>>WELCOME TO THE FIRST WEBINAR IN THE LESSONS LEARNED FROM GLOBAL FOOD AND NUTRITION INSURVEYS CURITY WEBINAR SERIES. MY NAME IS SUSAN VORKOPER AND I AM HERE WITH THE FOGARTY INTERNATIONAL HEALTH CENTER, CENTER FOR GLOBAL HEALTH STUDIES. THERE'S BEEN INCREASING INVESTMENT IN NUTRITION AND FOOD INSECURITY ACROSS GOVERNMENT AND THE NIH SPECIFICALLY. THE WHITE HOUSE CONFERENCE ON FOOD, NUTRITION AND HUNGER THAT JUST TOOK PLACE THAT LAST SUMMER,--AND HIGHLIGHTS THE ROLE THAT RESEARCH PLAYS. JUST A COUPLE WEEKS AGO, THE GLOBAL MALNUTRITION, PREVENTION AND TREATMENT ACT WAS SIGNED INTO LAW PROVIDING FUNDS TO STRENGTHEN GLOBAL FOOD SECURITY. AT THE NIH WE PUT TOGETHER WORKSHOPS, DEVELOPED RELEVANT FUNDING ANNOUNCEMENTS AND THEN SUMMER PUT OUT A NOTICE OF SPECIAL INTEREST TO STIMULATE RESEARCH TO UNDERSTAND AND ADDRESS HUNGER, FOOD AND NUTRITION INSECURITY. THIS WEBINAR SERIES SEEKS TO BUILD ON THESE EFFORTS. WE WILL HIGHLIGHT INNOVATIVE FOOD AND NUTRITION AND SECURITY AND HEALTH OUTCOMES THAT HAVE TAKEN PLACE IN FLOABAL SETTINGS AND IDENTIFY LESSONS LEARNED FOR OPPORTUNITIES FOR TIEWPTS AND CONTEXT. I AM EXCITED TO BE PARTNERING WITH THE NIH'S OFFICE OF GLOBAL NUTRITION, THEINANCAL KAGZER INSTITUTE, THE NATIONAL INSTITUTE FOR CHILD HEALTH AND HUMAN DEVELOPMENT AS WELL AS THE U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT, CDC AND USDA TO DEVELOP THIS 3 PART SERIES. SO THIS FIRST 1 WILL PROVIDE AN OVERVIEW OF FOOD AND NUTRITION INSECURITY CONCEPTUAL FRAMEWORK THAT CAN REALLY IDENTIFY THE IMPACTS OF FOOD INSECURITY ACROSS THE WORLD IN VARIOUS AGES AND SETTINGS AND ENCLUEDING THE CONNECTION TO CHRONIC AND INFECTIOUS DISEASES AND CHILDHOOD DEVELOPMENT. WE WILL ALSO HIGHLIGHT EXAMPLES OF INTERVENTION--INTERVENTION RESEARCH, THAT PRESENTS OPPORTUNITIES FOR TRANSLATION AND ADAPTATION, WE WELCOME QUESTIONS FROM THE AUDIENCE CURING OUR PANEL DISCUSSION--DURING OUR PANEL DISCUSSION, TO ANSWER QUESTIONS PLEASE KICKOT SEND LIVE FEEDBACK DIRECTORY BELOW THIS VIDEO. WITHOUT FURTHER ADO I WANT TO INTRODUCE OUR FIRST SPEAKERS, SO DR. RAFAEL PEREZ-CEREBELLUMS SCAMILLA, WITH YALE UNIVERSITY, AND DR. ALLYSON BROWN, PROGRAM DIRECTOR AT THE NATIONAL HEART LUNG AND BLOOD SLEEP INSTITUTE WILL MODERATE OUR PANEL DISCUSSION. RAFAEL, I WILL TURN IT OVER TO YOU. >>THANK YOU SO VERY MUCH FOR YOUR KIND INTRODUCTION AND I JUST WANT TO EXPRESS HOW GRATEFUL I AM THAT THESE WEBINAR SERIES IS HAPPENING SINCE I HAVE DEVOTED 2 DECADES OF MY PROFESSIONAL CAREER TOWARDS THIS END. SO, THE FIRST OBJECTIVE OF MY PRESENTATION IS TO TAKE YOU THROUGH THE DEFINITIONS OF FOOD INSECURITY, THE CONSTRUCTS UNDERLYING FOOD INSECURITY AND USEFUL FRAMEWORKS THAT HAVE BEEN USED TO TO GUIDE THE DEVELOPMENT OF MONITORING SYSTEM SYSTEM. SECONDLY, I WILL SHARE WITH YOU BASED ON MY PERSONAL EXPERIENCE AND THE LITERATURE SOME GLOBAL LESSONS ON FOOD INSECURITY RESEARCH AND EVALUATION THAT CAN BE TRANSFERRED ACROSS COUNTRIES. SO IN 1996 AT THE ROME WORLD FOOD SUMMIT, UNITED MEMBERS OF COUNTRIES UNITED WITH THE UNITED NATIONS UNANIMOUSLY AGREED THAT FOOD SECURITY EXISTS WHEN PEOPLE, AT ALL TIMES, HAVE PHYSICAL SOCIAL AND ECONOMIC ACCESS TO SUFFICIENT, SAFE AND NUTRITIOUS FOOD WHICH MEETS THEIR DIETARY NEEDS AND FOOD PREFERENCES FOR AN ACTIVE AND HEALTHY LIFE. IT FURTHER MORE IN THE YEAR 2000 USDA ACKNOWLEDGED THAT IN ADDITION TO THE DIFFERENT DOMAINS THAT WERE INCLUDED IN THE U. N. DEFINITION, IT WAS IMPORTANT TO RECOGNIZE THAT THE FOOD SECURITIES PEOPLE WOULD NEED TO ACQUIRE ACCEPTABLE FOODS IN SOCIALLY ACCEPTABLE WAYS THAT IS WITHOUT RESORTING TO EMERGENCY FOOD SUPPLIES, SCAVENGING, STEALING OR OTHER COPING STRATEGIES. THE USDA RECOGNIZES THAT FOOD INSECURITY EXISTS, HOWEVER, THE AVAILABILITY OF NUTRITIONALLY ADEQUATE AND SAFE FOODS OR THE ABILITY TO ACQUIRE SOCIAL ACCEPTABLE FOODS IN SOCIAL WAYS IS LIMITED OR UNCERTAIN. AT THE MOMENT, THE USDA RELEASED THE CURRENT DEFINITION FOR FOOD SECURITY THAT THEY USE AS ALICIA WILL COVER DURING HER TALK. FOOD SECURITY IS DEFINED BY USDA AS ACCESS TO ALL PEOPLE THEA ALL TIMES DOING ENOUGH FOOD FOR AN ACTIVE AND HEALTHY LIFE. AND FURTHER MORE, USDA DEFINES AN ACTIVE AND HEALTHY LIFE AS DEPENDING ON BOTH ADEQUATE AMOUNTS OF FOOD AND THE PROPER NEEDS OF NUTRIENT RICH FOODS TO MEET AN INDIVIDUAL'S NUTRITION AND HEALTH NEEDS. HENCE WE TAKE THE COLLECTIVE WISDOM FROM THE VERY CONSISTENT DEFINITIONS OF FOOD INSECURITY AND FOOD SECURITY ACROSS TIME OUTSIDE THE U.S. AND WITHIN THE U.S. WE HAVE TO REACH THE INESCAPABLE CONCLUSION THAT FOOD INSECURITY INCLUDES AT LEAST 6 DIFFERENT DIMENSIONS. AMOUNT OF CALORIES OR QUANTITY OF FOODS, DIETARY QUALITY OR ISSUES RELATED TO THE NUTRITIONAL VALUE OF THE FOODS PEOPLE ARE CONSUMING, ISSUES RELATED TO FOOD SAFETY, TO CULTURAL SUITABILITY AS WELL AS THE VERY POWERFUL STRESSOR THAT FOOD INSECURITY IS WHEN IT COMES TO PSYCHOLOGY ISSUES INCLUDING ANXIETY AND FEELINGS OF DEPRIVATION AND AT LUNG CANCER NOT LEAST IS RELATED TO SOCIAL UNACCEPTABILITY WHEN ACQUIRING FOODS. SO FOOD INSECURITY IN A COMPLEX, COMPLEX THAT INCLUDES AT LEAST THE 6 MENTIONS YOU SEE ON YOUR SCREEN. IN TERMS OF FRAMEWORKS, IN FACT, I FOUND VERY, VERY USEFUL THIS FRAMEWORK THAT WAS PUBLISHED BY UNICEF SOME YEARS AGO THAT ESSENTIALLY DETAILS IS THAT IN HUMAN SOCIETIES FOOD SECURITY IS BEST UNDERSTOOD AT THE HOUSEHOLD LEVEL AND THAT FOR HOUSEHOLDS TO BABLY TO BE FOOD SECURE, THEY NEED TO HAVE ACCESS IN THEIR COMMUNITIES TO ENOUGH AMOUNTS OF HEALTHY FOODS THAT ARE PHYSICALLY AND ECONOMICALLY AVAILABLE AND CULTURALLY APPROPRIATE AND SO ON. AND FOR THEIR COMMUNITIES TO HAVE ACCESS TO THESE FOODS, THERE NEEDS TO BE NATIONAL AVAILABILITY OF ENOUGH NUTRITIOUS FOOD WHICH INTURN DEPENDS ON FOOD IMPORTS,/EXPORTS AS WELL AS THE LOCAL FOOD PRODUCTION. AND AT THE END OF THE DAY, WE DO NEED FOR THE PLANET TO BE HEALTHY ENOUGH TO BE ABLE TO PROVIDE THE WORLD WITH ENOUGH CALORIES AND FOODS AND NUTRITIONAL VALUE TO MEET FOOD SECURITY NEEDS AT THE HOUSEHOLD LEVEL SO WE CAN SEE THAT THERE IS A NEED FOR MULTILEVEL INTERVENTIONS FROM THE GLOBAL, ALL THE WAY TO THE HOUSEHOLD LEVEL TO BE ABLE TO ADDRESS HOUSEHOLD SECURITY. THERE IS ALSO ANAR O THAT IS BLACK, YOU CAN'T SEE IT VERY WELL, BUT THERE IS A BIG DIRECTIONAL RELATIONSHIP BETWEEN FOOD SECURITY AND ACCESS TO HEALTHCARE, HOUSING AND OTHER BASIC NEEDS. UPON SO ESSENTIALLY THERE IS A CYCLE HERE WHEREBY IF PEOPLE ARE ILL, DO NOT HAVE ADEQUATE ACCESS, AND SO ON, THEN THEY'RE MORE LIKELY TO BE FOOD INSECURE AND THE MORE FOOD INSECURE THEY BECOME THAT MORE SICK THEY ARE GOING TO GET. AT THE END OF THE DAY, BOTH FOOD SECURITY AND ACCESS TO HEALTHCARE, ANOTHER BASIC SOCIAL DETERMINANTS OF HEALTH IS WHAT DETERMINES THE NUTRITIONAL ENSURVEYS CURITY. AND NUTRITION SECURITY HAS TO BE UNDERSTOOD AT THE INDIVIDUAL LEVEL BECAUSE IT'S A CONDITION THAT HAPPENS WHEN THE ORGANISMS OF INDIVIDUALS OF PEOPLE ARE ACTUALLY [INDISCERNIBLE] WITH REGARD TO THE AMOUNT OF NUCLEOTIDES T-REGENTS AND OTHER HEALTHY COMPONENTS IN FOODS TO BE ABLE FOR PEOPLE TO HAVE A HEALTHY AND ACTIVE LIFE. SO IT IS VERY IMPORTANT TO RECOGNIZE THAT SINCE THE LATE 80S IN THE U.S., IN NUTRITIONAL STATE BEING DEFINED AS THE ASSIMILATION AND UTILIZATION OF NUTRIENTS BY THE BODY PLUS INTERACTIONS OF ENVIRONMENTAL FACTORS SUCH AS THOSE THAT AFFECT FOOD COMSUMPTION AND SECURITY. I WANT TO MENTION THAT FOOD SECURITY IS A HUMAN RIGHT AND ALL THE FOLLOWING INTERNATIONAL CONVENTIONS REFLECT THE UNIVERSAL, INDIVISIBLE, INTERRELATED AND INTERDEPENDENCE HUMAN RIGHTS. SO IT IS ENCLUEDED AS PART OF THE RIGHT TO ADEQUATE FOOD, CHILDREN'S RIGHTS TO FOOD, HEALTHCARE, SURVIVAL AND DEVELOPMENT AND THE RIGHTS OF MOTHERS TO ADEQUATE NUTRITION CURING PREGNANCY AND LACTATION, SO THE DEFINITIONS OUTSIDE THE U.S., WITHIN THE U.S. THAT WE NOW HAVE FOR FOOD INSECURITY, NUTRITION SECURITY, AND SO ON ARE TOTALLY, TOTALLY PART ALSO OF HUMAN RIGHTS. SO HOW DO WE GO ABOUT ADDRESSING FOOD INSECURITY? IT CAN BE DONE DIRECTLY OR INDIRECTLY. SO THE APPROACH THAT HAS BEEN USED AT MACROLEVEL IS THE FAO BALANCE SHEETS TO COMPUTE THE CALORIES PERCAPITTA PER DAY AVAILABLE TO THE COUNTRIES BUT IN THESE DAYS AND TIMES WHEN THE PROBLEM OF OVERNUTRITION LINKED TO FOOD INSECURITY, IT ALMOST OVERTAKING IN MANY COUNTRIES, THE PROBLEM OF A LACK OF CALORIES, THERE IS A NEED OF COURSE FOR OTHER METHODS INCLUDING ASSESSING DIETARY INTAKE THROUGH 24 RECALLS, FREQUENCY QUESTIONNAIRES, FOOD RECORDS AND OTHER DIETARY INTAKE ASSESSMENT METHODOLOGIES. WE CAN ALSO ASSESS THIS DIRECTLY THROUGH FOOD INSECURITY THROUGH FOOD MEASUREMENTS THAT INCLUDE HEIGHT, WEIGHT, CONCEPTS AND SO ON, THERE ARE METHODS BASED ON BIOMARKERS, SO SUCH AS, YOU KNOW [INDISCERNIBLE] IN THE BLOOD STREAM IN RESPONSE TO THAT COMSUMPTION OF MORE FRUITS AND VEGETABLES AND SO ON. AND LAST BUT NOT LEAST, WE WILL TALK TO THE WEBINAR SERIES EXTENSE EVALUATION PROCESSLY IN TERMS OF THE METHOD BASED ON EXPERIENCE BASED SCALES. UPON SO IT IS VERY IMPORTANT TO START OFF THE BAT BY SAYING THAT THERE ISN'T A BEST METHOD AND A WORST METHOD. ALL THE FOOD INSECURITY METHODS HAVE STRENGTHS AND WEAKNESSES, WITH REGARDS TO THEIR SPECIFICITY, EASINESS OF APPLICATION, DATA COLLECTION SPEED, MEASUREMENT [INDISCERNIBLE], ET CETERA, AND IN FACT, THEY STRONGLY COMPLEMENT EACH OTHER. SO WE KNOW THAT FOR EXAMPLE, WHEN WE TALK ABOUT NUTRITION SECURITY, NUTRITIONAL STATEUS REQUIRES ASSESSMENT THROUGH ALL THESE METHODS FOR COMSUMPTION, FOOD INSECURITY AS WELL AS BY O CHEMICAL, CLINICAL AND ANTHROPROMETRIC INDICES OF NUTRITIONAL STATUS. WE HAVE PUBLISHED WHAT WE THINK IS AN INTERESTING PAPER, IT'S BEEN CITED QUITE A BIT ON DEMONSTRATING HOW THE BEST CHOICE AND METHODS FOR FOOD SECURITY, AND THE PROGRAM QUESTIONS, PROGRAM EVALUATION QUESTIONS OR RESEARCH QUESTIONS THAT WE HAVE AND WE DEVELOPED AN ALLEGOR RILGT IMPEDIMENTS BASED ON SMART CRITERIA TO IDENTIFY THE BEST POSSIBLE METHODS AND INDICATORS TO ANSWER QUESTIONS RELATED TO DIFFERENT TO 5 DIFFERENT SCENARIOS. SO I WILL NOW START TALKING A LITTLE BIT ABOUT EXPERIENCE BASED FOOD INSECURITY SCALES GIVEN THE ENORMOUS TRANSFORMATIONAL IMPACT THAT THEY HAVE HAD AT PLACING FOOD SECURITY FRONT AND CENTER AS PART OF THE INTERNATIONAL AND NATIONAL AGENDAS, AND THE PROPERTIES, THE SMART PROPERTIES THEY HAVE TO ACTUALLY ALLOW FOR A RAPID AND VERY USEFUL APPLICATIONS IN TERMS OF RESEARCH EVALUATION AND MONITORING AS WE WILL SEE IN A MOMENT. SO THE EXPERIENCE IN BASE SCALES, THE THEORETICAL FRAMEWORK WAS DEVELOPED BY [INDISCERNIBLE] AND COLLEAGUES AT CORNELL, WHERE THEY INTERVIEWED WOMEN IN UPSTATE NEW YORK WHO WERE EXPERIENCING FOOD INSECURITY IN THEIR HOUSEHOLDS AND USING FIRST OF ALL QUALITATIVE RESEARCH AROACHS, THEY WERE ABLE TO DOCUMENT THAT ESSENTIALLY IT CAN BE UNDERSTOOD AS A HOUSEHOLD IN A MANAGED PROCESS. SO WE ASSUME THAT THE HOUSEHOLD IS SECURE NOW BUT BECAUSE OF A ECONOMIC SHOCK, THEY WERE VERY CONCERNED THAT THE BREAD WINNER MAY LOSE HER OR HIS JOB IN A SHORT TIME, THEY START GETTING VERY ANXIOUS, VERY WORRIED ABOUT NOT HAVING FOOD ACCESS FOR THAT TIME IN THE FUTURE. IF THE SITUATION IS NOT CORRECT, THE FIRST COPING STRATEGY WILL BE FOR THE FAMILY TO SACRIFICE THE DIETARY QUALITY I MENTIONED OF FOOD SECURITY. AND IF THAT SITUATION WORSENS, THEN FIRST ADULTS WILL CUT FOOD CONSUSMS AND EVENTUALLY CHILDREN WILL CUT FOOD COMSUMPTION TO THE POINT WHERE THEY MAY GO FOR A WHOLE DAY OR MORE WITHOUT EATING ANYTHING BECAUSE OF JUST COMPLETE ACCESS TO FOODS. SO THIS FRAMEWORK IS INCREDIBLY USEFUL AND DIFFERENTIAL TO THE POINT THAT IT IS REALLY WHAT GUIDES THE APPLICATION OF THE FOOD INSECURITY ISSUES TO THE TARGET OF 2.2. SO WHAT IS FULLY RECOGNIZES IS THAT THE HOUSEHOLDS GO THROUGH DIFFERENT KIND OF EXPERIENCE, DIFFERENT LEVELS OF FOOD INSECURITY FROM MILD, ALL THE WAY TO SEVERE, THAT IS AFROM SIMPLY WORRYING ABOUT NOT HAVING ENOUGH FOOD, ALL THE WAY TO EXPERIENCING OR [INDISCERNIBLE]. AND THIS IS INCREDIBLY IMPORTANT BECAUSE WE KNOW THAT THE RANGE OF THE HOUSEHOLD FOOD INSECURITY CAPTURES DIFFERENT FOOD ACCESS PROBLEMS THAT MAY REQUIRE AND DO REQUIRE POLICY SOLUTIONS AND ALSO DIFFERENT LEVELS OF HOUSEHOLD INSECURITY ARE DETERMINED BY DIFFERENT PAT OTHER THANS AND MAY RESPOND DIFFERENTLY TO THE DIFFERENT POLICIES. SO IF YOU WANT TO LEARN A MORE ABOUT THE POINTS I'M MAKING HERE, I STRONGLY RECOMMEND YOU TO WITH THIS PAPER THAT I PUBLISHED, I PUBLISHED LAST YEAR. SO THE U.S. HOUSEHOLD FOOD SECURITY SURVEY MODULE THAT WAS OFFICIALLY RELEASED IN 1995 IN THE U.S., IS DERIVED FROM BOTH CONGRESS SCALE AND CHILD COMMUNITY HUNGER EDUCATION PROJECT BY RESEARCHERS AT MASSACHUSETTS. SO THE U.S. HOUSEHOLD FOOD SECURITY SURVEY MODULE INCLUDES 18 ITEMS PLUS SOME FILTER QUESTIONS, AND THEY ASK SOMEONE IN THE HOUSEHOLD WHO IS COGNIZANT ABOUT THE FOOD INSECURITY OR SECURITY SITUATION, QUESTIONS ABOUT AMOUNT OF FOODS, ABOUT NOT ONLY THE DIET, THE QUALITY OF THE NUTRITIONAL QUALITY OF THE FOOD AND THEY ESCORT THOSE IN RELATIONSHIP TO WHAT IS HAPPENING TO THE HOUSEHOLD AS A WHOLE OR ADULTS IN THE HOUSEHOLD, OR CHILDREN IN THE HOUSEHOLD. AND THEP EACH, A HOUSEHOLD GETS A SCORE AND BASED ON PREESTABLISHED CURRENT FUNDS THEY CAN GET CLASSIFIED ACCORDING TO DIFFERENT LEVELS OF SEVERITY OF FOOD INSECURITY. THE HOUSEHOLD FOOD INSECURITY MODULE HAS BEEN ADOPTED EXTENSIVELY THROUGH THE U.S. CENSUS BUREAU, CURRENT POPULATION SURVEY THROUGH THE HEALTH SECTOR, THE NATIONAL HEALTH AND APPRECIATION SURVEY, THROUGH THE EDUCATION SECTOR THROUGH THE EARLY CHILDHOOD STUDY PROGRAM AND THERE ARE OTHER SECTORS THAT ARE ALSO INCLUDING IT IN THEIR SURVEYS AND OF COURSE IT ALLOWED FOR AN EXPLOSION OF RESEARCH AND UNDERSTANDING THAT CAUSES THE CONSEQUENCES OF FOOD INSECURITY. THIS IS 1 OF THE SCALES THAT HAVE BEEN VALIDATED THE MOST, I WOULD SAY IN THE HISTORY OF HUMAN KIND AND IS IT IS ITY IT DOES HAVE EXCELLENT PSYCHOMETRIC PREDICTIVE AND CONCURRENT VALIDITY PROPERTIES. AND VERY IMPORTANTLY WHAT WE ARE TALKING ABOUT LESSONS LEARNED THAT CAN BE TRANSFERRED ACROSS COUNTRIES, IN FACT THE U.S. HOUSEHOLD FOOD SECURITY MODULE LED TO THE ADOPTION AND VALIDATION OF VERY SIMILAR SCALES IN DEFINITE PARTS OF THE WORLD ESPECIALLY LOW AND MIDDLE INCOME COUNTRIES THROUGH THE FANTA PROJECT, IT WAS THE BASIS FOR THE NATIONAL HOUSEHOLD FOOD INSECURITY MEASUREMENT PRODUCT THAT IN BRAZIL THAT LED TO THE [INDISCERNIBLE] AND THEN THESE SCALES COMBEANED ARE THE 1S FOR THE BASIS FOR DEVELOPMENT OF THE LATIN AMERICAN AND FOOD INSECURITY SCALE THAT WAS ENDORSED BY THE REGIONAL OFFICE OF [INDISCERNIBLE] CHILE AND THEN BECAME THE SCALE THAT IS USED TO FAO TO TRACT [INDISCERNIBLE] 2.2. SO IT'S FASCINATING TO SEE HOW THE GLOBAL DISSEMINATION OF A HOUSEHOLD PUTS SECURITY MEASUREMENT SURVEY IS REALLY THE GREAT GRANDMOTHER OF THE YEARS. ALL OF THE SCALES THAT ARE EXTENSIVELY AND PROPERLY TESTED FOR CONSTRUCT BASE AND PSYCHOMETRIC AND AMP FREE RADICALS DICTIBILITY AND ALL SCALES CORRELATE WELL WITH MEASURES OF DIETARY AND NUTRITION STATUS BIOMARKERS. SO THE TRANSITION FROM ELCSA TO FAO, I WAS ALSO PROUD TO BE PART OF THIS AND TO REALLY SEE HOW RAPIDLY IT DISSEMINATED ALL OVER THE WORLD AND THROUGH THE WORLD--THE GAL UP WORLD FOR PUBLIC OPINION POLLS, SURVEYS, IT HAS BEEN APPLIED TO MORE THAN 150 COUNTRIES. SO WHAT ARE SOME OF THE RESEARCH LESSONS THAT WE WORKED ON. FIRST OF ALL, COUNTRIES ACROSS THE WORLD HAVE BEEN ABLE TO UNDERSTAND FOOD INSECURITY CONSEQUENCES, ESPECIALLY USING EXPERIENCE BASED SCALES AND DIETARY INTAKE ASSESSMENT IN METHODOLOGIES AND TO SOME--TO SOME EXTENT BIOMARKERS AND [INDISCERNIBLE] AS WELL. SO IN USA, AND BRAZIL AND MANY OTHER COUNTRIES HAVE REALLY SHED LIGHT ON FOOD INSECURITY AND THE 3-POINT BURDEN OF UNDERNUTRITION, MICRONUTRITION INEFFICIENCIES AND OTHERS AND AS WELL AS NONCOMMUNICABLE DISEASES SUCH AS DIABETES, CARDIOVASCULAR DIABETES, AND SO ON. THERE HAS ALSO BEEN LIGHT SHED IN SOME COUNTRIES THAT CAN BE TRANSFERRED TO ANOTHER 1 SO THEY'RE UNDERSTANDING THE RELATIONSHIP BETWEEN FOOD INSECURITY AND REPREVENTION OR SELF-MANAGEMENT OF INFECTIOUS DISEASES. SUCH AS HIV, IN MANY COUNTRIES HAVE NOW CONDUCTED ANALYSIS OF WHAT HAPPENED TO FOOD INSECURITY AS A RESULT OF THAT COVID-19 PANDEMIC AND ALSO NOW THERE'S A BIT OF DATA ACROSS DIFFERENT COUNTRIES ON THE RELATIONSHIP WITH FOOD INSECURITY AND COMMON CHILDHOOD COMMUNICABLE DISEASES ESPECIALLY IN LOW AND MIDDLE INCOME COUNTRIES. AND FOOD INSECURITY SCALES IN PARTICULAR ARE APPLIED TO DATA SETS FROM ALL OVER THE WORLD ARE CONSISTENTLY SHOWING HOW FOOD INSECURITY NEGATIVELY AFFECTS MENTAL HEALTH OF PEOPLE AND WHEN IT COMES TO THE MENTAL HEALTH OF WOMEN IT ALSO HELPS UNDERSTAND WHY FOOD INSECURITY HAS BEEN SO CONSISTENTLY IDENTIFIED AS A MAJOR RISK FACTOR FOR POOR EARLY CHILDHOOD DEVELOPMENT. SO THERE ARE APPLICATIONS ACROSS COUNTRIES, ACROSS WORLD REGIONS THAT I THINK COULD HELP TRANSFER THESE RESEARCH AND DESIGNS, INSTRUMENTS, UTILIZED TO ANSWER 1, FOR DIFFERENT COUNTRIES TO ADDRESS THESE SAME TYPES OF VERY IMPORTANT QUESTIONS IN THEIR OWN CONTEXT AND SETTINGS. I WOULD SAY IN THE NEXT YEAR, TELL BE DIFFICULT TO APPLY DIFFERENT FOOD SECURITY METHODS TO UNDERSTAND MUCH BETTER NOT ONLY THE IF, BUT HOW FOOD INSECURITIES APPLY TO CLIMATE CHAISM AND PLANETARY HEALTH. AND A VERY NEW EXCITING AREA OF WORK IS THE WHOLE LINK BETWEEN HOUSEHOLD INSECURITY AND [INDISCERNIBLE] SECURITY, WE ALSO HAVE WATER INSECURITY SCALE, CALLED WISE, THAT HAVE BEEN DEVELOPED FOR WATER INSECURITY IN PARTNERSHIP WITH MANY ORGANIZATIONS AND NG Os AND SO ON AND JUST FINDINGS FROM MANY, MANY COUNTRIES NOW ARE FINDING A CONSISTENT RELATIONSHIP BETWEEN WHAT HOUSEHOLD WATER INSECURITY AND THE HOUSEHOLD FOR INSECURITY. AND THEN, YOU KNOW IT IS ALSO IMPORTANT TO ACKNOWLEDGE THAT CLIMATE CHANGE IS LEADING THROUGH HOUSEHOLD FOOD INSECURITY AND HOUSEHOLD FOOD INSECURITY CAN ALSO BE LEADING TO CLIMATE CHANGE WHICH AT THE END OF THE DAY IS I RELATIONSHIP THAT NEEDS TO BE DISENTANGLED TO REALLY UNDERSTAND HOW TO PREVENT ENORMOUS HARM THAT WE ARE CONTINUING TO INFLICT ON OUR PLANET. SO TO START CONCLUDING THIS PART OF MY PRESENTATION, GLOBAL FOOD INSECURITIES KEEP ACHIEVING THAT SUSTAINABLE TWEPMENT GOALS, EACH AND ALL OF THEM MEETING THESE AS THIS IS CRUCIAL FOR REDUCING FOOD INSECURITY AND WHAT WE ARE NOW ALSO LEARNING IS THAT IT'S NOT ONLY FOOD SECURITY BUT ALSO HOUSEHOLD WATER SECURITY THAT HAS TO BE TAKEN INTO ACCOUNT. SO THIS RESEARCH IS IN ITS INFANCY BUT I WOULD SAY IT'S OUR NEXT FRONTIER THAT NEEDS TO BE FURTHER CONSIDERED BY COUNTRIES ALL OVER THE WORLD ON HOW TO USE THE TOOLS THAT WE HAVE FOR ASSESSING FOOD INSECURITY AND WATER INSECURITY TO ACTUALLY FIGURE OUT FOR A WAY TO COORDINATE BETTER THE GOVERNMENTS OF THESE 2 SECTORS TO ACTUALLY IMPROVE THE HUMAN AND PLANETARY HEALTH AT THE SAME TIME. SO WHEN IT COMES TO POLICIES, AND PROGRAMS, FOOD INSECURITY MEASURES, HAVE BEEN USED ESPECIALLY FOOD INSECURITY, THE EXPERIENCE BASE SCALES FOR PROGRAM TARGETING INVOLVING THE U.S. BRAZIL FOR POLICY AND PROGRAM EVALUATIONS IN BOTH COUNTRIES AS WELL, AND THEY CAN--THE QUESTION IS IF THEY CAN BE USED FOR IMPROVING FOOD SECURITY PROGRAMS. SO I HAVE WRITTEN EXTENSIVE LOAMACY ON THIS TOPIC AND WE HAVE SPECIFIC EXAMPLES WE COULD GO OVER THE PANEL TIME IF YOU ARE INTERESTED ON HOW THERE ARE GOOD INDKAINGZS FOR FOOD INSECURITY BASED SCALES CAN HELP FOOD SECURITY WITH GOVERNMENTS. AND IN PART IT'S BECAUSE THEY GENERATE INDICATORS FOR MONITORING AND SURVEILLANCE AND THIS IS HAPPENING IN THE U.S., IT IS HAPPENING IN--OVER LATIN AMERICA BUT ALSO GLOBALLY THROUGH THE FAO VOICES OF THE HUNGRY, PROJECT BUT ALSO THROUGH THE DEVELOPMENT OF A VERY INNOVATIVE MONITORING SUGGESTS, AND FOOD SYSTEMS DASHBOARD THAT NOW INCLUDES ON WHAT THE WORLD EATS, PROJECT INDICATORS, AND WHAT IS FASCINATING IS THAT THIS IS A PROJECT THAT HAS JUST RELEASED ITS FIRST SET OF RESULTS, BASED ON THE LOW BURDEN FOR COLLECTING VALID COMPARABLE FOOD GROUP CONSUVENLINGS DATA IN POPULATIONS ACROSS WORLD SETTINGS AND IT IS VERY, VERY PARALLEL, VERY SIMILAR TO THE JUSTIFICATION AND THE APPROACH THAT WAS USED TO ACTUALLY LAUNCH THE FOOD IPT GREATER SECURITY EXPERIENCE SCALE ALL OVER THE WORLD FOR TRACKING AS WELL AS RESEARCH FOR GOVERNMENTS TO USE IT TO TARGET PROGRAMS AND ASSESS THE EMPACT OF SOME OF THOSE--OF THOSE POLICIES. SO IN CONCLUSION, THERE IS A CLEAR AND CONCISE DEFINITION OF FOOD INSECURITY. IT HAS BEEN IN PLACE FOR OVER 2 DECADES, DIFFERENT METHODS EXIST FOR ASSESSING DIRECTLY OR INDIRECTLY FOOD INSECURITY. THE BEST METHODS OF CHOICE NEED TO BE SELECTED BASED ON THE CONTEXT OF WHICH ARE THE QUESTIONS WE'RE TRYING TO ANSWER, THE RESOURCES THAT ARE AVAILABLE AND THE TIME FRAME THAT NEEDS TO BE--TO BE ADDRESSED. THE EXPERIENCE BASED FOOD INSECURITY MEASURES DISSEMINATED VERY RAPIDLY FROM THE USA TO THE REST OF THE WORLD IN THE EARLY 2000S AND THIS TRULY BECAME A GAME CHARGER IN WHOLE WORLD WHEN IT CAME TO EMPOWERING DECISION MAKERS AND INTERNATIONAL AGENCIES AND SO ON TO REALLY BE ABLE TO AND TO TRY TO GET INDICATORS AND DO SOMETHING ABOUT FOOD INSECURITY ACROSS DIFFERENT SETTINGS. MANY POLICIES AND PROGRAMS DESEEN AND EVALUATION THROUGH THE USE OF THESE METHODOLOGIES AND THE MAIN REASON FOR THESE WEBINAR IS BECAUSE THE TIME AS COME FOR THIS EXTENSIVE KNOWLEDGE TO BE SHARED ACROSS COUNTRIES. THANK YOU SO VERY MUCH FOR YOUR ATTENTION. >>THANK YOU SO MUCH RAFA. IT WAS WONDERFUL ISSUES I WILL NOW ASK DR. ALICIA COLE MAN-JENSEN TO COME AND SPEAK. SHE WILL BE SHARING OR SLIDES. >>THAIRNG YOU. CAN YOU HEAR ME SUSAN? >>I CAN. >>MY APOLOGIES TO EVERYONE, I'M HAVING SOME TECHNICAL BAND WIDTH ISSUES THIS MORNING SO, ALISHA WILL BE SHARING MY SLIDES SO THANK YOU FOR THAT, I'M ALISHA COLEMAN-JENSEN AT USDA ECONOMIC RESEARCH SERVICE AND I CONDUCT FOOD SECURITY AND U.S. HOUSE FOOD SECURITY RESEARCH AND HOUSEHOLDS IN THE UNITED STATES. AND LET ME BACK UP AND SAY FOR THOSE OF YOU THAT AREN'T FAMILIAR, THE ECONOMIC RESEARCH SERVICE IS THE SOCIAL SCIENCE RESEARCH AGENCY OF THE USDA. AND WE--1 OF THE AREAS THAT WE LEAD, THE FEDERAL GOVERNMENT HAS RESEARCH ON FOOD INSECURITY ON U.S. HOUSEHOLDS WANT SO THANK YOU FOR INVITING ME TO JOIN YOU FOR THIS CONVERSATION TODAY AND THANK YOU RAFAEL FOR THOSE WONDERFUL PRESENTATION. NEXT SLIDE, PLEASE. SO RAFAEL GAVE A GREAT INTRODUCTION OF FOOD INSECURITY AND ALL OF THE DIFFERENT MEASUREMENT METHODS, THE DEFINITIONS, I JUST WANT TO START OUT WITH THE USDA FOOD SECURITY DEFINITION, SO THIS IS WHAT WE'RE MEASURING WITH OUR SURVEY AND SCALES. FOOD INSECURITY MEANS SOME TIME DURING THE YEAR TO PROVIDE ADEQUATE FOOD FOR 1 OR MORE MEMBERS BECAUSE OF A LACK OF RESOURCES. SO WE TYPICALLY ASK ABOUT THE LAST 12 MONTHS SO A HOUSEHOLD THAT'S FOOD INSECURE ANYTIME DURING LAST 12 MONTHS, THEN IT IS FOOD INSECURITY. SO FOOD INSECURITY AND PREDICATED ON NOT BEING ABLE TO AFFORD FOOD. VERY LOW FOOD INSECURITY IS NORMAL EATING PATTERNS OF SOME HOUSEHOLD MEMBERS WERE DISRUPTED AT TIMES DURAN THE YEAR AND THEIR FOOD INTAKE REDUCED BECAUSE THEY COULD NOT AFFORD ENOUGH FOOD. SO DISRUPTED EATING PATTERNS MEANS SKIPPING MEALS AND MORE SITUATIONS GOING AN ENTIRE DAY WITHOUT EATING. AND THIS IS BASED ON THE EARLY MEASURE FROM THE RATIMEERER CORNELL HUNGER SCALE AND THE CHILD HUNGER IDENTIFICATION PROJECT. SO THERE'S A SERIES OF SURVEY QUESTIONS THAT FORM THE FOOD SECURITY MODULE. NEXT SLIDE, PLEASE. SO THE IMPORTANCE OF RESEARCH AND MEASURING HOUSEHOLD FOOD SECURITY SO AS YOU'VE HEARD ALREADY, USDA HAS BEEN COLLECTING DATA ON HOUSEHOLD FOOD INSECURITY FOR A NUMBER OF YEARS SO WE HAVE A NICE LONG TIME SERIES. SO WHY ARE WE DOING THIS? FIRST AND FOREMOST ASSESSING WELL BEING IS AN IMPORTANT ASPECT. THE FOOD SECURITY STATISTICS THAT ARE RELEASED ANNUALLY ARE USED BY POLICY MAKERS AND THEIR STAFF, BY GOVERNMENT AGENCIES INCLUDING FOR EXAMPLE, THE FOOD IS NUTRITION SERVICE OF USDA, THAT'S RESPONSIBLE FOR ADMINISTERING THE FOOD AND NUTRITION ASSISTANCE PROGRAMS, IT'S USED BY ANTIHUNGER ADVOCACY GROUPS IN THEIR WORK. IT'S USED BY ACADEMEC RESEARCHERS AND OTHERS INCLUDING THE MEDIA. ASK IT'S IMPORTANT TO SORT OF JUST ASSESS WELL BEING OVER TIME AS AN IMPORTANT MEASURE OF HARDSHIP AND OVERALL WELL BEING THAT CAN AFFECT HEALTH AND MANY OTHER ASPECTS OF PEOPLE'S LIVES. IT'S ALSO USED TO RESEARCH THE EFFECTIVENESS OF POLICIES AND PROGRAMS. SO FOR EXAMPLE, TO UNDERSTAND HOW USDA'S SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM OR THE SNAP PROGRAM CAN IMPACT OUTCOMES. FOOD INSECURITY IS A KEY OUTCOME THAT THRA PROGRAM IS TRYING TO IMPROVE. IT CAN ALSO BE USED TO UNDERSTAND HOW CHANGES IN POLICIES AND PROGRAMS MIGHT AFFECT FOOD INSECURITY IN DIFFERENT WAYS IF WE'RE TESTING DIFFERENT POLICIES AND PROGRAMS. AND THEN FINALLY RESEARCH TO DETERMINANTS AND OUTCOMES. SO DETERMINANTS ARE KEY FOR UNDERSTANDING WHAT POLICY SOLUTIONS MAY BE HELPFUL FOR REDUCING FOOD INSECURITY. WHAT FACTORS FOR HOUSEHOLDS, FOR INDIVIDUALS, FOR COMMUNITIES, FOR NATIONAL POLICY, FOR ECONOMIC TRENDS, UNDERSTANDING HOW ALL THOSE DIFFERENT FACTORS COME TOGETHER TO AND THEN UNDERSTANDING OUTCOMES IS EYE REALLY GOOD WAY TO MOTIVATE WHY WE KNOW ABOUT FOOD INSECURITY. SO WE KNOW AS HAS ALREADY PRESENTED THAT FOOD ISY RELATED TO HEALTH OUTCOMES. FOOD INSECURITY AFFECTS CHILDREN'S EDUCATIONAL OUTCOMES ANDASTS DIET AND OTHER FABLGHTORS, SO, THERE ARE IMPORTANT REASONS TO UNDERSTAND HOW FOOD INSECURITY BOTH COMES TO BE WITHIN A HOUSEHOLD ASK HOW THAT RASKTS OTHERS. THE FOOD SECURITY MODULES ARE USED IN MANY OTHER DATA COLLECTIONS AS RAFA MENTIONED A NUMBER OF OF U.S. FEDERAL SURVEYS, THEY'RE ALSO USED IN SMALLER, VALUATIONS IS FOR INSTANCE A FOOD AND NUCLEOTIDES TREGZ DEPARTMENT MAY BE TEST BEING CHANGES OR POLICIES TO FOOD PROGRAMS AND THE FOOD SECURITY MODULES CAN BE USED TO MEASURE IMPACT AND THEN OF COURSE FOOD SECURITY MEASUREMENT MODULES ARE USED BY INDEPENDENT RESEARCHERS AND THEIR STUDIES BOTH IN THE U.S. AND GLOBALLY. NEXT SLIDE, PLEASE. SO THIS IS A GRAPHIC OF THE PREVALENCE OF FOOD SECURITY AND LOW FOOD SECURITY FROM 2001 TO 2021. THE CPS FOOD SECURITY SUPPLEMENT IS SPONSORED BY ERS AND CONDUCTED BY THE CENSUS BUREAU AND THIS IS THE SOURCE FOR ANNUAL FEDERAL STATISTICS, YOU CAN FIND ALL THE PAST REPORTS ON THE ERS WEBSITE THERE. THANK YOU, NEXT SLIDE. SO IN ADDITION TO THE SDG GOALS HAD WHICH RAFAEL ALREADY COVERED QUITE NICELY, THE FOOD SECURITY IS ALSO USED IN HEALTHY PEOPLE 2030. SO THESE ARE U.S. GOALS, TO TRACK HEALTH AND WELL BEING OF THE U.S. POPULATION. THERE ARE 2 GOALS, 1 IS TO REDUCE--THERE ARE 2 FOOD SECURITY GOALS, EXCUSE ME, 1 S&P TO REDUCE HOUSEHOLD FOOD SECURITY AND HUNGER THAT, IS OBJECTIVE 1 AND IT'S BEEN IDENTIFIED AS A LEADING HEALTH INDICATOR WHICH IS IMPORTANT. ONLY A SUBSET OF HEALTHY PEOPLE GOALS ARE LEADING HEALTH INDICATORS AND I THINK IT RECOGNIZES THE IMPORTANCE OF FOOD INSECURITY TO OVERALL POPULATION HEALTH. THERE'S A LOT OF RESEARCH LATELY, AND THOSE WHO MAY HAVE TUNED INTO THE WHITE HOUSE CONFERENCE ON HUNGER AND NUTRITION AND HEALTH, HEARD ABOUT THESE MANY LINKAGES BETWEEN FOOD INSECURITY AND HEALTH OUTCOMES AND HOW FOOD INSURVEYS CURITY IS IMPORTANT TO CHRONIC DEC AND OTHER FACTORS OF HEALTH. NEXT SLIDE, PLEASE. SO WHAT'S ON THE HORRIZEON FOR FOOD SECURITY RESEARCH. I'M HIGHLIGHTING FOOD NUTRITION SECURITY, I THINK THERE ARE MANY TECHNOLOGY TRANSFERS ON THE HORIZON FOR FOOD INSECURITY RESEARCH, THIS IS JUST 1 OF THEM AND THIS IS A SCREEN SHOT ON THE RIGHT HAND SIDE OF ERS'S NUTRITION SECURITY RESEARCH RESOURCES PAGE. SO WE PULLED TOGETHER A NUMBER OF DIFFERENT ERS RESEARCH OUTPUTS THAT ARE RELATED TO NUTRITION SECURITY THAT MAY BE HELPFUL FOR PEOPLE WHO ARE RESEARCHING THE TOPIC OR TRYING TO UNDERSTAND IT MORE. I THINK THIS IS REALLY AN AREA WHERE WE CAN LEARN FROM GLOBAL RESEARCH. NUTRITION SECURITY WAS A TERM IN THE INTERNATIONAL FOOD SECURITY LITERATURE AND BEFORE IT WAS IN THE WIDELY USED IN THE UNITED STATESMENT WE CAN ALSO USE THE FOOD SECURITY MEASUREMENT AS A MODEL FOR NUTRITION SECURITY. SO RAFAEL REALLY, REALLY NICELY EXPLAINED KIND OF THE GENESIS OF FOOD SECURITIES AND MEASURE IN THIS LONG-TERM PROGRESSION AND SORT OF EXPANSION TO DIFFERENT COUNTRIES AND I THINK THAT'S LARGELY BECAUSE THE FOOD SECURITY MEASURE WAS SCIENTIFICALLY BASED, BASED ON EARLY RESEARCH STUDIES, YOU KNOW TALKING TO PEOPLE, UNDERSTANDING THEIR EXPERIENCES AND THEN BASED ON AN UNDERLYING MEASUREMENT MODEL THAT WAS WELL TESTED AND HAS WITHSTOOD THE TEST OF TIME, AND IT ALSO CAME TOGETHER FROM A CONSENSUS FROM A LARGE GROUP OF RESEARCHERS AND INPUT FROM ACADEMIC RESEARCHERS, RESEARCHERS IN NOT FOR PROVEIS SETTINGS IN GOVERNMENT, THAT REALLY CAME TOGETHER AND FORMED REALLY A STRONG MODEL, TO UNDERSTAND FOOD INSECURITY AND SORT OF INSTITUTIONALIZE FOOD INSECURITY MEASUREMENT WITHIN THE U.S. GOVERNMENT AND ALSO HELP GIVE CREDENCE TO THE STRENGTH AND VALIDITY OF THE MEASURE. SO WE CAN USE THAT SORT OF UNDERSTANDING OF THAT HISTORY TO HELP US AS WE THINK ABOUT NUTRITION SECURITY AND WORK ON DEVELOPING A CONCEPTUAL FRAMEWORK, MEASURES FOR FOOD INSECURITY, A CONSENSUS DEFINITION AND POTENTIALLY IN THE FUTURE DEVELOP DATA AROUND NUTRITION SECURITY. NEXT SLIDE, PLEASE. AND I JUST WANT TO HIGHLIGHT 1 PROJECT THAT ERS HAS FUNDED. WE'VE MADE A LOT OF INVESTMENTS IN INSURING HIGH QUALITY FOOD SECURITY DATA. THIS WAS A GRANT PROGRAM FUNDED BY E RS AND FUNDED BY TUFTs, WE FUNDED 6 PROJECTS AND I WANT HIGHLIGHT 2 HERE THAT FOCUSED ON DEVELOPING ALTERNATIVE IT SCALES FOR SPECIFIC CONTEXTMENT SO [INDISCERNIBLE] AT BOSTON UNIVERSITY SCHOOL OF MEDICINE AND CHILDREN'S HEALTH WATCH HAS BEEN WORKING ON THE VALIDATION OF AN ABBREVIATED CHILD AND ADULT FOOD SECURITIES SCALE. WITH THE ONSET OF THE PANDEMIC WE REALIZED THE REAL IMPORTANCE OF HAVING SHORTER MEASURES THAT CAN BE REALLY RESPONSIVE IN A LOT OF DIFFERENT SITUATIONS. AND WE HAD A SHORT FORM OF AN ADULT FOOD SECURITY MODULE BUT WE DIDN'T HAVE A SHORT FORM TAKEN--THEY INCLUDED MEASURES FOR CHILDREN. THIS IS AN IMPORTANT ADVANCEMENT IN MAKING THE FOOD SECURITY MEASURE MORE MALLEABLE AND USEFUL IN CONTEXT WHEN WE REALLY NEED TO GET TO KNOW CHILDREN FOOD INSECURITY STATUS AS WELL. AND THEN LAUREN CLAY, WHO WAS AT D'YOUVILLE COLLEGE, AND HAS BEEN DEVELOPING A DISASTER FOOD SECURITY SCALE, THINGS LIKE HURRICANES, EARTHQUAKES, GLOBAL PAN DEMI, TECHNOLOGY TRANSFERS OF THAT NATURE BECAUSE FOOD INSECURITY IN THOSE SITUATIONS MAY NOT BE THE SAME AS FOOD INSECURITY RELATED TO ECONOMIC CONSTRAINTS. NEXT SLIDE, PLEASE. SO JUST IN CONCLUSION WHEN WE THINK ABOUT SHARING WORK GLOBALLY, WE CAN THINK ABOUT THESE BIG STUDIES LIKE THE FOOD SECURITY MEASUREMENT MODULE, EVENTUALLY INFLUENCING THE FOOD INSECURITY INFLUENCE SCALE SO THAT'S KIND OF LARGE SCALE, BUT THE SMALL SCALE STUDIES CAN ALSO BE REALLY IMPORTANT LIKE DEMONSTRATION PILOT PROOF OF CONCEPT ABOUT WHAT MIGHT WORK IN DIFFERENT CONTEXT, AND SO I WILL STOP THERE AND THAIRK YOU FOR HAVING ME. >>EXCELLENT. THANK YOU RAFAEL AND ALISHA, YOUR PRESENTATIONS TODAY. AS SUSAN MENTIONED, I WILL BE MODERATING TODAY'S DISCUSSION AND JOINING US ARE 2 ADDITIONAL PANELISTS THAT WE'RE EXCITED ABOUT WE HAVE DR. JANELLE, WALKER SCIENTIST ADMEN STRAIGHTER AND THE OFFICE OF HEALTH AND OFFICE OF DIRECTOR AT THE NATIONAL INSTITUTE OF CHILD HEGHT AND HUMAN DEVELOPMENT. WE ALSO HAVE DR. EVY WOOD WHO IS THE GLOBAL COORDINATOR AND YOU THIS TRICIANIST OF GOVERNMENTAL AFFAIRS AT USDA FOOD AND NUTRITION SERVICE. SO WELCOME BOTH JANELLE AND YIBO, WHILE WE START, I HAVE A SET OF QUESTIONS I WILL GO THROUGH DURING THE DIG CUSHION, I WANT TO ENCOURAGE EACH OF OUR PAN WILLISTS TO ASK EACH OTHER QUESTIONS THAT MAY COME UP IN MIND DURING OUR DISCUSSION. SO WITH THAT A QUESTION WE HAVE FOR ALL THE PANELISTS IS WHAT DO YOU SEE AS THE GAPS IN THE FOOD INSECURITY SPACE AND WHAT ARE THE PRIORITY RESEARCH AREAS SO ALISHA AND RAFAEL OUTLINED THAT IN THEIR PRESENTATION SO WELCOME THAT QUESTION TO OUR OTHER PANELISTS AS WELL. PLEASE FEEL FREE TO JUST JUMP RIGHT IN. SO JANELLE, MAYBE YOU CAN START US OFF ON THAT 1. THANK YOU FOR THOSE PRESENTATIONS, THOSE ARE GREAT IN HIGHLIGHTING AREAS WHERE WE NEED TO FOCUS. --INCLUDING FOOD INSURVEYS CURITY AND SHOWED A LOT OF GAPS IN THOSE AREAS. THE PURPOSE OF THE CONFERENCE OVERALL WAS BETTER UNDERSTAND THE RECENT ETICSIO LOGICAL AND SOCIAL ECICOLOGICAL FACT ORS CONTRIBUTING TO THE INCREASED PREVALENCE OF THE DOUBLE BURDEN OF MALNUTRITION SPECIFICALLY IN AGES 3-18 YEARS IN LMICs AND THROUGH THAT CONFERENCE, WE EXPLORED THE EVIDENCE-BASED INTERVENTIONS, IDENTIFIED IMPORTANT RESEARCH QUESTIONS AND WE'RE REALLY LOOKING TO ALSO DISCUSS THE KNAPS AROUND THE POLICY UMPLICATIONS TOWARDS IMPROVING NUTRITION AND HEALTH OUTCOMES VIEWED GLOBALLY AND JUST STEPPING BACK 1 MOMENT TO MALNUTRITION AND ALL ITS FORMS. REALLY THE OUTCOMES ARE REVEALING THAT THERE ARE CRITICAL POINTS TO FOCUS ON AND TARGET FOR WORLD WIDE OPPORTUNITIES AND CHALLENGES LOOKING AROUND MALNUTRITION AND LOOKING AT THE DEFINITION, THE TERMINOLOGY, WHETHER IT'S DOUBLE OR TRIPLE BURDEN AND HOW THOSE HAPPEN IN DIFFERENT CULTURES OR ENVIRONMENTS AS WELL SO THAT REVEALED A LOT OF GAPS IN THOSE AREAS WE CAN FOCUS ON THAT WILL STILL NEED TO BE TARGETED AS FOOD INSECURITY AND HEAVILY INFLUENCED BY MALNUTRITION AND BIODIVERSE [INDISCERNIBLE]. >>AND RAFAEL MENTIONED THAT IS ANOTHER KIND OF WAY TO ASSESS FOOD INSECURITY LOOKING AT THOSE BIOMETRICS AND OTHER MEASURES. SO GREAT POINT. SO YIBO, DO YOU HAVE ANY THOUGHTS TO ADD ON THIS? >>THANK YOU FOR THE PRESENTATION, I THINK THE INFORMATION IS VERY INFORMATIVE. ONE THING AS I SEE IT, I THINK I AM IN A PROGRAM AREA WITHIN THE USDA AND WE WORK VERY CLOSELY WITH ERS FOR EXAMPLE, USING HAD-UTILIZING DATA TO ENHANCE, YOU KNOW AND PERFECT OUR PROGRAMS THAT CAN PREVENT THE FOOD INSECURITY OR AT THE MOMENT OF EMERGENCY PANDEMIC FOR EXAMPLE THAT MAKE OUR PROGRAM MORE SUITABLE TO ME, THE PEOPLE'S NEEDS, SO THAT THEY DON'T HAVE TO GO HUNGRY. AS YOU KNOW, THAT A LOT OF OTHER COUNTRIES WITH OTHER RESOURCES AND PROGRAMS, YOU KNOW FAMINE CAN HAPPEN, A LOT OF DISASTERS CAN HAPPEN, BUT HERE IN THE U.S., YOU KNOW WE ARE ABLE BY AND LARGE KEEP PEOPLE, KEEP FOOD INSECURITY AT BAY BY AND LARGE BECAUSE OF THE SNAP PROGRAM. SO I THINK IT'S IMPORTANT TO LOOK AT SOME OF THE SOLUTIONS AS RESEARCH TELLS US WHAT ARE THE POPULATIONS HAVING PROBLEMS AND HOW WE CAN BETTER COMBAT YOU KNOW FINDING SOLUTIONS TO SOLVE THOSE PROBLEMS. >>EXCELLENT POINT YIBO, AND FEEL FREE RAFAEL OR ALICIA FEEL FREE TO ADD TO ADD ON TO THE NEXT QUESTION. >>CAN I REQUESTICALLY ADD SOMETHING, TO TO ME IN TERMS OF PRIORITIES, LIKE IT IS VERY CLEAR THAT THE GLOBAL FOOD SYSTEMS ARE VERY UNHEALTHY, WE DON'T EAT PROCESSED FOOD, SUGAR BEVERAGES AND SO ON AND THE NUTRITION IS VERY DIFFICULT TO ADDRESS NOWADAYS BECAUSE THAT IS WHAT PEOPLE ARE HAVING ACCESS TO PHYSICALLY IN TERMS OF PRICES AND SO ON. SO I THINK THE TRANSFORM EAGZ OF THE CURRENT FOOD SYSTEMS IS A HIGH PRIORITY AREA FOR RESEARCH, FOR POLICY AND SO ON IN ORDER TO ADDRESS THE, YOU KNOW FOOD INSECURITY ON A COMPREHENSIVE WAY AND ALONG THOSE LINES I THINK WE MUST REMEMBER THAT THE FITTER 1000 DAYS SHOULD BE ENCLUEDED AS PART OF FOOD SECURITY SYSTEMS, ISSUES RELATED TO THE DIETARY ISSUES FACING WOMEN DURING PREGNANCY. LACTATING WOMEN COMPLIMENTARY FOOTS AND ALL THOSE FESTER QUEERS OF LIFE WHAT WE CALL THE FIRST FOOD SYSTEMS SOMEHOW ARE STILL BEING LEFT OUT OF POLICY AGENDAS OF RESEARCH AGENDAS AND SO ON. AND I THINK THAT WE SHOULD PRIORITIZE MORE THE NEED TO UNDERSTAND BETTER FOOD SYSTEMS. >>EXCELLENT POINT RAFAEL AND ALSO THE FIRST POINT ABOUT THE ABUNDANCE OF OVERPROCESSED FOODS THAT TIES INTO THE NUTRITION SECURITY HELIOS POSITIVE MENTORSHIP SKILL THAT ALISHA MENTIONED TOWARDS THE LATTER PART OF HER PRESENTATION, SO THANK YOU FOR RAISING THAT POINT. SO THE NEXT QUESTION WE HAVE IS WHAT CAN THE U.S. LEARNED FROM THE GLOBAL FOOD INSECURITY RESEARCH AND VICE VERSA WHAT CAN THE GROABAL FOOD INSECURITY RESEARCH LEARN FROM THE U.S., POLICIES, PROGRAMS THAT THEY'RE DEVELOPING TO ADDRESS FOOD INSECURITY. WE WELCOME OUR PANELISTS TO SHARE THEIR THOUGHTS ON THAT. >>WELL, I CAN BEGIN. I KNOW THERE'S A LOT IN THAT AREA AND 1 THING I DID ALSO WANT TO HIGHLIGHT WAS THAT NICHD DOES HAVE THE BOND KIDS PROJECT WHICH IS LOOKING AT A LOT OF THIS AND PERHAPS THAT'S AN AREA WHERE OTHER COUNTRIES CAN FEED OFF OF WHAT'S BEING DONE AND A BOND PROJECT AS BIOMARKERS FOR INDICATING DIETARY SUFFICIENCY SO IT'S LOOKING TO BUILD ON THAT FIRST THOUSAND DAYS OF LIFE THAT DR. PEREZ-ESCAME LLA WAS TALKING ABOUT AND THIS IS LED BY OUR PEDIATRIC GROWTH AND NUTRITION BRANCH AND THE WHOLE PRONG ECTOMYOSIN WAS ORGANIZED BY DR. DAN [INDISCERNIBLE], AND IT'S LOOKING AT THOSE NUTRITION BIOMARKERS AND FOCUSES ON SCHOOL AGE CHILDREN SO PERHAPS THERE ARE SOME SYNERGYS AND THINGS THAT CAN COME FROM THAT AS IT'S FOCUSED DOMESTICALLY AND GLOBALLY, AND ALSO LOOKING AT THE NUTRITION ENTERPRISES AND FOOD INSECURITY SO THERE MAY BE AREAS UP THERE OF OVERLAP AND WHERE WE CAN HAVE SOME RECIPROCAL SYNERGYS AROUND THAT. >>EXCELLENT. ANY OTHER THOUGHTS, I SEE SOME HEAD NODS. >>SO I JUST WANT TO ADD THAT THE U.S. IS ALREADY LEARNING QUITE A BIT FRANCIS COLLINS LATIN AMERICA AND OTHER LOWER INCOME COUNTRIES, HOW POWERFUL ASPECT OBESITY POLICIES CAN BE WHEN THEY ARE IMPLEMENTED BY GOVERNMENTS BASED ON STRONG ADVOCACY EFFORTS IN THE COUNTRIES. SO IT IS VERY ENCOURAGING TO SEE THAT IN THE NEW WHITE HOUSE STRATEGY ON HUNGER AND NUTRITIONAL HEALTH FOR THE COUNTRY, THEY ARE ADDRESSING FOR EXAMPLE, THE ISSUE OF IMPROVING THE TRANSPARENCY IN THE LABELING OF THE PACKAGES FOR EXAMPLE. ALSO, SOME AREAS IN THE U.S., SOME TOWNS, SOME CITIES HAVE NOW USED ALSO THE TECHNIQUE OF THE SUGAR SWEETENED BEVERAGES TAXES AND SO ON. SO I THINK THAT WHAT THE U.S. CAN LEARN IN TERMS OF IMPROVING ALSO PUTS SECURITY THROUGH CONSUMER PROTECTION MEASURES, WE'RE LEARNING A LOT FROM WHAT IS HAPPENING, FROM WHAT IS HAPPENING ABROAD AND THE OTHER WAY AROUND, I MEAN I JUST THINK THAT THE ENORMOUS CONTRIBUTION THAT THE U.S. HAS MADE TO THE U.S. COUNCIL FOOD SECURITY SURVEY MODULE AND ILLUSTRATING HOW WE CAN BED INCORPORATED INTO A VERY POWERFUL FOOD INSECURITY MONITORING SYSTEM HAS REALLY OPENED THE FLOOD GATES FOR MANY COUNTRIES ABROAD TO UNDERSTAND HOW IT CAN BE DONE. >>EXCELLENTMENT YEAH, GREAT POINT RAFAEL, IT'S ACTUALLY AT OBESITY WEEK IN SAN DIEGO AND ATTENDED A SESSION FROM AN INDIVIDUAL FROM MEXICO AND THEIR PUBLIC HEALTH DEPARTMENT TALKING ABOUT FOOD MARKETING TO CHILDREN PARTICULARLY AROUND ULTRA PROCESSED FOOD AND ELIMINATING THESE CARTOONS IN THAT ADVERTISING AS WAY TO ADDRESS OBESITY IN THOSE CONTEXT. SO EXCELLENT POINTS THERE. ANY OTHER THOUGHTS OR QUESTIONS OF THE PANELISTS IF THEY WANT TO SHARE WITH OTHER PANELISTS? AGAIN WANT THIS TO BE AS INTERACTIVE AS POSSIBLE BUT ALSO HAVE A SET OF QUESTIONS THAT I CAN ALSO GO THROUGH. >>SO I JUST WANT TO ASK JENELLE, SENTENCE I TOTALLY AGREED WAS AN INCREDIBLY IMPORTANT CONFERENCE, THE 1 ON CHILDREN ADOLESCENCE AND THE DOUBLE BURDEN OF MALNUTRITION AND WERE THERE ANY LESSONS JENELLE THAT WERE LEARNED FROM THAT, A VERY GLOBAL REPRESENTATION FOR THE U.S. ON A WAY FORWARD? ON HOW TO ENGEAJ MORE ADOLESCENCE IN THE SIGN OR PROGRAMS OR POLICY THAT MAY HELP THEIR AGE GROUP TO REALLY PREVENT THE DEVELOPMENT OF MALNUTRITION EMPLOY. >>AH, YES, QUITE A FEW LESSONS LEARNED THAT WE'RE STILL GOING THROUGH AS WELL, BUT SPECIFICALLY WITH ADOLESCENCE, I WAS THINKING ABOUT YOUR PRESENTATION THAT YOU GAVE DURING THE CONFERENCE AND, REALLY YOU'RE TALKING ABOUT HOW ADOLESCENCE, THEY KNOW A BIT ABOUT THE HEALTHY FOODS AND NONHEALTHY FOODS AND THE JUNK FOODS THAT ARE PRESENTED AND HOW THAT FEEDS INTO FOOD INSECURITY. BUT REALLY WE NOTICED THAT THE FIRST THOUSAND DAYS OF LIFE, YES, IS NOT HIGHLIGHTED AS MUCH BUT THE 7 [INDISCERNIBLE] DAYS OF LIFE SO HOW DO WE MERGE THIS, SEVERAL THOUSAND YEARS OF LIFE AND NOT LEAVE ALL OF THOSE COMPONENTS OUT. AND NICHD IN GENERAL WE LOOK AT THE WHOLE SPAN OF LIFE FROM CONCEPTION ALL THE WAY THROUGH. AND SO, IT'S JUST REALLY BEEN AN IDEA OF HOW DO WE LOOK AT THIS IN ALL OF THESE AREAS, HOW DO WE LOOK AT THIS FROM A MULTIFACETED APPROACH. ONE OF THE MAJOR THINGS WE LEARNED IS THAT FOCUSING ON THESE, WHY WE HAVE THESE, THE REASON WHY WE LOOK AT THE SOCIAL ECOLOGICAL MODEL AS A BASE IS THAT WE REALLY CAN'T FOCUS ON THESE SPECIFIC AREAS ALONE AND HAS TO BE A TOTAL APPROACH AND THEN WHILE IT HAS TO BE A TOTAL APPROACH TO IT, IT ALSO HAS TO LOOK AT HOW WE IMPLEMENT IT, SO THE WHOLE--IT'S A COMPONENT. I KNOW WE HAVE 1 OF THE WEBINARS, WE HAVE THAT, BECAUSE WE HAVE ALL THE EVIDENCE BASED INTERVENTIONS IN THE WORLD BUT IF WE CAPTAIN IMPLEMENT THEM, THAT'S WHERE THE CHALLENGE COMES AND THEN ALSO, WITHIN DIFFERENT CULTURES AND CONTEXTS, 1 OF THE MAJOR TECHNOLOGY TRANSFERS LEARNED IS THAT WHILE LOOKING AT DOUBLE BURDEN MALNUTRITION AS SOME OF OUR RESEARCHERS AND STAFF SET AS A SINGLE MONOLITH IS AN ERROR AND WE REALLY NEED TO LOOK AT IT FROM A MULTIFACETED APPROACH AND HOW DO WE CONNECT THAT TO DIFFERENT CULTURES AND ENVIRONMENTS SPECIFICALLY SEEING THE ISSUES THAT ARE INCREASING IN THE LMICs SO, THEREY'S QUITE A FEW THINGS THERE BUT OVERALL NOT LOOKING AT THE MONOLITH AND REALLY TAKING OUT MULTIFACETED APPROACH AND HOW DO WE LOOK AT OVER THE LIFE SPAN AS A WHOLE VERSUS INDIVIDUALLY. >>EXCELLENT. THANK YOU JANELLE. >>CAN I QUICKLY MAKE 2-POINTS, FIRST I THINK IT'S VERY IMPORTANT TALKING ABOUT FIRST THOUSAND DAYS AND FIRST 7000 DAYS AND I THINK NUTRITION IS A CONTINUAL NEED IS SUPPORT. WE AFTER 7000 DAYS YOU STILL GO UP TO PROUCTIVE ADULTS AND GO TO ELDERLY SECURITY, NUTRITION SUPPORT IS ONGOING, SO WE CAN'T OVERLOOK 1 AND FORGET ABOUT OTHER. IT'S A COMPREHENSIVE APPROACH. SECONDLY, I ALSO WANT TO MENTION ON ULTRA PROCESSED FOODS, THERE'S A LOT TO TALK ABOUT PROCESSED FOODS VERSUS ULTRA PROCESSED FOODS MPLET I THINK IN ORDER TO DIRECT CONSUMERS, YOU KNOW WE NEED TO HAVE OUR RESEARCH TO BETTER DEFEIGN OW TO PROCESS, I DON'T KNOW IF WHETHER WE HAVE A GLOBAL DE NOVO DEFINITION IS NOT REALLY LOOKING AT NUTRIENT CONTENT FOR EXAMPLE, AND I THINK FOR FOOD SECURITY PROCESSING FOOD SYSTEM VERY INFORMATIVE, WE WILL NOT ALWAYS HAVE ACCESS TO FRESH FOODS, SO FOODS NEED TO BE PROCESSED FOR 1 PART AVOID THE FOOD LOSS AND WASTE, SO WE NEED TO PRESERVE THESE FOODS TO CONSUM IN A NUTRITIONAL WAY, SO I THINK THAT'S SOMETHING REALLY NEEDED FOR RESEARCH COMMUNITY TO TAKE A CLOSE LOOK AT THE DEFINITIONS AND THAT IMPACT WHERE WE DRAW THE LINE IN TERMS OF PROCESSED FOODS, VERSUS ULTRA PROCESSED FOODS AND AVOID THE PUBLIC'S MISCONCEPTION THAT WE HAVE TO EAT EVERYTHING FRESH, IF IT'S PROCESSED FROM A BOX THAT'S UNHEALTHY AND THAT'S PROBABLE NOT TRUE. >>EXCELLENT POINT YIBO. SO THE IMPORTANCE OF INCIDENCE OF THE LIFE COURSE PERSPECTIVE, YES, 1000 DAYS AND CRITICAL BUT ALSO ELDERLY ADULTS AND SO FORTH, THERE ARE OTHER KEY DEMOGRAPHICS WE SHOULD CONSIDER AND THEN MEETING SOME CLEAR DEFINITION AROUND ULTRA PROCESSED FOODS, IN THE GLOBAL CONTEXT AND HERE DOMESTICALLY. SO EXCELLENT POINT. >>SO WE HAVE 1 MORE QUESTION AND TIME FOR 1 MORE QUESTION. SO HOW CAN WE CONTINUE TO CONNECT FOOD INSECURITY RESEARCH ACTIVITIES AND RESULTS ACROSS THE GLOBE? YOU KNOW WHAT CAN WE DO TO CONTINUE THIS SHARED LEARNING BETWEEN THE U.S. CONTEXT AND THE GLOBAL CONTEXT. >>WEBINARS LIKE THIS. >>EXACTLY. >>THAT'S THE WHOLE PURPOSE OF THIS WEBINAR SERIES. YEAH. >>EXACTLY. WE DON'T WANT TO OPERATE IN SILOS, WE WANT TO DISCUSS WHAT'S HAPPENING IN THIS CONTEXT, WHAT'S HAPPENING IN ANOTHER AND WHAT OUR SHARED LEARNINGS THAT CAN BE APPLIED IN THOSE SPECIFIC CONTEXT. ANY OTHER THOUGHTS BEFORE WE CLOSE? WELL, WITH THAT, I REALLY WANT TO THANK ALL OF OUR PANELISTS, THANKS SUSAN AND THE ORGANIZING COMMITTEE FOR PULLING THIS WEBINAR TOGETHER, THIS IS A GREAT FIRST STEP TO THE WEBINAR SERIES SO I WILL PASS IT OVER TO SUSAN NOW TO CLOSE US OFF AND HIGHLIGHT WHAT'S TO COME FOR THE SERIES. >>EXCELLENT, WELL, THANK YOU TO ALL OF OUR SPEAKERS AND PANELISTS AND I CAN'T SAY ENOUGH. YOU KNOW VERY NICELY ACTUALLY WRAPPED THAT UP, YOU KNOW SPLENDIDLY IN TERMS OF THE POINT OF THIS WEBINAR SERIES AND EVEN WHAT I THINK WE GOT OUT OF THIS FIRST 1. YOU KNOW I THINK FOR ANYBODY, IF THIS HAS SPARKED ANY IDEAS, I ENCOURAGE TO YOU LOOK AT THE NOSI TO STIMULATING WERE AND ADDRESS HUNGER, FOOD AND NUTRITION INSECURITY. IT HIGHLIGHTS 11 ANNOUNCEMENTS FROM 11 NIH EN--STRATEGIESITUTES, CENTERS AND OFFICES. I ALSO WANT TO MENTION THE RECORDING OF TODAY'S SESSION AND ALL WEBINARS WILL BE POSTED AFTER THE SERIES IS OVER. PLEASE JOAN US FOR OUR SECOND WEBINAR IN THIS SERIES, TELL TAKE PLACE NEXT THURSDAY, THE TENTH AT 10 AMEASTERN TIME. THIS 1 WILL BE ON LEVERAGING FOOD ENVIRONMENTS FOR FOOD AND NUTRITION INSECURITY LED BY DR. [INDISCERNIBLE] FROM THE UNIVERSITY OF GHANA, IT WILL DISCUSS ROLE OF FOOD ENSURVEYS CURITY IN HOME AND GOVERNMENTS AND FOOD ENVIRONMENT INTERVENTIONS ACROSS MULTIPLE REGIONS THAT ADDRESS EQUITY ACCESS DISPARITY AND SUSTAINABILITY. I REALLY HOPE CAN YOU JOAN US ALL THEN AND THANK YOU AGAIN TO ALL OF OUR SPEAKERS AND THAIRNG -THANK YOU TO EVERYONE WHO'S JOINED US.