4515 02:50:32,760 --> 02:50:34,960 DURING THAT PART OF THE LIFE 4516 02:50:34,960 --> 02:50:35,200 COURSE? 4517 02:50:35,200 --> 02:50:36,640 I WAS WONDERING IF YOU HAD ANY 4518 02:50:36,640 --> 02:50:39,560 THOUGHTS. 4519 02:50:39,560 --> 02:50:43,680 >> I MEAN, THE COPOUT ANSWER IS 4520 02:50:43,680 --> 02:50:45,320 BOTH. 4521 02:50:45,320 --> 02:50:47,120 I THINK THE IMPLIED ANSWER TO 4522 02:50:47,120 --> 02:50:48,080 YOUR QUESTION BASED ON YOUR 4523 02:50:48,080 --> 02:50:51,920 STATEMENT I THINK IS TRUE, THE 4524 02:50:51,920 --> 02:50:52,920 BIGGEST BANG FOR YOUR BUCK 4525 02:50:52,920 --> 02:50:54,120 HAPPENS EARLIER IN LIFE BECAUSE 4526 02:50:54,120 --> 02:50:56,400 A LOT OF CONDITIONS ARE THE AS A 4527 02:50:56,400 --> 02:51:00,120 RESULT, END RESULT, OF CHRONIC 4528 02:51:00,120 --> 02:51:10,480 LONG-TERM, THEY CALL IT 4529 02:51:10,480 --> 02:51:15,120 MARINATION, PICKLING EFFECT FOR 4530 02:51:15,120 --> 02:51:18,160 HIGH SUGARS OVER TIME. 4531 02:51:18,160 --> 02:51:21,360 THE EARLIER YOU INTERVENE THE 4532 02:51:21,360 --> 02:51:24,640 BETTER, FOR LIPIDS AND DIABETES, 4533 02:51:24,640 --> 02:51:28,360 TRYING TO MORE AGGRESSIVELY DEAL 4534 02:51:28,360 --> 02:51:29,400 WITH IT EARLIER. 4535 02:51:29,400 --> 02:51:31,120 WE'RE PUTTING PEOPLE ON STATINS 4536 02:51:31,120 --> 02:51:32,160 AND BLOOD PRESSURE MEDICATIONS 4537 02:51:32,160 --> 02:51:32,400 EARLIER. 4538 02:51:32,400 --> 02:51:35,600 I DON'T THINK THERE CAN BE AN 4539 02:51:35,600 --> 02:51:37,560 EARLY ENOUGH, BUT THE EARLIER 4540 02:51:37,560 --> 02:51:39,720 THAT WE DO PUT THESE INTO EFFECT 4541 02:51:39,720 --> 02:51:41,040 THE BETTER HEALTH EFFECTS WE'LL 4542 02:51:41,040 --> 02:51:45,640 SEE IN THE LONG RUN. 4543 02:51:45,640 --> 02:51:47,480 I WILL SAY THAT THERE IS A POINT 4544 02:51:47,480 --> 02:51:50,040 WE MAY START TO WONDER IF WE'RE 4545 02:51:50,040 --> 02:51:51,760 ACTUALLY PAST A CERTAIN POINT ON 4546 02:51:51,760 --> 02:51:57,920 THE CURVE SO I DO SOME RESEARCH 4547 02:51:57,920 --> 02:52:00,640 LOOKING AT SYNCOPE, VERY 4548 02:52:00,640 --> 02:52:01,240 AGGRESSIVE BLOOD PRESSURE 4549 02:52:01,240 --> 02:52:03,040 CONTROL AT EXTREME AGES MAY NOT 4550 02:52:03,040 --> 02:52:03,840 BE SUPER BENEFICIAL BECAUSE 4551 02:52:03,840 --> 02:52:05,680 WE'RE DEALING WITH A LOT OF 4552 02:52:05,680 --> 02:52:06,560 COMPETING RISKS FOR MORTALITY AT 4553 02:52:06,560 --> 02:52:09,400 THE END, BUT IF YOU'RE REALLY 4554 02:52:09,400 --> 02:52:11,480 AGGRESSIVELY DRIVING BLOOD 4555 02:52:11,480 --> 02:52:13,840 PRESSURE DOWN YOU HAVE SYNCOPE, 4556 02:52:13,840 --> 02:52:15,120 LOSING CONSCIOUSNESS, FALLING, A 4557 02:52:15,120 --> 02:52:16,080 GREATER SOURCE OF POTENTIAL 4558 02:52:16,080 --> 02:52:17,480 TRAUMA AND DEATH. 4559 02:52:17,480 --> 02:52:18,600 THE ANSWER IS CAN'T INTERVENE 4560 02:52:18,600 --> 02:52:20,480 EARLY ENOUGH BUT THERE'S A POINT 4561 02:52:20,480 --> 02:52:22,000 IN LIFE MAYBE SOMEWHERE IN THE 4562 02:52:22,000 --> 02:52:23,280 '80s WHERE PERHAPS MAYBE WE 4563 02:52:23,280 --> 02:52:26,480 SHOULD BE BACKING OFF AND JUST 4564 02:52:26,480 --> 02:52:27,960 LETTING IT BE WHAT IT IS. 4565 02:52:27,960 --> 02:52:28,760 >> THANK YOU. 4566 02:52:28,760 --> 02:52:30,520 THAT ALSO BRINGS BACK TO DAN'S 4567 02:52:30,520 --> 02:52:33,120 POINT OF WHAT HAPPENS IF YOU I 4568 02:52:33,120 --> 02:52:35,440 DON'T INTEGRATE NUTRITION AND 4569 02:52:35,440 --> 02:52:37,520 CLIMATE AND HEALTH, IS WE'RE 4570 02:52:37,520 --> 02:52:39,160 SEEING A POPULATIONS THAT ARE 4571 02:52:39,160 --> 02:52:41,080 AGING, DON'T ADDRESS IT NOW, I 4572 02:52:41,080 --> 02:52:42,000 THINK IT'S GOING TO BE MUCH 4573 02:52:42,000 --> 02:52:46,000 HARDER TO ADDRESS IN THE FUTURE. 4574 02:52:46,000 --> 02:52:47,400 >> I MEAN, THERE'S SOME -- WHEN 4575 02:52:47,400 --> 02:52:49,240 I SAY YOU CAN'T START EARLY 4576 02:52:49,240 --> 02:52:52,440 ENOUGH, I MEAN THERE'S TRAGIC 4577 02:52:52,440 --> 02:52:57,680 DATA FROM THE DUTCH FAMINE IN 4578 02:52:57,680 --> 02:53:00,760 1944, NAZIS BLOCKADE THE THE 4579 02:53:00,760 --> 02:53:01,760 ENTIRE COUNTRY TO PUNISH THEM 4580 02:53:01,760 --> 02:53:03,640 FOR A RAIL STRIKE. 4581 02:53:03,640 --> 02:53:06,240 PEOPLE WHO ARE IN UTERO DURING 4582 02:53:06,240 --> 02:53:07,000 THIS 12-WEEK EXTREME FAMINE 4583 02:53:07,000 --> 02:53:10,400 LATER WOULD GO ON TO HAVE 2 1/2 4584 02:53:10,400 --> 02:53:12,240 TIMES HIGHER ODDS OF HEART 4585 02:53:12,240 --> 02:53:15,400 ATTACKS AND DIABETES LATER ON IN 4586 02:53:15,400 --> 02:53:15,600 LIFE. 4587 02:53:15,600 --> 02:53:16,960 SO IT STARTS IN UTERO. 4588 02:53:16,960 --> 02:53:27,480 YOU CAN'T START EARLY ENOUGH. 4589 02:53:28,200 --> 02:53:33,480 >> I THINK I WANTED TO MAKE A 4590 02:53:33,480 --> 02:53:34,800 COUPLE POINTS. 4591 02:53:34,800 --> 02:53:37,720 TO DAN'S POINT, WHICH IS WE 4592 02:53:37,720 --> 02:53:38,920 THINK ABOUT NUTRITIONAL 4593 02:53:38,920 --> 02:53:43,000 REQUIREMENTS AND INTAKE AND LIFE 4594 02:53:43,000 --> 02:53:45,400 STAGES TO BE DIFFERENT. 4595 02:53:45,400 --> 02:53:48,640 AND THOSE TO IMPACT PERSONAL 4596 02:53:48,640 --> 02:53:48,960 REQUIREMENT. 4597 02:53:48,960 --> 02:53:52,200 BUT -- AND IN THE CONTEXT OF 4598 02:53:52,200 --> 02:53:53,080 CLIMATE CHANGING NUTRITION 4599 02:53:53,080 --> 02:53:54,400 REQUIREMENTS, IT'S REALLY ABOUT 4600 02:53:54,400 --> 02:53:57,080 CONTEXT, RIGHT? 4601 02:53:57,080 --> 02:53:59,320 IN SOME CONTEXTS WHERE, SAY, THE 4602 02:53:59,320 --> 02:54:00,440 AIR IS REALLY, REALLY, REALLY 4603 02:54:00,440 --> 02:54:04,000 BAD THAT IMPACT MAY BE MUCH 4604 02:54:04,000 --> 02:54:05,440 GREATER THAN THE KIND OF 4605 02:54:05,440 --> 02:54:09,160 INFLUENCES PERHAPS IN THE LARGER 4606 02:54:09,160 --> 02:54:11,560 U.S. POPULATION, MAYBE 4607 02:54:11,560 --> 02:54:12,640 LOCALIZED, SAY, WILDFIRE SETTING 4608 02:54:12,640 --> 02:54:19,360 MIGHT GET A LOT OF EXPOSURE TO 4609 02:54:19,360 --> 02:54:20,880 PM2.5 BUT WHEN ALL THE AIR YOU 4610 02:54:20,880 --> 02:54:22,200 BREATHE IS BAD THE CONTEXT IS 4611 02:54:22,200 --> 02:54:23,000 VERY DIFFERENT. 4612 02:54:23,000 --> 02:54:24,960 WE'VE GOT TO FRAME THIS IN TERMS 4613 02:54:24,960 --> 02:54:25,400 OF CONTEXT. 4614 02:54:25,400 --> 02:54:27,160 THAT WAS ONE OF THE KIND OF 4615 02:54:27,160 --> 02:54:29,640 POINTS THAT MAYBE WE SHOULD 4616 02:54:29,640 --> 02:54:29,880 DISCUSS. 4617 02:54:29,880 --> 02:54:34,480 SECONDLY WE WERE TALKING ABOUT 4618 02:54:34,480 --> 02:54:37,160 WHAT DIETARY THINGS WE WOULD USE 4619 02:54:37,160 --> 02:54:38,640 FOR INTERVENTION. 4620 02:54:38,640 --> 02:54:40,800 AND TYPICALLY WE THINK ABOUT 4621 02:54:40,800 --> 02:54:42,560 GOOD THINGS YOU CAN GIVE PEOPLE 4622 02:54:42,560 --> 02:54:44,000 TO IMPROVE NUTRITION BUT WE HAVE 4623 02:54:44,000 --> 02:54:47,040 TO LOOK AT FOOD SYSTEM AND THINK 4624 02:54:47,040 --> 02:54:49,440 ABOUT BAD THINGS, BUT THINGS 4625 02:54:49,440 --> 02:54:53,800 THAT MIGHT IMPACT, SAY, THE 4626 02:54:53,800 --> 02:54:57,120 EXAMPLE THAT'S INTERESTING, 4627 02:54:57,120 --> 02:54:58,400 FRUCTOSE, HYDRATION, WHETHER IN 4628 02:54:58,400 --> 02:55:00,400 COUNTRIES WHERE THERE'S A LOT OF 4629 02:55:00,400 --> 02:55:02,440 FRUCTOSE EASILY AVAILABLE, KIDS 4630 02:55:02,440 --> 02:55:05,440 CONSUME IT A LOT, SUSCEPTIBLE TO 4631 02:55:05,440 --> 02:55:07,200 HEAT STRESS AND DISEASE, THERE'S 4632 02:55:07,200 --> 02:55:09,280 THE WHOLE ANGLE ABOUT LOOKING 4633 02:55:09,280 --> 02:55:15,040 INTO OUR FOOD SYSTEM AND 4634 02:55:15,040 --> 02:55:16,320 THINKING ABOUT VERY PREVALENT 4635 02:55:16,320 --> 02:55:17,800 MODERATELY GOOD FOODS. 4636 02:55:17,800 --> 02:55:24,280 THOSE WERE TWO POINTS I REALLY 4637 02:55:24,280 --> 02:55:27,200 THOUGHT -- 4638 02:55:27,200 --> 02:55:29,480 >> I REALLY LIKED THE 4639 02:55:29,480 --> 02:55:32,600 PERSPECTIVE FROM DON ABOUT HOW 4640 02:55:32,600 --> 02:55:35,080 THE SCHOOL LUNCH PROGRAMS WERE 4641 02:55:35,080 --> 02:55:36,440 CHANGING LOCAL AGRICULTURE AND 4642 02:55:36,440 --> 02:55:37,840 FOOD SUPPLY, I DON'T KNOW IF 4643 02:55:37,840 --> 02:55:40,120 THAT CAN BE BUILT INTO A LONGER 4644 02:55:40,120 --> 02:55:42,080 BROADER CHANGE IN DIETARY 4645 02:55:42,080 --> 02:55:43,720 PATTERNS BUT MAYBE WORK GROUP 2 4646 02:55:43,720 --> 02:55:47,920 OR 3 WILL TAKE THAT ON. 4647 02:55:47,920 --> 02:55:50,480 ARE YOU OKAY IF WE OPEN TO OTHER 4648 02:55:50,480 --> 02:55:53,880 PARTICIPANTS ON THE WEBINAR? 4649 02:55:53,880 --> 02:55:54,320 >> OH, ABSOLUTELY. 4650 02:55:54,320 --> 02:55:58,360 >> I FOR GOT WHO IS GOING TO 4651 02:55:58,360 --> 02:56:00,960 BE -- THE QUESTIONS FROM THE 4652 02:56:00,960 --> 02:56:05,800 AUDIENCE WENT TO AN E-MAIL 4653 02:56:05,800 --> 02:56:07,360 ADDRESS SOMEONE IS GOING TO -- 4654 02:56:07,360 --> 02:56:09,480 >>DREW IS IN CHARGE OF THAT. 4655 02:56:09,480 --> 02:56:10,880 >>I'M MONITORING THAT. 4656 02:56:10,880 --> 02:56:11,680 WE'VE NOT HAD A LOT OF TRAFFIC 4657 02:56:11,680 --> 02:56:14,840 COME IN BUT I DO, FOR THOSE ON 4658 02:56:14,840 --> 02:56:18,480 THE VIDEOCAST, PLEASE FEEL FREE 4659 02:56:18,480 --> 02:56:19,480 TO SEND COMMENTS AND QUESTIONS. 4660 02:56:19,480 --> 02:56:21,720 WE'LL TRY TO ADDRESS THEM IN 4661 02:56:21,720 --> 02:56:23,440 REAL TIME WITH OUR PANELISTS AND 4662 02:56:23,440 --> 02:56:25,120 WORKING GROUP MEMBERS BUT THEY 4663 02:56:25,120 --> 02:56:27,640 ALSO WILL BE ARCHIVED. 4664 02:56:27,640 --> 02:56:30,160 AS THESE GROUPS CONTINUE WITH 4665 02:56:30,160 --> 02:56:32,240 THEIR CHARGE OF PUTTING TOGETHER 4666 02:56:32,240 --> 02:56:33,920 REPORTS AND OUTPUTS, IT'S SUPER 4667 02:56:33,920 --> 02:56:38,600 HELPFUL TO HAVE INPUT FROM THE 4668 02:56:38,600 --> 02:56:38,880 COMMUNITY. 4669 02:56:38,880 --> 02:56:40,480 >> COULD I ASK WORKING GROUP 4670 02:56:40,480 --> 02:56:42,800 MEMBERS TO TURN ON YOUR VIDEO 4671 02:56:42,800 --> 02:56:45,080 AND THEN WHILE WE'RE WAITING FOR 4672 02:56:45,080 --> 02:56:46,160 QUESTIONS TO COME IN, I'D LIKE 4673 02:56:46,160 --> 02:56:48,280 TO OFFER THE OPPORTUNITY FOR ANY 4674 02:56:48,280 --> 02:56:52,440 OF THE WORKING GROUP MEMBERS TO 4675 02:56:52,440 --> 02:56:54,200 ASK QUESTIONS OF EACH OVER. 4676 02:56:54,200 --> 02:56:55,120 THESE ARE GREAT PRESENTATIONS. 4677 02:56:55,120 --> 02:56:56,720 IF THERE ARE ISSUES THAT CAME UP 4678 02:56:56,720 --> 02:56:58,760 IN WHAT YOU HEARD IF YOU WOULD 4679 02:56:58,760 --> 02:57:01,640 LIKE TO ASK ANY QUESTIONS. 4680 02:57:01,640 --> 02:57:03,280 APOLOGIES, I HAVE SOMEBODY 4681 02:57:03,280 --> 02:57:04,280 BANGING IN THE BACKGROUND SO 4682 02:57:04,280 --> 02:57:06,000 I'LL BE ON MUTE EXCEPT WHEN 4683 02:57:06,000 --> 02:57:09,120 SPEAKING. 4684 02:57:09,120 --> 02:57:13,440 4685 02:57:13,440 --> 02:57:17,600 >> SO I HAVE A GENERAL QUESTION 4686 02:57:17,600 --> 02:57:20,560 ABOUT ATTRIBUTION AND I WANT TO 4687 02:57:20,560 --> 02:57:22,960 LEARN MORE ABOUT WHAT WE CAN 4688 02:57:22,960 --> 02:57:25,720 TRULY -- I THINK WE HAVE THIS IN 4689 02:57:25,720 --> 02:57:27,360 OUR VOCABULARY CLIMATE DOES 4690 02:57:27,360 --> 02:57:34,360 THIS, CLIMATE DOES THAT, BUT 4691 02:57:34,360 --> 02:57:36,120 REALLY IN TERMS OF ATTRIBUTION, 4692 02:57:36,120 --> 02:57:37,360 MAYBE IT'S SOMETHING WE COULD 4693 02:57:37,360 --> 02:57:37,560 LEARN. 4694 02:57:37,560 --> 02:57:41,520 >> THIS IS A WELL-DEVELOPED 4695 02:57:41,520 --> 02:57:42,280 FIELD IN CLIMATE SCIENCE. 4696 02:57:42,280 --> 02:57:46,040 DEVELOPED OVER THE LAST COUPLE 4697 02:57:46,040 --> 02:57:46,400 DECADES. 4698 02:57:46,400 --> 02:57:48,160 AND THERE WAS AN EXPERT MEETING 4699 02:57:48,160 --> 02:57:51,320 ON THIS TOPIC, I DON'T KNOW, 4700 02:57:51,320 --> 02:57:53,720 ABOUT 2006, 2007, SOMETHING LIKE 4701 02:57:53,720 --> 02:57:54,360 THAT. 4702 02:57:54,360 --> 02:57:55,720 PART OF THEIR METHODS ARE QUITE 4703 02:57:55,720 --> 02:57:57,440 FAMILIAR TO THOSE OF US IN 4704 02:57:57,440 --> 02:57:58,640 HEALTH BECAUSE THEY COME 4705 02:57:58,640 --> 02:58:02,920 STRAIGHT FROM HOW WE THINK ABOUT 4706 02:58:02,920 --> 02:58:05,200 ATTRIBUTION IN HEALTH. 4707 02:58:05,200 --> 02:58:07,200 IN HEALTH ATTRIBUTION IS 4708 02:58:07,200 --> 02:58:09,680 PRIMARILY A TWO-STAGE PROCESS. 4709 02:58:09,680 --> 02:58:12,640 FIRST YOU HAVE ATTRIBUTION TO 4710 02:58:12,640 --> 02:58:14,200 WHATEVER WEATHER VARIABLES OR 4711 02:58:14,200 --> 02:58:17,680 WEATHER EVENTS YOU'RE INTERESTED 4712 02:58:17,680 --> 02:58:20,200 IN. 4713 02:58:20,200 --> 02:58:25,440 SO MOSTLY ATTRIBUTION IS AROUND 4714 02:58:25,440 --> 02:58:25,880 HEAT. 4715 02:58:25,880 --> 02:58:28,840 I LIVE IN THE PACIFIC NORTHWEST, 4716 02:58:28,840 --> 02:58:32,560 THE HEAT TOMORROW. 4717 02:58:32,560 --> 02:58:35,120 ACROSS OREGON, WASHINGTON, 4718 02:58:35,120 --> 02:58:36,600 BRITISH COLUMBIA THERE WAS 800 4719 02:58:36,600 --> 02:58:37,400 EXCESS DEATHS. 4720 02:58:37,400 --> 02:58:40,760 WE CAN SAY THEY WERE DUE TO 4721 02:58:40,760 --> 02:58:41,200 CLIMATE CHANGE. 4722 02:58:41,200 --> 02:58:44,480 THERE WAS A HEAT WAVE THAT HAD A 4723 02:58:44,480 --> 02:58:46,040 RETURN PERIOD OF 1 IN 3 MILLION 4724 02:58:46,040 --> 02:58:50,000 YEARS, WHICH I STILL HAVE REALLY 4725 02:58:50,000 --> 02:58:54,800 HARD TIME CONCEPTUALIZING. 4726 02:58:54,800 --> 02:58:58,240 IN SCANDINAVIA OVER 700 EXCESS 4727 02:58:58,240 --> 02:58:59,480 DEATHS, FROM CLIMATE CHANGE. 4728 02:58:59,480 --> 02:59:00,480 MORE COMPLICATED WHEN YOU THINK 4729 02:59:00,480 --> 02:59:04,640 ABOUT THE HEAT WAVE IN EUROPE IN 4730 02:59:04,640 --> 02:59:06,880 2003, CLIMATE CHANGE MADE IT 4731 02:59:06,880 --> 02:59:08,320 MUCH MORE LIKELY, INCREASED 4732 02:59:08,320 --> 02:59:10,320 LIKELIHOOD OF THE SEVERITY OF 4733 02:59:10,320 --> 02:59:13,640 THAT EVENT, INTENSITY OF THAT 4734 02:59:13,640 --> 02:59:15,080 EVENT BY ABOUT THREE-QUARTERS. 4735 02:59:15,080 --> 02:59:17,680 AND THERE IS NOT YET A CONSENSUS 4736 02:59:17,680 --> 02:59:24,240 IN THE HEALTH SECTOR HOW DO WE 4737 02:59:24,240 --> 02:59:30,400 PARTITION OUT HOW MANY, 70,000 4738 02:59:30,400 --> 02:59:33,160 EXCESS DEATHS, DOO WE LOOK AT 4739 02:59:33,160 --> 02:59:38,640 THREE-QUARTERS, ABOVE A CERTAIN 4740 02:59:38,640 --> 02:59:39,840 TEMPERATURE TAKE THAT? 4741 02:59:39,840 --> 02:59:42,760 WELLCOME TRUST IS QUITE 4742 02:59:42,760 --> 02:59:47,400 INTERESTED IN THIS, WELL COME 4743 02:59:47,400 --> 02:59:47,560 -- 4744 02:59:47,560 --> 02:59:50,240 WELLCOME TRUST IS GOING TO FUND 4745 02:59:50,240 --> 02:59:51,440 RESEARCH OVER THE NEXT DECADE, 4746 02:59:51,440 --> 02:59:53,080 AREAS WE'RE INTERESTED IN TO 4747 02:59:53,080 --> 02:59:54,840 ADVANCE THE METHODS BEYOND HEAT 4748 02:59:54,840 --> 02:59:58,120 TO VECTOR BORNE DISEASES AND 4749 02:59:58,120 --> 02:59:58,840 OTHER ISSUES. 4750 02:59:58,840 --> 03:00:02,640 >> IF I COULD ADD TO THAT, 4751 03:00:02,640 --> 03:00:05,120 YOU'RE RAISING A COUPLE POINTS, 4752 03:00:05,120 --> 03:00:06,760 REALLY IMPORTANT POINTS. 4753 03:00:06,760 --> 03:00:07,640 ONE IS INDICATORS. 4754 03:00:07,640 --> 03:00:09,840 WHAT DO WE NEED TO INTEGRATE 4755 03:00:09,840 --> 03:00:15,080 INTO OUR CURRENT SYSTEMS FOR 4756 03:00:15,080 --> 03:00:15,400 SURVEILLANCE? 4757 03:00:15,400 --> 03:00:17,800 THERE ARE SYSTEMS THAT ARE 4758 03:00:17,800 --> 03:00:18,800 SURVEILLING IMPACT OF CERTAIN 4759 03:00:18,800 --> 03:00:21,040 ASPECTS OF THE CLIMATE ON 4760 03:00:21,040 --> 03:00:22,960 CERTAIN ASPECTS OF THE FOOD 4761 03:00:22,960 --> 03:00:24,160 SYSTEM BUT NOT INTEGRATING 4762 03:00:24,160 --> 03:00:25,200 HEALTH. 4763 03:00:25,200 --> 03:00:27,640 OR THERE MAY BE SOME LOOKING AT 4764 03:00:27,640 --> 03:00:29,640 HEALTH, ASPECTS OF CLIMATE BUT 4765 03:00:29,640 --> 03:00:30,480 NOT INTEGRATING FOOD SYSTEMS. 4766 03:00:30,480 --> 03:00:34,000 SO THIS IS AN IMPORTANT ISSUE. 4767 03:00:34,000 --> 03:00:36,080 WORKING GROUP 4 IS GOING TO BE 4768 03:00:36,080 --> 03:00:37,080 THE FOCAL POINT. 4769 03:00:37,080 --> 03:00:38,400 YOU CAN RAISE THESE ISSUES, 4770 03:00:38,400 --> 03:00:40,360 WHERE THE NEEDS ARE. 4771 03:00:40,360 --> 03:00:44,400 WORKING GROUP 4 IS REALLY 4772 03:00:44,400 --> 03:00:45,600 FOCUSING ON ANALYTICAL 4773 03:00:45,600 --> 03:00:47,360 FRAMEWORKS FOR LOOKING AT 4774 03:00:47,360 --> 03:00:48,800 COMPLEX SYSTEMS. 4775 03:00:48,800 --> 03:00:50,960 BOTH IN TERMS OF RESEARCH DESIGN 4776 03:00:50,960 --> 03:00:53,600 BUT ALSO PERHAPS AS IT RELATES 4777 03:00:53,600 --> 03:00:54,760 TO PUBLIC HEALTH SURVEILLANCE. 4778 03:00:54,760 --> 03:00:56,120 IT'S REALLY AT THE CORE OF WHAT 4779 03:00:56,120 --> 03:00:57,520 WE'RE TRYING TO ACCOMPLISH HERE, 4780 03:00:57,520 --> 03:00:59,160 HOW DO YOU INTEGRATE THESE 4781 03:00:59,160 --> 03:01:01,040 THINGS INTO WHAT'S GOING ON SO 4782 03:01:01,040 --> 03:01:02,600 THAT WE CAN ATTRIBUTE WHAT'S 4783 03:01:02,600 --> 03:01:04,200 REALLY HAPPENING TO WHAT'S 4784 03:01:04,200 --> 03:01:06,200 REALLY GOING ON. 4785 03:01:06,200 --> 03:01:08,240 ALSO I'LL ADD THAT WE MENTIONED 4786 03:01:08,240 --> 03:01:09,440 EARLY ON IN THE PRESENTATION 4787 03:01:09,440 --> 03:01:11,960 TODAY THAT THERE'S A NUMBER OF 4788 03:01:11,960 --> 03:01:13,400 GOVERNMENT -- U.S. GOVERNMENTAL 4789 03:01:13,400 --> 03:01:16,800 EFFORTS THAT ARE ONGOING, ONE OF 4790 03:01:16,800 --> 03:01:17,480 WHICH IS INTERGOVERNMENTAL 4791 03:01:17,480 --> 03:01:19,080 COMMITTEE ON CLIMATE CHANGE AND 4792 03:01:19,080 --> 03:01:23,440 HEALTH, THERE'S A WORK STREAM 4793 03:01:23,440 --> 03:01:24,760 THAT'S SPECIFICALLY DEVOTED TO 4794 03:01:24,760 --> 03:01:27,760 FOOD SAFETY AND NUTRITION 4795 03:01:27,760 --> 03:01:29,800 SECURITY. 4796 03:01:29,800 --> 03:01:34,160 IT'S LED BY SHEILA FLESHHACKER 4797 03:01:34,160 --> 03:01:34,520 AND OTHERS. 4798 03:01:34,520 --> 03:01:38,560 THERE'S A SPECIFIC ACTIVITY 4799 03:01:38,560 --> 03:01:41,160 FOCUSED ON INDICATORS, AND 4800 03:01:41,160 --> 03:01:42,920 INTERESTINGLY THE CASE STUDY 4801 03:01:42,920 --> 03:01:46,640 THAT IT STARTED WITH IS VIBRIO. 4802 03:01:46,640 --> 03:01:48,920 THERE'S A LOT GOING ON, BUT THE 4803 03:01:48,920 --> 03:01:51,120 POINT OF WHAT WE'RE DOING HERE 4804 03:01:51,120 --> 03:01:54,640 IS THAT IT HASN'T INCLUDED 4805 03:01:54,640 --> 03:01:54,920 NUTRITION. 4806 03:01:54,920 --> 03:01:57,600 IT HAS DONE SOME STUFF ON FOOD 4807 03:01:57,600 --> 03:02:00,120 SYSTEMS BUT HASN'T DONE 4808 03:02:00,120 --> 03:02:02,080 NUTRITION, CERTAINTY HAS NOT 4809 03:02:02,080 --> 03:02:07,000 DONE NUTRITION AS IT INTERSECTS, 4810 03:02:07,000 --> 03:02:07,880 THE BIDIRECTIONAL WAY WE'RE 4811 03:02:07,880 --> 03:02:08,200 TALKING HERE. 4812 03:02:08,200 --> 03:02:09,840 >> IF I COULD ADD TO THAT ONE 4813 03:02:09,840 --> 03:02:11,040 OF MY ROLES THROUGHOUT THIS 4814 03:02:11,040 --> 03:02:13,120 PROCESS IS TO MAKE SURE WE'RE 4815 03:02:13,120 --> 03:02:16,400 ALL ACCURATE TALKING ABOUT 4816 03:02:16,400 --> 03:02:17,280 WEATHER, CLIMATE VARIABILITY, 4817 03:02:17,280 --> 03:02:18,440 AND CLIMATE CHANGE BECAUSE THEY 4818 03:02:18,440 --> 03:02:21,240 ARE ALL PART OF THE CONTINUUM. 4819 03:02:21,240 --> 03:02:23,520 THEY ARE DIFFERENT PARTS OF THE 4820 03:02:23,520 --> 03:02:23,960 CONTINUUM. 4821 03:02:23,960 --> 03:02:26,480 THERE SEEMS TO BE CONFUSION IN 4822 03:02:26,480 --> 03:02:28,560 THE HEALTH SECTOR, ALTHOUGH 4823 03:02:28,560 --> 03:02:31,720 WE'RE COMFORTABLE WITH UV. 4824 03:02:31,720 --> 03:02:33,680 VARIOUS CATEGORIES OF UV ON A 4825 03:02:33,680 --> 03:02:35,520 CONTINUUM BUT WE DON'T CONFUSE 4826 03:02:35,520 --> 03:02:37,080 UVA FROM UVB. 4827 03:02:37,080 --> 03:02:38,360 AND THERE'S LOTS OF CONFUSION 4828 03:02:38,360 --> 03:02:39,600 UNFORTUNATELY IN THE LITERATURE 4829 03:02:39,600 --> 03:02:43,320 BETWEEN WHAT'S WEATHER AND 4830 03:02:43,320 --> 03:02:44,360 WHAT'S CLIMATE. 4831 03:02:44,360 --> 03:02:47,520 >>IN YOUR REPORT, KRIS, WHAT 4832 03:02:47,520 --> 03:02:49,040 YOU PRESENTED TODAY WILL BE 4833 03:02:49,040 --> 03:02:50,760 GREAT AS AN INTRODUCTION. 4834 03:02:50,760 --> 03:02:52,200 THE WHOLE ISSUE EVER VERNACULAR 4835 03:02:52,200 --> 03:02:53,760 IS CRITICAL TO WHAT WE'RE TRYING 4836 03:02:53,760 --> 03:02:54,720 TO DO HERE. 4837 03:02:54,720 --> 03:02:58,560 SO IT'S IMPORTANT TO MAKE 4838 03:02:58,560 --> 03:03:00,280 THOSE -- HIGHLIGHT ISSUES, IN 4839 03:03:00,280 --> 03:03:01,160 YOUR REPORT, THROUGHOUT THE 4840 03:03:01,160 --> 03:03:02,480 OTHER REPORTS, MAKE SURE WE'RE 4841 03:03:02,480 --> 03:03:04,560 ALL TALKING ABOUT THE SAME THING 4842 03:03:04,560 --> 03:03:06,520 ACROSS ALL REPORTS, AND 4843 03:03:06,520 --> 03:03:09,040 CERTAINLY IN THE PROJECT SUMMARY 4844 03:03:09,040 --> 03:03:10,800 THE SECRETARIAT WILL DRAFT WE'LL 4845 03:03:10,800 --> 03:03:13,400 MAKE SURE TO INTRODUCE THIS 4846 03:03:13,400 --> 03:03:14,040 ISSUE OF VERNACULAR. 4847 03:03:14,040 --> 03:03:18,000 >> THANK YOU. 4848 03:03:18,000 --> 03:03:20,400 >>ONE OF THE THINGS WE HAVEN'T 4849 03:03:20,400 --> 03:03:23,040 TOUCHED ON MUCH, ALTHOUGH ANDY 4850 03:03:23,040 --> 03:03:25,240 AND KARTIK ALLUDED TO THIS, 4851 03:03:25,240 --> 03:03:29,080 EFFECT OF CLIMATE CHANGE ON THE 4852 03:03:29,080 --> 03:03:32,000 GENOME ITSELF. 4853 03:03:32,000 --> 03:03:34,560 AND FUNCTIONING OF THE GENOME, 4854 03:03:34,560 --> 03:03:36,880 BOTH KARTIK DID IT AT EARLIER 4855 03:03:36,880 --> 03:03:40,120 STAGES, ANDY AT LATER STAGES, 4856 03:03:40,120 --> 03:03:43,760 BUT AS YOU MENTIONED, KRIS, 4857 03:03:43,760 --> 03:03:45,040 THERE'S A CONTINUUM OF CHANGE 4858 03:03:45,040 --> 03:03:46,480 AND INFLUENCE, THE DEGREE TO 4859 03:03:46,480 --> 03:03:47,240 WHICH THAT'S OPERATING 4860 03:03:47,240 --> 03:03:48,440 THROUGHOUT LIFE. 4861 03:03:48,440 --> 03:03:50,960 AND THE REVERSIBILITY OF ALL OF 4862 03:03:50,960 --> 03:03:51,760 THAT. 4863 03:03:51,760 --> 03:03:52,960 I THINK, YOU KNOW, REALLY THEY 4864 03:03:52,960 --> 03:03:53,920 ARE INTERESTING QUESTIONS. 4865 03:03:53,920 --> 03:03:57,240 IT WOULD BE GOOD FOR US TO AT 4866 03:03:57,240 --> 03:03:59,520 LEAST IDENTIFY THE RESEARCH GAPS 4867 03:03:59,520 --> 03:04:01,360 HERE BECAUSE I THINK THEY ARE 4868 03:04:01,360 --> 03:04:02,360 PRETTY WIDE. 4869 03:04:02,360 --> 03:04:06,480 BUT THE A LEAST TO BRING THAT 4870 03:04:06,480 --> 03:04:06,640 UP. 4871 03:04:06,640 --> 03:04:08,360 >>THAT'S A GOOD POINT. 4872 03:04:08,360 --> 03:04:10,440 THERE'S STUDIES ON FRUIT FLIES 4873 03:04:10,440 --> 03:04:11,880 SHOWING WITH WARMER TEMPERATURES 4874 03:04:11,880 --> 03:04:14,720 THEY ARE EVOLVING A LOT FASTER. 4875 03:04:14,720 --> 03:04:16,480 GOES STRAIGHT TO INFECTIOUS 4876 03:04:16,480 --> 03:04:17,760 DISEASES, WHAT IT'S GOING TO 4877 03:04:17,760 --> 03:04:20,400 MEAN IF OUR VECTORS ARE EVOLVING 4878 03:04:20,400 --> 03:04:24,560 FASTER THAN WE'RE ABLE TO MANAGE 4879 03:04:24,560 --> 03:04:26,880 SHIFTS IN THE GEOGRAPHIC RANGE, 4880 03:04:26,880 --> 03:04:28,960 IN SEASONALITY. 4881 03:04:28,960 --> 03:04:30,840 WE'RE NOT DOING GREAT FOR SOME 4882 03:04:30,840 --> 03:04:31,680 INFECTIOUS DISEASES RIGHT NOW. 4883 03:04:31,680 --> 03:04:34,200 IT'S GOING TO BE EVEN MORE 4884 03:04:34,200 --> 03:04:35,640 CHALLENGING AS THEY EVOLVE MORE 4885 03:04:35,640 --> 03:04:37,800 QUICKLY. 4886 03:04:37,800 --> 03:04:40,000 4887 03:04:40,000 --> 03:04:42,280 >> JUST TO ADD ONE POINT TO 4888 03:04:42,280 --> 03:04:42,480 THAT. 4889 03:04:42,480 --> 03:04:48,000 I INTERPRETED INTERPRETED COMMS 4890 03:04:48,000 --> 03:04:50,760 TO EPIGENOME OF THE INDIVIDUAL. 4891 03:04:50,760 --> 03:04:54,440 OBVIOUSLY CHANGES TO GENOME OF 4892 03:04:54,440 --> 03:04:55,880 VECTORS, DISEASE-CAUSING 4893 03:04:55,880 --> 03:04:58,040 PATHOGENS, BUT ALMOST WITH 4894 03:04:58,040 --> 03:04:58,960 CERTAINTY THINGS THAT CHANGE 4895 03:04:58,960 --> 03:05:01,000 ABOUT SCIENCE HAVE BEEN SHOWN TO 4896 03:05:01,000 --> 03:05:04,080 BE ASSOCIATED WITH PERSISTENT 4897 03:05:04,080 --> 03:05:05,520 CHANGES IN THE EPIGENOME. 4898 03:05:05,520 --> 03:05:07,480 THE LEVEL OF CHANGE OR EFFECT 4899 03:05:07,480 --> 03:05:11,520 SIZE WHERE WE HAVE LOW BIRTH 4900 03:05:11,520 --> 03:05:14,600 WEIGHT, WE'RE ALMOST CERTAINLY 4901 03:05:14,600 --> 03:05:18,720 TALKING ABOUT LONG-TERM 4902 03:05:18,720 --> 03:05:19,480 DOHaD-TYPE EFFECTS. 4903 03:05:19,480 --> 03:05:23,160 >> THAT'S WHAT I MEANT BY 4904 03:05:23,160 --> 03:05:25,000 FUNCTIONALITY. 4905 03:05:25,000 --> 03:05:28,000 WHAT IS CONTROLLING GENETIC 4906 03:05:28,000 --> 03:05:28,400 EXPRESSION? 4907 03:05:28,400 --> 03:05:32,720 ABSOLUTELY THE EPIGENOME IS 4908 03:05:32,720 --> 03:05:35,520 WHERE IT'S LOCATED. 4909 03:05:35,520 --> 03:05:37,320 >>INTERESTING TOO, TO IDENTIFY 4910 03:05:37,320 --> 03:05:39,040 NATURAL EXPERIMENTS. 4911 03:05:39,040 --> 03:05:41,760 THERE'S A FASCINATING STUDY 4912 03:05:41,760 --> 03:05:42,880 PUBLISHED YEARS AGO WHICH YOU 4913 03:05:42,880 --> 03:05:53,480 MAY OF BE AWARE OF, MASSIVING G 4914 03:06:05,480 --> 03:06:05,840 -- 4915 03:06:05,840 --> 03:06:07,480 MASSIVE MIGRATION IN ITALY FROM 4916 03:06:07,480 --> 03:06:08,400 THE SOUTH TO THE NORTH. 4917 03:06:08,400 --> 03:06:11,320 THOSE BORN IN THE SOUTH HAD 4918 03:06:11,320 --> 03:06:13,040 LOWER HEAT-RELATED MORTALITY, 4919 03:06:13,040 --> 03:06:14,720 PRESUMABLY IT'S SOMETHING 4920 03:06:14,720 --> 03:06:16,880 EPIGENETIC THAT STAYS THROUGHOUT 4921 03:06:16,880 --> 03:06:18,880 OUR LIVES. 4922 03:06:18,880 --> 03:06:20,520 THERE HASN'T BEEN OTHER 4923 03:06:20,520 --> 03:06:21,200 FOLLOW-UP EXPERIMENTS. 4924 03:06:21,200 --> 03:06:22,080 THINKING ABOUT WHERE IT'S 4925 03:06:22,080 --> 03:06:26,520 POSSIBLE TO DO SOME KINDS OF 4926 03:06:26,520 --> 03:06:29,080 COMPARISONS WOULD BE REALLY 4927 03:06:29,080 --> 03:06:29,520 VALUABLE. 4928 03:06:29,520 --> 03:06:31,240 SO, I DON'T HAVE ANY SUGGESTIONS 4929 03:06:31,240 --> 03:06:33,560 FOR THOSE STUDIES BUT I HOPE 4930 03:06:33,560 --> 03:06:41,320 SOMEBODY'S GOT SOME IDEAS WHERE 4931 03:06:41,320 --> 03:06:41,840 TO LOOK. 4932 03:06:41,840 --> 03:06:43,480 WE'VE GOT THREE MINUTES LEFT. 4933 03:06:43,480 --> 03:06:45,120 ARE THERE ANY QUESTIONS, DREW, 4934 03:06:45,120 --> 03:06:46,120 YOU HAVE FROM THE E-MAILS THAT 4935 03:06:46,120 --> 03:06:51,280 YOU'D LIKE TO POSE TO US? 4936 03:06:51,280 --> 03:06:53,800 >> I SEE A TOOLS HANDOUT, 4937 03:06:53,800 --> 03:06:58,080 THERE'S BEEN NOT MUCH TRAFFIC ON 4938 03:06:58,080 --> 03:07:01,880 THE E-MAIL BUT A TOOL. 4939 03:07:01,880 --> 03:07:03,120 >> I'M A PROFESSOR AT THE 4940 03:07:03,120 --> 03:07:04,880 UNIVERSITY OF ILLINOIS. 4941 03:07:04,880 --> 03:07:07,560 I DON'T HAVE MUCH EXPERIENCE OR 4942 03:07:07,560 --> 03:07:11,640 MY BACKGROUND IS NOT IN HEALTH 4943 03:07:11,640 --> 03:07:12,960 SECTOR, BUT I'M JUST 4944 03:07:12,960 --> 03:07:15,920 UNDERSTANDING THE IMPACTS OF THE 4945 03:07:15,920 --> 03:07:17,000 NUTRIENTS MICRO AND MACRO ON THE 4946 03:07:17,000 --> 03:07:19,280 CLIMATE CHANGE. 4947 03:07:19,280 --> 03:07:23,480 SO FAR I'VE HEARD IN THIS GROUP 4948 03:07:23,480 --> 03:07:25,200 DISCUSSION HOW THE HUMANS ARE 4949 03:07:25,200 --> 03:07:28,640 BEING IMPACTED BY CLIMATE CHANGE 4950 03:07:28,640 --> 03:07:32,520 BUT IT'S ALSO THE OTHER WAY 4951 03:07:32,520 --> 03:07:34,400 AROUND, THAT FOOD SECTOR, SOURCE 4952 03:07:34,400 --> 03:07:36,280 OF THE MACRONUTRIENT OR MICRO 4953 03:07:36,280 --> 03:07:37,360 NUTRIENT, IS ALSO DRIVING 4954 03:07:37,360 --> 03:07:38,480 CLIMATE CHANGE. 4955 03:07:38,480 --> 03:07:40,560 THAT'S WHAT WE STUDY IN OUR 4956 03:07:40,560 --> 03:07:41,880 RESEARCH GROUP. 4957 03:07:41,880 --> 03:07:44,280 IN FACT, OUR STUDY SUGGESTS THAT 4958 03:07:44,280 --> 03:07:47,640 ABOUT 35% OF THE EMISSIONS 4959 03:07:47,640 --> 03:07:50,920 COMPOUND, FOOD SECTOR, BUT IT IS 4960 03:07:50,920 --> 03:07:53,040 ALSO WE NEED TO TRANSFORM HOW 4961 03:07:53,040 --> 03:07:55,680 THE FOOD SECTOR IS BEING 4962 03:07:55,680 --> 03:07:58,760 ACTUALLY PRODUCED, PROCESSED, AS 4963 03:07:58,760 --> 03:08:01,040 WELL AS CONSUMED. 4964 03:08:01,040 --> 03:08:02,640 AT THE SAME TIME THIS QUESTION 4965 03:08:02,640 --> 03:08:05,440 HAS BEEN RAISED MANY TIMES THAT 4966 03:08:05,440 --> 03:08:07,240 PERHAPS WE SHOULD SWITCH TO THE 4967 03:08:07,240 --> 03:08:11,960 PLANT-BASED DIET RATHER THAN 4968 03:08:11,960 --> 03:08:13,520 ANIMAL BASED, SO HEALTH OF THE 4969 03:08:13,520 --> 03:08:15,800 HUMANS BEING PART OF THIS 4970 03:08:15,800 --> 03:08:16,680 EQUATION, WONDERING IF THERE'S 4971 03:08:16,680 --> 03:08:20,720 ANY INTEREST IN THIS GROUP ABOUT 4972 03:08:20,720 --> 03:08:23,600 UNDERSTANDING LINKAGE BETWEEN 4973 03:08:23,600 --> 03:08:25,880 THE TWO IN THE BEGINNING OF THE 4974 03:08:25,880 --> 03:08:29,720 TALK THAT YOU'RE INTERESTED IN 4975 03:08:29,720 --> 03:08:31,120 THE SYSTEM-BASED APPROACH OR 4976 03:08:31,120 --> 03:08:32,240 INTEGRATED APPROACH SO I BELIEVE 4977 03:08:32,240 --> 03:08:35,200 THERE WILL BE SOME KIND OF 4978 03:08:35,200 --> 03:08:36,080 INTERACTION BETWEEN IMPACT OF 4979 03:08:36,080 --> 03:08:38,160 CLIMATE CHANGE OF THE HEALTH BUT 4980 03:08:38,160 --> 03:08:40,680 ALSO AT THE SAME TIME HOW 4981 03:08:40,680 --> 03:08:42,320 NUTRIENTS AND MACRONUTRIENTS AND 4982 03:08:42,320 --> 03:08:45,040 MICRO NUTRIENTS IMPACT THE 4983 03:08:45,040 --> 03:08:45,520 CLIMATE CHANGE. 4984 03:08:45,520 --> 03:08:46,600 >> LETS MAKE THAT QUICK. 4985 03:08:46,600 --> 03:08:48,680 WE HAVE A WHOLE WORKING GROUP 4986 03:08:48,680 --> 03:08:50,000 THAT'S DEVOTED TO THAT. 4987 03:08:50,000 --> 03:08:51,640 THOSE ISSUES ARE GOING TO BE 4988 03:08:51,640 --> 03:08:54,280 INTEGRATED INTO ALL THE REPORTS. 4989 03:08:54,280 --> 03:08:58,080 SO WE APPRECIATE THE COMMENT. 4990 03:08:58,080 --> 03:09:01,720 HIGHLIGHTING THE COMPLEXITY OF 4991 03:09:01,720 --> 03:09:02,920 THESE INTERACTIONS. 4992 03:09:02,920 --> 03:09:05,240 DOES ANYBODY ELSE HAVE ANY OTHER 4993 03:09:05,240 --> 03:09:05,480 QUESTIONS? 4994 03:09:05,480 --> 03:09:07,960 >> I DON'T HAVE A QUESTION BUT 4995 03:09:07,960 --> 03:09:10,920 BEFORE WE GO I WANT TO THANK 4996 03:09:10,920 --> 03:09:12,120 LISA MALONEY, REALLY CRITICAL 4997 03:09:12,120 --> 03:09:14,960 FOR HELPING US PULL ALL OF THIS 4998 03:09:14,960 --> 03:09:15,200 TOGETHER. 4999 03:09:15,200 --> 03:09:16,560 AND APOLOGIES, WE DIDN'T 5000 03:09:16,560 --> 03:09:18,040 SPECIFICALLY CALL HER OUT AT THE 5001 03:09:18,040 --> 03:09:19,200 BEGINNING. 5002 03:09:19,200 --> 03:09:21,320 AND THEN THANKS TO YOU, DAN, AND 5003 03:09:21,320 --> 03:09:23,800 TO EVERYONE ELSE FOR MAKING THIS 5004 03:09:23,800 --> 03:09:24,040 HAPPEN. 5005 03:09:24,040 --> 03:09:24,680 IT'S BEEN REALLY, REALLY 5006 03:09:24,680 --> 03:09:28,080 INTERESTING. 5007 03:09:28,080 --> 03:09:31,240 >> THANK YOU, EVERYONE. 5008 03:09:31,240 --> 03:09:34,120 I WANT TO ECHO A SHOUT OUT TO 5009 03:09:34,120 --> 03:09:34,440 LISA. 5010 03:09:34,440 --> 03:09:36,200 WE MENTIONED THE TEAM IS 5011 03:09:36,200 --> 03:09:37,840 INTEGRAL TO THIS. 5012 03:09:37,840 --> 03:09:40,000 LISA IS ONE OF OUR PARTNERS, 5013 03:09:40,000 --> 03:09:42,200 EACH OF THE WORKING GROUPS HAS 5014 03:09:42,200 --> 03:09:43,640 SOMEONE TO SUPPORT THEIR 5015 03:09:43,640 --> 03:09:43,880 EFFORTS. 5016 03:09:43,880 --> 03:09:45,520 YOU'LL MEET THEM ALL IN THE 5017 03:09:45,520 --> 03:09:47,680 COURSE OF THESE WORKSHOPS. 5018 03:09:47,680 --> 03:09:47,880 DREW? 5019 03:09:47,880 --> 03:09:50,320 >>I WANT TO THANK -- EXPRESS 5020 03:09:50,320 --> 03:09:51,600 GRATITUDE AND THANKS FOR 5021 03:09:51,600 --> 03:09:52,040 EVERYONE. 5022 03:09:52,040 --> 03:09:54,440 I WILL LET YOU KNOW THAT MY 5023 03:09:54,440 --> 03:09:58,200 DAUGHTER HAS BEEN HOME ON SPRING 5024 03:09:58,200 --> 03:10:01,800 BREAK, YOU'RED -- YOU'RE 5025 03:10:01,800 --> 03:10:03,640 EDUCATING US AND THE NEXT 5026 03:10:03,640 --> 03:10:09,120 GENERATION OF INVESTIGATORS. 5027 03:10:09,120 --> 03:10:10,760 DAD, THAT'S COOL STUFF! 5028 03:10:10,760 --> 03:10:13,720 HIGH PRAISE FROM A 10-YEAR-OLD. 5029 03:10:13,720 --> 03:10:15,560 TO DAN'S POINT THE TEAM IS 5030 03:10:15,560 --> 03:10:15,920 FANTASTIC. 5031 03:10:15,920 --> 03:10:19,600 I WANT TO CALL OUT OUR NICHD 5032 03:10:19,600 --> 03:10:28,200 SUPPORT TEAM BECAUSE THEY ARE 5033 03:10:28,200 --> 03:10:30,160 BEYOND FANTASTIC. 5034 03:10:30,160 --> 03:10:31,680 I INVITE YOU BACK NEXT THURSDAY 5035 03:10:31,680 --> 03:10:33,640 FOR THE NEXT WORKING GROUP. 5036 03:10:33,640 --> 03:10:36,160 I WISH EVERYONE AN ENJOYABLE 5037 03:10:36,160 --> 03:10:36,400 FRIDAY. 5038 03:10:36,400 --> 03:10:37,760 A GREAT WEEKEND. 5039 03:10:37,760 --> 03:10:38,200 WITH THAT -- 5040 03:10:38,200 --> 03:10:40,240 >>THIS IS ALL RECORDED, 5041 03:10:40,240 --> 03:10:43,080 AVAILABLE TO YOU AT ANY TIME, 5042 03:10:43,080 --> 03:10:44,920 THE ADVANTAGE TEAM. 5043 03:10:44,920 --> 03:10:46,680 WE'LL HAVE A WRITTEN RECORDING 5044 03:10:46,680 --> 03:10:49,440 OF THIS AS WELL, A TEXT 5045 03:10:49,440 --> 03:10:50,480 RECORDING AS WELL. SO YOU'LL HAE 5046 03:10:50,480 --> 03:10:51,520 THAT AT YOUR DISPOSAL AS WELL AS 5047 03:10:51,520 --> 03:10:52,840 POWER POINTS. 5048 03:10:52,840 --> 00:00:00,000 >> THANKS, EVERYBODY.