1 00:00:07,840 --> 00:00:13,480 >>WELCOME, I'M DEIDRE 2 00:00:13,480 --> 00:00:21,120 O'NEIL, WORKSHOP COORDINATOR FOR 3 00:00:21,120 --> 00:00:21,520 CHRONONUTRITION. 4 00:00:21,520 --> 00:00:22,440 OUR WORKSHOP HOUSEKEEPING SIDE 5 00:00:22,440 --> 00:00:24,200 IS AS FOLLOWS. 6 00:00:24,200 --> 00:00:25,560 THIS WORKSHOP IS BEING RECORDED. 7 00:00:25,560 --> 00:00:30,600 LOCATED ON THE TOOL BAR, 8 00:00:30,600 --> 00:00:32,680 STAY OFF MUTE AND OFF CAMERA. 9 00:00:32,680 --> 00:00:38,480 TYPE YOUR QUESTIONS IN THE Q&A, 10 00:00:38,480 --> 00:00:39,040 MODERATORS WILL ANSWER. 11 00:00:39,040 --> 00:00:43,440 THANK YOU AND WE'RE HAPPY TO 12 00:00:43,440 --> 00:00:45,840 HAVE YOU TODAY. 13 00:00:45,840 --> 00:00:53,360 NEXT SLIDE. 14 00:00:53,360 --> 00:00:57,960 WE'RE GOING TO OPEN WITH OUR 15 00:00:57,960 --> 00:01:01,200 WELCOME REMARKS, VALUE OF 16 00:01:01,200 --> 00:01:04,400 NUTRITIONAL RESEARCH BY DR. 17 00:01:04,400 --> 00:01:09,000 DAVID GOFF, NHLBI. 18 00:01:09,000 --> 00:01:09,440 WELCOME, DR. GOFF. 19 00:01:09,440 --> 00:01:10,120 >>THANK YOU. 20 00:01:10,120 --> 00:01:12,240 IT'S A PLEASURE TO BE HERE. 21 00:01:12,240 --> 00:01:14,040 I WANT TO START BY THANKING ALL 22 00:01:14,040 --> 00:01:16,160 OF YOU FOR SPENDING TIME WITH US 23 00:01:16,160 --> 00:01:17,080 DURING THIS WORKSHOP. 24 00:01:17,080 --> 00:01:18,680 WE KNOW THAT THERE ARE MANY WAYS 25 00:01:18,680 --> 00:01:21,120 THAT YOU CAN BE SPENDING THIS 26 00:01:21,120 --> 00:01:21,320 TIME. 27 00:01:21,320 --> 00:01:23,440 EVERYONE IS BUSY THESE DAYS. 28 00:01:23,440 --> 00:01:25,800 WE'RE GRATEFUL ARE YOU CHOSE TO 29 00:01:25,800 --> 00:01:28,240 SPEND SOME TIME WITH US AND WITH 30 00:01:28,240 --> 00:01:29,760 EACH OTHER, TO HAVE THESE 31 00:01:29,760 --> 00:01:30,840 DISCUSSIONS AND TO PROVIDE SOME 32 00:01:30,840 --> 00:01:35,120 INPUT INTO HOW WE CAN MOVE THIS 33 00:01:35,120 --> 00:01:36,120 FIELD FORWARD. 34 00:01:36,120 --> 00:01:37,000 NEXT SLIDE PLEASE. 35 00:01:37,000 --> 00:01:40,720 I WAS ASKED TO GIVE A FEW 36 00:01:40,720 --> 00:01:43,360 THOUGHTS ABOUT THE -- HOW WE'RE 37 00:01:43,360 --> 00:01:45,280 IMPLEMENTING THE STRATEGIC 38 00:01:45,280 --> 00:01:46,400 VISION OF THE NATIONAL HEART, 39 00:01:46,400 --> 00:01:48,680 LUNG AND BLOOD INSTITUTE IN THE 40 00:01:48,680 --> 00:01:50,360 DIVISION OF CARDIOVASCULAR 41 00:01:50,360 --> 00:01:52,400 SCIENCES, HOW TOPICS YOU'RE 42 00:01:52,400 --> 00:01:54,920 DISCUSSING FEED INTO THAT 43 00:01:54,920 --> 00:01:55,440 PROCESS. 44 00:01:55,440 --> 00:01:57,120 SO I'LL START BY SAYING FIRST 45 00:01:57,120 --> 00:01:58,600 THAT THIS MATERIAL REPRESENTS MY 46 00:01:58,600 --> 00:02:00,280 OWN PERSONAL VIEWS ON THESE 47 00:02:00,280 --> 00:02:02,360 ISSUES, AND DOES NOT NECESSARILY 48 00:02:02,360 --> 00:02:04,560 REPRESENT THE OFFICIAL VIEWS OF 49 00:02:04,560 --> 00:02:05,960 NHLBI AND NIH, HHS, AND U.S. 50 00:02:05,960 --> 00:02:06,480 FEDERAL GOVERNMENT. 51 00:02:06,480 --> 00:02:07,960 WITH THAT OUT OF THE WAY, WE CAN 52 00:02:07,960 --> 00:02:17,240 MOVE TO THE NEXT SLIDE. 53 00:02:17,240 --> 00:02:19,320 NEXT SLIDE PLEASE. 54 00:02:19,320 --> 00:02:23,160 THANK YOU. 55 00:02:23,160 --> 00:02:25,240 SO, IN 2016 NHLBI SHARED ITS 56 00:02:25,240 --> 00:02:27,760 CURRENT STRATEGIC VISION WITH 57 00:02:27,760 --> 00:02:29,400 THE BIOMEDICAL RESEARCH 58 00:02:29,400 --> 00:02:29,960 COMMUNITY. 59 00:02:29,960 --> 00:02:31,480 THIS WAS CREATED IN A PROCESS 60 00:02:31,480 --> 00:02:33,440 THAT WAS HIGHLY ENGAGING WITH 61 00:02:33,440 --> 00:02:34,160 THE BIOMEDICAL RESEARCH 62 00:02:34,160 --> 00:02:34,440 COMMUNITY. 63 00:02:34,440 --> 00:02:36,360 MANY OF YOU MAY HAVE 64 00:02:36,360 --> 00:02:37,480 PARTICIPATED. 65 00:02:37,480 --> 00:02:38,680 THOUSANDS OF SCIENTISTS AROUND 66 00:02:38,680 --> 00:02:40,760 THE COUNTRY AND AROUND THE WORLD 67 00:02:40,760 --> 00:02:43,400 CONTRIBUTED TO THE CROWDSOURCING 68 00:02:43,400 --> 00:02:45,000 PLATFORM THAT RESULTED IN 69 00:02:45,000 --> 00:02:47,120 DEVELOPMENT OF THIS VISION 70 00:02:47,120 --> 00:02:51,280 DOCUMENT THAT HAS FOUR 71 00:02:51,280 --> 00:02:51,720 OVERARCHING GOALS. 72 00:02:51,720 --> 00:02:55,000 , TO UNDERSTAND HUMAN BIOLOGY, 73 00:02:55,000 --> 00:02:57,280 REDUCE HUMAN DISEASE, ADVANCE 74 00:02:57,280 --> 00:02:58,960 TRANSLATIONAL RESEARCH, AND 75 00:02:58,960 --> 00:03:02,440 DEVELOP WORKFORCE AND RESOURCES. 76 00:03:02,440 --> 00:03:05,320 AS YOU'LL SEE ON THE NEXT SLIDE 77 00:03:05,320 --> 00:03:07,680 UNDER THESE FOUR GOALS WERE 78 00:03:07,680 --> 00:03:09,000 EIGHT STRATEGIC OBJECTIVES. 79 00:03:09,000 --> 00:03:10,960 AND I WON'T LIST THEM ALL FOR 80 00:03:10,960 --> 00:03:13,160 YOU BUT I WILL POINT OUT SEVERAL 81 00:03:13,160 --> 00:03:14,560 THAT ARE PARTICULARLY PERTINENT 82 00:03:14,560 --> 00:03:17,880 TO TOPICS BEING DISCUSSED HERE. 83 00:03:17,880 --> 00:03:20,080 THAT WOULD BE OBJECTIVE 4 ABOUT 84 00:03:20,080 --> 00:03:21,600 ADVANCING PRECISION MEDICINE FOR 85 00:03:21,600 --> 00:03:25,240 HEART LUNG BLOOD AND SLEEP 86 00:03:25,240 --> 00:03:25,640 CONDITIONS. 87 00:03:25,640 --> 00:03:29,720 NUMBER 6 WHICH HAS TO DO WITH 88 00:03:29,720 --> 00:03:30,800 CLINICAL AND IMPLEMENTATION 89 00:03:30,800 --> 00:03:31,320 SCIENCE. 90 00:03:31,320 --> 00:03:33,000 AND CERTAINLY WE NEED MORE OF 91 00:03:33,000 --> 00:03:35,280 THAT IN THE AREA OF NUTRITION 92 00:03:35,280 --> 00:03:36,840 AND NUTRITION RESEARCH. 93 00:03:36,840 --> 00:03:39,480 AS WELL AS POTENTIALLY SOMEWHAT 94 00:03:39,480 --> 00:03:43,080 IN OTHER AREAS LIKE OBJECTIVE 5 95 00:03:43,080 --> 00:03:44,840 WITH NOVEL THERAPEUTICS. 96 00:03:44,840 --> 00:03:45,920 PRECISION NUTRITION IS ALSO 97 00:03:45,920 --> 00:03:48,240 RELATED TO THE CONCEPT OF 98 00:03:48,240 --> 00:03:50,480 POPULATION DIFFERENCES, WHICH IS 99 00:03:50,480 --> 00:03:51,600 RELATED TO OBJECTIVE 3. 100 00:03:51,600 --> 00:03:53,160 NOW, THE OTHER THING YOU'LL 101 00:03:53,160 --> 00:03:55,360 NOTICE ON THIS SLIDE PERHAPS IS 102 00:03:55,360 --> 00:03:58,000 THAT THESE STRATEGIC OBJECTIVES 103 00:03:58,000 --> 00:04:00,840 ARE SOMEWHAT DISEASE AGNOSTIC, 104 00:04:00,840 --> 00:04:02,880 WHICH IS PERHAPS NOT SURPRISING 105 00:04:02,880 --> 00:04:04,640 FOR AN INSTITUTE THAT COVERS A 106 00:04:04,640 --> 00:04:06,280 FAIRLY BROAD RANGE OF 107 00:04:06,280 --> 00:04:09,520 RESPONSIBILITY ACROSS HEART, 108 00:04:09,520 --> 00:04:10,560 LUNG, BLOOD, SLEEP DISORDERS. 109 00:04:10,560 --> 00:04:13,920 AND SO WHEN I GOT TO THE 110 00:04:13,920 --> 00:04:15,400 INSTITUTE IN 2016, DR. GIBBONS 111 00:04:15,400 --> 00:04:17,680 ASKED ME TO HELP LEAD OUR 112 00:04:17,680 --> 00:04:19,880 DIVISION THROUGH A PROCESS OF 113 00:04:19,880 --> 00:04:22,480 DEVELOPING A STRATEGIC VISION 114 00:04:22,480 --> 00:04:24,040 IMPLEMENTATION PLAN, BECAUSE AS 115 00:04:24,040 --> 00:04:27,560 THEY SAY A VISION WITHOUT A PLAN 116 00:04:27,560 --> 00:04:28,600 IS JUST A DREAM. 117 00:04:28,600 --> 00:04:30,040 OF COURSE A PLAN WITHOUT VISION 118 00:04:30,040 --> 00:04:31,120 IS A NIGHTMARE. 119 00:04:31,120 --> 00:04:33,800 WE HAD OUR VISION STATEMENT. 120 00:04:33,800 --> 00:04:36,120 AND EVEN UNDER THESE EIGHT 121 00:04:36,120 --> 00:04:40,680 OBJECTIVES THERE WERE WELL OVER 122 00:04:40,680 --> 00:04:41,920 100 CRITICAL QUESTIONS AND 123 00:04:41,920 --> 00:04:44,520 CHALLENGES THAT HAD BEEN 124 00:04:44,520 --> 00:04:45,440 IDENTIFIED. 125 00:04:45,440 --> 00:04:47,160 SO IF YOU WOULD LIKE SOME 126 00:04:47,160 --> 00:04:51,440 READING MATERIAL, YOU CAN GO 127 00:04:51,440 --> 00:04:52,400 ONLINE, DOWNLOAD THE STRATEGIC 128 00:04:52,400 --> 00:04:54,160 VISION DOCUMENT AND TAKE A LOOK 129 00:04:54,160 --> 00:04:55,800 AT COMPELLING QUESTIONS AND 130 00:04:55,800 --> 00:04:58,360 CRITICAL CHALLENGES. 131 00:04:58,360 --> 00:05:01,400 NEXT SLIDE PLEASE. 132 00:05:01,400 --> 00:05:03,680 SO WITHIN THE -- WE MIGHT HAVE 133 00:05:03,680 --> 00:05:09,720 SKIPPED A SLIDE. 134 00:05:09,720 --> 00:05:11,080 SOMETHING MUST HAVE GOTTEN 135 00:05:11,080 --> 00:05:11,280 HIDDEN. 136 00:05:11,280 --> 00:05:13,080 I'LL JUST MENTION WHEN WE 137 00:05:13,080 --> 00:05:14,800 STARTED THE PROCESS OF 138 00:05:14,800 --> 00:05:15,680 DEVELOPING STRATEGIC VISION 139 00:05:15,680 --> 00:05:17,960 IMPLEMENTATION PLAN, THE FIRST 140 00:05:17,960 --> 00:05:22,560 THING WE DID WAS A LANDSCAPE AS 141 00:05:22,560 --> 00:05:25,320 A COUNTRY, AND THIS SLIDE 142 00:05:25,320 --> 00:05:28,480 DEPICTS THAT AT THE TIME WE WERE 143 00:05:28,480 --> 00:05:31,440 DEVELOPING OUR IMPLEMENTATION 144 00:05:31,440 --> 00:05:33,040 PLAN BACK IN 2017. 145 00:05:33,040 --> 00:05:35,680 SO THE LEFT-HAND PANEL SHOWS 146 00:05:35,680 --> 00:05:38,960 AFTER DECADES OF DECLINE IN 147 00:05:38,960 --> 00:05:39,880 DEATH RATES FROM CORONARY 148 00:05:39,880 --> 00:05:41,680 DISEASE IN THE U.S., WE HAD 149 00:05:41,680 --> 00:05:44,560 ENTERED A PERIOD OF STAGNATION, 150 00:05:44,560 --> 00:05:45,320 BEGINNING IN ABOUT 2010. 151 00:05:45,320 --> 00:05:48,080 THIS IS HOW THE DATA LOOKED WHEN 152 00:05:48,080 --> 00:05:49,120 WE LOOKED IN 2017. 153 00:05:49,120 --> 00:05:52,800 AND EVEN IF YOU LOOK MORE 154 00:05:52,800 --> 00:05:54,160 RECENTLY, THIS STAGNATION 155 00:05:54,160 --> 00:05:54,920 CONTINUES. 156 00:05:54,920 --> 00:05:57,560 WE'RE NO LONGER SEEING PROGRESS 157 00:05:57,560 --> 00:05:59,120 OR SUBSTANTIAL REDUCTIONS IN 158 00:05:59,120 --> 00:06:01,640 DEATH RATES FROM CORONARY 159 00:06:01,640 --> 00:06:03,080 DISEASE AND HEART DISEASE IN 160 00:06:03,080 --> 00:06:03,520 GENERAL. 161 00:06:03,520 --> 00:06:05,560 IN ADDITION TO STAGNATION WE SAW 162 00:06:05,560 --> 00:06:06,560 PERSISTENT DISPARITIES. 163 00:06:06,560 --> 00:06:10,640 IN THE MIDDLE PANEL, IT SHOWS 164 00:06:10,640 --> 00:06:11,840 DISPARITIES BY RACE AND 165 00:06:11,840 --> 00:06:13,800 ETHNICITY FOR ISCHEMIC HEART 166 00:06:13,800 --> 00:06:16,200 DISEASE AND HEART FAILURE. 167 00:06:16,200 --> 00:06:18,280 THE RIGHT-HAND PANEL SHOWS 168 00:06:18,280 --> 00:06:19,920 DISPARITIES BY GEOGRAPHY IN THE 169 00:06:19,920 --> 00:06:20,080 U.S. 170 00:06:20,080 --> 00:06:24,400 AND I REAL WANT TO CALL YOUR 171 00:06:24,400 --> 00:06:27,480 ATTENTION TO THE LEGEND FOR THAT 172 00:06:27,480 --> 00:06:27,720 FIGURE. 173 00:06:27,720 --> 00:06:28,920 BECAUSE IT'S IMPORTANT TO HAVE 174 00:06:28,920 --> 00:06:31,760 AN IDEA OF HOW BIG THESE 175 00:06:31,760 --> 00:06:34,960 DIFFERENCES ARE. 176 00:06:34,960 --> 00:06:37,800 THE COUNTIES COLORED RED HAVE 177 00:06:37,800 --> 00:06:39,840 THE HIGHEST RATES OF 178 00:06:39,840 --> 00:06:40,840 AGE-ADJUSTED CARDIOVASCULAR 179 00:06:40,840 --> 00:06:41,240 MORTALITY. 180 00:06:41,240 --> 00:06:43,280 THE COUNTIES COLORED BLUE HAVE 181 00:06:43,280 --> 00:06:44,160 LOWEST RATES. 182 00:06:44,160 --> 00:06:47,760 AND OF COURSE, ONE CAN ALWAYS 183 00:06:47,760 --> 00:06:48,840 RANK COUNTIES SO THE QUESTION 184 00:06:48,840 --> 00:06:51,320 HERE IS ARE THESE DIFFERENCES 185 00:06:51,320 --> 00:06:51,800 MEANINGFUL. 186 00:06:51,800 --> 00:06:54,080 IF YOU ARE ABLE TO SEE THE 187 00:06:54,080 --> 00:06:56,840 LEGEND, DOWN AT THE BLUE END OF 188 00:06:56,840 --> 00:06:58,920 THE SPECTRUM, THE ANNUAL 189 00:06:58,920 --> 00:07:01,960 MORTALITY RATES ARE SOMEWHERE 190 00:07:01,960 --> 00:07:04,720 AROUND 100, 100,000 PEOPLE. 191 00:07:04,720 --> 00:07:06,680 THAT'S 100 PER 100,000 PEOPLE. 192 00:07:06,680 --> 00:07:09,160 AT THE HIGH END, THE COUNTIES 193 00:07:09,160 --> 00:07:11,400 THAT ARE COLORED DARK RED DEATH 194 00:07:11,400 --> 00:07:13,600 RATE IS AROUND 500 PER 100,000 195 00:07:13,600 --> 00:07:14,120 PEOPLE. 196 00:07:14,120 --> 00:07:18,600 THAT'S A RELATIVE RANGE OF 197 00:07:18,600 --> 00:07:21,240 FIVE-FOLD DIFFERENCE IN 198 00:07:21,240 --> 00:07:21,800 AGE-ADJUSTED CARDIOVASCULAR 199 00:07:21,800 --> 00:07:22,440 DISEASE MORTALITY ACROSS 200 00:07:22,440 --> 00:07:24,520 COUNTIES IN THE UNITED STATES. 201 00:07:24,520 --> 00:07:26,280 WE'RE NOT COMPARING LOW INCOME 202 00:07:26,280 --> 00:07:27,480 AND HIGH-INCOME COUNTRIES WHERE 203 00:07:27,480 --> 00:07:28,680 YOU MIGHT EXPECT TO SEE THIS 204 00:07:28,680 --> 00:07:32,280 KIND OF RANGE OF DIFFERENCE. 205 00:07:32,280 --> 00:07:33,560 BUT WE'RE SEEING THAT HERE IN 206 00:07:33,560 --> 00:07:37,320 THE U.S. ACROSS COUNTIES WITH 207 00:07:37,320 --> 00:07:39,160 STARKLY DIFFERENT MORTALITY 208 00:07:39,160 --> 00:07:39,840 RATES FOR CARDIOVASCULAR 209 00:07:39,840 --> 00:07:40,080 DISEASE. 210 00:07:40,080 --> 00:07:47,720 AND IF YOU LOOK AT OTHER 211 00:07:47,720 --> 00:07:49,360 PATTERNS, CHRONIC OBSTRUCTIVE 212 00:07:49,360 --> 00:07:52,320 PULMONARY DISEASE IS SIMILAR, 213 00:07:52,320 --> 00:07:56,120 POVERTY IS HIGHLY CORRELATED. 214 00:07:56,120 --> 00:08:00,480 WE SEE AROUND 20 AFTER DECADES 215 00:08:00,480 --> 00:08:02,680 OF PROGRESS HAD STAGNATION AND 216 00:08:02,680 --> 00:08:03,040 DISPARITIES. 217 00:08:03,040 --> 00:08:04,000 CLICK PLEASE. 218 00:08:04,000 --> 00:08:06,960 WHAT WE ADOPTED WAS A RENEWED 219 00:08:06,960 --> 00:08:09,280 COMMITMENT TO THE MISSION OF 220 00:08:09,280 --> 00:08:10,560 TURNING DISCOVERY INTO 221 00:08:10,560 --> 00:08:12,400 CARDIOVASCULAR HEALTH, WITH THE 222 00:08:12,400 --> 00:08:14,520 GOALS OF REIGNITING DECLINE IN 223 00:08:14,520 --> 00:08:17,040 CARDIOVASCULAR DISEASE MORTALITY 224 00:08:17,040 --> 00:08:19,200 FOR WHICH WE HAD STAGNATION. 225 00:08:19,200 --> 00:08:22,200 AND CLOSING THE EQUITY GAP IN 226 00:08:22,200 --> 00:08:23,720 CARDIOVASCULAR DISEASE AND 227 00:08:23,720 --> 00:08:25,120 CARDIOVASCULAR HEALTH. 228 00:08:25,120 --> 00:08:28,080 THAT WOULD DRIVE OUR STRATEGIC 229 00:08:28,080 --> 00:08:30,920 VISION IMPLEMENTATION PLAN. 230 00:08:30,920 --> 00:08:32,040 NEXT SLIDE PLEASE. 231 00:08:32,040 --> 00:08:34,120 THROUGH A PROCESS THAT ENGAGED 232 00:08:34,120 --> 00:08:36,600 EXTERNAL STAKEHOLDERS AND A LOT 233 00:08:36,600 --> 00:08:38,800 OF DISCUSSION INTERNALLY AS WELL 234 00:08:38,800 --> 00:08:41,640 WE IDENTIFIED SIX PILLARS OF OUR 235 00:08:41,640 --> 00:08:43,760 STRATEGIC VISION IMPLEMENTATION 236 00:08:43,760 --> 00:08:46,760 PLAN PUBLISHED IN CIRCULATION 237 00:08:46,760 --> 00:08:48,560 RESEARCH BACK IN 2019. 238 00:08:48,560 --> 00:08:51,600 IT'S THE FIRST SIX BULLETS IN 239 00:08:51,600 --> 00:08:53,800 THE LEFT-HAND COLUMN THAT ARE 240 00:08:53,800 --> 00:08:57,400 THE PILLARS OF THE DCDS 241 00:08:57,400 --> 00:08:58,480 STRATEGIC VISION IMPLEMENTATION 242 00:08:58,480 --> 00:09:03,400 PLAN, THE FIRST ADDRESSING 243 00:09:03,400 --> 00:09:03,960 SOCIAL DETERMINANTS OF 244 00:09:03,960 --> 00:09:08,880 CARDIOVASCULAR HEALTH AND HEALTH 245 00:09:08,880 --> 00:09:09,960 INEQUITIES, THE ROOT CAUSES OF 246 00:09:09,960 --> 00:09:13,360 CARDIOVASCULAR DISEASE AND OTHER 247 00:09:13,360 --> 00:09:14,000 CONDITIONS. 248 00:09:14,000 --> 00:09:16,120 IT'S ADDRESSING, NOT OBSERVING 249 00:09:16,120 --> 00:09:16,880 OR UNDERSTANDING. 250 00:09:16,880 --> 00:09:17,880 WE'VE BEEN DOING THAT A LONG 251 00:09:17,880 --> 00:09:18,200 TIME. 252 00:09:18,200 --> 00:09:23,120 IT'S TIME TO GET ON WITH THE 253 00:09:23,120 --> 00:09:24,640 WORK, TESTING APPROACHES TO 254 00:09:24,640 --> 00:09:26,000 IMPROVE SOCIAL DETERMINANTS OR 255 00:09:26,000 --> 00:09:28,600 MITIGATE THE IMPACT OF SOCIAL 256 00:09:28,600 --> 00:09:30,600 DETERMINANTS ON CARDIOVASCULAR 257 00:09:30,600 --> 00:09:33,080 HEALTH AND OTHER CONDITIONS. 258 00:09:33,080 --> 00:09:34,480 ENHANCING AND UNDERSTANDING 259 00:09:34,480 --> 00:09:37,120 RESILIENCE SO WE CAN LEVERAGE 260 00:09:37,120 --> 00:09:40,760 KNOWLEDGE TO HELP PEOPLE DO 261 00:09:40,760 --> 00:09:41,240 BETTER DESPITE ADVERSE 262 00:09:41,240 --> 00:09:43,400 ENVIRONMENTS WE LIVE IN. 263 00:09:43,400 --> 00:09:44,720 PROMOTING CARDIOVASCULAR HEALTH 264 00:09:44,720 --> 00:09:47,840 ACROSS THE LIFESPAN, AS THEY SAY 265 00:09:47,840 --> 00:09:51,640 FROM THE TWINKLE TO THE WRINKLE. 266 00:09:51,640 --> 00:09:53,040 ELIMINATING HYPERTENSION-RELATED 267 00:09:53,040 --> 00:09:53,560 CARDIOVASCULAR DISEASE. 268 00:09:53,560 --> 00:09:54,240 HYPERTENSION IS THE LEADING 269 00:09:54,240 --> 00:09:58,000 CAUSE OF DEATH AND DISABILITY ON 270 00:09:58,000 --> 00:10:00,360 OUR PLANET, ACCORDING TO THE 271 00:10:00,360 --> 00:10:03,000 GLOBAL BURDEN OF DISEASE 272 00:10:03,000 --> 00:10:03,280 CONSORTIUM. 273 00:10:03,280 --> 00:10:04,760 REDUCING BURDEN OF HEART 274 00:10:04,760 --> 00:10:08,800 FAILURE, WHICH IS A CHALLENGE, 275 00:10:08,800 --> 00:10:10,760 ESPECIALLY HEART FAILURE WITH 276 00:10:10,760 --> 00:10:13,840 PRESERVED EJECTION FRACTION WITH 277 00:10:13,840 --> 00:10:17,520 FEW EFFECTIVE THERAPIES AND 278 00:10:17,520 --> 00:10:19,600 PREVENTING VASCULAR DEMENTIA, 279 00:10:19,600 --> 00:10:21,040 WE'RE WOEFULLY NOT PREPARED TO 280 00:10:21,040 --> 00:10:23,200 CONFRONT IN THE COMING DECADES. 281 00:10:23,200 --> 00:10:25,640 I WOULD PROPOSE NUTRITION AND 282 00:10:25,640 --> 00:10:27,600 DIET, HEALTHY DIET, IS CRITICAL 283 00:10:27,600 --> 00:10:30,880 IN EVERY ONE OF THESE PILLARS 284 00:10:30,880 --> 00:10:33,400 THAT WE HAVE AS MAJOR AREAS OF 285 00:10:33,400 --> 00:10:39,560 FOCUS WITHIN OUR STRATEGIC 286 00:10:39,560 --> 00:10:40,560 VISION IMPLEMENTATION. 287 00:10:40,560 --> 00:10:45,800 IF I HAD MORE TIME COULD GO INTO 288 00:10:45,800 --> 00:10:46,040 DETAIL. 289 00:10:46,040 --> 00:10:47,520 WE'VE PUBLISHED AN UPDATE WITH 290 00:10:47,520 --> 00:10:49,080 IMPLEMENTATION PLAN, THAT WAS 291 00:10:49,080 --> 00:10:49,920 PUBLISHED IN CIRCULATION 292 00:10:49,920 --> 00:10:53,320 RESEARCH JUST THIS PAST YEAR. 293 00:10:53,320 --> 00:10:54,760 BOTH THOSE CITATIONS ARE ON THE 294 00:10:54,760 --> 00:10:56,480 SLIDES THAT ARE MADE AVAILABLE 295 00:10:56,480 --> 00:10:57,840 TO YOU. 296 00:10:57,840 --> 00:10:58,960 OF COURSE IN ADDITION TO WHAT 297 00:10:58,960 --> 00:11:01,640 WE'RE DOING IN THE DIVISION 298 00:11:01,640 --> 00:11:03,000 WE'RE HIGHLY ENGAGED IN THE 299 00:11:03,000 --> 00:11:05,280 STRATEGIC PRIORITIES OF THE 300 00:11:05,280 --> 00:11:08,120 INSTITUTE OVERALL. 301 00:11:08,120 --> 00:11:09,040 WHICH INCLUDE WORKFORCE 302 00:11:09,040 --> 00:11:11,280 DEVELOPMENT, PRECISION MEDICINE, 303 00:11:11,280 --> 00:11:12,840 DATA SCIENCE, HIV RESEARCH, 304 00:11:12,840 --> 00:11:15,400 CLIMATE AND HEALTH RESEARCH, AND 305 00:11:15,400 --> 00:11:20,680 COVID RESEARCH. 306 00:11:20,680 --> 00:11:23,000 NEXT SLIDE PLEASE. 307 00:11:23,000 --> 00:11:24,520 I MENTIONED NUTRITION PLAYS A 308 00:11:24,520 --> 00:11:26,080 CRITICAL ROLE IN MANY AREAS, 309 00:11:26,080 --> 00:11:28,920 WE'VE BEEN ACTIVE IN SUPPORTING 310 00:11:28,920 --> 00:11:31,000 EFFORTS IN THIS AREA. 311 00:11:31,000 --> 00:11:34,280 THIS SHOWS A COUPLE RECENT 312 00:11:34,280 --> 00:11:35,720 PUBLICATIONS THAT FOCUS ON 313 00:11:35,720 --> 00:11:37,240 RESEARCH OPPORTUNITIES IN THE 314 00:11:37,240 --> 00:11:39,000 AREAS OF NUTRITION RESEARCH 315 00:11:39,000 --> 00:11:40,960 RELEVANT FOR HEART, LUNG, BLOOD 316 00:11:40,960 --> 00:11:41,840 AND SLEEP CONDITIONS. 317 00:11:41,840 --> 00:11:44,680 IN PARTICULAR RELATED TO CONCEPT 318 00:11:44,680 --> 00:11:47,640 OF PRECISION NUTRITION RESEARCH. 319 00:11:47,640 --> 00:11:50,040 THE IDEA THAT INDIVIDUALS MAY 320 00:11:50,040 --> 00:11:51,680 DIFFER IN THEIR NUTRITIONAL 321 00:11:51,680 --> 00:11:54,280 NEEDS AND RESPONSES TO 322 00:11:54,280 --> 00:11:58,120 NUTRITIONAL INTERVENTIONS. 323 00:11:58,120 --> 00:11:59,240 NEXT SLIDE. 324 00:11:59,240 --> 00:12:00,760 I HOPE I'VE IMPRESSED UPON YOU 325 00:12:00,760 --> 00:12:02,840 CRITICAL NATURE OF THE WORK THAT 326 00:12:02,840 --> 00:12:05,720 YOU'RE DOING IN THE AREA YOU'RE 327 00:12:05,720 --> 00:12:07,320 DISCUSSING TO THESE STRATEGIC 328 00:12:07,320 --> 00:12:08,640 VISION OF THE INSTITUTE AND 329 00:12:08,640 --> 00:12:10,720 DIVISION AND TO OUR PLANS FOR 330 00:12:10,720 --> 00:12:14,320 MOVING FORWARD TO IMPLEMENT THAT 331 00:12:14,320 --> 00:12:15,680 VISION. 332 00:12:15,680 --> 00:12:18,440 YESTERDAY IN YOUR DISCUSSIONS 333 00:12:18,440 --> 00:12:23,560 YOU DISCUSSED THE CONCEPTS POOR 334 00:12:23,560 --> 00:12:24,320 SLEEP AND CIRCADIAN 335 00:12:24,320 --> 00:12:25,400 MISALIGNMENT, ASSOCIATED WITH 336 00:12:25,400 --> 00:12:27,840 RISK AND BECOMING OVERWEIGHT AND 337 00:12:27,840 --> 00:12:30,120 OBESE, THAT SLEEP LOSS 338 00:12:30,120 --> 00:12:31,640 INFLUENCES HUNGER AND APPETITE, 339 00:12:31,640 --> 00:12:35,120 AND PROMOTES FOOD INTAKE AND 340 00:12:35,120 --> 00:12:36,480 PROBABLY UNHEALTHY FOOD INTAKE. 341 00:12:36,480 --> 00:12:38,000 LATER EATING TIME AND GREATER 342 00:12:38,000 --> 00:12:40,760 CALORIC INTAKE IN THE EVENING 343 00:12:40,760 --> 00:12:42,560 CAN INCREASE RISK OF 344 00:12:42,560 --> 00:12:45,160 CARDIOMETABOLIC CONDITIONS. 345 00:12:45,160 --> 00:12:47,280 THIS REMINDS ME OF SOMETHING 346 00:12:47,280 --> 00:12:49,400 ATTRIBUTED TO I THINK ADELE 347 00:12:49,400 --> 00:12:53,760 DAVIS THAT ONE SHOULD EAT 348 00:12:53,760 --> 00:12:55,640 BREAKFAST LIKE A KING, LUNCH 349 00:12:55,640 --> 00:12:58,480 LIKE A PRINCE, DINNER LIKE A 350 00:12:58,480 --> 00:12:59,880 PAUPER. 351 00:12:59,880 --> 00:13:00,320 YOU'VE ALL HEARD THAT. 352 00:13:00,320 --> 00:13:02,680 IN THE U.S. WE HAVE OUR LARGEST 353 00:13:02,680 --> 00:13:05,920 MEAL AT THE END OF THE DAY AND 354 00:13:05,920 --> 00:13:09,720 SOME PEOPLE SKIP BREAKFAST ON 355 00:13:09,720 --> 00:13:11,800 THEIR WAY OUT THE DOOR AND DRINK 356 00:13:11,800 --> 00:13:15,440 A CUP OF COFFEE OR SOMETHING. 357 00:13:15,440 --> 00:13:16,640 SO REBALANCING OUR APPROACH TO 358 00:13:16,640 --> 00:13:21,560 FOOD OVER THE COURSE OF THE MAY 359 00:13:21,560 --> 00:13:23,320 BE HELPFUL SO CIRCADIAN TIMING 360 00:13:23,320 --> 00:13:24,960 CAN POTENTIALLY BE QUITE HELPFUL 361 00:13:24,960 --> 00:13:26,920 IN THAT RESPECT. 362 00:13:26,920 --> 00:13:27,920 AND YOU ALSO IDENTIFIED 363 00:13:27,920 --> 00:13:29,280 CHALLENGES AND OPPORTUNITIES TO 364 00:13:29,280 --> 00:13:32,280 MOVE THE WHOLE FIELD OF 365 00:13:32,280 --> 00:13:33,800 CHRONONUTRITION FURTHER INTO 366 00:13:33,800 --> 00:13:35,360 CLINICAL PRACTICE THROUGH 367 00:13:35,360 --> 00:13:36,560 TRANSLATION RESEARCH AND 368 00:13:36,560 --> 00:13:38,160 IMPLEMENTATION SCIENCE. 369 00:13:38,160 --> 00:13:39,720 I'M EXCITED ABOUT WHAT YOU'VE 370 00:13:39,720 --> 00:13:41,840 DONE, LOOKING FORWARD TO THE 371 00:13:41,840 --> 00:13:43,680 DISCUSSIONS THAT WE'LL BE HAVING 372 00:13:43,680 --> 00:13:45,360 TODAY, LOOK FORWARD TO YOUR 373 00:13:45,360 --> 00:13:45,680 INPUT. 374 00:13:45,680 --> 00:13:48,040 WE'LL TAKE IT VERY SERIOUSLY. 375 00:13:48,040 --> 00:13:52,560 IT REALLY WILL HELP DIED OUR 376 00:13:52,560 --> 00:13:53,600 STRATEGIC INITIATIVES GOING 377 00:13:53,600 --> 00:13:54,040 FORWARD. 378 00:13:54,040 --> 00:13:57,120 AND I'LL PASS THE BATON BACK TO 379 00:13:57,120 --> 00:13:57,880 THE WORKSHOP ORGANIZERS. 380 00:13:57,880 --> 00:14:02,840 THANK YOU. 381 00:14:02,840 --> 00:14:06,000 >>THANK YOU SO MUCH, DR. GOFF. 382 00:14:06,000 --> 00:14:09,560 MY NAME IS KAREN GAMBLE. 383 00:14:09,560 --> 00:14:11,920 IF YOU MISSED THE DAY 12 FROM 384 00:14:11,920 --> 00:14:14,240 YESTERDAY, I'M ONE OF THE 385 00:14:14,240 --> 00:14:18,960 CO-CHAIRS OF THE WORKSHOP ALONG 386 00:14:18,960 --> 00:14:20,440 WITH DR. MARIE-PIERRE ST-ONGE. 387 00:14:20,440 --> 00:14:22,760 I WANTED TO DO A QUICK 388 00:14:22,760 --> 00:14:24,080 FIVE-MINUTE RECAP OF WHAT WE 389 00:14:24,080 --> 00:14:25,960 LEARNED YESTERDAY. 390 00:14:25,960 --> 00:14:28,440 SO I WILL SHARE MY SLIDES VERY 391 00:14:28,440 --> 00:14:33,640 QUICKLY. 392 00:14:33,640 --> 00:14:34,840 OKAY. 393 00:14:34,840 --> 00:14:36,480 GETTING INTO OUR DAY 1 RECAP, 394 00:14:36,480 --> 00:14:38,120 THE FIRST THING WE DID 395 00:14:38,120 --> 00:14:40,200 YESTERDAY, WE HEARD A GREAT 396 00:14:40,200 --> 00:14:41,720 KEYNOTE ON STATE OF 397 00:14:41,720 --> 00:14:42,480 CHRONONUTRITION SCIENCE AND 398 00:14:42,480 --> 00:14:44,360 OPPORTUNITIES TO ADVANCE THE 399 00:14:44,360 --> 00:14:44,720 FIELD. 400 00:14:44,720 --> 00:14:46,120 AND ONE OF THE HIGHLIGHTS THAT 401 00:14:46,120 --> 00:14:48,160 WE HEARD ABOUT IS THE IMPORTANCE 402 00:14:48,160 --> 00:14:50,040 OF FOOD TIMING ASSESSMENT ACROSS 403 00:14:50,040 --> 00:14:51,600 ALL COHORT STUDIES EVEN ON 404 00:14:51,600 --> 00:14:52,680 CIRCADIAN STUDIES. 405 00:14:52,680 --> 00:14:54,760 I'M NOT GOING TO DELVE INTO 406 00:14:54,760 --> 00:14:56,520 THESE BULLET POINTS BECAUSE WE 407 00:14:56,520 --> 00:14:57,400 WILL SHOW THESE POINTS AGAIN 408 00:14:57,400 --> 00:15:01,880 LATER IN THE DAY WHEN WE 409 00:15:01,880 --> 00:15:02,880 SYNTHESIZE ALL THE INFORMATION 410 00:15:02,880 --> 00:15:04,640 FROM YESTERDAY AND TODAY. 411 00:15:04,640 --> 00:15:05,760 SO BEAR WITH ME. 412 00:15:05,760 --> 00:15:06,920 THERE MAY BE A LOT OF 413 00:15:06,920 --> 00:15:08,280 INFORMATION ON THIS SLIDE BUT 414 00:15:08,280 --> 00:15:12,080 YOU'LL HAVE ACCESS TO IT LATER. 415 00:15:12,080 --> 00:15:14,280 SECONDLY, WE LEARNED ABOUT THE 416 00:15:14,280 --> 00:15:17,200 IMPORTANCE AND OPPORTUNITIES FOR 417 00:15:17,200 --> 00:15:18,520 HAVING THIS MULTI-DIMENSIONAL 418 00:15:18,520 --> 00:15:20,720 CIRCADIAN SCORE, LOOKING AT 419 00:15:20,720 --> 00:15:22,360 ENDPOINTS AND BIOMARKERS. 420 00:15:22,360 --> 00:15:24,160 AND ALONG WITH THAT, IT'S 421 00:15:24,160 --> 00:15:26,240 IMPORTANT TO CONSIDER GENETICS. 422 00:15:26,240 --> 00:15:29,360 THERE ARE A LOT OF 423 00:15:29,360 --> 00:15:29,960 CIRCADIAN-RELATED GENES AND 424 00:15:29,960 --> 00:15:30,800 POLYMORPHISMS THAT NEED TO BE 425 00:15:30,800 --> 00:15:35,080 TAKEN INTO CONSIDERATION WITH 426 00:15:35,080 --> 00:15:36,600 RESPECT TO FOOD TIMING. 427 00:15:36,600 --> 00:15:38,440 NEXT WE STARTED OUR FIRST 428 00:15:38,440 --> 00:15:40,960 SESSION ON THE BASIC 429 00:15:40,960 --> 00:15:42,280 TRANSLATIONAL RESEARCH. 430 00:15:42,280 --> 00:15:43,880 WE DISCUSSED IMPORTANT POINTS 431 00:15:43,880 --> 00:15:46,560 SUCH AS DIFFERENCE BETWEEN 432 00:15:46,560 --> 00:15:47,720 EFFECTS ON PERIPHERAL CLOCKS 433 00:15:47,720 --> 00:15:50,480 VERSUS LACK OF EFFECT OR LACK OF 434 00:15:50,480 --> 00:15:52,880 LARGER EFFECT ON CENTRAL CLOCK. 435 00:15:52,880 --> 00:15:54,720 AND WE ALSO DISCUSSED CERTAIN 436 00:15:54,720 --> 00:15:57,480 RISK FACTORS FOR OBESITY AND 437 00:15:57,480 --> 00:15:59,760 DIABETES, INCLUDING SLEEP AND 438 00:15:59,760 --> 00:16:00,760 CIRCADIAN DISRUPTION. 439 00:16:00,760 --> 00:16:03,280 WE TALKED ABOUT HOW INSUFFICIENT 440 00:16:03,280 --> 00:16:04,800 SLEEP OR SLEEP RESTRICTION CAN 441 00:16:04,800 --> 00:16:08,840 AFFECT A LOT OF METABOLIC 442 00:16:08,840 --> 00:16:10,280 PATHWAYS AFFECTED BY MEAL 443 00:16:10,280 --> 00:16:10,840 TIMING. 444 00:16:10,840 --> 00:16:13,560 FINALLY WE TALKED ABOUT 445 00:16:13,560 --> 00:16:16,960 OPPORTUNITIES FOR 446 00:16:16,960 --> 00:16:22,200 COUNTER-MEASURES TO SORT OF 447 00:16:22,200 --> 00:16:24,080 REAMELIORATE CIRCADIAN 448 00:16:24,080 --> 00:16:25,400 MISALIGNMENT BY IMPROPERLY 449 00:16:25,400 --> 00:16:26,720 RESTRICTED TIME RESTRICTED 450 00:16:26,720 --> 00:16:28,920 EATING AND IMPORTANT ECOLOGICAL 451 00:16:28,920 --> 00:16:31,080 STUDIES IN THE FUTURE IN ORDER 452 00:16:31,080 --> 00:16:32,720 TO ADDRESS THIS INCREASE IN 453 00:16:32,720 --> 00:16:34,280 PREVALENCE OF OBESITY THAT YOU 454 00:16:34,280 --> 00:16:36,680 JUST HEARD DR. GOFF TALK ABOUT. 455 00:16:36,680 --> 00:16:40,400 AND THEN WE NEED MORE STUDIES 456 00:16:40,400 --> 00:16:42,240 LOOKING AT UNDERLYING MECHANISMS 457 00:16:42,240 --> 00:16:47,320 FOR HOW SLEEP RESTRICTION IS 458 00:16:47,320 --> 00:16:49,520 LINKED TO CALORIC INTAKE. 459 00:16:49,520 --> 00:16:52,040 FINALLY, IN SESSION 1 WE TALKED 460 00:16:52,040 --> 00:16:53,000 ABOUT IMPORTANCE OF EXERCISE, 461 00:16:53,000 --> 00:16:56,200 SINCE THE MUSCLE IS AN IMPORTANT 462 00:16:56,200 --> 00:16:57,960 METABOLIC REGULATOR IN OUR 463 00:16:57,960 --> 00:17:01,680 BODIES, AND EXERCISE AND THE 464 00:17:01,680 --> 00:17:04,000 MUSCLES ARE ALSO VERY ATTUNED TO 465 00:17:04,000 --> 00:17:10,640 THE TIMING OF FOOD INTAKE AND 466 00:17:10,640 --> 00:17:10,920 NUTRITION. 467 00:17:10,920 --> 00:17:12,840 ON SESSION 2, MEAL TIMING, 468 00:17:12,840 --> 00:17:16,120 EATING PATTERNS AND HUMAN HEALTH 469 00:17:16,120 --> 00:17:19,080 OUTCOMES, WE TALKED ABOUT HOW 470 00:17:19,080 --> 00:17:21,880 THIS IDEA A CALORIE IS A CALORIE 471 00:17:21,880 --> 00:17:24,680 IS PROBABLY NOT CORRECT AND 472 00:17:24,680 --> 00:17:25,640 MACRONUTRIENTS AND TIMING ARE 473 00:17:25,640 --> 00:17:26,880 REALLY IMPORTANT. 474 00:17:26,880 --> 00:17:30,920 WE TALKED ABOUT HOW IN THE FIELD 475 00:17:30,920 --> 00:17:32,880 THERE'S BEEN AN INCREASE IN 476 00:17:32,880 --> 00:17:35,480 INTEREST IN THIS TOPIC AREA. 477 00:17:35,480 --> 00:17:39,360 AS MORE PEOPLE ARE JUMPING IN TO 478 00:17:39,360 --> 00:17:41,760 FIGURE OUT DIRECTIONS AND 479 00:17:41,760 --> 00:17:42,680 UNDERLYING IMPLICATIONS, WE'VE 480 00:17:42,680 --> 00:17:44,800 GOTTEN SORT OF A LOT OF VARIETY 481 00:17:44,800 --> 00:17:47,560 OF DIFFERENT DEFINITIONS AND 482 00:17:47,560 --> 00:17:48,840 TERMINOLOGY AND NEED TO DEFINE 483 00:17:48,840 --> 00:17:49,400 THINGS BETTER. 484 00:17:49,400 --> 00:17:50,840 THERE'S SORT OF A WHOLE LIST OF 485 00:17:50,840 --> 00:17:54,000 THINGS THAT WE CAN DO BETTER IN 486 00:17:54,000 --> 00:17:54,760 THIS AREA. 487 00:17:54,760 --> 00:17:56,040 FINALLY IT'S IMPORTANT TO 488 00:17:56,040 --> 00:17:56,840 CONSIDER INTERACTIONS BECAUSE AT 489 00:17:56,840 --> 00:18:00,000 THE END OF THE DAY THIS IS A 490 00:18:00,000 --> 00:18:00,520 MULTI-DISCIPLINARY FIELD. 491 00:18:00,520 --> 00:18:03,280 THERE'S A LOT OF CROSS-TALK 492 00:18:03,280 --> 00:18:06,680 BETWEEN ORGAN SYSTEMS AND THAT 493 00:18:06,680 --> 00:18:10,840 IS DUE TO FACTORS INTRINSIC AND 494 00:18:10,840 --> 00:18:13,040 BIOLOGICAL, TO THINGS OUTSIDE 495 00:18:13,040 --> 00:18:15,360 THAT ARE EITHER ENVIRONMENTAL OR 496 00:18:15,360 --> 00:18:17,400 BEHAVIORAL, AND THERE ARE ALSO 497 00:18:17,400 --> 00:18:21,000 INTERACTIONS WITH THINGS LIKE 498 00:18:21,000 --> 00:18:23,000 OTHER DRUGS AND 499 00:18:23,000 --> 00:18:23,640 PHARMACODYNAMICS. 500 00:18:23,640 --> 00:18:25,320 FINALLY WE SHOULD CONTINUE THAT 501 00:18:25,320 --> 00:18:28,480 MAYBE THE VARIABILITY THAT WE 502 00:18:28,480 --> 00:18:29,680 SEE IN MEAL TIMING MAY BE 503 00:18:29,680 --> 00:18:31,560 IMPORTANT TO CONSIDER AND MEAL 504 00:18:31,560 --> 00:18:35,480 TIMING REGULARITY IS REALLY 505 00:18:35,480 --> 00:18:35,880 IMPORTANT. 506 00:18:35,880 --> 00:18:37,920 SO, THAT WRAPS UP FROM SESSION 1 507 00:18:37,920 --> 00:18:39,000 AND 2, KEYNOTE FROM DAY 1. 508 00:18:39,000 --> 00:18:40,640 WE LEARNED A LOT. 509 00:18:40,640 --> 00:18:42,320 WE'RE REALLY EXCITED TO MOVE ON 510 00:18:42,320 --> 00:18:45,680 TO DAY 2. 511 00:18:45,680 --> 00:18:47,840 SO I'M GOING TO TURN IT OVER TO 512 00:18:47,840 --> 00:18:51,160 MY CO-CHAIR TO INTRODUCE OUR 513 00:18:51,160 --> 00:18:51,720 NEXT SPEAKER. 514 00:18:51,720 --> 00:18:53,560 >>THANK YOU, KAREN, FOR THE 515 00:18:53,560 --> 00:18:55,840 GREAT OVERVIEW OF YESTERDAY'S 516 00:18:55,840 --> 00:18:56,200 SESSION. 517 00:18:56,200 --> 00:18:58,920 IT'S MY PLEASURE TO INTRODUCE 518 00:18:58,920 --> 00:19:01,040 OUR NEXT FEW SPEAKERS, TALKING 519 00:19:01,040 --> 00:19:05,480 ON RESEARCH RESEARCH PRIORITIEM 520 00:19:05,480 --> 00:19:08,480 FEDERAL PARTNERS. 521 00:19:08,480 --> 00:19:12,040 DR. CHRISTOPHER LYNCH COMPLETED 522 00:19:12,040 --> 00:19:22,440 HIS PhD at northwestern, 523 00:19:22,880 --> 00:19:25,560 during his tenure at Penn State 524 00:19:25,560 --> 00:19:27,960 he co-chaired the nutrition task 525 00:19:27,960 --> 00:19:38,320 force for curriculum. 526 00:19:46,520 --> 00:19:47,560 HE SERVED AS EXECUTIVE SECRETARY 527 00:19:47,560 --> 00:19:49,120 OF THE RESEARCH TASK FORCE, 528 00:19:49,120 --> 00:19:51,400 WHICH DEVELOPED THE FIRST EVER 529 00:19:51,400 --> 00:19:55,240 STRATEGIC PLAN FOR NIH NUTRITION 530 00:19:55,240 --> 00:19:57,640 RESEARCH AND SET UP 7 WORK 531 00:19:57,640 --> 00:20:01,400 GROUPS TO GUIDE IMPLEMENTATION. 532 00:20:01,400 --> 00:20:03,440 HE LED EFFORTS TO DEVELOP A 533 00:20:03,440 --> 00:20:05,840 COMMON FUND PROJECT IN 2020, 534 00:20:05,840 --> 00:20:07,200 NUTRITION FOR PRECISION HEALTH, 535 00:20:07,200 --> 00:20:09,800 POWERED BY THE "ALL OF US" 536 00:20:09,800 --> 00:20:10,840 PROGRAM, THE FIRST ANCILLARY 537 00:20:10,840 --> 00:20:14,400 STUDY NESTED IN "ALL OF US." 538 00:20:14,400 --> 00:20:16,800 IN 2021, DR. LYNCH WAS APPOINTED 539 00:20:16,800 --> 00:20:18,680 BY FRANCIS COLLINS AS THE ACTING 540 00:20:18,680 --> 00:20:21,160 DIRECTOR OF NIH OFFICE OF 541 00:20:21,160 --> 00:20:22,080 NUTRITION RESEARCH, AND WE'RE 542 00:20:22,080 --> 00:20:25,120 VERY HAPPY TO HAVE HIM SPEAK 543 00:20:25,120 --> 00:20:28,320 TODAY ABOUT THE OFFICE OF 544 00:20:28,320 --> 00:20:31,640 NUTRITION RESEARCH STRATEGIC FOR 545 00:20:31,640 --> 00:20:33,480 NUTRITION RESEARCH. 546 00:20:33,480 --> 00:20:34,440 >>THANKS VERY MUCH. 547 00:20:34,440 --> 00:20:36,000 DO YOU HAVE MY SLIDES? 548 00:20:36,000 --> 00:20:45,400 DO YOU WANT ME TO SHARE THEM? 549 00:20:45,400 --> 00:20:46,280 VERY GOOD. 550 00:20:46,280 --> 00:20:49,880 YEAH, I'M GOING TO TALK ABOUT 551 00:20:49,880 --> 00:20:53,280 THE NIH OFFICE OF NUTRITION 552 00:20:53,280 --> 00:20:55,240 RESEARCH AND STRATEGIC PLAN FOR 553 00:20:55,240 --> 00:21:00,600 NIH NUTRITION RESEARCH AND I 554 00:21:00,600 --> 00:21:02,040 APPRECIATE THE ORGANIZERS FOR 555 00:21:02,040 --> 00:21:06,400 INVITING ME. 556 00:21:06,400 --> 00:21:07,600 NEXT SLIDE. 557 00:21:07,600 --> 00:21:11,240 SO AS MARIE MENTIONED, OUR 558 00:21:11,240 --> 00:21:17,880 OFFICE WAS A NEW OFFICE, 559 00:21:17,880 --> 00:21:19,320 NUTRITION RESEARCH, TO PROMOTE 560 00:21:19,320 --> 00:21:22,760 HEALTH, AND TO REDUCE BURDEN OF 561 00:21:22,760 --> 00:21:24,840 DIET-RELATED DISEASES AND 562 00:21:24,840 --> 00:21:28,640 NUTRITION HEALTH DISPARITIES. 563 00:21:28,640 --> 00:21:32,560 NEXT SLIDE. 564 00:21:32,560 --> 00:21:37,200 AS SHE MENTIONED, WE 565 00:21:37,200 --> 00:21:37,840 COLLABORATIVELY DEVELOPED A 566 00:21:37,840 --> 00:21:43,200 TRANS-NIH STRATEGIC PLAN FOR NIH 567 00:21:43,200 --> 00:21:47,280 NUTRITION RESEARCH, WHICH HAS A 568 00:21:47,280 --> 00:21:49,160 UNIFYING VISION OF PRECISION 569 00:21:49,160 --> 00:21:49,440 NUTRITION. 570 00:21:49,440 --> 00:21:51,880 ONE CLICK AND IT WILL SHIFT THAT 571 00:21:51,880 --> 00:21:52,840 BOOK COVER OVER. 572 00:21:52,840 --> 00:21:56,120 THANK YOU. 573 00:21:56,120 --> 00:22:00,840 AND SO IT HAS FOUR STRATEGIC 574 00:22:00,840 --> 00:22:01,240 OBJECTIVES. 575 00:22:01,240 --> 00:22:08,360 FIRST IS DISCOVERY AND INVASION 576 00:22:08,360 --> 00:22:10,000 THROUGH RESEARCH, WHAT DO WE EAT 577 00:22:10,000 --> 00:22:11,640 AND HOW DOES IT AFFECT US? 578 00:22:11,640 --> 00:22:15,040 THE SECOND ONE THAT HAS THE 579 00:22:15,040 --> 00:22:16,840 FOCUS IN THE CHRONONUTRITION 580 00:22:16,840 --> 00:22:18,640 AREA, THAT'S TO INVESTIGATE THE 581 00:22:18,640 --> 00:22:21,280 ROLE OF DIETARY PATTERNS AND 582 00:22:21,280 --> 00:22:25,560 BEHAVIORS FOR OPTIMAL HEALTH, 583 00:22:25,560 --> 00:22:28,840 WHAT AND WHEN SHOULD WE EAT? 584 00:22:28,840 --> 00:22:31,160 SO THIS PART OF THE PLAN, YOU 585 00:22:31,160 --> 00:22:33,880 KNOW, LOOKS AT NOT ONLY 586 00:22:33,880 --> 00:22:34,840 FOOD-BASED DIETARY PATTERNS BUT 587 00:22:34,840 --> 00:22:37,080 ALSO OTHER KINDS OF DIETARY 588 00:22:37,080 --> 00:22:38,800 PATTERNS SUCH AS WHEN WE EAT AND 589 00:22:38,800 --> 00:22:42,160 WHO WE EAT WITH, AND THOSE KINDS 590 00:22:42,160 --> 00:22:44,880 OF BEHAVIORS. 591 00:22:44,880 --> 00:22:47,200 WE HAVE ANOTHER ONE ON DEFINING 592 00:22:47,200 --> 00:22:50,120 ROLE OF NUTRITION ACROSS THE 593 00:22:50,120 --> 00:22:50,600 LIFESPAN. 594 00:22:50,600 --> 00:22:52,760 AND THEN A FOURTH ONE ON 595 00:22:52,760 --> 00:22:55,920 REDUCING THE BURDEN OF DISEASE 596 00:22:55,920 --> 00:22:57,480 IN CLINICAL SETTINGS, HOW CAN WE 597 00:22:57,480 --> 00:22:59,760 IMPROVE THE USE OF FOOD AS 598 00:22:59,760 --> 00:23:02,280 MEDICINE, WHICH IS A VERY 599 00:23:02,280 --> 00:23:03,160 POPULAR TOPIC RECENTLY. 600 00:23:03,160 --> 00:23:07,440 AND CAN I HAVE THE NEXT SLIDE. 601 00:23:07,440 --> 00:23:09,840 WE HAVE A NUMBER OF 602 00:23:09,840 --> 00:23:10,600 CROSS-CUTTING RESEARCH AREAS, 603 00:23:10,600 --> 00:23:12,760 MINORITY HEALTH AND HEALTH 604 00:23:12,760 --> 00:23:15,120 DISPARITIES, HEALTH OF WOMEN, 605 00:23:15,120 --> 00:23:17,480 RIGOR AND REPRODUCIBILITY, DATA 606 00:23:17,480 --> 00:23:19,160 SCIENCE, SYSTEM SCIENCE, AND 607 00:23:19,160 --> 00:23:21,400 ARTIFICIAL INTELLIGENCE. 608 00:23:21,400 --> 00:23:25,480 AND THEN TRAINING THE SCIENTIFIC 609 00:23:25,480 --> 00:23:26,240 WORKFORCE. 610 00:23:26,240 --> 00:23:27,560 NEXT SLIDE PLEASE. 611 00:23:27,560 --> 00:23:30,640 TO CARRY OUT THIS STRATEGIC PLAN 612 00:23:30,640 --> 00:23:35,320 WE ORIGINALLY STOOD UP SEVEN 613 00:23:35,320 --> 00:23:36,680 IMPLEMENTATION WORKING GROUPS 614 00:23:36,680 --> 00:23:40,600 THAT FOCUSED ON DIFFERENT TOPIC 615 00:23:40,600 --> 00:23:41,040 AREAS. 616 00:23:41,040 --> 00:23:43,880 CAN YOU JUST DO ONE CLICK FOR ME 617 00:23:43,880 --> 00:23:44,120 PLEASE. 618 00:23:44,120 --> 00:23:47,160 AND WE RECENTLY STOOD UP ANOTHER 619 00:23:47,160 --> 00:23:50,600 ONE ON INCREASING DIVERSITY, 620 00:23:50,600 --> 00:23:51,440 EQUITY, INCLUSION, AND 621 00:23:51,440 --> 00:23:54,040 ACCESSIBILITY IN THE NUTRITION 622 00:23:54,040 --> 00:23:55,200 WORKFORCE, BOTH NUTRITION 623 00:23:55,200 --> 00:23:58,480 SCIENCE WORKFORCE, ALSO IN THE 624 00:23:58,480 --> 00:24:02,840 AREA OF, YOU KNOW, THE OTHER 625 00:24:02,840 --> 00:24:08,440 PARTS OF THE NUTRITION 626 00:24:08,440 --> 00:24:08,760 PROFESSIONALS. 627 00:24:08,760 --> 00:24:09,200 NEXT SLIDE. 628 00:24:09,200 --> 00:24:11,520 AND SO I'M GOING TO TALK IN THE 629 00:24:11,520 --> 00:24:13,480 NEXT FEW SLIDES ABOUT SOME OF 630 00:24:13,480 --> 00:24:15,320 THE THINGS THAT WE ARE -- OUR 631 00:24:15,320 --> 00:24:19,800 OFFICE IS WORKING ON. 632 00:24:19,800 --> 00:24:24,600 OUR OFFICE WORKS WITH THE OTHER 633 00:24:24,600 --> 00:24:27,000 INSTITUTES AND OFFICES TO 634 00:24:27,000 --> 00:24:28,400 DEVELOP RESEARCH PROGRAMS, AND 635 00:24:28,400 --> 00:24:33,160 THE FIRST ONE I THINK DOES HAVE 636 00:24:33,160 --> 00:24:34,600 AN OPPORTUNITY FOR 637 00:24:34,600 --> 00:24:34,960 CHRONONUTRITION. 638 00:24:34,960 --> 00:24:36,360 THE GOAL IS NUTRITION FOR 639 00:24:36,360 --> 00:24:37,520 PRECISION HEALTH POWERED BY THE 640 00:24:37,520 --> 00:24:40,920 "ALL OF US" RESEARCH PROGRAM. 641 00:24:40,920 --> 00:24:45,400 AND SO THE GOAL OF THIS IS TO 642 00:24:45,400 --> 00:24:46,400 DEVELOP ALGORITHMS TO PREDICT 643 00:24:46,400 --> 00:24:50,560 INDIVIDUAL RESPONSES TO FOODS 644 00:24:50,560 --> 00:24:52,880 AND DIETARY PATTERNS USING 645 00:24:52,880 --> 00:24:55,960 COMPREHENSIVE SET OF MICROBIOME, 646 00:24:55,960 --> 00:24:58,600 GENOMIC, PHYSIOLOGIC, METABOLIC, 647 00:24:58,600 --> 00:25:00,920 BEHAVIORAL, COGNITIVE, 648 00:25:00,920 --> 00:25:02,200 CONTEXTUAL EHR SURVEY, 649 00:25:02,200 --> 00:25:05,200 ENVIRONMENTAL DATA, LARGE AND 650 00:25:05,200 --> 00:25:07,440 DIVERSE POPULATION OF 651 00:25:07,440 --> 00:25:09,000 PARTICIPANTS. 652 00:25:09,000 --> 00:25:11,960 CURRENTLY THIS PROGRAM RECENTLY 653 00:25:11,960 --> 00:25:15,680 LAUNCHED, AND WE'RE AIMING TO 654 00:25:15,680 --> 00:25:19,160 RECRUIT 10,000 PARTICIPANTS INTO 655 00:25:19,160 --> 00:25:19,400 IT. 656 00:25:19,400 --> 00:25:21,480 BUT ONE OF THE AREAS OF FOCUS 657 00:25:21,480 --> 00:25:27,200 FOR THIS WILL BE SLEEP. 658 00:25:27,200 --> 00:25:28,480 SLEEP AND NUTRITION. 659 00:25:28,480 --> 00:25:34,280 WE'LL BE DOING A CAREFUL DIETARY 660 00:25:34,280 --> 00:25:36,680 ASSESSMENT, WHEN PEOPLE EAT, 661 00:25:36,680 --> 00:25:40,440 ALSO HAVING A LOT OF RECORDINGS 662 00:25:40,440 --> 00:25:43,160 OF PEOPLE'S SLEEP PATTERNS. 663 00:25:43,160 --> 00:25:45,560 NOW, THE -- REALLY THE NICE 664 00:25:45,560 --> 00:25:46,880 THING ABOUT THIS STUDY, ABOUT 665 00:25:46,880 --> 00:25:49,280 THE "ALL OF US" RESEARCH 666 00:25:49,280 --> 00:25:52,240 PROGRAM, IS THEY NOT ONLY 667 00:25:52,240 --> 00:25:55,960 DEVELOP PLANS TO RELEASE THEIR 668 00:25:55,960 --> 00:25:58,480 DATA TO THEIR PARTICIPANTS, BUT 669 00:25:58,480 --> 00:26:00,880 THE DATA IS OPEN ACCESS TO 670 00:26:00,880 --> 00:26:01,880 ALMOST ANYBODY. 671 00:26:01,880 --> 00:26:05,040 YOU JUST HAVE TO APPLY, FILL OUT 672 00:26:05,040 --> 00:26:09,640 A FORM TO USE THE DATA. 673 00:26:09,640 --> 00:26:14,840 BUT, YOU KNOW, YOU CAN GO THERE 674 00:26:14,840 --> 00:26:19,720 NOW, THEY JUST RELEASED I THINK 675 00:26:19,720 --> 00:26:23,120 ABOUT AT LEAST, YOU KNOW, MANY 676 00:26:23,120 --> 00:26:24,360 THOUSANDS OF GENETIC RECORDS, 677 00:26:24,360 --> 00:26:27,400 AND JUST GO THROUGH AND LOOK FOR 678 00:26:27,400 --> 00:26:28,880 YOUR FAVORITE GENE OR SNP THAT'S 679 00:26:28,880 --> 00:26:30,920 IN THERE AND YOU CAN SEE HOW 680 00:26:30,920 --> 00:26:35,120 FREQUENT IT IS IN THE 681 00:26:35,120 --> 00:26:35,400 POPULATION. 682 00:26:35,400 --> 00:26:37,120 SO THE GREAT THING FOR US IN 683 00:26:37,120 --> 00:26:38,160 GETTING INVOLVED WITH "ALL OF 684 00:26:38,160 --> 00:26:44,440 US" IS THEY WERE ALREADY DOING 685 00:26:44,440 --> 00:26:45,840 COMPLETE GENOMIC SEQUENCING ON 686 00:26:45,840 --> 00:26:47,920 ALL PARTICIPANTS, A GREAT THING 687 00:26:47,920 --> 00:26:49,680 FOR US. 688 00:26:49,680 --> 00:26:51,080 THEY ARE -- WE ALREADY HAD 689 00:26:51,080 --> 00:26:53,880 ACCESS TO A LOT OF OTHER SURVEY 690 00:26:53,880 --> 00:26:56,600 DATA THAT THEY HAD ALREADY 691 00:26:56,600 --> 00:26:59,520 PERFORMED, AND THEY HAVE A 692 00:26:59,520 --> 00:27:01,520 LIVE -- MORE OR LESS LIVE 693 00:27:01,520 --> 00:27:02,840 ELECTRONIC HEALTH RECORDS 694 00:27:02,840 --> 00:27:05,240 UPDATED THREE TIMES A YEAR. 695 00:27:05,240 --> 00:27:08,160 IT DOESN'T MATTER WHAT EHR 696 00:27:08,160 --> 00:27:12,680 SYSTEM YOU'RE IN. 697 00:27:12,680 --> 00:27:14,800 THEY ARE WORKING WITH SOME -- 698 00:27:14,800 --> 00:27:16,400 WITH ANOTHER TRANSACTIONAL 699 00:27:16,400 --> 00:27:19,040 AUTHORITY WITH A GROUP THAT'S 700 00:27:19,040 --> 00:27:21,640 SORT OF HARMONIZING THE 701 00:27:21,640 --> 00:27:23,080 ELECTRONIC MEDICAL RECORDS 702 00:27:23,080 --> 00:27:29,200 BETWEEN DIFFERENT PLATFORMS SO 703 00:27:29,200 --> 00:27:34,480 THAT THEY CAN BE A.I.-ABLE, SO 704 00:27:34,480 --> 00:27:37,560 WE CAN EASILY ANALYZE THEM. 705 00:27:37,560 --> 00:27:41,160 THIS NPH STUDY IS MODULAR STUDY, 706 00:27:41,160 --> 00:27:43,920 THE FIRST PART WILL EXAMINE 707 00:27:43,920 --> 00:27:44,800 BASELINE DIET AND PHYSIOLOGIC 708 00:27:44,800 --> 00:27:46,320 RESPONSE TO MEAL CHALLENGES. 709 00:27:46,320 --> 00:27:48,160 WE'LL BE RECORDING SLEEP AND 710 00:27:48,160 --> 00:27:53,200 TIME OF DAY FOOD IS CONSUMED, 711 00:27:53,200 --> 00:27:53,480 INCLUDED. 712 00:27:53,480 --> 00:27:56,480 ALL THE PEOPLE WILL GET A MIXED 713 00:27:56,480 --> 00:27:59,880 MEAL TOLERANCE TEST AT THE END 714 00:27:59,880 --> 00:28:03,160 WITH REPEATED BLOOD SAMPLES 715 00:28:03,160 --> 00:28:03,520 BEING COLLECTED. 716 00:28:03,520 --> 00:28:04,600 BUT WE'LL HAVE A LOT OF THIS 717 00:28:04,600 --> 00:28:05,920 OTHER DATA. 718 00:28:05,920 --> 00:28:06,960 THESE PEOPLE ARE ALREADY 719 00:28:06,960 --> 00:28:09,440 ENROLLED IN "ALL OF US" SO WE'LL 720 00:28:09,440 --> 00:28:12,080 HAVE ELECTRONIC HEALTH RECORD 721 00:28:12,080 --> 00:28:15,000 DATA ON ALL OF THEM. 722 00:28:15,000 --> 00:28:17,120 THEN THE PEOPLE CAN EITHER LEAVE 723 00:28:17,120 --> 00:28:23,000 THE STUDY AT THAT POINT OR ENTER 724 00:28:23,000 --> 00:28:29,360 MODULE 2 OR MODULE 3, IN BOTH OF 725 00:28:29,360 --> 00:28:32,000 THOSE MODULES WE'LL BE EXAMINING 726 00:28:32,000 --> 00:28:37,120 RESPONSES TO THREE SHORT-TERM, 727 00:28:37,120 --> 00:28:42,400 THE LENGTH TIMED TO ALLOW 728 00:28:42,400 --> 00:28:45,160 CHANGES IN THE BETA DIVERSITY OF 729 00:28:45,160 --> 00:28:46,320 MICROBIOME WITH WASHOUT PERIODS, 730 00:28:46,320 --> 00:28:47,760 PRESENTED WITH ANOTHER CHALLENGE 731 00:28:47,760 --> 00:28:49,800 DIET AND ANOTHER CHALLENGE DIET. 732 00:28:49,800 --> 00:28:51,920 AND EACH TIME THEY WILL BE 733 00:28:51,920 --> 00:28:53,240 GETTING A MIXED MEAL TOLERANCE 734 00:28:53,240 --> 00:28:54,320 TEST AT THE END. 735 00:28:54,320 --> 00:28:58,360 SOME OF THIS WILL BE DONE IN 736 00:28:58,360 --> 00:28:59,640 FREE LIVING CONTROL EATING 737 00:28:59,640 --> 00:29:02,640 STUDIES WHERE THEY WILL COME IN 738 00:29:02,640 --> 00:29:03,960 AND MAYBE HAVE BREAKFAST AND 739 00:29:03,960 --> 00:29:06,800 LUNCH ON SITE. 740 00:29:06,800 --> 00:29:10,400 AND THEN PACK THEM OUT THEIR 741 00:29:10,400 --> 00:29:12,480 DINNER OR MEALS FOR THE WEEKEND. 742 00:29:12,480 --> 00:29:15,640 AND THEN THE OTHER PART WILL BE 743 00:29:15,640 --> 00:29:18,560 DONE IN A DOMICILED FEEDING 744 00:29:18,560 --> 00:29:21,120 CENTERS, WHERE WE'LL BE ABLE TO 745 00:29:21,120 --> 00:29:25,400 DO HIGHER LEVEL OF INTERVENTION 746 00:29:25,400 --> 00:29:26,680 SUCH AS 24-HOUR URINE AND THINGS 747 00:29:26,680 --> 00:29:28,680 LIKE THAT. 748 00:29:28,680 --> 00:29:32,040 WE HAVE TWO GROUPS USING MACHINE 749 00:29:32,040 --> 00:29:33,600 LEARNING AND ARTIFICIAL 750 00:29:33,600 --> 00:29:35,040 INTELLIGENCE TO DEVELOP 751 00:29:35,040 --> 00:29:36,240 PREDICTIVE ALGORITHMS AND 752 00:29:36,240 --> 00:29:38,960 ADDRESS OTHER QUESTIONS THAT THE 753 00:29:38,960 --> 00:29:41,040 CONSORTIUM COMES UP WITH. 754 00:29:41,040 --> 00:29:46,400 AGAIN, THIS DATA IS GOING TO BE 755 00:29:46,400 --> 00:29:51,880 FAIRLY AVAILABLE IF NOT OWNED BY 756 00:29:51,880 --> 00:29:55,600 THE CONSORTIUM, IN THE 757 00:29:55,600 --> 00:29:58,360 RESEARCHER'S WORKBENCH AT "ALL 758 00:29:58,360 --> 00:30:02,800 OF US" FOR PEOPLE TO STUDY BUT 759 00:30:02,800 --> 00:30:04,680 DOES REQUIRE, THEY HAVE A 760 00:30:04,680 --> 00:30:06,440 PLATFORM THAT MAKES SOME DATA 761 00:30:06,440 --> 00:30:08,960 VERY EASY TO USE BUT IF YOU WANT 762 00:30:08,960 --> 00:30:10,280 TO ENTER SPECIFIC QUESTIONS YOU 763 00:30:10,280 --> 00:30:13,680 TO HAVE BE ABLE TO USE R OR 764 00:30:13,680 --> 00:30:17,080 JUPYTER NOTEBOOKS OR SOMETHING 765 00:30:17,080 --> 00:30:19,360 LIKE THAT TO ACCESS THE DATA. 766 00:30:19,360 --> 00:30:22,200 AND FOR THAT REASON, WE STARTED 767 00:30:22,200 --> 00:30:25,720 LAST YEAR A TRAINING PROGRAM TO 768 00:30:25,720 --> 00:30:28,000 TRY AND GET MORE WORKERS WHO CAN 769 00:30:28,000 --> 00:30:31,200 USE THE KIND OF DATA THAT NHLBI 770 00:30:31,200 --> 00:30:34,800 HAS, AND THAT DATA THAT'S IN 771 00:30:34,800 --> 00:30:37,200 "ALL OF US" TO ANSWER QUESTIONS 772 00:30:37,200 --> 00:30:41,680 THAT MIGHT BE ON THE REALM OF 773 00:30:41,680 --> 00:30:44,200 HUMAN INTUITION. 774 00:30:44,200 --> 00:30:46,280 WE RELEASED A TRAINING PROGRAM 775 00:30:46,280 --> 00:30:48,120 ON ARTIFICIAL INTELLIGENCE FOR 776 00:30:48,120 --> 00:30:49,880 PRECISION NUTRITION, TO START 777 00:30:49,880 --> 00:30:51,640 TRAINING THE NEXT GENERATION OF 778 00:30:51,640 --> 00:30:53,360 NUTRITION SCIENTISTS TO BE ABLE 779 00:30:53,360 --> 00:30:57,680 TO USE BIG DATA SETS SUCH AS 780 00:30:57,680 --> 00:31:00,080 TOPMed AND OTHER DATASETS THAT 781 00:31:00,080 --> 00:31:02,560 THE COMMON FUND AND THIS NPH 782 00:31:02,560 --> 00:31:06,000 STUDY AND ALL OF US HAS. 783 00:31:06,000 --> 00:31:07,080 NEXT SLIDE. 784 00:31:07,080 --> 00:31:10,240 ANOTHER AREA THAT WE'VE BEEN 785 00:31:10,240 --> 00:31:13,640 WORKING IN, WE RELEASED A NOSI 786 00:31:13,640 --> 00:31:15,400 WITH 16 INSTITUTES AND CENTERS 787 00:31:15,400 --> 00:31:17,360 TO STIMULATE RESEARCH TO 788 00:31:17,360 --> 00:31:19,680 UNDERSTAND AND ADDRESS HUNGER, 789 00:31:19,680 --> 00:31:23,120 FOOD, AND NUTRITION SECURITY. 790 00:31:23,120 --> 00:31:26,000 AND THIS IS TO SUPPORT NOVEL AND 791 00:31:26,000 --> 00:31:27,200 INNOVATIVE STRATEGIES TO ADDRESS 792 00:31:27,200 --> 00:31:31,600 NUTRITION INSECURITY AND ITS 793 00:31:31,600 --> 00:31:36,000 EFFECTS ON HEALTH OUTCOMES. 794 00:31:36,000 --> 00:31:41,000 AND THIS IS AN ONGOING -- THIS 795 00:31:41,000 --> 00:31:45,440 NOSI IS STILL OPEN TO FUND 796 00:31:45,440 --> 00:31:49,640 INVESTIGATOR-INITIATED IDEAS. 797 00:31:49,640 --> 00:31:50,400 NEXT SLIDE. 798 00:31:50,400 --> 00:31:54,080 ANOTHER AREA THAT WE'RE WORKING 799 00:31:54,080 --> 00:31:55,720 ON, THAT YOU MAY BE SEEING ABOUT 800 00:31:55,720 --> 00:31:58,840 IN THE NEWS AND THINGS IS FOOD 801 00:31:58,840 --> 00:32:00,720 AS MEDICINE. 802 00:32:00,720 --> 00:32:04,200 FOOD IS MEDICINE REFERS TO TO 803 00:32:04,200 --> 00:32:05,560 THE PROVISION OF FOOD, BUT IT'S 804 00:32:05,560 --> 00:32:08,160 AN ACTIVITY WHICH IS USUALLY 805 00:32:08,160 --> 00:32:11,120 DONE IN THE CONTEXT OR WITH THE 806 00:32:11,120 --> 00:32:14,400 NEXUS TO THE HEALTHCARE SYSTEM. 807 00:32:14,400 --> 00:32:16,800 AND SO THE TYPE OF SERVICES THAT 808 00:32:16,800 --> 00:32:18,960 THIS IS DESCRIBING ARE THINGS 809 00:32:18,960 --> 00:32:26,280 LIKE MEDICALLY TAILORED MEALS, 810 00:32:26,280 --> 00:32:27,240 MEDICALLY TAILORED GROCERIES. 811 00:32:27,240 --> 00:32:30,480 WE HAVE A RISING RATE OF 812 00:32:30,480 --> 00:32:33,280 DIET-RELATED DISEASES IN THIS 813 00:32:33,280 --> 00:32:38,600 COUNTRY, AND AS WE LOOKED ACROSS 814 00:32:38,600 --> 00:32:42,440 NIH, WHAT KIND OF EFFORTS NIH 815 00:32:42,440 --> 00:32:44,160 HAS ACCOMPLISHED TO ADDRESS 816 00:32:44,160 --> 00:32:47,680 DIET -- LIKE OTHER DISEASES, WE 817 00:32:47,680 --> 00:32:50,520 LOOKED AT THE COMPREHENSIVE 818 00:32:50,520 --> 00:32:53,280 CANCER CENTERS, WHICH THERE'S 819 00:32:53,280 --> 00:32:59,000 CURRENTLY 71 OF ACROSS THE 820 00:32:59,000 --> 00:32:59,800 COUNTRIES. 821 00:32:59,800 --> 00:33:01,280 THOSE COMPREHENSIVE CANCER 822 00:33:01,280 --> 00:33:03,400 CENTERS PERFORM RESEARCH. 823 00:33:03,400 --> 00:33:06,480 THEY DO EDUCATION AND TRAINING. 824 00:33:06,480 --> 00:33:10,040 THEY PROVIDE PATIENT SERVICES. 825 00:33:10,040 --> 00:33:12,160 AND THEY DO A CRITICAL PART OF 826 00:33:12,160 --> 00:33:16,640 THEIR APPLICATION DO COMMUNITY 827 00:33:16,640 --> 00:33:17,640 OUTREACH AND ENGAGEMENT. 828 00:33:17,640 --> 00:33:21,440 AND SO WE'RE EXPLORING AS A 829 00:33:21,440 --> 00:33:22,280 CONCEPT, YOU KNOW, DEVELOPING 830 00:33:22,280 --> 00:33:25,040 THINGS THAT WOULD BE AT THE 831 00:33:25,040 --> 00:33:30,080 SCALE OF NCI COMPREHENSIVE 832 00:33:30,080 --> 00:33:30,640 CANCER CENTER. 833 00:33:30,640 --> 00:33:32,720 WE DON'T HAVE ANY FOR DIET 834 00:33:32,720 --> 00:33:35,120 RELATED DISEASES THAT DO PATIENT 835 00:33:35,120 --> 00:33:37,560 CARE, COMMUNITY OUTREACH 836 00:33:37,560 --> 00:33:38,200 ENGAGEMENT, EDUCATION TRAINING, 837 00:33:38,200 --> 00:33:39,560 AND RESEARCH. 838 00:33:39,560 --> 00:33:41,080 WE WOULD LIKE TO DO IT AS AN 839 00:33:41,080 --> 00:33:46,200 EXPERIMENT TO SEE IF THESE WOULD 840 00:33:46,200 --> 00:33:49,040 HELP REDUCE DIET-RELATED 841 00:33:49,040 --> 00:33:50,960 DISEASES AND CLINICAL 842 00:33:50,960 --> 00:33:54,200 MALNUTRITION, AND IN -- YOU 843 00:33:54,200 --> 00:33:58,440 KNOW, IN CERTAIN CATCHMENT 844 00:33:58,440 --> 00:34:00,760 AREAS, EXPANDING THEM TO EXPAND 845 00:34:00,760 --> 00:34:03,800 FOOD INSECURITY AND NUTRITIONAL 846 00:34:03,800 --> 00:34:04,800 STATUS ASSESSMENT SUCH AS 847 00:34:04,800 --> 00:34:07,000 PHYSICAL EXAMS AND TOUCH POINTS 848 00:34:07,000 --> 00:34:09,920 AND WHERE INDICATED PROVIDE 849 00:34:09,920 --> 00:34:13,240 THESE FOOD IS MEDICINE SERVICES. 850 00:34:13,240 --> 00:34:14,520 WE'VE RECENTLY RELEASED A 851 00:34:14,520 --> 00:34:16,920 REQUEST FOR INFORMATION ON FOOD 852 00:34:16,920 --> 00:34:17,800 IS MEDICINE RESEARCH 853 00:34:17,800 --> 00:34:18,160 OPPORTUNITIES. 854 00:34:18,160 --> 00:34:21,200 THERE'S A GREAT INTEREST IN THIS 855 00:34:21,200 --> 00:34:23,160 ACROSS THE FEDERAL GOVERNMENT, 856 00:34:23,160 --> 00:34:25,120 AND WITH THE AMERICAN HEART 857 00:34:25,120 --> 00:34:25,560 ASSOCIATION. 858 00:34:25,560 --> 00:34:27,640 THE AMERICAN HEART ASSOCIATION 859 00:34:27,640 --> 00:34:31,840 TOGETHER WITH ROCKEFELLER 860 00:34:31,840 --> 00:34:32,440 FOUNDATION HAS ANNOUNCED A $250 861 00:34:32,440 --> 00:34:34,120 MILLION COMMITMENT TO FOOD IS 862 00:34:34,120 --> 00:34:34,800 MEDICINE RESEARCH. 863 00:34:34,800 --> 00:34:36,760 VERY LITTLE FOOD IS MEDICINE 864 00:34:36,760 --> 00:34:39,080 RESEARCH IS CURRENTLY BEING 865 00:34:39,080 --> 00:34:41,120 CONDUCTED AT NIH. 866 00:34:41,120 --> 00:34:44,680 WE RELEASED THIS RFI WITH 12 867 00:34:44,680 --> 00:34:46,200 FEDERAL AGENCIES INCLUDING 868 00:34:46,200 --> 00:34:47,000 CENTERS FOR MEDICAID SERVICES 869 00:34:47,000 --> 00:34:47,920 INTERESTED BECAUSE THEY ARE 870 00:34:47,920 --> 00:34:50,320 STARTING TO PAY FOR FOOD IS 871 00:34:50,320 --> 00:34:51,400 MEDICINE SERVICES, WANT TO KNOW 872 00:34:51,400 --> 00:34:53,280 WHERE THEY SHOULD BE DEPLOYING 873 00:34:53,280 --> 00:34:55,040 AND WHAT KIND OF SERVICE SHOULD 874 00:34:55,040 --> 00:35:00,960 BE USED WHERE AND FOR HOW LONG. 875 00:35:00,960 --> 00:35:04,120 FIFTEEN INSTITUTE CENTERS AND 876 00:35:04,120 --> 00:35:11,120 OFFICES ARE PARTICIPATING IN 877 00:35:11,120 --> 00:35:12,240 THIS AS WELL. 878 00:35:12,240 --> 00:35:15,160 ANOTHER AREA, SLEEP WILL BE AN 879 00:35:15,160 --> 00:35:17,120 OPPORTUNITY, WE HAVE RELEASED 880 00:35:17,120 --> 00:35:18,640 ANOTHER CONCEPT, INITIATIVE 881 00:35:18,640 --> 00:35:23,360 CONCEPT THAT HAS BEEN CLEARED AT 882 00:35:23,360 --> 00:35:24,040 THE COUNCIL. 883 00:35:24,040 --> 00:35:27,600 FOR THE LAST TWO THINGS, WE'RE 884 00:35:27,600 --> 00:35:33,800 HOPING FOR FUNDING IN THE NEXT 885 00:35:33,800 --> 00:35:35,560 FISCAL YEAR, BUT WE'RE IN THE 886 00:35:35,560 --> 00:35:37,960 NEXT FEW DAYS ANNOUNCING WE'RE 887 00:35:37,960 --> 00:35:40,040 HAVING A WORKSHOP ON NUTRITION 888 00:35:40,040 --> 00:35:42,440 AND DEVELOPMENTAL ORIGINS OF 889 00:35:42,440 --> 00:35:44,880 HEALTH AND DISEASE. 890 00:35:44,880 --> 00:35:48,280 AND SO WE HAVE PROPOSED A 891 00:35:48,280 --> 00:35:49,680 DISCOVERY SCIENCE PROJECT THAT 892 00:35:49,680 --> 00:35:52,640 WE'RE CURRENTLY SHOPPING AROUND 893 00:35:52,640 --> 00:35:53,720 LOOKING FOR COHORT STUDIES TO 894 00:35:53,720 --> 00:35:56,680 NEST THIS IN LIKE WE DID WITH 895 00:35:56,680 --> 00:35:57,720 "ALL OF US." 896 00:35:57,720 --> 00:36:00,520 THAT WOULD EXAMINE ROLE OF DIET, 897 00:36:00,520 --> 00:36:02,480 FOOD, ENVIRONMENT, THINGS LIKE 898 00:36:02,480 --> 00:36:03,680 SLEEP AND RELATED ENVIRONMENTAL 899 00:36:03,680 --> 00:36:05,320 EXPOSURES ON THE DEVELOPMENTAL 900 00:36:05,320 --> 00:36:07,800 ORIGINS OF HEALTH AND DISEASE. 901 00:36:07,800 --> 00:36:09,680 WE WOULD BE LOOKING AT THINGS, 902 00:36:09,680 --> 00:36:14,200 HOPEFULLY AS MUCH AS POSSIBLE, 903 00:36:14,200 --> 00:36:14,840 IN PARENTS, PRE-CONCEPTUALLY, 904 00:36:14,840 --> 00:36:20,000 AND THEN, YOU KNOW, INTENSIVELY 905 00:36:20,000 --> 00:36:21,400 STUDYING THE MOTHER DURING 906 00:36:21,400 --> 00:36:27,000 PREGNANCY THROUGHOUT THE THREE 907 00:36:27,000 --> 00:36:34,240 TRIMESTERS, AND LOOKING ALSO AT 908 00:36:34,240 --> 00:36:38,760 THE MICROBIOME, CHILD'S 909 00:36:38,760 --> 00:36:40,600 MICROBIOME AND CHILDHOOD 910 00:36:40,600 --> 00:36:40,840 EXPOSURES. 911 00:36:40,840 --> 00:36:44,520 ONE DEEP DIVE WOULD LOOK AT 912 00:36:44,520 --> 00:36:45,960 HUMAN MILK COMPOSITION, THE 913 00:36:45,960 --> 00:36:46,600 FEDERAL GOVERNMENT KNOWS MORE 914 00:36:46,600 --> 00:36:48,360 ABOUT WHAT'S IN A STRAWBERRY OR 915 00:36:48,360 --> 00:36:49,640 BANANA THAN HUMAN MILK. 916 00:36:49,640 --> 00:36:51,880 WE HAVE A LOT OF RESEARCH GOING 917 00:36:51,880 --> 00:36:55,680 ON, A LOT OF VARIABILITY IN 918 00:36:55,680 --> 00:36:57,000 HUMAN MILK COMPOSITION, AND WE 919 00:36:57,000 --> 00:36:58,640 NEED TO BETTER UNDERSTAND HOW 920 00:36:58,640 --> 00:37:00,720 THAT VARIABILITY IS LINKED TO 921 00:37:00,720 --> 00:37:08,160 THINGS LIKE NUTRITION, AND 922 00:37:08,160 --> 00:37:17,560 GENETICS, EPIGENETIC PHENOMENON, 923 00:37:17,560 --> 00:37:18,640 AFFECTING DEVELOPMENTAL OUTCOMES 924 00:37:18,640 --> 00:37:24,120 OF THE INFANT, ANOTHER STUDY WE 925 00:37:24,120 --> 00:37:26,560 HAVE GOING ON. 926 00:37:26,560 --> 00:37:28,640 NEXT SLIDE. 927 00:37:28,640 --> 00:37:38,160 THERE'S OTHER OPPORTUNITIES ONR 928 00:37:38,160 --> 00:37:42,640 IS CLOCKING. 929 00:37:42,640 --> 00:37:47,400 ONE OF THE THINGS IS THAT A FEW 930 00:37:47,400 --> 00:37:52,440 YEARS AGO, NATIONAL INSTITUTES 931 00:37:52,440 --> 00:37:56,080 OF AGING STARTED PILOTING A 932 00:37:56,080 --> 00:38:01,880 STUDY TO COMPARE TIME-RESTRICTED 933 00:38:01,880 --> 00:38:04,080 EATING WITH CALORIC RESTRICTION. 934 00:38:04,080 --> 00:38:05,800 THEY RELEASED AN RFI THAT WOULD 935 00:38:05,800 --> 00:38:08,760 OFFER PEOPLE TO LOOK AT 936 00:38:08,760 --> 00:38:11,960 DIFFERENT DIETARY PATTERNS IN 937 00:38:11,960 --> 00:38:13,040 COMPARISON TO CALORIC 938 00:38:13,040 --> 00:38:14,160 RESTRICTION. 939 00:38:14,160 --> 00:38:17,320 THE ONE THE INVESTIGATORS 940 00:38:17,320 --> 00:38:21,040 SETTLED ON WAS TIME-RESTRICTED 941 00:38:21,040 --> 00:38:21,600 EATING. 942 00:38:21,600 --> 00:38:23,360 THIS AREA OF -- THIS 943 00:38:23,360 --> 00:38:25,880 CHRONONUTRITION IS VERY MUCH 944 00:38:25,880 --> 00:38:30,680 PART OF THE ONR STRATEGIC PLAN, 945 00:38:30,680 --> 00:38:32,240 WHICH IN STRATEGIC OBJECTIVE 2 946 00:38:32,240 --> 00:38:34,440 HAS THIS PRIORITY TO DETERMINE 947 00:38:34,440 --> 00:38:36,400 HEALTH BENEFITS AND MECHANISMS 948 00:38:36,400 --> 00:38:39,520 OF MEAL TIMING, DIETARY 949 00:38:39,520 --> 00:38:43,720 PATTERNS, SOMETHING FRANCIS 950 00:38:43,720 --> 00:38:47,000 COLLINS WAS VERY INTERESTED IN 951 00:38:47,000 --> 00:38:49,640 AND SO TEXT IN OUR PLAN SAID 952 00:38:49,640 --> 00:38:50,720 THERE IS BROAD TRANS-NIH 953 00:38:50,720 --> 00:38:51,920 INTEREST IN IMPROVING HOW 954 00:38:51,920 --> 00:38:55,400 UNDERSTANDING OF HOW OUR DIETARY 955 00:38:55,400 --> 00:38:58,400 PATTERNS FOCUSED ON CIRCADIAN 956 00:38:58,400 --> 00:39:00,360 MEAL TIME OR INTERMITTENT 957 00:39:00,360 --> 00:39:04,720 FASTING, TO IMPROVE OUTCOMES AND 958 00:39:04,720 --> 00:39:05,480 UNDERSTAND VARIABILITY. 959 00:39:05,480 --> 00:39:06,920 WE'LL CONSIDER OPPORTUNITIES TO 960 00:39:06,920 --> 00:39:09,480 EXPAND OUR MECHANISTIC KNOWLEDGE 961 00:39:09,480 --> 00:39:12,200 IN THIS AREA. 962 00:39:12,200 --> 00:39:15,800 SO A NUMBER OF INSTITUTES HAVE 963 00:39:15,800 --> 00:39:19,200 AN INTEREST IN THIS. 964 00:39:19,200 --> 00:39:20,760 NEXT SLIDE. 965 00:39:20,760 --> 00:39:22,760 AND THEN NATIONAL INSTITUTE OF 966 00:39:22,760 --> 00:39:28,240 AGING STARTED A STUDY AND HAD 967 00:39:28,240 --> 00:39:33,480 THIS CALORIE TWO STUDY, GREATEST 968 00:39:33,480 --> 00:39:34,720 ENERGY RESTRICTION ACCOMPLISHED 969 00:39:34,720 --> 00:39:36,560 BY ITS PARTICIPANTS OVER A 970 00:39:36,560 --> 00:39:38,760 TWO-YEAR PERIOD THAN ANY OTHER 971 00:39:38,760 --> 00:39:40,720 NIH STUDY THEY ACHIEVED, AROUND 972 00:39:40,720 --> 00:39:48,040 A 12% INCREASE IN ENERGY 973 00:39:48,040 --> 00:39:50,320 RESTRICTION, LOOKING AT OTHER 974 00:39:50,320 --> 00:39:51,960 OPPORTUNITIES AFTER THE CALORIE 975 00:39:51,960 --> 00:39:52,200 STUDY. 976 00:39:52,200 --> 00:39:57,440 SO THEY DEVELOPED THIS IDEA OF 977 00:39:57,440 --> 00:39:59,840 HAVING A FIVE-YEAR STUDY, BUT 978 00:39:59,840 --> 00:40:01,280 THEY -- THAT WOULD COMPARE 979 00:40:01,280 --> 00:40:03,240 CALORIC RESTRICTION TO SOME 980 00:40:03,240 --> 00:40:05,680 OTHER DIETARY PATTERN OF 981 00:40:05,680 --> 00:40:05,960 INTEREST. 982 00:40:05,960 --> 00:40:10,040 IT DID CENTER ON TIME-RESTRICTED 983 00:40:10,040 --> 00:40:10,760 EATING. 984 00:40:10,760 --> 00:40:13,680 AND SO THEY INVITED APPLICATIONS 985 00:40:13,680 --> 00:40:15,320 FOR PLANNING PROJECTS TO DEVELOP 986 00:40:15,320 --> 00:40:16,880 TWO FIVE-YEAR TRIALS ON EFFECTS 987 00:40:16,880 --> 00:40:18,520 OF NUTRITION INTERVENTION IN 988 00:40:18,520 --> 00:40:20,720 YOUNGER AND OLDER ADULTS ON RISK 989 00:40:20,720 --> 00:40:21,720 FACTORS FOR AGING-RELATED 990 00:40:21,720 --> 00:40:26,160 CONDITIONS AND MECHANISMS THAT 991 00:40:26,160 --> 00:40:33,000 MAY INFLUENCE HEALTH SPAN AND 992 00:40:33,000 --> 00:40:33,240 LONGEVITY. 993 00:40:33,240 --> 00:40:35,920 TWO INVESTIGATORS GOT ONE ON THE 994 00:40:35,920 --> 00:40:36,920 YOUNGER ADULTS DIETARY 995 00:40:36,920 --> 00:40:42,040 APPROACHES FOR LONGEVITY AND 996 00:40:42,040 --> 00:40:42,680 HEALTH. 997 00:40:42,680 --> 00:40:44,880 AND THEN COLLINGS AT WAKE FOREST 998 00:40:44,880 --> 00:40:47,400 GOT THE OTHER PILOT STUDY, 999 00:40:47,400 --> 00:40:49,480 HEALTH AGING AND LIFE OUTCOMES. 1000 00:40:49,480 --> 00:40:52,240 PART OF THE PLANNING PROJECT WAS 1001 00:40:52,240 --> 00:40:57,720 FOR THEM TO GET TOGETHER TO 1002 00:40:57,720 --> 00:40:59,720 DEVELOP A PLAN FOR THE STUDY TO 1003 00:40:59,720 --> 00:41:02,080 COME TO SOME AGREEMENT ON THAT. 1004 00:41:02,080 --> 00:41:10,560 AND THEN TO START PILOTING THE 1005 00:41:10,560 --> 00:41:11,040 STUDY FOR FEASIBILITY. 1006 00:41:11,040 --> 00:41:12,800 AND SO THEY HAVE BEEN GIVEN 1007 00:41:12,800 --> 00:41:14,480 THREE YEARS TO DO THIS. 1008 00:41:14,480 --> 00:41:16,600 WE'RE GOING TO HEAR ABOUT THE 1009 00:41:16,600 --> 00:41:19,880 OUTCOMES OF THESE PILOT STUDIES 1010 00:41:19,880 --> 00:41:20,200 SOON. 1011 00:41:20,200 --> 00:41:24,280 BUT OUTCOMES OF THE PILOT 1012 00:41:24,280 --> 00:41:26,920 STUDIES ARE POSITIVE. 1013 00:41:26,920 --> 00:41:29,840 THEN I BELIEVE NATIONAL 1014 00:41:29,840 --> 00:41:31,680 INSTITUTES OF AGING WILL, YOU 1015 00:41:31,680 --> 00:41:34,000 KNOW, TRY AND FUND THIS 1016 00:41:34,000 --> 00:41:36,720 FIVE-YEAR STUDY THEY PLAN. 1017 00:41:36,720 --> 00:41:39,880 AND YOU CAN IMAGINE -- NEXT 1018 00:41:39,880 --> 00:41:43,400 SLIDE TO SEE IF THERE'S -- YOU 1019 00:41:43,400 --> 00:41:47,640 CAN -- YEAH, SO THIS IS WHAT'S 1020 00:41:47,640 --> 00:41:52,120 HAPPENED SO FAR IN THIS STUDY. 1021 00:41:52,120 --> 00:41:54,000 THEY HAVE THIS DSMB, TRIAL 1022 00:41:54,000 --> 00:41:56,080 LAUNCHED IN JUNE OF 2022. 1023 00:41:56,080 --> 00:41:58,640 AND THEN THEY SAID HERE THE 1024 00:41:58,640 --> 00:42:00,160 DECISION ABOUT ACCEPTANCE OF 1025 00:42:00,160 --> 00:42:03,240 APPLICATIONS FOR THE MAIN TRIALS 1026 00:42:03,240 --> 00:42:06,760 WILL BE AROUND THIS SUMMER 2024. 1027 00:42:06,760 --> 00:42:09,280 WE INITIALLY SPOKE TO THEM, THEY 1028 00:42:09,280 --> 00:42:11,920 WERE PLANNING A LARGE STUDY, 1029 00:42:11,920 --> 00:42:16,160 LOOKING AT OLDER ADULTS AND 1030 00:42:16,160 --> 00:42:17,200 MIDDLE AGED YOUNGER PEOPLE, AND 1031 00:42:17,200 --> 00:42:21,120 IF YOU DID A FIVE-YEAR STUDY YOU 1032 00:42:21,120 --> 00:42:22,560 CAN IMAGINE IF YOU HAD, YOU 1033 00:42:22,560 --> 00:42:26,840 KNOW, A LARGE ENOUGH STUDY AND 1034 00:42:26,840 --> 00:42:29,320 COULD, FOR EXAMPLE, GET 300 1035 00:42:29,320 --> 00:42:30,320 CASES OF CARDIOVASCULAR DISEASE 1036 00:42:30,320 --> 00:42:33,920 IN ONE OF THE ARMS SUCH AS 1037 00:42:33,920 --> 00:42:36,000 PLACEBO ARM, YOU COULD DETERMINE 1038 00:42:36,000 --> 00:42:38,760 WHETHER CALORIC RESTRICTION OR 1039 00:42:38,760 --> 00:42:40,360 TIME-RESTRICTED FEEDING WOULD 1040 00:42:40,360 --> 00:42:45,000 HAVE A BENEFIT FOR THAT DISEASE. 1041 00:42:45,000 --> 00:42:46,120 AND THIS STUDY I THINK WILL BE 1042 00:42:46,120 --> 00:42:48,160 ABLE TO ANSWER A NUMBER OF 1043 00:42:48,160 --> 00:42:50,800 SCIENTIFIC QUESTIONS WE HAVE. 1044 00:42:50,800 --> 00:42:52,080 FOR EXAMPLE, DOES 1045 00:42:52,080 --> 00:42:53,840 TIME-RESTRICTED EATING HAVE 1046 00:42:53,840 --> 00:42:59,680 ADDITIONAL BENEFITS ABOVE AND 1047 00:42:59,680 --> 00:43:04,120 BEYOND CALORIC RESTRICTION 1048 00:43:04,120 --> 00:43:04,720 ALONE? 1049 00:43:04,720 --> 00:43:06,960 THEY HAD A VERY GOOD EXPERIENCE 1050 00:43:06,960 --> 00:43:09,240 WITH THEIR CALORIE TWO STUDY AND 1051 00:43:09,240 --> 00:43:11,120 THIS IS A VERY GOOD GROUP. 1052 00:43:11,120 --> 00:43:12,960 I THINK THE IDEA HERE MIGHT BE 1053 00:43:12,960 --> 00:43:15,640 TO EXPAND THIS STUDY AND TO TRY 1054 00:43:15,640 --> 00:43:19,760 AND BRING OTHER I.C.s IN TO 1055 00:43:19,760 --> 00:43:23,440 CO-FUND THIS, TO LOOK AT 1056 00:43:23,440 --> 00:43:26,960 ENDPOINTS OF INTEREST TO EACH 1057 00:43:26,960 --> 00:43:28,520 NCI AND NHLBI AND NIDDK. 1058 00:43:28,520 --> 00:43:31,800 I THINK THERE'S A BIG 1059 00:43:31,800 --> 00:43:34,040 OPPORTUNITY THERE TO LOOK AT 1060 00:43:34,040 --> 00:43:36,360 THIS, TO ADDRESS A NUMBER OF 1061 00:43:36,360 --> 00:43:37,000 NUTRITION QUESTIONS INCLUDING, 1062 00:43:37,000 --> 00:43:43,880 YOU KNOW, IN THE AREA OF 1063 00:43:43,880 --> 00:43:44,520 CHRONONUTRITION. 1064 00:43:44,520 --> 00:43:54,960 SO THAT'S MY LAST SLIDE. 1065 00:43:56,520 --> 00:43:56,920 THANK YOU. 1066 00:43:56,920 --> 00:43:59,400 >>WE'LL HOLD OFF FOR QUESTIONS 1067 00:43:59,400 --> 00:44:01,920 UNTIL THE END OF THIS SESSION, 1068 00:44:01,920 --> 00:44:04,320 WHERE WE'LL HAVE DISCUSSION AND 1069 00:44:04,320 --> 00:44:11,760 Q&A. 1070 00:44:11,760 --> 00:44:20,280 NOW WE'LL MOVE TO DR. 1071 00:44:20,280 --> 00:44:23,480 TUSAREBECCA PANNUCCI, A MASTER'S 1072 00:44:23,480 --> 00:44:25,840 IN PUBLIC HEALTH HARVARD SCHOOL 1073 00:44:25,840 --> 00:44:32,120 OF PUBLIC HEALTH, POSTDOC WORK 1074 00:44:32,120 --> 00:44:34,840 AT NATIONAL CANCER INSTITUTE, 1075 00:44:34,840 --> 00:44:37,360 DIETARY TOOLS TO ANALYSIS OF 1076 00:44:37,360 --> 00:44:38,760 DIETARY PATTERNS. 1077 00:44:38,760 --> 00:44:41,640 DR. PANNUCCI JOINED THE CENTER 1078 00:44:41,640 --> 00:44:46,320 FOR POLICY PROMOTION IN 2015, 1079 00:44:46,320 --> 00:44:49,160 BRANCH CHIEF, LEADS A TEAM 1080 00:44:49,160 --> 00:44:51,480 CONDUCTING ANALYSES FOR USDA 1081 00:44:51,480 --> 00:44:54,240 FOOD PLANS, HEALTH EATING INDEX 1082 00:44:54,240 --> 00:44:59,000 AND USDA FOOD PATTERNS. 1083 00:44:59,000 --> 00:44:59,520 THE FLOOR IS YOURS. 1084 00:44:59,520 --> 00:45:00,800 >>THANK YOU VERY MUCH. 1085 00:45:00,800 --> 00:45:02,840 IT'S A PLEASURE TO BE HERE AND 1086 00:45:02,840 --> 00:45:07,360 TO BE A PART OF THE BROADER 1087 00:45:07,360 --> 00:45:08,440 CONVERSATION AROUND 1088 00:45:08,440 --> 00:45:08,840 CHRONONUTRITION. 1089 00:45:08,840 --> 00:45:10,840 ONE OF MY ROLES AT THE CENTER 1090 00:45:10,840 --> 00:45:12,920 FOR NUTRITION POLICY AND 1091 00:45:12,920 --> 00:45:17,280 PROMOTION IS RELATED TO OUR 1092 00:45:17,280 --> 00:45:18,400 COLLABORATIVE WORK WITH OFFICE 1093 00:45:18,400 --> 00:45:22,040 OF DISEASE PREVENTION AND HEALTH 1094 00:45:22,040 --> 00:45:24,720 PROMOTION AT HHS. 1095 00:45:24,720 --> 00:45:26,400 AND SUPPORTING THE DEVELOPMENT 1096 00:45:26,400 --> 00:45:28,160 OF THE DIETARY GUIDELINES FOR 1097 00:45:28,160 --> 00:45:28,400 AMERICANS. 1098 00:45:28,400 --> 00:45:30,560 SO TODAY I'LL BE GIVING AN 1099 00:45:30,560 --> 00:45:31,680 OVERVIEW OF THAT PROCESS, SOME 1100 00:45:31,680 --> 00:45:32,880 OF THE WORK RELATED TO TOPICS 1101 00:45:32,880 --> 00:45:36,800 THAT MIGHT BE OF INTEREST TO 1102 00:45:36,800 --> 00:45:37,520 YOU. 1103 00:45:37,520 --> 00:45:39,040 NEXT SLIDE PLEASE. 1104 00:45:39,040 --> 00:45:42,360 LET'S GO OVER A LITTLE BIT ABOUT 1105 00:45:42,360 --> 00:45:44,240 THE DIETARY GUIDELINES. 1106 00:45:44,240 --> 00:45:46,280 THIS PRESENTATION IS A FAST 1107 00:45:46,280 --> 00:45:49,480 TRACK OR ADVANCED TRACK IN THE 1108 00:45:49,480 --> 00:45:50,920 DIETARY GUIDELINES DEVELOPMENT. 1109 00:45:50,920 --> 00:45:53,240 WE WANT TO SPEND A MINUTE TO 1110 00:45:53,240 --> 00:45:54,640 LEVEL SET TO MAKE SURE WE'RE ALL 1111 00:45:54,640 --> 00:45:56,520 ON THE SAME PAGE ABOUT THE 1112 00:45:56,520 --> 00:45:59,360 PURPOSE OF THE DIETARY 1113 00:45:59,360 --> 00:45:59,840 GUIDELINES. 1114 00:45:59,840 --> 00:46:01,440 THE DIETARY GUIDELINES PROVIDE 1115 00:46:01,440 --> 00:46:02,640 SIGH INSURE-BASED ADVICE ON WHAT 1116 00:46:02,640 --> 00:46:07,000 TO EAT AND DRINK TO PROMOTE 1117 00:46:07,000 --> 00:46:09,840 HEALTH, REDUCE RISK OF CHRONIC 1118 00:46:09,840 --> 00:46:11,600 DISEASE, MEET NUTRIENT NEEDS, 1119 00:46:11,600 --> 00:46:15,240 INTENDED FOR POLICYMAKERS AND 1120 00:46:15,240 --> 00:46:17,960 HEALTH PROFESSIONALS TO HELP THE 1121 00:46:17,960 --> 00:46:19,680 GENERAL PUBLIC CONSUME A HEALTHY 1122 00:46:19,680 --> 00:46:26,280 AND ADEQUATE DIET, THE 1123 00:46:26,280 --> 00:46:26,920 CORNERSTONE FOR FEDERAL 1124 00:46:26,920 --> 00:46:28,040 NUTRITION PROGRAMS AND POLICIES. 1125 00:46:28,040 --> 00:46:32,600 WE WORK ON A FIVE-YEAR PSYCH 1126 00:46:32,600 --> 00:46:35,160 TOLL REFLECT PREPONDERANCE OF 1127 00:46:35,160 --> 00:46:37,560 EVIDENCE, PUBLISHED JOINTLY AS 1128 00:46:37,560 --> 00:46:41,160 MENTIONED EARLIER BY USDA AND 1129 00:46:41,160 --> 00:46:41,400 HHS. 1130 00:46:41,400 --> 00:46:45,080 AND THIS IS ALL MANDATED IN THE 1131 00:46:45,080 --> 00:46:46,440 1990 NATIONAL NUTRITION 1132 00:46:46,440 --> 00:46:50,760 MONITORING AND RELATED RESEARCH 1133 00:46:50,760 --> 00:46:51,040 ACT. 1134 00:46:51,040 --> 00:46:55,280 NEXT SLIDE. 1135 00:46:55,280 --> 00:46:59,760 NATIONAL DIETARY GUIDANCE IS NOT 1136 00:46:59,760 --> 00:47:01,040 KNEW, WE'VE PROVIDED GUIDANCE 1137 00:47:01,040 --> 00:47:03,400 FOR MORE THAN 100 YEARS. 1138 00:47:03,400 --> 00:47:04,480 ADVICE HAS TENDED TO FOCUS ON 1139 00:47:04,480 --> 00:47:07,120 WHAT TO EAT AND DRINK FOR BETTER 1140 00:47:07,120 --> 00:47:08,640 HEALTH BUT SPECIFIC MESSAGING OF 1141 00:47:08,640 --> 00:47:10,400 COURSE HAS CHANGED THROUGHOUT 1142 00:47:10,400 --> 00:47:13,000 THE YEARS TO REFLECT ADVANCES IN 1143 00:47:13,000 --> 00:47:14,000 NUTRITION SCIENCE, MUCH OF WHAT 1144 00:47:14,000 --> 00:47:18,720 WE'RE GOING TO COVER TODAY. 1145 00:47:18,720 --> 00:47:22,000 EARLY GUIDANCE REFLECTED IN THE 1146 00:47:22,000 --> 00:47:23,520 TOP LEFT-HAND CORNER FOCUSED ON 1147 00:47:23,520 --> 00:47:27,280 THE FOOD GROUPS AND HEALTHY 1148 00:47:27,280 --> 00:47:27,800 DEET. 1149 00:47:27,800 --> 00:47:28,920 WITH ADDITIONAL GUIDANCE AROUND 1150 00:47:28,920 --> 00:47:30,520 FOOD SAFETY AND FOOD STORAGE, 1151 00:47:30,520 --> 00:47:32,080 ENSURING PEOPLE GOT ENOUGH 1152 00:47:32,080 --> 00:47:34,040 VITAMINS AND MINERALS TO PREVENT 1153 00:47:34,040 --> 00:47:35,320 DISEASES CAUSED BY NUTRIENT 1154 00:47:35,320 --> 00:47:38,320 DEFICIENCY, BUT OF COURSE AS 1155 00:47:38,320 --> 00:47:39,840 NUTRITION SCIENCE HAS EVOLVED 1156 00:47:39,840 --> 00:47:41,360 THERE WAS GREATER RECOGNITION OF 1157 00:47:41,360 --> 00:47:43,680 THE ROLE DIET PLAYED IN DISEASE 1158 00:47:43,680 --> 00:47:44,760 PRE-INVESTIGATORS AND HEALTH 1159 00:47:44,760 --> 00:47:45,000 PROMOTION. 1160 00:47:45,000 --> 00:47:46,280 THIS IS REFLECTED IN THE FIRST 1161 00:47:46,280 --> 00:47:48,800 FORMAL ADDITION OF THE DIETARY 1162 00:47:48,800 --> 00:47:52,840 GUIDELINES THAT WAS RELEASED IN 1163 00:47:52,840 --> 00:47:53,760 1980s. 1164 00:47:53,760 --> 00:47:56,040 IN 1985 THE EDITION FOLLOWED, 1165 00:47:56,040 --> 00:47:59,080 THE FIRST EDITION FOR WHICH USDA 1166 00:47:59,080 --> 00:48:00,960 AND HHS CONVENED A FEDERAL 1167 00:48:00,960 --> 00:48:04,120 ADVISORY COMMITTEE TO PROVIDE 1168 00:48:04,120 --> 00:48:05,680 THAT OUTSIDE SCIENTIFIC 1169 00:48:05,680 --> 00:48:07,960 EXPERTISE THAT WOULD INFORM 1170 00:48:07,960 --> 00:48:08,960 DIETARY GUIDELINES. 1171 00:48:08,960 --> 00:48:13,200 THAT PRACTICE CONTINUES TODAY. 1172 00:48:13,200 --> 00:48:14,320 NEXT SLIDE. 1173 00:48:14,320 --> 00:48:16,080 WITH THAT BACKGROUND IN MIND, 1174 00:48:16,080 --> 00:48:18,280 THE LAST IMPORTANT POINT IS TO 1175 00:48:18,280 --> 00:48:20,160 NOTE THAT THE DIETARY GUIDELINE 1176 00:48:20,160 --> 00:48:23,200 IS ONE PIECE OF THE LARGER 1177 00:48:23,200 --> 00:48:23,720 NUTRITION LANDSCAPE, AND 1178 00:48:23,720 --> 00:48:26,280 SOMETIMES IT'S NICE TO BE 1179 00:48:26,280 --> 00:48:28,800 REMINDED OF THE DIFFERENT ROLES 1180 00:48:28,800 --> 00:48:32,160 THAT ARE PLAYED BY DIFFERENT 1181 00:48:32,160 --> 00:48:33,000 AGENCIES. 1182 00:48:33,000 --> 00:48:33,840 WHILE THE DIETARY GUIDELINES 1183 00:48:33,840 --> 00:48:36,440 PROVIDE THE WHAT AND HOW MUCH OF 1184 00:48:36,440 --> 00:48:38,880 FOODS AND BEVERAGES TO CONSUME, 1185 00:48:38,880 --> 00:48:41,280 TO ACHIEVE GOOD HEALTH, REDUCE 1186 00:48:41,280 --> 00:48:43,120 RISK OF CHRONIC RELATED 1187 00:48:43,120 --> 00:48:45,600 DIET-RELATED CHRONIC DISEASE AND 1188 00:48:45,600 --> 00:48:47,080 MEET NUTRIENT NEEDS, THEY ARE 1189 00:48:47,080 --> 00:48:48,960 JUST ONE PIECE. 1190 00:48:48,960 --> 00:48:55,280 NUTRITION REQUIREMENTS ARE 1191 00:48:55,280 --> 00:48:57,160 LIMITS, UPDATED BY NATIONAL 1192 00:48:57,160 --> 00:48:58,400 ACADEMIES OF SCIENCE, 1193 00:48:58,400 --> 00:49:02,960 ENGINEERING AND MEDICINE, WE'RE 1194 00:49:02,960 --> 00:49:04,240 NOT SETTING NUTRIENT 1195 00:49:04,240 --> 00:49:04,760 RECOMMENDATIONS. 1196 00:49:04,760 --> 00:49:05,600 CLINICAL GUIDANCE IS NOT COVERED 1197 00:49:05,600 --> 00:49:07,240 IN THE GUIDELINES. 1198 00:49:07,240 --> 00:49:09,320 THE GUIDELINES SERVE AS 1199 00:49:09,320 --> 00:49:11,400 REFERENCE IN DEVELOPMENT OF 1200 00:49:11,400 --> 00:49:12,520 CLINICAL NUTRITION GUIDANCE, 1201 00:49:12,520 --> 00:49:15,240 TAILORED FOR PEOPLE LIVING WITH 1202 00:49:15,240 --> 00:49:17,080 SPECIFIC MEDICAL CONDITIONS. 1203 00:49:17,080 --> 00:49:21,360 BUT THE DIETARY GUIDELINE FOR 1204 00:49:21,360 --> 00:49:24,120 AMERICANS ARE NOT INTENDED FOR 1205 00:49:24,120 --> 00:49:25,080 CLINICAL GUIDANCE. 1206 00:49:25,080 --> 00:49:26,720 LET'S KEEP THAT CONTEXT IN MIND 1207 00:49:26,720 --> 00:49:29,640 AND WE'LL LEARN MORE ABOUT THE 1208 00:49:29,640 --> 00:49:31,080 CURRENT SCIENCE THAT IS THE 1209 00:49:31,080 --> 00:49:35,880 BASIS OF THE DIETARY GUIDELINES. 1210 00:49:35,880 --> 00:49:36,440 NEXT SLIDE. 1211 00:49:36,440 --> 00:49:39,520 SO TO THE RIGHT YOU SEE THERE 1212 00:49:39,520 --> 00:49:42,040 ARE FOUR KEY MESSAGES, FOUR KEY 1213 00:49:42,040 --> 00:49:44,000 GUIDELINES THAT WERE PUBLISHED 1214 00:49:44,000 --> 00:49:46,840 AS PART OF THE 2020-2025 ISSUE 1215 00:49:46,840 --> 00:49:48,600 OF THE DIETARY GUIDELINES FOR 1216 00:49:48,600 --> 00:49:49,160 AMERICANS. 1217 00:49:49,160 --> 00:49:50,800 FIRST IS TO FOLLOW HEALTHY 1218 00:49:50,800 --> 00:49:52,160 PATTERN AT EVERY LIFE STAGE. 1219 00:49:52,160 --> 00:49:55,000 FOR THE FIRST TIME WE INCLUDED 1220 00:49:55,000 --> 00:49:59,000 HEALTHY DIETARY PATTERNS FOR 1221 00:49:59,000 --> 00:50:01,240 1-YEAR-OLDS AND MORE -- BROADER 1222 00:50:01,240 --> 00:50:03,920 SET SPECIFIC TO INFANTS AND 1223 00:50:03,920 --> 00:50:05,840 TODDLERS UNDER 2. 1224 00:50:05,840 --> 00:50:09,360 AS WELL AS WOMEN PREGNANT OR 1225 00:50:09,360 --> 00:50:10,120 LACTATING. 1226 00:50:10,120 --> 00:50:11,560 THE SECOND GUIDELINE IS 1227 00:50:11,560 --> 00:50:12,680 CUSTOMIZE AND ENJOY NUTRIENT 1228 00:50:12,680 --> 00:50:15,800 DENSE FOODS AND BEVERAGES TO 1229 00:50:15,800 --> 00:50:19,560 REFLECT PERSONAL PREFERENCES, 1230 00:50:19,560 --> 00:50:24,800 CULTURAL TRADITIONS, BUDGETARY 1231 00:50:24,800 --> 00:50:25,280 CONSIDERATIONS. 1232 00:50:25,280 --> 00:50:26,240 WE RECOGNIZE GUIDELINES PROVIDE 1233 00:50:26,240 --> 00:50:29,280 A FRAMEWORK THAT CAN BE 1234 00:50:29,280 --> 00:50:29,960 CUSTOMIZED. 1235 00:50:29,960 --> 00:50:33,440 THREE FOCUS ON MEETING FOOD 1236 00:50:33,440 --> 00:50:36,960 GROUP NEEDS WITH FOODS AND 1237 00:50:36,960 --> 00:50:39,160 BEVERAGES, STAYING WITHIN 1238 00:50:39,160 --> 00:50:41,120 CALORIE LIMITS, EMPHASIZES 1239 00:50:41,120 --> 00:50:44,640 CHOOSING FOODS AND BEVERAGES 1240 00:50:44,640 --> 00:50:49,000 THAT HAVE -- PROVIDE NUTRIENTS, 1241 00:50:49,000 --> 00:50:52,160 WHILE LIMITING CONTRIBUTION TO 1242 00:50:52,160 --> 00:50:54,480 SATURATED FAT, ADDED SUGARS, 1243 00:50:54,480 --> 00:50:55,120 SODIUM. 1244 00:50:55,120 --> 00:50:56,440 WHICH TRANSITIONS AND SEGUES 1245 00:50:56,440 --> 00:51:02,440 INTO NUMBER FOUR, TO LIMIT THOSE 1246 00:51:02,440 --> 00:51:04,200 FRUITS AND BEVERAGESES HIGHER IN 1247 00:51:04,200 --> 00:51:05,840 SUGARS AND SATURATED FATS AND 1248 00:51:05,840 --> 00:51:06,800 ALCOHOLIC BEVERAGE. 1249 00:51:06,800 --> 00:51:08,680 THERE'S NOTHING ABOUT TIMING IN 1250 00:51:08,680 --> 00:51:11,000 THE KEY GUIDELINES. 1251 00:51:11,000 --> 00:51:14,040 2020 DIETARY GUIDELINES ADVISORY 1252 00:51:14,040 --> 00:51:15,040 COMMITTEE DID CONDUCT REVIEWS 1253 00:51:15,040 --> 00:51:16,120 RELATED TO TIMING AND FREQUENCY 1254 00:51:16,120 --> 00:51:18,440 OF EATING AND HEALTH OUTCOMES, 1255 00:51:18,440 --> 00:51:21,720 BUT THOSE DIDN'T YIELD ANSWERS 1256 00:51:21,720 --> 00:51:22,920 ABOUT THAT RELATIONSHIP. 1257 00:51:22,920 --> 00:51:25,720 IN PART, HOW IT WAS DEFINED IN 1258 00:51:25,720 --> 00:51:29,200 THE QUESTION AND INCLUSION AND 1259 00:51:29,200 --> 00:51:30,520 EXCLUSION CRITERIA. 1260 00:51:30,520 --> 00:51:32,160 THE COMMITTEE REVIEWED DATA 1261 00:51:32,160 --> 00:51:34,680 ANALYSIS THAT DESCRIBED CURRENT 1262 00:51:34,680 --> 00:51:36,400 EATING FREQUENCY OF AMERICANS IN 1263 00:51:36,400 --> 00:51:40,920 RELATION TO DIET QUALITY, AND 1264 00:51:40,920 --> 00:51:44,320 RECOGNIZED FOR GROUPS OF 1265 00:51:44,320 --> 00:51:47,680 INDIVIDUALS WHERE THEY REPORTED 1266 00:51:47,680 --> 00:51:49,920 NOT CONSUMING AS MANY MEALS OR 1267 00:51:49,920 --> 00:51:51,840 SNACKS, THERE MAY HAVE BEEN A 1268 00:51:51,840 --> 00:51:55,120 MISSED OPPORTUNITY TO ACHIEVE 1269 00:51:55,120 --> 00:51:57,000 FOOD GROUP RECOMMENDATIONS, SO 1270 00:51:57,000 --> 00:51:58,440 DIET QUALITY SCORES USING 1271 00:51:58,440 --> 00:52:00,280 HEALTHY EATING INDEX WERE LOWER 1272 00:52:00,280 --> 00:52:04,560 FOR THOSE GROUPS, FEWER EATING 1273 00:52:04,560 --> 00:52:04,800 EVENTS. 1274 00:52:04,800 --> 00:52:06,600 HEALTHY DIETARY PATTERNS AND 1275 00:52:06,600 --> 00:52:07,720 EATING FREQUENCIES CAN BE 1276 00:52:07,720 --> 00:52:09,920 CONSTRUCTED IN A VARIETY OF 1277 00:52:09,920 --> 00:52:12,320 WAYS, TO SUIT DIFFERING LIFE 1278 00:52:12,320 --> 00:52:15,600 STAGES OR CULTURAL PRACTICES. 1279 00:52:15,600 --> 00:52:17,000 WE RECOGNIZE THAT CUSTOMIZING 1280 00:52:17,000 --> 00:52:19,240 ENJOYING A HEALTHY DIETARY 1281 00:52:19,240 --> 00:52:20,800 PATTERN MIGHT FIT SOME DIFFERENT 1282 00:52:20,800 --> 00:52:24,800 WAYS THAT FREQUENCY MIGHT BE 1283 00:52:24,800 --> 00:52:26,320 ACHIEVED. 1284 00:52:26,320 --> 00:52:28,200 REDUCING SNACKING AND 1285 00:52:28,200 --> 00:52:31,160 EMPHASIZING MEALS BOTH PRIMARILY 1286 00:52:31,160 --> 00:52:33,040 COMPRISE FOODS AND BEVERAGE THAT 1287 00:52:33,040 --> 00:52:34,200 CONTRIBUTE TO RECOMMENDATIONS 1288 00:52:34,200 --> 00:52:36,720 CAN HELP ALIGN EATING PATTERNS 1289 00:52:36,720 --> 00:52:41,560 WITH DIETARY GUIDELINES FOR 1290 00:52:41,560 --> 00:52:42,040 RECOMMENDATIONS. 1291 00:52:42,040 --> 00:52:42,440 NEXT SLIDE. 1292 00:52:42,440 --> 00:52:45,360 SO RIGHT NOW IS AN EXCITING TIME 1293 00:52:45,360 --> 00:52:50,680 FOR ALL OF AT CNPP AND ODP, 1294 00:52:50,680 --> 00:52:52,320 RIGHT AT THE BEGINNING OF THE 1295 00:52:52,320 --> 00:52:54,640 PROCESS TO DEVELOP THE NEXT 1296 00:52:54,640 --> 00:52:57,880 EDITION OF THE DIETARY 1297 00:52:57,880 --> 00:52:58,200 GUIDELINES. 1298 00:52:58,200 --> 00:53:03,160 THIS STARTED IN 2022, WHERE THE 1299 00:53:03,160 --> 00:53:04,040 PROPOSED SCIENTIFIC QUESTIONS 1300 00:53:04,040 --> 00:53:05,240 WERE POSTED FOR PUBLIC COMMENT. 1301 00:53:05,240 --> 00:53:09,720 THERE WAS A CALL FOR NOMINATIONS 1302 00:53:09,720 --> 00:53:12,360 FOR ADVISORY COMMITTEE MEMBERS, 1303 00:53:12,360 --> 00:53:14,120 AND THOSE ADVISORY COMMITTEE 1304 00:53:14,120 --> 00:53:14,920 MEMBERS WERE APPOINTED THIS YEAR 1305 00:53:14,920 --> 00:53:20,880 AND I SHOULD HAVE MOVED THAT 1306 00:53:20,880 --> 00:53:21,200 STAR. 1307 00:53:21,200 --> 00:53:23,080 WE'RE ACTUALLY PREPARING FOR THE 1308 00:53:23,080 --> 00:53:24,320 SECOND PUBLIC MEETING AND THAT 1309 00:53:24,320 --> 00:53:25,920 WILL OCCUR NEXT WEEK. 1310 00:53:25,920 --> 00:53:27,240 I'LL PROVIDE INFORMATION AT THE 1311 00:53:27,240 --> 00:53:28,840 END OF THE PRESENTATION FOR 1312 00:53:28,840 --> 00:53:32,040 THOSE WHO MIGHT WANT TO TUNE IN. 1313 00:53:32,040 --> 00:53:33,600 THERE WILL BE SIX PUBLIC 1314 00:53:33,600 --> 00:53:35,120 MEETINGS WHERE THE ADVISORY 1315 00:53:35,120 --> 00:53:38,520 COMMITTEE IS GOING TO DISCUSS 1316 00:53:38,520 --> 00:53:42,680 THEIR EVALUATION OF THE EVIDENCE 1317 00:53:42,680 --> 00:53:44,800 AND FINALLY PROVIDE A REPORT TO 1318 00:53:44,800 --> 00:53:47,600 THE DEPARTMENT, THERE WILL BE AN 1319 00:53:47,600 --> 00:53:48,720 OPPORTUNITY FOR PUBLIC COMMENT 1320 00:53:48,720 --> 00:53:49,920 ON THAT REPORT. 1321 00:53:49,920 --> 00:53:52,400 THERE'S AN OPPORTUNITY FOR 1322 00:53:52,400 --> 00:53:56,360 PUBLIC COMMENT THROUGHOUT THEIR 1323 00:53:56,360 --> 00:53:57,440 DELIBERATION, AND SPECIFICALLY 1324 00:53:57,440 --> 00:53:59,000 PUBLIC COMMENTS ARE OPEN FOR THE 1325 00:53:59,000 --> 00:54:02,600 PROTOCOLS THAT THEY WILL BE 1326 00:54:02,600 --> 00:54:04,120 POSTING ONLINE FOR HOW THEY ARE 1327 00:54:04,120 --> 00:54:09,680 GOING TO APPROACH THE SCIENTIFIC 1328 00:54:09,680 --> 00:54:09,960 QUESTIONS. 1329 00:54:09,960 --> 00:54:14,000 NEXT SLIDE.. 1330 00:54:14,000 --> 00:54:19,560 THE BEGINNING IS IDENTIFY 1331 00:54:19,560 --> 00:54:21,640 SCIENTIFIC QUESTIONS BASED ON 1332 00:54:21,640 --> 00:54:23,160 RELEVANCE, IMPORTANCE, POTENTIAL 1333 00:54:23,160 --> 00:54:23,800 FEDERAL IMPACT, AVOIDING 1334 00:54:23,800 --> 00:54:26,400 DUPLICATION WITH OTHER FEDERAL 1335 00:54:26,400 --> 00:54:26,760 AGENCIES. 1336 00:54:26,760 --> 00:54:28,120 THESE WERE POSTED FOR PUBLIC 1337 00:54:28,120 --> 00:54:30,760 COMMENT FOR 30 DAYS. 1338 00:54:30,760 --> 00:54:32,840 WE CONSIDER PUBLIC COMMENT AND 1339 00:54:32,840 --> 00:54:35,640 RESEARCH AVAILABILITY AS THE 1340 00:54:35,640 --> 00:54:37,320 COMMITTEE WILL PRIORITIZE THE 1341 00:54:37,320 --> 00:54:43,520 QUESTIONS THEY WILL REVIEW. 1342 00:54:43,520 --> 00:54:44,320 NEXT SLIDE. 1343 00:54:44,320 --> 00:54:46,320 THOSE QUESTIONS THEN HELP US IN 1344 00:54:46,320 --> 00:54:48,360 THE APPOINTMENT OF THE ADVISORY 1345 00:54:48,360 --> 00:54:51,520 COMMITTEE TO UNDERSTAND 1346 00:54:51,520 --> 00:54:53,760 EXPERTISE THAT'S NEEDED. 1347 00:54:53,760 --> 00:54:54,600 WE REQUEST COMMITTEE NOMINATIONS 1348 00:54:54,600 --> 00:54:56,480 FROM THE PUBLIC FOR 30 DAYS, 1349 00:54:56,480 --> 00:54:58,880 SELECT A BALANCED COMMITTEE 1350 00:54:58,880 --> 00:55:00,760 BASED ON EDUCATION, EXPERIENCE, 1351 00:55:00,760 --> 00:55:02,200 DEMONSTRATED EXPERTISE AND 1352 00:55:02,200 --> 00:55:05,360 DESIRE FOR DIVERSE MEMBERSHIP. 1353 00:55:05,360 --> 00:55:08,640 AND THEN THE SECRETARIES OF HHS 1354 00:55:08,640 --> 00:55:10,480 AND USDA JOINTLY APPOINT 1355 00:55:10,480 --> 00:55:16,640 COMMITTEE MEMBERS. 1356 00:55:16,640 --> 00:55:17,280 NEXT SLIDE. 1357 00:55:17,280 --> 00:55:18,600 NEXT SLIDE PLEASE. 1358 00:55:18,600 --> 00:55:19,560 GREAT. 1359 00:55:19,560 --> 00:55:21,000 SO WE'RE IN THIS PROCESS, THIS 1360 00:55:21,000 --> 00:55:22,440 STEP OF THE PROCESS NOW WHERE 1361 00:55:22,440 --> 00:55:25,160 ADVISORY COMMITTEE IS BEGINNING 1362 00:55:25,160 --> 00:55:26,160 TO REVIEW SCIENTIFIC EVIDENCE. 1363 00:55:26,160 --> 00:55:28,440 THEY ARE GOING TO REVIEW 1364 00:55:28,440 --> 00:55:29,760 SCIENTIFIC EVIDENCE ON NUTRITION 1365 00:55:29,760 --> 00:55:31,400 AND HEALTH ACROSS THE LIFESPAN, 1366 00:55:31,400 --> 00:55:34,600 THEY ARE GOING TO DISCUSS 1367 00:55:34,600 --> 00:55:40,600 REVIEW, AS A FULL COMMITTEE, IN 1368 00:55:40,600 --> 00:55:42,040 PUBLIC MEETING, CONSIDER PUBLIC 1369 00:55:42,040 --> 00:55:42,840 COMMENT THROUGHOUT THE PROCESS, 1370 00:55:42,840 --> 00:55:45,560 AND AGAIN AS I MENTIONED THEY 1371 00:55:45,560 --> 00:55:47,960 WILL SUBMIT SCIENTIFIC REPORT TO 1372 00:55:47,960 --> 00:55:50,480 THE SECRETARIES OF HHS AND USDA. 1373 00:55:50,480 --> 00:55:54,520 I WANT TO DISTINGUISH THEIR 1374 00:55:54,520 --> 00:55:56,720 REPORT IS THEIR SUMMARY SPECIFIC 1375 00:55:56,720 --> 00:55:58,920 AND CONCLUSIONS DRAWN THAT THEY 1376 00:55:58,920 --> 00:56:00,360 PRESENT MAKING RECOMMENDATIONS 1377 00:56:00,360 --> 00:56:03,040 TO THE DEPARTMENTS, BUT THEIR 1378 00:56:03,040 --> 00:56:04,160 REPORT IS NOT THE DIETARY 1379 00:56:04,160 --> 00:56:05,080 GUIDELINES FOR AMERICANS IN AND 1380 00:56:05,080 --> 00:56:07,360 OF ITSELF. 1381 00:56:07,360 --> 00:56:08,840 NEXT SLIDE PLEASE. 1382 00:56:08,840 --> 00:56:12,920 SO THE COMMITTEE WILL USE THREE 1383 00:56:12,920 --> 00:56:14,760 SCIENTIFIC APPROACHES AS THEY 1384 00:56:14,760 --> 00:56:15,840 REVIEW EVIDENCE, COMPLEMENTARY 1385 00:56:15,840 --> 00:56:18,400 IN NATURE, AND EACH HAS A UNIQUE 1386 00:56:18,400 --> 00:56:24,480 PERSPECTIVE TO ADD TO THE 1387 00:56:24,480 --> 00:56:27,920 CONVERSATION. 1388 00:56:27,920 --> 00:56:30,760 SO, OUR NESR REVIEW BRANCH, WE 1389 00:56:30,760 --> 00:56:33,040 HAVE AN ENTIRE TEAM THAT 1390 00:56:33,040 --> 00:56:34,240 CONDUCTS THESE SYSTEMATIC 1391 00:56:34,240 --> 00:56:36,560 REVIEWS USING GOLD STANDARD 1392 00:56:36,560 --> 00:56:38,000 EVIDENCE SYNTHESIS TO ANSWER 1393 00:56:38,000 --> 00:56:40,400 QUESTIONS ABOUT NUTRITION AND 1394 00:56:40,400 --> 00:56:43,440 PUBLIC HEALTH IMPORTANCE. 1395 00:56:43,440 --> 00:56:45,600 ALL OF THE PROTOCOLS FOR THESE 1396 00:56:45,600 --> 00:56:47,920 SYSTEMATIC REVIEWS WILL BE 1397 00:56:47,920 --> 00:56:48,960 POSTED ONLINE. 1398 00:56:48,960 --> 00:56:51,920 THEY WILL ALSO REVIEW THE DATA. 1399 00:56:51,920 --> 00:56:55,880 WE USE COLLECTION OF DATA 1400 00:56:55,880 --> 00:56:57,520 ANALYSIS FROM NATIONAL -- 1401 00:56:57,520 --> 00:56:59,120 FEDERAL NATIONALLY REPRESENTED 1402 00:56:59,120 --> 00:57:00,520 DATASETS TO DESCRIBE CURRENT 1403 00:57:00,520 --> 00:57:03,120 HEALTH AND DIETARY INTAKE OF 1404 00:57:03,120 --> 00:57:03,400 AMERICANS. 1405 00:57:03,400 --> 00:57:05,960 THE DATA REALLY HELP MAKE THE 1406 00:57:05,960 --> 00:57:07,240 DIETARY GUIDELINES PRACTICAL, 1407 00:57:07,240 --> 00:57:10,040 RELEVANT, ACHIEVABLE, TO GIVE AN 1408 00:57:10,040 --> 00:57:12,800 UNDERSTANDING OF WHERE WE ARE AS 1409 00:57:12,800 --> 00:57:15,400 A COUNTRY RELATIVE TO THESE 1410 00:57:15,400 --> 00:57:16,160 TOPICS. 1411 00:57:16,160 --> 00:57:17,480 FINALLY, FOOD PATTERN MODELING, 1412 00:57:17,480 --> 00:57:19,240 CLOSE TO MY HEART BECAUSE PART 1413 00:57:19,240 --> 00:57:22,400 OF THE WORK I LEAD. 1414 00:57:22,400 --> 00:57:23,240 IT'S ANALYSIS THAT ILLUSTRATES 1415 00:57:23,240 --> 00:57:25,360 HOW CHANGES TO THE AMOUNTS AND 1416 00:57:25,360 --> 00:57:28,000 TYPES OF FOODS AND BEVERAGES AND 1417 00:57:28,000 --> 00:57:29,720 DIETARY PATTERN MIGHT AFFECT 1418 00:57:29,720 --> 00:57:33,600 MEETING NUTRIENT NEEDS ACROSS 1419 00:57:33,600 --> 00:57:34,200 THE POPULATION. 1420 00:57:34,200 --> 00:57:35,200 I HOPE YOU'LL BE INTERESTED IN 1421 00:57:35,200 --> 00:57:37,400 SOME OF THE WORK AND QUESTIONS 1422 00:57:37,400 --> 00:57:41,000 THE COMMITTEE IS ASKING, USING 1423 00:57:41,000 --> 00:57:42,640 THOSE FOOD PATTERN MODELING THIS 1424 00:57:42,640 --> 00:57:45,480 GO ROUND. 1425 00:57:45,480 --> 00:57:46,600 NEXT SLIDE. 1426 00:57:46,600 --> 00:57:50,400 THEN AFTER THE COMMITTEE SUBMITS 1427 00:57:50,400 --> 00:57:52,160 THEIR REPORT, THEN WE USE THAT 1428 00:57:52,160 --> 00:57:53,840 REPORT TO INFORM THE DEVELOPMENT 1429 00:57:53,840 --> 00:57:54,960 OF THE DIETARY GUIDELINES FOR 1430 00:57:54,960 --> 00:57:58,320 AMERICANS WHICH WILL BE THE 1431 00:57:58,320 --> 00:57:59,080 2025-2030 EDITION. 1432 00:57:59,080 --> 00:58:00,720 WE FORM A FEDERAL WRITING TEAM 1433 00:58:00,720 --> 00:58:03,360 TO UPDATE THE DIETARY 1434 00:58:03,360 --> 00:58:03,920 GUIDELINES. 1435 00:58:03,920 --> 00:58:05,880 WE DEVELOP THOSE GUIDELINES 1436 00:58:05,880 --> 00:58:07,640 AGAIN USING THE COMMITTEE 1437 00:58:07,640 --> 00:58:10,800 SCIENTIFIC REPORT, ALSO FEDERAL 1438 00:58:10,800 --> 00:58:13,360 RESOURCES AND INPUT FROM 1439 00:58:13,360 --> 00:58:14,960 AGENCIES AND THE PUBLIC. 1440 00:58:14,960 --> 00:58:17,400 WE CONSIDER PEER REVIEW BY 1441 00:58:17,400 --> 00:58:18,040 FEDERAL AND NON-FEDERAL 1442 00:58:18,040 --> 00:58:19,400 SCIENTISTS, ONCE THE DRAFT OF 1443 00:58:19,400 --> 00:58:22,320 THE GUIDELINES IS COMPLETE. 1444 00:58:22,320 --> 00:58:24,000 AND THEN WE FACILITATE THE 1445 00:58:24,000 --> 00:58:26,840 APPROVAL PROCESS THROUGH BOTH 1446 00:58:26,840 --> 00:58:29,880 DEPARTMENTS, USDA AND HHS. 1447 00:58:29,880 --> 00:58:32,240 THE SECRETARIES JOINTLY RELEASE 1448 00:58:32,240 --> 00:58:34,280 THE NEW EDITION OF DIETARY 1449 00:58:34,280 --> 00:58:36,960 GUIDELINES FOR AMERICANS. 1450 00:58:36,960 --> 00:58:38,000 NEXT SLIDE. 1451 00:58:38,000 --> 00:58:40,640 SO THEN WE GET TO THE 1452 00:58:40,640 --> 00:58:43,680 IMPLEMENTATION WHICH IS ALWAYS 1453 00:58:43,680 --> 00:58:44,320 FUN. 1454 00:58:44,320 --> 00:58:45,000 DIETARY GUIDELINES INFORM 1455 00:58:45,000 --> 00:58:50,360 FEDERAL PROGRAMS SUCH AS FOOD 1456 00:58:50,360 --> 00:58:51,760 ASSISTANCE, MEAL PROGRAMS, 1457 00:58:51,760 --> 00:58:53,520 RESEARCH, PRIORITIES, NUTRITION 1458 00:58:53,520 --> 00:58:55,720 EDUCATION EFFORTS, AND NATIONAL 1459 00:58:55,720 --> 00:58:56,920 HEALTH OBJECTIVES. 1460 00:58:56,920 --> 00:58:58,200 GUIDELINES PROVIDE A STRUCTURE 1461 00:58:58,200 --> 00:59:01,040 FOR STATE AND LOCAL PUBLIC 1462 00:59:01,040 --> 00:59:02,280 HEALTH INITIATIVES. 1463 00:59:02,280 --> 00:59:05,160 IT OFFERS NUTRITION GUIDANCE FOR 1464 00:59:05,160 --> 00:59:07,480 POLICYMAKERS, HEALTH CARE 1465 00:59:07,480 --> 00:59:08,800 PROVIDERS, NUTRITION EDUCATORS, 1466 00:59:08,800 --> 00:59:11,520 IMPLEMENTED THROUGH MY PLATE, 1467 00:59:11,520 --> 00:59:12,840 FEDERAL NUTRITION SYMBOL TO HELP 1468 00:59:12,840 --> 00:59:14,320 AMERICANS PUT GUIDELINES INTO 1469 00:59:14,320 --> 00:59:21,920 ACTION AND HOST OF RESOURCES 1470 00:59:21,920 --> 00:59:32,360 ONLINE THROUGH MY PLATE. 1471 00:59:44,120 --> 00:59:45,840 NEXT SLIDE PLEASE. 1472 00:59:45,840 --> 00:59:46,920 OH NO. 1473 00:59:46,920 --> 00:59:48,920 CAN SOMEBODY ALERT ME IF YOU CAN 1474 00:59:48,920 --> 00:59:49,960 LARRY ME? 1475 00:59:49,960 --> 00:59:53,240 I THINK MY INTERNET JUST KICKED. 1476 00:59:53,240 --> 00:59:59,240 1477 00:59:59,240 --> 00:59:59,480 1478 00:59:59,480 --> 01:00:02,200 >>IT SEEMS LIKE SHE WAS SAYING 1479 01:00:02,200 --> 01:00:03,400 HER INTERNET KICKED HER OUT. 1480 01:00:03,400 --> 01:00:05,000 THERE SHE IS. 1481 01:00:05,000 --> 01:00:11,040 >>I'M SORRY FOR THAT SNAFU. 1482 01:00:11,040 --> 01:00:11,280 THANKS. 1483 01:00:11,280 --> 01:00:13,480 BACK UP ONE SLIDE TO MAKE SURE 1484 01:00:13,480 --> 01:00:16,440 I'M ON TRACK. 1485 01:00:16,440 --> 01:00:16,760 PERFECT. 1486 01:00:16,760 --> 01:00:18,520 NEXT SLIDE. 1487 01:00:18,520 --> 01:00:18,880 GREAT. 1488 01:00:18,880 --> 01:00:21,960 SO, THINKING ABOUT THE 1489 01:00:21,960 --> 01:00:23,120 COMMITTEE'S EVIDENCE REVIEW, 1490 01:00:23,120 --> 01:00:25,960 SOME OF THE SCIENTIFIC TOPICS TO 1491 01:00:25,960 --> 01:00:28,400 BE ADDRESSED ARE DIETARY 1492 01:00:28,400 --> 01:00:32,680 PATTERNS, ULTRA PROCESSED FOOD, 1493 01:00:32,680 --> 01:00:35,800 ADDED SUGAR, SATURATED FAT, 1494 01:00:35,800 --> 01:00:37,520 BEHAVIOR STRATEGIES, WEIGHT 1495 01:00:37,520 --> 01:00:38,000 MANAGEMENT. 1496 01:00:38,000 --> 01:00:39,040 HEALTH MANAGEMENT INCLUDES 1497 01:00:39,040 --> 01:00:41,880 OVERWEIGHT AND OBESITY, 1498 01:00:41,880 --> 01:00:44,640 CARDIOVASCULAR DISEASE, TYPE 2 1499 01:00:44,640 --> 01:00:47,840 DIABETES, CANCER, NEUROCOGNITIVE 1500 01:00:47,840 --> 01:00:50,360 HEALTH, SARCOPENIA, ALL-CAUSE 1501 01:00:50,360 --> 01:00:51,360 MORTALITY, BONE HEALTH, 1502 01:00:51,360 --> 01:00:53,120 PREGNANCY AND ALL CAUSE 1503 01:00:53,120 --> 01:00:55,400 MORTALITY, THREE SOURCES OF 1504 01:00:55,400 --> 01:00:58,000 EVIDENCE USE AND SYNTHESIZED IN 1505 01:00:58,000 --> 01:00:59,360 THE REPORT. 1506 01:00:59,360 --> 01:01:00,960 FINALLY, WE HAVE ASKED THE 1507 01:01:00,960 --> 01:01:02,960 COMMITTEE TO TAKE -- TO 1508 01:01:02,960 --> 01:01:04,360 INCORPORATE HEALTH EQUITY 1509 01:01:04,360 --> 01:01:06,440 PRINCIPLES USING LIFE STAGE 1510 01:01:06,440 --> 01:01:07,440 APPROACH ACROSS ITS REVIEW. 1511 01:01:07,440 --> 01:01:10,280 I SHOULD ON THAT NOTE APOLOGIZE 1512 01:01:10,280 --> 01:01:12,280 THAT THERE ARE SOME TERMS THAT 1513 01:01:12,280 --> 01:01:15,440 ARE BEING VERY CAREFULLY 1514 01:01:15,440 --> 01:01:17,640 CONSIDERED BY THE COMMITTEE. 1515 01:01:17,640 --> 01:01:21,080 OVERWEIGHT AND OBESITY, OR THE 1516 01:01:21,080 --> 01:01:22,360 TERM DIET-RELATED CHRONIC 1517 01:01:22,360 --> 01:01:23,800 DISEASE, RECOGNIZING IT'S NOT 1518 01:01:23,800 --> 01:01:25,000 NECESSARILY JUST DIET AND THERE 1519 01:01:25,000 --> 01:01:28,600 ARE MANY THINGS THAT CREATE A 1520 01:01:28,600 --> 01:01:30,040 COMPLEX ENVIRONMENT THAT CAN 1521 01:01:30,040 --> 01:01:31,520 CONTRIBUTE TO HEALTH OUTCOMES. 1522 01:01:31,520 --> 01:01:34,160 I WANT TO ACKNOWLEDGE THAT MAYBE 1523 01:01:34,160 --> 01:01:36,280 SOME OF MY TERMINOLOGY COULD USE 1524 01:01:36,280 --> 01:01:39,800 IMPROVING, AND WE'RE ALL WORKING 1525 01:01:39,800 --> 01:01:41,200 QUITE HARD TO LEARN AND THINK 1526 01:01:41,200 --> 01:01:43,600 WITH A HEALTH EQUITY LENS AS WE 1527 01:01:43,600 --> 01:01:46,120 PRESENT THESE TOPICS. 1528 01:01:46,120 --> 01:01:48,520 I'M STILL LEARNING TO REMEMBER 1529 01:01:48,520 --> 01:01:50,920 TO BE COGNIZANT OF THESE TERMS 1530 01:01:50,920 --> 01:01:56,400 AS I GO ALONG. 1531 01:01:56,400 --> 01:01:58,040 NEXT SLIDE PLEASE. 1532 01:01:58,040 --> 01:01:59,320 THERE ARE PROPOSED SCIENTIFIC 1533 01:01:59,320 --> 01:02:01,440 QUESTIONS RELATED TO TIMING OF 1534 01:02:01,440 --> 01:02:01,680 EATING. 1535 01:02:01,680 --> 01:02:03,400 ONE IS WHAT IS THE RELATIONSHIP 1536 01:02:03,400 --> 01:02:05,880 BETWEEN TIMING OF EATING 1537 01:02:05,880 --> 01:02:07,120 OCCASIONS, EATING BREAKFAST, 1538 01:02:07,120 --> 01:02:11,640 LIMITING EATING LATE IN THE DAY, 1539 01:02:11,640 --> 01:02:13,920 SNACKING, INTERMITTENT FASTING, 1540 01:02:13,920 --> 01:02:15,120 TIME-RESTRICTED EATING, AND SOME 1541 01:02:15,120 --> 01:02:18,200 OF THE OUTCOMES THAT I MENTIONED 1542 01:02:18,200 --> 01:02:20,480 ON A PREVIOUS SLIDE. 1543 01:02:20,480 --> 01:02:22,320 RELATIONSHIP BETWEEN TIMING OF 1544 01:02:22,320 --> 01:02:26,480 EATING AND OUTCOMES SUCH AS 1545 01:02:26,480 --> 01:02:27,880 GROWTH, BODY COMPOSITION, 1546 01:02:27,880 --> 01:02:29,120 OVERWEIGHT, OBESITY, WEIGHT 1547 01:02:29,120 --> 01:02:30,680 LOSS, WEIGHT GAIN. 1548 01:02:30,680 --> 01:02:32,720 WITH CONSUMING DIETARY PATTERNS 1549 01:02:32,720 --> 01:02:35,120 MORE ALIGNED WITH DIETARY 1550 01:02:35,120 --> 01:02:36,240 GUIDELINES FOR AMERICANS. 1551 01:02:36,240 --> 01:02:39,320 WE'LL USE DATA ANALYSIS TO 1552 01:02:39,320 --> 01:02:41,080 DESCRIBE CURRENT INTAKE, 1553 01:02:41,080 --> 01:02:42,400 PREVALENCE OF NUTRITION RELATED 1554 01:02:42,400 --> 01:02:43,800 CHRONIC HEALTH CONDITIONS, AND 1555 01:02:43,800 --> 01:02:47,120 DIETARY COMPONENTS OF PUBLIC 1556 01:02:47,120 --> 01:02:48,080 HEALTH CONCERN WILL BE CONDUCTED 1557 01:02:48,080 --> 01:02:50,400 TO INFORM THE WORK. 1558 01:02:50,400 --> 01:02:51,920 WE'LL LOOK AT DATA RELATED TO 1559 01:02:51,920 --> 01:02:55,240 FREQUENCY OF EATING AND HOW 1560 01:02:55,240 --> 01:02:56,520 THOSE EATING EVENTS ARE LABELED. 1561 01:02:56,520 --> 01:02:57,720 NOW, THERE ARE TWO TOPICS THAT 1562 01:02:57,720 --> 01:03:00,800 WEREN'T ON THE LIST OF QUESTIONS 1563 01:03:00,800 --> 01:03:02,760 TO BE EXAMINED BY THE 2025 1564 01:03:02,760 --> 01:03:06,280 COMMITTEE THAT I DO WANT TO 1565 01:03:06,280 --> 01:03:06,520 RECOGNIZE. 1566 01:03:06,520 --> 01:03:09,320 YOU CAN GO TO THE NEXT SLIDE I 1567 01:03:09,320 --> 01:03:09,680 THINK. 1568 01:03:09,680 --> 01:03:12,160 OH, NO, WE'LL GO BACK. 1569 01:03:12,160 --> 01:03:14,600 I DO WANT TO RECOGNIZE THAT 1570 01:03:14,600 --> 01:03:16,120 THERE'S SOME TOPICS THAT WILL BE 1571 01:03:16,120 --> 01:03:17,760 ADDRESSED IN A SEPARATE PROCESS 1572 01:03:17,760 --> 01:03:19,520 OUTSIDE THE ADVISORY COMMITTEE. 1573 01:03:19,520 --> 01:03:21,360 ONE IS ALCOHOLIC BEVERAGES. 1574 01:03:21,360 --> 01:03:24,520 THIS REMAINS HIGH PRIORITY TOPIC 1575 01:03:24,520 --> 01:03:26,840 BUT BECAUSE IT REQUIRES 1576 01:03:26,840 --> 01:03:28,040 SIGNIFICANT AND SPECIFIC 1577 01:03:28,040 --> 01:03:29,680 EXPERTISE AND HAS UNIQUE 1578 01:03:29,680 --> 01:03:31,000 CONSIDERATIONS IT'S GOING TO BE 1579 01:03:31,000 --> 01:03:33,520 EXAMINE IN A SEPARATE EFFORT LED 1580 01:03:33,520 --> 01:03:36,480 BY HHS AGENCIES TO SUPPORT WORK 1581 01:03:36,480 --> 01:03:37,680 ON THE TOPIC. 1582 01:03:37,680 --> 01:03:41,160 OTHER TOPICS THAT I WANTED TO BE 1583 01:03:41,160 --> 01:03:43,360 TRANSPARENT ABOUT IS 1584 01:03:43,360 --> 01:03:44,240 SUSTAINABILITY AND COMPLEX 1585 01:03:44,240 --> 01:03:44,920 RELATIONSHIP BETWEEN NUTRITION 1586 01:03:44,920 --> 01:03:46,560 AND CLIMATE CHANGE WHICH WE FEEL 1587 01:03:46,560 --> 01:03:50,560 IS A VERY IMPORTANT 1588 01:03:50,560 --> 01:03:52,200 CROSS-CUTTING AND HIGH-PRIORITY 1589 01:03:52,200 --> 01:03:54,840 TOPIC, THAT ALSO REQUIRES 1590 01:03:54,840 --> 01:03:55,480 SPECIFIC EXPERTISE. 1591 01:03:55,480 --> 01:03:57,040 HHS AND USDA WILL ADDRESS THIS 1592 01:03:57,040 --> 01:03:59,440 TOPIC SEPARATE FROM THE 1593 01:03:59,440 --> 01:04:01,840 COMMITTEE'S PROCESS, TO ENOUGH 1594 01:04:01,840 --> 01:04:02,960 WORK ACROSS THE DEPARTMENT. 1595 01:04:02,960 --> 01:04:06,440 I HOPE THAT GIVES YOU A SENSE OF 1596 01:04:06,440 --> 01:04:09,440 PROCESS, WHERE WE ARE NOW, AND 1597 01:04:09,440 --> 01:04:11,280 SCIENCE THAT WILL BE EXPLORED BY 1598 01:04:11,280 --> 01:04:12,320 THE CURRENT COMMITTEE. 1599 01:04:12,320 --> 01:04:16,520 YOU CAN GO TO THE FINAL SLIDE 1600 01:04:16,520 --> 01:04:18,080 WITH MY CONTACT INFORMATION. 1601 01:04:18,080 --> 01:04:20,280 ALSO INFORMATION TO STAY 1602 01:04:20,280 --> 01:04:26,480 CONNECTED AND JOIN IN ON THIS 1603 01:04:26,480 --> 01:04:27,040 PROCESS. 1604 01:04:27,040 --> 01:04:27,840 SO DIETARYGUIDELINES.GOV, YOU 1605 01:04:27,840 --> 01:04:29,600 CAN FIND A VARIETY OF RESOURCES 1606 01:04:29,600 --> 01:04:34,240 THAT MIGHT BE USEFUL IN YOUR 1607 01:04:34,240 --> 01:04:36,440 RESEARCH, INCLUDING SLIDE DECKS, 1608 01:04:36,440 --> 01:04:39,000 THAT HAVE DATA TABLES AND 1609 01:04:39,000 --> 01:04:40,480 FIGURES, TALKING POINTS ABOUT 1610 01:04:40,480 --> 01:04:43,600 THE DIETARY GUIDELINES, SPECIFIC 1611 01:04:43,600 --> 01:04:45,080 TO EACH LIFE STAGE, ALSO THE 1612 01:04:45,080 --> 01:04:46,520 CURRENT PLACE WE ARE NOW. 1613 01:04:46,520 --> 01:04:50,480 YOU CAN SIGN UP TO GET UPDATES 1614 01:04:50,480 --> 01:04:51,560 WITH THINGS LIKE REGISTRATION 1615 01:04:51,560 --> 01:04:53,400 FOR PUBLIC MEETINGS LIKE THE ONE 1616 01:04:53,400 --> 01:04:55,360 THAT WILL OCCUR NEXT WEEK, ALSO 1617 01:04:55,360 --> 01:04:58,480 AT THE LINK WITH THE OPPORTUNITY 1618 01:04:58,480 --> 01:05:00,000 TO PROVIDE PUBLIC COMMENT. 1619 01:05:00,000 --> 01:05:03,720 SO PARTICULARLY AS PROTOCOLS GET 1620 01:05:03,720 --> 01:05:06,360 DEVELOPED YOU MIGHT BE 1621 01:05:06,360 --> 01:05:08,000 INTERESTED TO REVIEW PROTOCOLS, 1622 01:05:08,000 --> 01:05:13,960 AND PROVIDE COMMENTS TO THE 1623 01:05:13,960 --> 01:05:15,800 COMMITTEE IN SUPPORT OR OFFERING 1624 01:05:15,800 --> 01:05:17,480 SUGGESTIONS HOW THEY MIGHT LOOK 1625 01:05:17,480 --> 01:05:18,880 AT THE RESEARCH DIFFERENTLY. 1626 01:05:18,880 --> 01:05:21,720 I ENCOURAGE YOU TO STAY UPDATED 1627 01:05:21,720 --> 01:05:23,800 AND WELCOME YOUR PARTICIPATION 1628 01:05:23,800 --> 01:05:25,520 THROUGH PUBLIC COMMENT AND BY 1629 01:05:25,520 --> 01:05:29,800 ATTENDING THE MEETINGS. 1630 01:05:29,800 --> 01:05:33,160 AND AM HAPPY TO ENTERTAIN ANY 1631 01:05:33,160 --> 01:05:35,840 QUESTIONS. 1632 01:05:35,840 --> 01:05:37,400 1633 01:05:37,400 --> 01:05:41,640 >>THANK YOU, DR. PANNUCCI. 1634 01:05:41,640 --> 01:05:44,920 IT IS OPEN FOR DISCUSSION AND 1635 01:05:44,920 --> 01:05:45,680 Q&A. 1636 01:05:45,680 --> 01:05:47,240 I WANT TO SUMMARIZE THE 1637 01:05:47,240 --> 01:05:48,960 DISCUSSION, THANKING DR. LYNCH 1638 01:05:48,960 --> 01:05:53,480 FOR GUIDING US THROUGH THE NIH'S 1639 01:05:53,480 --> 01:05:54,480 NUTRITION RESEARCH PRIORITIES. 1640 01:05:54,480 --> 01:05:55,760 ANSWERING QUESTIONS AS TO WHAT 1641 01:05:55,760 --> 01:05:58,160 AND WHEN WE SHOULD EAT, 1642 01:05:58,160 --> 01:06:00,720 DISCUSSION ABOUT THE "ALL OF US" 1643 01:06:00,720 --> 01:06:04,120 RESEARCH PROGRAM. 1644 01:06:04,120 --> 01:06:07,000 AND THEN THE NIA RESEARCH 1645 01:06:07,000 --> 01:06:08,600 EFFORTS RELATED TO 1646 01:06:08,600 --> 01:06:09,240 TIME-RESTRICTED EATING, ALSO THE 1647 01:06:09,240 --> 01:06:11,440 "ALL OF US" RESEARCH PROGRAM. 1648 01:06:11,440 --> 01:06:19,680 DR. PA PANNUCCI FOR GUIDING US 1649 01:06:19,680 --> 01:06:21,000 THROUGH HISTORY AND DEVELOPMENT, 1650 01:06:21,000 --> 01:06:21,880 INTERROGATORY HEAR ABOUT THE 1651 01:06:21,880 --> 01:06:23,480 PROCESS BY WHICH A COMMITTEE IS 1652 01:06:23,480 --> 01:06:27,000 APPOINTED AND WHAT ROLES ARE AND 1653 01:06:27,000 --> 01:06:29,400 HOW THAT CULMINATES INTO THE 1654 01:06:29,400 --> 01:06:32,920 PUBLICATION OF GUIDELINES FOR 1655 01:06:32,920 --> 01:06:33,720 AMERICANS. 1656 01:06:33,720 --> 01:06:36,080 WE HAVE SOME QUESTIONS FOR YOU 1657 01:06:36,080 --> 01:06:38,360 IN THE Q&A. 1658 01:06:38,360 --> 01:06:41,560 DR. LYNCH, A QUESTION ABOUT THE 1659 01:06:41,560 --> 01:06:42,200 SHORT-TERM DIETARY INTERVENTIONS 1660 01:06:42,200 --> 01:06:44,800 USED IN THE NUTRITION FOR 1661 01:06:44,800 --> 01:06:46,880 PREVENTION "ALL OF US" RESEARCH 1662 01:06:46,880 --> 01:06:49,000 PROGRAM. 1663 01:06:49,000 --> 01:06:53,480 YOU TALKED ABOUT THE THREE 1664 01:06:53,480 --> 01:06:58,480 MODULES, WHAT DIETS ARE BEING 1665 01:06:58,480 --> 01:06:58,760 EVALUATED? 1666 01:06:58,760 --> 01:07:01,360 >> RIGHT, SO -- AND, YOU KNOW, 1667 01:07:01,360 --> 01:07:04,120 WHEN WE MADE THE FRAMEWORK FOR 1668 01:07:04,120 --> 01:07:06,840 THIS STUDY, BUT WE ALLOWED THE 1669 01:07:06,840 --> 01:07:10,040 CONSORTIUM, YOU KNOW, WHICH IS A 1670 01:07:10,040 --> 01:07:12,120 BIG CONSORTIUM, TO, YOU KNOW, 1671 01:07:12,120 --> 01:07:15,400 MAKE THOSE DECISIONS ABOUT THE 1672 01:07:15,400 --> 01:07:16,000 DIETS. 1673 01:07:16,000 --> 01:07:19,240 SO THE DIETS, AND THERE'S MANY 1674 01:07:19,240 --> 01:07:21,440 PEOPLE WELL KNOWN NUTRITION 1675 01:07:21,440 --> 01:07:24,160 EXPERTS, SO THREE DIETS THEY 1676 01:07:24,160 --> 01:07:26,640 DECIDED TO CHALLENGE 1677 01:07:26,640 --> 01:07:30,080 PARTICIPANTS WITH, AND THEY WILL 1678 01:07:30,080 --> 01:07:33,720 BE ROTATED, RANDOMIZED. 1679 01:07:33,720 --> 01:07:37,000 BUT THE FIRST ONE IS WHAT WE 1680 01:07:37,000 --> 01:07:42,360 CALL STANDARD AMERICAN DIET, 1681 01:07:42,360 --> 01:07:42,640 SAD. 1682 01:07:42,640 --> 01:07:44,960 THE OTHER ONE IS SOMETHING ALONG 1683 01:07:44,960 --> 01:07:46,960 THE LINES OF KETOGENIC DEET 1684 01:07:46,960 --> 01:07:52,080 CETERA, LOW CARB, HIGH FAT. 1685 01:07:52,080 --> 01:07:56,600 AND THE LAST DIET IS WHAT THEY 1686 01:07:56,600 --> 01:08:00,520 ARE TERMING MEDITERRANEAN/DASH 1687 01:08:00,520 --> 01:08:06,440 DIET, WHICH ARE TWO OF THE MOST 1688 01:08:06,440 --> 01:08:08,640 POPULAR DIETS MEDITERRANEAN AND 1689 01:08:08,640 --> 01:08:14,600 DASH, OF COURSE FROM INVENTION 1690 01:08:14,600 --> 01:08:15,440 OF THE NHLBI. 1691 01:08:15,440 --> 01:08:17,320 >>THANK YOU. 1692 01:08:17,320 --> 01:08:19,280 ALSO, ANOTHER QUESTION RELATED 1693 01:08:19,280 --> 01:08:20,640 TO HOW THE ACADEMIC COMMUNITY 1694 01:08:20,640 --> 01:08:23,000 CAN BE MORE INVOLVED WITH THE 1695 01:08:23,000 --> 01:08:24,000 DEVELOPMENT OF POLICY 1696 01:08:24,000 --> 01:08:24,320 GUIDELINES. 1697 01:08:24,320 --> 01:08:28,600 MAYBE THAT'S SOMETHING BOTH OF 1698 01:08:28,600 --> 01:08:29,720 YOU COULD ADDRESS. 1699 01:08:29,720 --> 01:08:32,720 >>WELL, I'LL LET THE DIETARY 1700 01:08:32,720 --> 01:08:33,840 GUIDELINES FOLKS ANSWER THAT 1701 01:08:33,840 --> 01:08:34,280 FIRST. 1702 01:08:34,280 --> 01:08:35,480 WHAT KIND OF POLICIES DO YOU 1703 01:08:35,480 --> 01:08:40,840 THINK THEY ARE ASKING ABOUT? 1704 01:08:40,840 --> 01:08:43,560 >>I BELIEVE NUTRITION 1705 01:08:43,560 --> 01:08:43,840 GUIDANCE. 1706 01:08:43,840 --> 01:08:51,440 >>DIETARY GUIDELINES, OKAY. 1707 01:08:51,440 --> 01:08:52,920 >>I WAS LOOKING AT A QUESTION 1708 01:08:52,920 --> 01:08:54,720 IN THE CHAT, IF YOU COULD REPEAT 1709 01:08:54,720 --> 01:08:56,480 THE QUESTION THAT WOULD BE 1710 01:08:56,480 --> 01:08:56,720 HELPFUL. 1711 01:08:56,720 --> 01:08:58,000 >>HOW CAN THE ACADEMIC 1712 01:08:58,000 --> 01:09:00,200 COMMUNITY SUPPORT OR GET MORE 1713 01:09:00,200 --> 01:09:06,640 INVOLVED WITH THE DEVELOPMENT OF 1714 01:09:06,640 --> 01:09:07,040 POLICY GUIDELINES. 1715 01:09:07,040 --> 01:09:07,840 >>SURE. 1716 01:09:07,840 --> 01:09:10,360 I THINK ONE WAY IS PARTICIPATE 1717 01:09:10,360 --> 01:09:11,680 IN THE PUBLIC COMMENTS. 1718 01:09:11,680 --> 01:09:14,520 IF THERE'S A QUESTION RELATED TO 1719 01:09:14,520 --> 01:09:15,720 YOUR AREA OF RESEARCH, TO TAKE 1720 01:09:15,720 --> 01:09:17,920 THE TIME TO REVIEW THE PROTOCOLS 1721 01:09:17,920 --> 01:09:23,000 FOR HOW THE COMMITTEE PLANS TO 1722 01:09:23,000 --> 01:09:23,960 ADDRESS THE RESEARCH QUESTION 1723 01:09:23,960 --> 01:09:26,160 AND MAYBE PROVIDE YOUR THOUGHTS, 1724 01:09:26,160 --> 01:09:29,000 EITHER TO SUPPORT OR IMPROVE 1725 01:09:29,000 --> 01:09:30,000 THAT APPROACH. 1726 01:09:30,000 --> 01:09:31,600 I THINK FOLLOWING ALONG AND 1727 01:09:31,600 --> 01:09:33,520 ENCOURAGING YOUR STUDENTS TO 1728 01:09:33,520 --> 01:09:36,240 FOLLOW ALONG TOO, TO UNDERSTAND 1729 01:09:36,240 --> 01:09:38,960 THE RIGORS BEHIND THE REVIEW OF 1730 01:09:38,960 --> 01:09:41,920 THE EVIDENCE, AND TO FOLLOW 1731 01:09:41,920 --> 01:09:46,080 ALONG THE DISCUSSIONS THE 1732 01:09:46,080 --> 01:09:47,840 COMMITTEE MEMBERS ARE HAVING IS 1733 01:09:47,840 --> 01:09:49,480 ALSO QUITE HELPFUL. 1734 01:09:49,480 --> 01:09:50,560 AND TO DO GOOD RESEARCH, 1735 01:09:50,560 --> 01:09:52,320 CONTINUE DOING GOOD RESEARCH. 1736 01:09:52,320 --> 01:09:54,160 BECAUSE OF THE GOOD RESEARCH 1737 01:09:54,160 --> 01:09:57,040 YOU'RE DOING, RESEARCH IS BEING 1738 01:09:57,040 --> 01:09:57,760 REVIEWED BY THE COMMITTEE. 1739 01:09:57,760 --> 01:10:00,440 THERE ARE MULTIPLE WAYS TO GET 1740 01:10:00,440 --> 01:10:00,720 INVOLVED. 1741 01:10:00,720 --> 01:10:03,000 ALSO MANY COMMITTEE MEMBERS OF 1742 01:10:03,000 --> 01:10:04,240 COURSE ARE IN ACADEMIA. 1743 01:10:04,240 --> 01:10:06,120 SO BEING WILLING TO BE PART OF 1744 01:10:06,120 --> 01:10:07,800 THE PROCESS AND CONTRIBUTE YOUR 1745 01:10:07,800 --> 01:10:16,360 EXPERTISE THAT WAY, MAYBE ON 1746 01:10:16,360 --> 01:10:16,760 FUTURE COMMITTEES. 1747 01:10:16,760 --> 01:10:18,280 >>OPPORTUNITIES TO BE INVOLVED 1748 01:10:18,280 --> 01:10:18,960 IN PROPOSING SCIENTIFIC 1749 01:10:18,960 --> 01:10:22,960 QUESTIONS THAT SHOULD BE 1750 01:10:22,960 --> 01:10:25,520 ADDRESSED BY THE ADVISORY 1751 01:10:25,520 --> 01:10:25,760 COMMITTEE. 1752 01:10:25,760 --> 01:10:27,360 >>THAT TOO, AND PUBLIC COMMENT 1753 01:10:27,360 --> 01:10:28,440 PROCESS WHEN TOPICS AND 1754 01:10:28,440 --> 01:10:32,600 QUESTIONS ARE PROPOSED, THERE'S 1755 01:10:32,600 --> 01:10:33,240 AN OPPORTUNITY FOR CONTRIBUTING 1756 01:10:33,240 --> 01:10:34,480 YOUR THOUGHTS IN THE PUBLIC 1757 01:10:34,480 --> 01:10:37,400 COMMENT PROCESS FOR THAT AS 1758 01:10:37,400 --> 01:10:38,000 WELL. 1759 01:10:38,000 --> 01:10:43,040 >>DR. LYNCH, YOU MENTIONED -- 1760 01:10:43,040 --> 01:10:45,720 >> I WANTED TO MENTION, WE HAVE 1761 01:10:45,720 --> 01:10:47,400 SOMETHING SIMILAR BUT WE DON'T 1762 01:10:47,400 --> 01:10:49,800 CALL THEM PUBLIC COMMENTS. 1763 01:10:49,800 --> 01:10:52,480 WE PUT OUT REQUESTS FOR 1764 01:10:52,480 --> 01:10:53,160 INFORMATION. 1765 01:10:53,160 --> 01:10:57,240 AND NIH IS PUTTING THOSE OUT ALL 1766 01:10:57,240 --> 01:10:59,760 THE TIME TO REQUEST INPUT ON 1767 01:10:59,760 --> 01:11:04,240 WHAT IT IS THAT WE DO. 1768 01:11:04,240 --> 01:11:08,720 THE OFFICE OF NUTRITION RESEARCH 1769 01:11:08,720 --> 01:11:09,720 HAS LISTENING SESSIONS, 1770 01:11:09,720 --> 01:11:11,800 NUTRITIONALS, SOME OF THEM ARE 1771 01:11:11,800 --> 01:11:12,880 EFFORTS TO HELP PEOPLE THROUGH 1772 01:11:12,880 --> 01:11:14,000 THE GRANT PROCESS OR SOMETHING, 1773 01:11:14,000 --> 01:11:16,440 BUT OTHER TIMES WE HAVE LARGER 1774 01:11:16,440 --> 01:11:19,040 GROUPS SAYING, A, WE THINK THAT, 1775 01:11:19,040 --> 01:11:21,240 YOU KNOW, YOU SHOULD BE DOING 1776 01:11:21,240 --> 01:11:25,080 MORE RESEARCH ON X OR Y. 1777 01:11:25,080 --> 01:11:27,560 AND SO WE GET AD HOC INPUT THAT 1778 01:11:27,560 --> 01:11:30,200 WAY, IN ADDITION TO HAVING THESE 1779 01:11:30,200 --> 01:11:34,960 REQUESTS FOR INFORMATION FROM 1780 01:11:34,960 --> 01:11:35,680 TIME TO TIME. 1781 01:11:35,680 --> 01:11:36,960 >>THANK YOU. 1782 01:11:36,960 --> 01:11:40,720 DR. LYNCH, YOU TALKED ABOUT 1783 01:11:40,720 --> 01:11:41,920 CLOCKING IN, CHRONONUTRITION, 1784 01:11:41,920 --> 01:11:44,760 AND THE NIA INITIATIVES IN THIS 1785 01:11:44,760 --> 01:11:49,120 AREA THAT ALIGN WITH STRATEGIC 1786 01:11:49,120 --> 01:11:51,320 GOALS TWO, INITIATED PLANNING 1787 01:11:51,320 --> 01:12:01,800 PROJECTS, YOUNGER ADULTS BY 1788 01:12:04,080 --> 01:12:06,440 PENNINGTON AND KOJESKI, THE NIA 1789 01:12:06,440 --> 01:12:07,560 WILL FOUND FIVE YEAR PROJECTS. 1790 01:12:07,560 --> 01:12:13,440 >>AT THE ENDS OF THE PLANNING 1791 01:12:13,440 --> 01:12:16,600 PROJECTS, THE NIA WILL -- AS DR. 1792 01:12:16,600 --> 01:12:19,120 GOFF MENTIONED, I'M SPEAKING ON 1793 01:12:19,120 --> 01:12:22,080 MY PERSONAL BEHALF, NOT WORKING 1794 01:12:22,080 --> 01:12:24,640 FOR NIA, BUT I BELIEVE WHAT THEY 1795 01:12:24,640 --> 01:12:26,800 WILL DO IS EVALUATE THE OUTCOMES 1796 01:12:26,800 --> 01:12:32,160 OF THE PILOT STUDIES. 1797 01:12:32,160 --> 01:12:35,920 WAS WHAT THEY WERE DOING IN 1798 01:12:35,920 --> 01:12:39,520 THOSE STUDIES FEASIBLE? 1799 01:12:39,520 --> 01:12:42,200 AND, YOU KNOW, COULD THEY 1800 01:12:42,200 --> 01:12:42,880 RECRUIT SUFFICIENT PARTICIPANTS 1801 01:12:42,880 --> 01:12:46,400 TO TAKE PART IN THAT KIND OF 1802 01:12:46,400 --> 01:12:47,040 THING? 1803 01:12:47,040 --> 01:12:48,720 AND BECAUSE SOME PEOPLE, THE 1804 01:12:48,720 --> 01:12:51,120 EVENTUAL STUDY THEY WERE 1805 01:12:51,120 --> 01:12:53,280 REFLECTING ABOUT WOULD HAVE, YOU 1806 01:12:53,280 --> 01:12:55,400 KNOW, A CONTROL ARM, PLACEBO 1807 01:12:55,400 --> 01:12:58,640 ARM, AND TWO INTERVENTION DIETS 1808 01:12:58,640 --> 01:13:00,000 FOR FIVE YEARS. 1809 01:13:00,000 --> 01:13:04,280 YOU KNOW, THAT'S VERY RISKY. 1810 01:13:04,280 --> 01:13:06,680 AND IT INVOLVES A LARGE 1811 01:13:06,680 --> 01:13:07,880 INVESTMENT PER YEAR. 1812 01:13:07,880 --> 01:13:09,400 SO, THEY ARE GOING TO LOOK AT 1813 01:13:09,400 --> 01:13:11,280 THAT AND SEE, AND MAKE THE 1814 01:13:11,280 --> 01:13:13,360 DECISION ABOUT WHETHER THEY 1815 01:13:13,360 --> 01:13:17,080 SHOULD PROCEED, YOU KNOW, WITH 1816 01:13:17,080 --> 01:13:18,520 WHETHER IT'S VIABLE TO PROCEED 1817 01:13:18,520 --> 01:13:19,720 AHEAD OR NOT. 1818 01:13:19,720 --> 01:13:22,560 SO IT'S THAT POINT. 1819 01:13:22,560 --> 01:13:26,840 BUT I THINK, YOU KNOW, WE -- 1820 01:13:26,840 --> 01:13:30,320 BECAUSE MANY INSTITUTES, YOU 1821 01:13:30,320 --> 01:13:31,960 KNOW, PLAN AHEAD, WE NEED TO -- 1822 01:13:31,960 --> 01:13:33,480 IN CASE THE OUTCOME IS WE'RE 1823 01:13:33,480 --> 01:13:36,400 GOING TO DO THIS, I THINK WE 1824 01:13:36,400 --> 01:13:39,080 NEED TO NOW, YOU KNOW, GET THE 1825 01:13:39,080 --> 01:13:40,920 BAND -- BECAUSE WE GOT TOGETHER 1826 01:13:40,920 --> 01:13:43,320 WITH THEM AT THE BEGINNING, TO 1827 01:13:43,320 --> 01:13:45,920 GET THE BAND BACK TOGETHER TO, 1828 01:13:45,920 --> 01:13:49,280 YOU KNOW, SEE WHAT KIND OF, YOU 1829 01:13:49,280 --> 01:13:50,920 KNOW, WHAT KIND OF THINGS THE 1830 01:13:50,920 --> 01:13:52,160 INSTITUTES WOULD BE INTERESTED 1831 01:13:52,160 --> 01:13:55,080 IN, ARE THEY INTERESTED IN A 1832 01:13:55,080 --> 01:13:56,480 PARTICULAR POPULATION, ARE THEY 1833 01:13:56,480 --> 01:13:58,400 INTERESTED IN DISEASE OUTCOMES 1834 01:13:58,400 --> 01:14:01,120 TO BE MEASURED IN ADDITION TO 1835 01:14:01,120 --> 01:14:04,840 WHATEVER NIA IS GOING TO DO, 1836 01:14:04,840 --> 01:14:09,960 WOULD THAT BE FEASIBLE OR 1837 01:14:09,960 --> 01:14:11,160 RELATIVE EASY. 1838 01:14:11,160 --> 01:14:13,120 I THINK THERE'S BIG 1839 01:14:13,120 --> 01:14:16,120 OPPORTUNITIES THERE TO LOOK AT 1840 01:14:16,120 --> 01:14:18,080 DISEASES OF INTEREST, MULTIPLE, 1841 01:14:18,080 --> 01:14:21,000 YOU KNOW, INSTITUTES AND 1842 01:14:21,000 --> 01:14:21,560 CENTERS. 1843 01:14:21,560 --> 01:14:26,280 YOU KNOW, OBESITY, YOU KNOW, 1844 01:14:26,280 --> 01:14:29,040 CARDIOVASCULAR OUTCOMES, CANCER 1845 01:14:29,040 --> 01:14:31,000 OUTCOMES, AND, YOU KNOW, OTHER 1846 01:14:31,000 --> 01:14:34,840 OUTCOMES IN PREGNANCY AND SO ON 1847 01:14:34,840 --> 01:14:36,120 FOR THE OTHER INSTITUTES THAT 1848 01:14:36,120 --> 01:14:38,800 MIGHT BE INTERESTED IN. 1849 01:14:38,800 --> 01:14:41,080 >>AGING-RELATED OUTCOMES, THE 1850 01:14:41,080 --> 01:14:42,120 REASON I'M PROBING, A QUESTION 1851 01:14:42,120 --> 01:14:48,040 IN THE Q&A RELATED TO POTENTIAL 1852 01:14:48,040 --> 01:14:49,480 RFAs OR PROGRAM ANNOUNCEMENTS 1853 01:14:49,480 --> 01:14:51,320 THAT WOULD COME OUT, WHETHER 1854 01:14:51,320 --> 01:14:52,520 THESE WOULD BE PROJECTS THAT 1855 01:14:52,520 --> 01:14:59,360 WOULD COME OUT OF THE CURRENTLY 1856 01:14:59,360 --> 01:15:02,600 FUNDED LABS FOR THE PROJECTS. 1857 01:15:02,600 --> 01:15:07,520 >> WELL, YEAH, I DON'T KNOW HOW 1858 01:15:07,520 --> 01:15:09,040 THAT WOULD LOOK. 1859 01:15:09,040 --> 01:15:12,440 NIA REPORT -- THEY DO A LOT OF 1860 01:15:12,440 --> 01:15:15,400 NUTRITION RESEARCH FRANKLY. 1861 01:15:15,400 --> 01:15:17,320 AND THEY HAVE THIS BALTIMORE 1862 01:15:17,320 --> 01:15:19,360 LONGITUDINAL STUDY THAT THEY 1863 01:15:19,360 --> 01:15:23,240 HAVE GOING ON INTRAMURALLY. 1864 01:15:23,240 --> 01:15:24,720 THEIR INTRAMURAL SCIENTISTS DO A 1865 01:15:24,720 --> 01:15:28,240 LOT OF RESEARCH ON CALORIC 1866 01:15:28,240 --> 01:15:31,160 RESTRICTION AND OTHER, YOU KNOW, 1867 01:15:31,160 --> 01:15:36,320 DIETARY PATTERNS IN PRE-CLINICAL 1868 01:15:36,320 --> 01:15:36,560 MODELS. 1869 01:15:36,560 --> 01:15:38,640 AND THEY SUPPORT A LOT OF 1870 01:15:38,640 --> 01:15:43,080 NUTRITION RESEARCH FROM THE 1871 01:15:43,080 --> 01:15:45,000 BASIC SCIENCE LEVEL TO INCLUDING 1872 01:15:45,000 --> 01:15:47,160 INVESTIGATOR -- A LOT OF 1873 01:15:47,160 --> 01:15:47,800 INVESTIGATOR-INITIATED RESEARCH 1874 01:15:47,800 --> 01:15:49,800 THAT YOU DON'T HAVE TO WAIT FOR 1875 01:15:49,800 --> 01:15:50,760 AN RFA FOR. 1876 01:15:50,760 --> 01:15:54,720 THIS IS THE NIH'S STRENGTH IS 1877 01:15:54,720 --> 01:15:58,640 YOU COMING UP WITH THE IDEA, AND 1878 01:15:58,640 --> 01:16:00,600 SO THERE'S -- WE'VE RECOGNIZED 1879 01:16:00,600 --> 01:16:01,800 THERE'S OPPORTUNITIES IN THIS 1880 01:16:01,800 --> 01:16:03,640 SPACE AND THERE'S A LOT OF 1881 01:16:03,640 --> 01:16:06,480 INSTITUTES THAT ARE INTERESTED 1882 01:16:06,480 --> 01:16:07,000 IN THIS SPACE. 1883 01:16:07,000 --> 01:16:08,800 >>AND WE HAVE A QUESTION FROM 1884 01:16:08,800 --> 01:16:11,200 ONE OF OUR PANELISTS ABOUT THE 1885 01:16:11,200 --> 01:16:12,640 DIETARY GUIDELINES. 1886 01:16:12,640 --> 01:16:14,280 WE KNOW MANY AMERICANS AREN'T 1887 01:16:14,280 --> 01:16:17,880 MEETING EVEN THE BASIC DIETARY 1888 01:16:17,880 --> 01:16:18,640 RECOMMENDATIONS, THE EXERCISE 1889 01:16:18,640 --> 01:16:19,960 RECOMMENDATIONS THAT GO WITH 1890 01:16:19,960 --> 01:16:20,200 THOSE. 1891 01:16:20,200 --> 01:16:22,280 WHAT ARE THE WAYS IN WHICH WE 1892 01:16:22,280 --> 01:16:25,760 CAN IMPROVE ADHERENCE TO 1893 01:16:25,760 --> 01:16:28,400 EXISTING GUIDELINES AND WOULD 1894 01:16:28,400 --> 01:16:30,280 PRECISION MEDICINE HELP THEM? 1895 01:16:30,280 --> 01:16:32,760 YOU MEANINGSED A LITTLE BIT OF 1896 01:16:32,760 --> 01:16:36,520 THIS IN YOUR CLOSING STATEMENT, 1897 01:16:36,520 --> 01:16:38,800 HOW WE SHOULD EVALUATE WHETHER 1898 01:16:38,800 --> 01:16:40,360 TIMING OF EATING CAN HELP 1899 01:16:40,360 --> 01:16:44,040 SOMEONE ADHERE TO DIETARY 1900 01:16:44,040 --> 01:16:44,600 GUIDELINES. 1901 01:16:44,600 --> 01:16:45,800 IS THAT SOMETHING WE SHOULD BE 1902 01:16:45,800 --> 01:16:47,880 PUSHING FORWARD IN TERMS OF THE 1903 01:16:47,880 --> 01:16:53,040 RESEARCH AGENDA IN THIS AREA? 1904 01:16:53,040 --> 01:16:55,880 1905 01:16:55,880 --> 01:17:01,000 1906 01:17:01,000 --> 01:17:04,200 WELL, ON AVERAGE THE POPULATION 1907 01:17:04,200 --> 01:17:06,280 IS NOT -- DOES NOT HAVE DIETS 1908 01:17:06,280 --> 01:17:08,440 THAT ALIGN WITH DIETARY 1909 01:17:08,440 --> 01:17:09,320 GUIDELINES, CERTAINLY FALLS 1910 01:17:09,320 --> 01:17:11,640 SHORT OF MANY OF THE FOOD GROUPS 1911 01:17:11,640 --> 01:17:15,480 THAT WE HAVE ADEQUACY GOALS FOR. 1912 01:17:15,480 --> 01:17:16,600 FRUITS, VEGETABLES, WHOLE GRAINS 1913 01:17:16,600 --> 01:17:17,320 IN PARTICULAR. 1914 01:17:17,320 --> 01:17:23,880 AND EXCEEDS LIMITS ON SATURATED 1915 01:17:23,880 --> 01:17:25,640 FAT, ADDED SUGAR, SODIUM. 1916 01:17:25,640 --> 01:17:30,680 WHAT THE COMMITTEE NOTED LAST 1917 01:17:30,680 --> 01:17:32,320 TIME WAS THAT FOR THOSE WITH FEW 1918 01:17:32,320 --> 01:17:34,200 EATING EVENTS MAY BE A MISSED 1919 01:17:34,200 --> 01:17:38,000 OPPORTUNITY TO ACHIEVE THOSE 1920 01:17:38,000 --> 01:17:38,440 GOALS. 1921 01:17:38,440 --> 01:17:40,040 I THINK THERE ARE MANY BARRIERS 1922 01:17:40,040 --> 01:17:41,160 TO HEALTHY EATING THAT ARE 1923 01:17:41,160 --> 01:17:44,680 COMPLEX AND NEED TO BE UNPACKED. 1924 01:17:44,680 --> 01:17:46,400 BUT CERTAINLY WHEN WE THINK 1925 01:17:46,400 --> 01:17:48,080 ABOUT THE HEALTH EQUITY 1926 01:17:48,080 --> 01:17:50,920 APPROACH, WE NEED TO THINK ABOUT 1927 01:17:50,920 --> 01:17:55,720 WHAT THOSE BARRIERS ARE, AND HOW 1928 01:17:55,720 --> 01:17:58,160 WE CAN WORK TOGETHER TO 1929 01:17:58,160 --> 01:18:01,000 DISMANTLE THOSE BARRIERS. 1930 01:18:01,000 --> 01:18:04,600 THAT'S SOMETHING THAT IS BEING 1931 01:18:04,600 --> 01:18:05,200 DISCUSSED. 1932 01:18:05,200 --> 01:18:08,120 BUT I THINK TIMING OF EATING 1933 01:18:08,120 --> 01:18:10,080 COULD BE SOMETHING THAT MIGHT 1934 01:18:10,080 --> 01:18:12,720 HAVE A ROLE. 1935 01:18:12,720 --> 01:18:15,880 OR MIGHT -- WHERE RESEARCH MIGHT 1936 01:18:15,880 --> 01:18:17,400 HAVE A ROLE ELUCIDATING 1937 01:18:17,400 --> 01:18:22,200 BARRIERS, BUT IT'S A CHALLENGE 1938 01:18:22,200 --> 01:18:27,000 BETWEEN CHOICES AND ACCESS, AND 1939 01:18:27,000 --> 01:18:28,880 AFFORDABILITY, EDUCATION, SO 1940 01:18:28,880 --> 01:18:31,400 MANY COMPLEX FACTORS THAT MIGHT 1941 01:18:31,400 --> 01:18:32,240 CREATE BARRIERS. 1942 01:18:32,240 --> 01:18:34,120 IT LOOKS LIKE YOU WERE GOING TO 1943 01:18:34,120 --> 01:18:35,560 ADD TO THAT, CHRIS. 1944 01:18:35,560 --> 01:18:36,760 >>I'M THINKING, AT THE END OF 1945 01:18:36,760 --> 01:18:41,120 EACH ONE OF THESE GUIDELINES, 1946 01:18:41,120 --> 01:18:42,000 THE SCIENTIFIC COMMITTEE 1947 01:18:42,000 --> 01:18:47,600 PRODUCES A SET OF GAPS AND RE-- 1948 01:18:47,600 --> 01:18:49,560 RESEARCH GAPS AND OPPORTUNITIES, 1949 01:18:49,560 --> 01:18:51,400 THAT, YOU KNOW, IT MIGHT NOT BE 1950 01:18:51,400 --> 01:18:53,600 THE PART THAT WE GET TO WHEN 1951 01:18:53,600 --> 01:18:56,360 WE'RE READING THE DIETARY 1952 01:18:56,360 --> 01:18:58,880 GUIDELINES, BUT MAYBE THEY NEED 1953 01:18:58,880 --> 01:19:01,960 TO COME UP WITH -- WE'VE ASKED 1954 01:19:01,960 --> 01:19:04,880 THIS LAST TIME. 1955 01:19:04,880 --> 01:19:07,160 IT WOULD BE HELPFUL IF 1956 01:19:07,160 --> 01:19:09,280 ORGANIZERS WROTE TO THE GRANT 1957 01:19:09,280 --> 01:19:10,600 INSTITUTIONS, THE PEOPLE GIVING 1958 01:19:10,600 --> 01:19:13,000 OUT GRANTS, AND LET THEM KNOW, 1959 01:19:13,000 --> 01:19:19,480 LIKE NOT THE WHOLE LAUNDRY LIST 1960 01:19:19,480 --> 01:19:20,920 BUT WHAT THE SCIENTIFIC 1961 01:19:20,920 --> 01:19:23,080 COMMITTEE THOUGHT WERE GOOD 1962 01:19:23,080 --> 01:19:24,080 OPPORTUNITIES AND GAPS AND 1963 01:19:24,080 --> 01:19:25,400 OPPORTUNITIES AND COULD YOU HELP 1964 01:19:25,400 --> 01:19:27,720 US WITH THESE. 1965 01:19:27,720 --> 01:19:29,400 >>SO GLAD YOU BROUGHT THAT UP. 1966 01:19:29,400 --> 01:19:31,960 THAT'S RIGHT, AT THE END OF EACH 1967 01:19:31,960 --> 01:19:35,600 CHAPTER, THERE'S A LIST OF 1968 01:19:35,600 --> 01:19:37,120 RESEARCH RECOMMENDATIONS. 1969 01:19:37,120 --> 01:19:40,280 AND THAT'S AN INTERESTING IDEA 1970 01:19:40,280 --> 01:19:43,120 TO HAVE THOSE COMMUNICATED THAT 1971 01:19:43,120 --> 01:19:43,280 WAY. 1972 01:19:43,280 --> 01:19:43,960 >>GREAT. 1973 01:19:43,960 --> 01:19:45,560 THANK YOU BOTH SO MUCH. 1974 01:19:45,560 --> 01:19:49,960 WE'RE ENDING RIGHT ON TIME WITH 1975 01:19:49,960 --> 01:19:51,360 THIS DISCUSSION PERIOD. 1976 01:19:51,360 --> 01:19:57,760 NOW IT'S TIME FOR A TEN-MINUTE 1977 01:19:57,760 --> 01:20:00,160 STRETCH BREAK, BACK AT 1:30 FOR 1978 01:20:00,160 --> 01:20:00,960 THE NEXT SESSION. 1979 01:20:00,960 --> 01:20:05,160 SEE YOU SOON. 1980 01:20:05,160 --> 01:20:05,960 >>WELCOME BACK. 1981 01:20:05,960 --> 01:20:16,480 IT'S MY PLEASURE TO INTRODUCE 1982 01:20:16,480 --> 01:20:18,960 THE SESSION CHAIR, DR. KEN 1983 01:20:18,960 --> 01:20:22,360 WRIGHT, DIRECTOR OF THE SLEEP 1984 01:20:22,360 --> 01:20:23,800 LABORATORY, UNIVERSITY OF 1985 01:20:23,800 --> 01:20:25,200 COLORADO BOULDER, 25 YEARS OF 1986 01:20:25,200 --> 01:20:35,080 EXPERIENCE IN THE SLEEP AND 1987 01:20:35,080 --> 01:20:39,920 CIRCADIAN FIELD, TO UNDERSTAND 1988 01:20:39,920 --> 01:20:42,840 DISRUPTION, SUCH AS 1989 01:20:42,840 --> 01:20:44,720 CARDIOMETABOLIC RECOGNITION TO 1990 01:20:44,720 --> 01:20:51,200 IMPROVE PUBLIC HEALTH AND SAVED. 1991 01:20:51,200 --> 01:20:57,400 DIRECTS NIH T32 GRANT IN SLEEP 1992 01:20:57,400 --> 01:21:01,040 AND CIRCADIAN RESEARCH, NINDS 1993 01:21:01,040 --> 01:21:02,680 GRANT, TO PROMOTE DIVERSITY AND 1994 01:21:02,680 --> 01:21:04,760 EXCELLENCE IN SLEEP AND 1995 01:21:04,760 --> 01:21:06,000 CIRCADIAN RESEARCH CAREERS, 1996 01:21:06,000 --> 01:21:07,720 SERVED IN LEADERSHIP AND 1997 01:21:07,720 --> 01:21:09,560 ADVISORY ROLES FOR GOVERNMENT 1998 01:21:09,560 --> 01:21:10,800 PROFESSIONAL, COMMUNITY AND 1999 01:21:10,800 --> 01:21:12,320 COMMERCIAL STAKEHOLDERS SUCH AS 2000 01:21:12,320 --> 01:21:13,440 SLEEP DISORDERS RESEARCH 2001 01:21:13,440 --> 01:21:15,720 ADVISORY BOARD OF THE NIH, 2002 01:21:15,720 --> 01:21:18,880 NHLBI, AND BOARD OF DIRECTORS OF 2003 01:21:18,880 --> 01:21:22,040 THIS SLEEP RESEARCH SOCIETY. 2004 01:21:22,040 --> 01:21:24,320 IT'S MY PLEASURE TO HAVE HIM 2005 01:21:24,320 --> 01:21:27,320 GIVE THE INTRODUCTORY ADDRESS 2006 01:21:27,320 --> 01:21:27,920 FOR TODAY'S AFTERNOON SESSION. 2007 01:21:27,920 --> 01:21:30,480 >>THANK YOU FOR THE KIND 2008 01:21:30,480 --> 01:21:30,800 INTRODUCTION. 2009 01:21:30,800 --> 01:21:41,320 I'D LIKE TO THANK THE ORGANIZERS 2010 01:21:41,320 --> 01:21:43,200 AND ACKNOWLEDGE MY FACILITATOR 2011 01:21:43,200 --> 01:21:45,280 A POSTDOCTORAL FELLOW AND 2012 01:21:45,280 --> 01:21:47,120 ASSISTANT ASSOCIATE WE SEARCH 2013 01:21:47,120 --> 01:21:48,320 SCIENTIST, DEPARTMENT OF 2014 01:21:48,320 --> 01:21:49,840 MEDICINE, COLUMBIA UNIVERSITY 2015 01:21:49,840 --> 01:21:52,480 WORKING WITH DR. ST-ONGE ON 2016 01:21:52,480 --> 01:21:55,480 TOPICS WE'RE TALKING ABOUT 2017 01:21:55,480 --> 01:21:56,000 TODAY. 2018 01:21:56,000 --> 01:21:57,920 NEXT SLIDE PLEASE. 2019 01:21:57,920 --> 01:21:59,360 NEXT SLIDE. 2020 01:21:59,360 --> 01:22:01,760 QUICK DISCLOSURES, I DO HAVE 2021 01:22:01,760 --> 01:22:02,520 RESEARCH SUPPORT, DONATED 2022 01:22:02,520 --> 01:22:05,600 MATERIALS FROM A NUMBER OF 2023 01:22:05,600 --> 01:22:08,560 COMPANIES FOR OUR MICROBIOME AND 2024 01:22:08,560 --> 01:22:10,080 SLEEP AND CIRCADIAN RESEARCH, 2025 01:22:10,080 --> 01:22:12,200 AND CONSULTING FOR A NUMBER OF 2026 01:22:12,200 --> 01:22:14,400 COMPANIES THAT ARE DESIGNING 2027 01:22:14,400 --> 01:22:15,160 CIRCADIAN INTERVENTIONS BUT NONE 2028 01:22:15,160 --> 01:22:21,400 ARE GOING TO BE DISCUSSED TODAY. 2029 01:22:21,400 --> 01:22:22,160 NEXT SLIDE PLEASE. 2030 01:22:22,160 --> 01:22:24,800 ONE THING I CAN DO IS HIGHLIGHT 2031 01:22:24,800 --> 01:22:25,680 SOMETHING ELSE FROM ANOTHER 2032 01:22:25,680 --> 01:22:27,280 STRATEGIC PLANS FROM THE NIH. 2033 01:22:27,280 --> 01:22:30,040 THIS COMES FROM THE SLEEP 2034 01:22:30,040 --> 01:22:32,120 RESEARCH PLAN. 2035 01:22:32,120 --> 01:22:34,440 TO HIGHLIGHT THAT GOAL 2 OF THE 2036 01:22:34,440 --> 01:22:37,600 PLAN, LISTED AS HIGH-PRIORITY 2037 01:22:37,600 --> 01:22:40,040 AREA, ELUDICATE REMEMBER WHEN 2038 01:22:40,040 --> 01:22:44,160 CIRCADIAN BIOLOGY, SLEEP HEALTH 2039 01:22:44,160 --> 01:22:46,480 AND TIMING OF FOOD INTAKE. 2040 01:22:46,480 --> 01:22:47,800 FOR THOSE LOOKING FOR STRATEGIES 2041 01:22:47,800 --> 01:22:49,880 TO CONSIDER IN TERMS OF APPLYING 2042 01:22:49,880 --> 01:22:55,120 FOR GRANTS AND EMPHASIS THE NIH 2043 01:22:55,120 --> 01:22:57,320 IS HIGH LIGHTING HERE, IT'S 2044 01:22:57,320 --> 01:23:02,120 RELEVANT TO THE TOPIC TODAY. 2045 01:23:02,120 --> 01:23:04,800 WHAT I WOULD LIKE TO GO IS GO 2046 01:23:04,800 --> 01:23:06,800 OVER BACKGROUND OF CLINICAL 2047 01:23:06,800 --> 01:23:09,040 TRIALS, BUT PURPOSELY AM NOT 2048 01:23:09,040 --> 01:23:10,320 INCLUDING ANY TRIALS THAT THE 2049 01:23:10,320 --> 01:23:11,120 SUBSEQUENT SPEAKERS WILL BE 2050 01:23:11,120 --> 01:23:11,760 TALKING ABOUT. 2051 01:23:11,760 --> 01:23:17,000 I'M GOING TO GIVE A BROAD 2052 01:23:17,000 --> 01:23:18,760 OVERVIEW SURVEY AND KEY AREAS OF 2053 01:23:18,760 --> 01:23:19,760 OTHER OPPORTUNITIES THAT ARE NOT 2054 01:23:19,760 --> 01:23:22,800 SCHEDULED TO BE TALKED ABOUT 2055 01:23:22,800 --> 01:23:23,240 HERE. 2056 01:23:23,240 --> 01:23:27,080 FIRST, THIS IS RESULTS A 2057 01:23:27,080 --> 01:23:29,600 SYSTEMATIC REVIEW AND 2058 01:23:29,600 --> 01:23:31,440 META-ANALYSIS LOOKING AT 2059 01:23:31,440 --> 01:23:34,440 TIME-RESTRICTED EATING ON BODY 2060 01:23:34,440 --> 01:23:36,640 WEIGHT AND METABOLISM AND 2061 01:23:36,640 --> 01:23:39,320 HUMANS, WITH A NUMBER OF KEY 2062 01:23:39,320 --> 01:23:41,000 OUTCOMES STUDIES LOOKED AT. 2063 01:23:41,000 --> 01:23:42,400 ONE IS WEIGHT LOSS. 2064 01:23:42,400 --> 01:23:45,120 YOU CAN SEE IF YOU LOOK AT THE 2065 01:23:45,120 --> 01:23:47,760 BOTTOM, THE OVERALL REDUCTION IN 2066 01:23:47,760 --> 01:23:49,920 WEIGHT LOSS HERE IS ABOUT 1 2067 01:23:49,920 --> 01:23:52,720 KILOGRAM ON AVERAGE ACROSS THE 2068 01:23:52,720 --> 01:23:53,000 STUDIES. 2069 01:23:53,000 --> 01:23:53,920 MAJORITY OF STUDIES SHOW 2070 01:23:53,920 --> 01:23:55,440 BENEFITS IN TERMS OF WEIGHT LOSS 2071 01:23:55,440 --> 01:23:58,600 DID YOU SOME HAVE SMALLER SAMPLE 2072 01:23:58,600 --> 01:24:01,600 SIZES THAN OTHERS, AND AGAIN 2073 01:24:01,600 --> 01:24:03,880 SOME ARE OBSERVATIONAL VERSUS 2074 01:24:03,880 --> 01:24:04,960 RANDOMIZED CONTROLLED TRIALS. 2075 01:24:04,960 --> 01:24:07,280 BUT IT IS BENEFICIAL FOR WEIGHT 2076 01:24:07,280 --> 01:24:08,840 LOSS AND WE'LL HEAR MORE ABOUT 2077 01:24:08,840 --> 01:24:11,120 THAT LATER TODAY. 2078 01:24:11,120 --> 01:24:11,560 NEXT SLIDE. 2079 01:24:11,560 --> 01:24:12,760 IN PARTICULAR ONE OF THE THINGS 2080 01:24:12,760 --> 01:24:14,160 WE SHOULD BE CONSIDERING WHEN WE 2081 01:24:14,160 --> 01:24:15,600 LOOK AT THESE STUDIES IS NOT 2082 01:24:15,600 --> 01:24:17,120 JUST WEIGHT LOSS BUT WHAT TYPE 2083 01:24:17,120 --> 01:24:19,000 OF WEIGHT IS BEING LOST, 2084 01:24:19,000 --> 01:24:19,760 ESPECIALLY IN SPECIAL 2085 01:24:19,760 --> 01:24:22,160 POPULATIONS WHEN WE CONSIDER THE 2086 01:24:22,160 --> 01:24:23,520 LOSS OF FAT-FREE MASS MAY BE 2087 01:24:23,520 --> 01:24:26,240 SOMETHING WE WANT TO TRY TO 2088 01:24:26,240 --> 01:24:26,920 AVOID. 2089 01:24:26,920 --> 01:24:28,200 IN ANY CALORIC RESTRICTION TYPE 2090 01:24:28,200 --> 01:24:30,640 STUDY WE SHOULD HAVE THE LOSS OF 2091 01:24:30,640 --> 01:24:31,600 BOTH. 2092 01:24:31,600 --> 01:24:33,840 AND YOU CAN SEE HERE IN THESE 2093 01:24:33,840 --> 01:24:36,000 PARTICULAR TRIALS AND SO FORTH 2094 01:24:36,000 --> 01:24:38,960 WE CAN SEE THERE IS A LOSS OF 2095 01:24:38,960 --> 01:24:44,760 BOTH FAT MASS AND FAT FREE MASS, 2096 01:24:44,760 --> 01:24:48,520 AND LOSS OF FAT FREE MASS IS 2097 01:24:48,520 --> 01:24:49,800 SIGNIFICANT -- I'M SORRY, ALSO 2098 01:24:49,800 --> 01:24:50,360 NOT SIGNIFICANT. 2099 01:24:50,360 --> 01:24:53,200 THERE ARE INDIVIDUAL TRIALS THAT 2100 01:24:53,200 --> 01:24:54,120 DO HAVE SIGNIFICANT CHANGES. 2101 01:24:54,120 --> 01:24:58,680 THIS IS AN AREA BEING WATCHED 2102 01:24:58,680 --> 01:24:59,880 ESPECIALLY CONSIDERING OLDER 2103 01:24:59,880 --> 01:25:01,560 ADULTS, THE OTHER THING I'D LIKE 2104 01:25:01,560 --> 01:25:05,160 TO HIGHLIGHT HERE IS A STUDY 2105 01:25:05,160 --> 01:25:08,560 DONE A NUMBER OF YEARS AGO, 2106 01:25:08,560 --> 01:25:10,840 RANDOMIZED CLINICAL TRIAL WITH 2107 01:25:10,840 --> 01:25:11,640 CALORIC RESTRICTIONS UNDER 2108 01:25:11,640 --> 01:25:13,080 CONDITIONS OF SUFFICIENT SLEEP 2109 01:25:13,080 --> 01:25:14,560 AND INSUFFICIENT SLEEP. 2110 01:25:14,560 --> 01:25:22,120 THE SAME INDIVIDUALS, RANDOMIZED 2111 01:25:22,120 --> 01:25:22,360 CONTROL. 2112 01:25:22,360 --> 01:25:23,440 WEIGHT LOSS WAS THE SAME BUT 2113 01:25:23,440 --> 01:25:26,520 WHAT WAS LOST WAS DIFFERENT. 2114 01:25:26,520 --> 01:25:29,240 PEOPLE LOST MORE FAT FREE MASS 2115 01:25:29,240 --> 01:25:32,320 WITH CALORIC RESTRICTION UNDER 2116 01:25:32,320 --> 01:25:33,280 INSUFFICIENT THAN FAT MASS. 2117 01:25:33,280 --> 01:25:36,560 THAT'S A KEY THING WHEN LOOKING 2118 01:25:36,560 --> 01:25:38,880 AT TRIALS IN THE FUTURE WHERE 2119 01:25:38,880 --> 01:25:40,000 SLEEP COULD BE INSUFFICIENT IN A 2120 01:25:40,000 --> 01:25:41,520 NUMBER OF PATIENTS IN THE 2121 01:25:41,520 --> 01:25:43,240 POPULATION AND TO CONSIDER HOW 2122 01:25:43,240 --> 01:25:45,360 THAT MAY BE IMPACTING THE TYPE 2123 01:25:45,360 --> 01:25:49,520 OF MASS THAT IS BEING LOST, BODY 2124 01:25:49,520 --> 01:25:50,480 MASS BEING LOST. 2125 01:25:50,480 --> 01:25:51,480 NEXT SLIDE. 2126 01:25:51,480 --> 01:25:54,440 WHEN WE LOOK AT FASTING GLUCOSE 2127 01:25:54,440 --> 01:25:57,720 AND FASTING INSULIN WE HAVE 2128 01:25:57,720 --> 01:26:00,440 SIGNIFICANT DECREASE IN FASTING 2129 01:26:00,440 --> 01:26:01,760 GLUCOSE, NON-SIGNIFICANT EFFECT 2130 01:26:01,760 --> 01:26:03,520 ON FASTING INSULIN. 2131 01:26:03,520 --> 01:26:06,160 SO SOME POTENTIAL IMPROVEMENTS 2132 01:26:06,160 --> 01:26:10,000 IN FASTING GLUCOSE, TRIALS HAVE 2133 01:26:10,000 --> 01:26:11,400 BEEN DONE. 2134 01:26:11,400 --> 01:26:13,520 IF WE LOOK AT CARDIOVASCULAR 2135 01:26:13,520 --> 01:26:18,640 OUTCOMES, SYSTOLIC AND DIE 2136 01:26:18,640 --> 01:26:19,640 TOLL -- DIASTOLIC BLOOD 2137 01:26:19,640 --> 01:26:22,560 PRESSURE, CHANGES IN STUDIES 2138 01:26:22,560 --> 01:26:24,280 OVERALL ARE NON-SIGNIFICANT. 2139 01:26:24,280 --> 01:26:27,480 AGAIN, WE'LL HAVE SOME STUDIES 2140 01:26:27,480 --> 01:26:28,800 THAT WILL SHOW SIGNIFICANCE, AND 2141 01:26:28,800 --> 01:26:29,480 OTHERS WON'T. 2142 01:26:29,480 --> 01:26:30,200 NEXT SLIDE. 2143 01:26:30,200 --> 01:26:33,600 NEXT I WANT TO SWITCH TO THIS 2144 01:26:33,600 --> 01:26:34,360 STUDY, ILLUSTRATING ANOTHER 2145 01:26:34,360 --> 01:26:36,360 CONCEPT THAT WE CAN BE 2146 01:26:36,360 --> 01:26:40,600 CONSIDERING IN THE TIMES OF 2147 01:26:40,600 --> 01:26:42,600 TRIALS, USING ENHANCED GLUCOSE 2148 01:26:42,600 --> 01:26:44,120 MONITORING IN EIGHT MALES, 2149 01:26:44,120 --> 01:26:44,800 RANDOMIZED CROSSOVER STUDY, 2150 01:26:44,800 --> 01:26:46,840 EARLY OR LATE MEAL TIMING. 2151 01:26:46,840 --> 01:26:49,040 YOU CAN SEE THE TIME ON THE 2152 01:26:49,040 --> 01:26:50,240 UPPER RIGHT-HAND CORNER. 2153 01:26:50,240 --> 01:26:52,000 FOR THREE DAYS AND TWO NIGHTS 2154 01:26:52,000 --> 01:26:52,560 EACH. 2155 01:26:52,560 --> 01:26:55,840 IF WE LOOK AT CONTINUOUS GLUCOSE 2156 01:26:55,840 --> 01:26:59,760 MONITORING, INTERSTITIAL LEVELS 2157 01:26:59,760 --> 01:27:02,600 ON THE Y-AXIS, CLOCK TIME ON THE 2158 01:27:02,600 --> 01:27:03,080 X-AXIS. 2159 01:27:03,080 --> 01:27:04,920 PINK FOR LATE-EATING GROUP, 2160 01:27:04,920 --> 01:27:07,600 LEVELS OF GLUCOSE THROUGHOUT THE 2161 01:27:07,600 --> 01:27:08,760 SLEEP OPPORTUNITY ARE MUCH MEYER 2162 01:27:08,760 --> 01:27:11,720 THAN WHAT IS SEEN IN THOSE WITH 2163 01:27:11,720 --> 01:27:14,120 THE EARLIER TIMING PATTERN. 2164 01:27:14,120 --> 01:27:16,600 I THINK IT BEHOOVES US AS 2165 01:27:16,600 --> 01:27:18,280 SCIENTISTS AND TRYING TO LOOK AT 2166 01:27:18,280 --> 01:27:20,040 THESE QUESTIONS NOT JUST TO LOOK 2167 01:27:20,040 --> 01:27:21,240 AT RESPONSES TO MEALS WHEN WE'RE 2168 01:27:21,240 --> 01:27:23,760 EATING BUT ALSO TO LOOK TO SEE 2169 01:27:23,760 --> 01:27:24,520 WHAT'S HAPPENING OVERNIGHT TO 2170 01:27:24,520 --> 01:27:27,280 GLUCOSE AND, FOR EXAMPLE, TO 2171 01:27:27,280 --> 01:27:29,680 LIPID METABOLISM AND HOW THAT 2172 01:27:29,680 --> 01:27:32,320 COULD CONTRIBUTE TO OUTCOMES 2173 01:27:32,320 --> 01:27:34,040 WE'RE EXAMINING. 2174 01:27:34,040 --> 01:27:34,920 NEXT SLIDE. 2175 01:27:34,920 --> 01:27:36,120 WE HAVEN'T HEARD AS MUCH ABOUT 2176 01:27:36,120 --> 01:27:37,760 SHIFT WORK BUT THIS IS ANOTHER 2177 01:27:37,760 --> 01:27:43,480 KEY AREA WHEN WE THINK ABOUT 2178 01:27:43,480 --> 01:27:44,080 TIME-RESTRICTED. 2179 01:27:44,080 --> 01:27:44,360 NEXT SLIDE. 2180 01:27:44,360 --> 01:27:46,920 ONE OF THE THINGS THAT WE CAN 2181 01:27:46,920 --> 01:27:48,200 CONSIDER BEYOND LOOKING AT 2182 01:27:48,200 --> 01:27:49,720 METABOLIC OUTCOMES IS OTHER 2183 01:27:49,720 --> 01:27:51,400 OUTCOMES IN THESE TYPES OF 2184 01:27:51,400 --> 01:27:51,920 TRIALS. 2185 01:27:51,920 --> 01:27:53,240 THIS IS TO ILLUSTRATE IN 2186 01:27:53,240 --> 01:27:56,200 ADDITION TO WORK WE'VE HEARD 2187 01:27:56,200 --> 01:27:56,960 ALREADY PRESENTED YESTERDAY, 2188 01:27:56,960 --> 01:27:59,480 THIS IS AN EXAMPLE OF A STUDY IN 2189 01:27:59,480 --> 01:28:01,240 AUSTRALIA WHERE THEY WENT AHEAD 2190 01:28:01,240 --> 01:28:02,760 AND COMPARED EATING A SMALL 2191 01:28:02,760 --> 01:28:04,280 SNACK OR NOT EATING AT ALL AT 2192 01:28:04,280 --> 01:28:06,360 NIGHT COMPARED TO EATING A 2193 01:28:06,360 --> 01:28:09,200 TYPICAL MEAL, 30% OF TOTAL DAILY 2194 01:28:09,200 --> 01:28:10,840 ENERGY EXPENDITURE. 2195 01:28:10,840 --> 01:28:16,200 SMALL SNACK, 10% OF TOTAL DAILY 2196 01:28:16,200 --> 01:28:20,240 EXPENDITURE, AND NOT EATING, 2197 01:28:20,240 --> 01:28:21,880 IMPROVED PERFORMANCE IN THE 2198 01:28:21,880 --> 01:28:23,560 LEFT-HAND AND MIDDLE GRAPH, 2199 01:28:23,560 --> 01:28:28,840 LAPSES IN ATTENTION, ON THE 2200 01:28:28,840 --> 01:28:31,320 SECOND TASK, AND THE SOLID BAR 2201 01:28:31,320 --> 01:28:34,600 IS REPRESENTING THE MEAL, AND 2202 01:28:34,600 --> 01:28:39,200 THE ONE WITH THE OPEN SYMBOL IS 2203 01:28:39,200 --> 01:28:45,080 THE SNACK AND THEN NOT EATING IS 2204 01:28:45,080 --> 01:28:46,120 THE DASHED LINE, REDUCED IN 2205 01:28:46,120 --> 01:28:48,400 SMALL SNACK OR NOT EATING AT 2206 01:28:48,400 --> 01:28:50,040 ALL, CONSISTING SHOWING FASTING 2207 01:28:50,040 --> 01:28:52,120 OVERNIGHT WHEN PEOPLE ARE AWARE 2208 01:28:52,120 --> 01:28:53,000 SHOWS IMPROVEMENTS IN 2209 01:28:53,000 --> 01:28:53,400 PERFORMANCE. 2210 01:28:53,400 --> 01:28:56,280 SO THERE COULD BE AGAIN OTHER 2211 01:28:56,280 --> 01:28:59,120 RELEVANT OUTCOMES TO CONSIDER. 2212 01:28:59,120 --> 01:29:01,720 THE FAR RIGHT HERE IT REDUCED 2213 01:29:01,720 --> 01:29:03,040 SLEEPINESS IN TERMS OF JUST 2214 01:29:03,040 --> 01:29:06,760 HAVING A SNACK ON THE NIGHT 2215 01:29:06,760 --> 01:29:07,520 SHIFT. 2216 01:29:07,520 --> 01:29:10,000 NEXT SLIDE. 2217 01:29:10,000 --> 01:29:11,200 WE TALKED ABOUT ASSESSING 2218 01:29:11,200 --> 01:29:12,920 CIRCADIAN PHASE RELATED TO 2219 01:29:12,920 --> 01:29:14,120 TIMING OF EATING. 2220 01:29:14,120 --> 01:29:16,680 THAT'S IMPORTANT IN OUR DAYTIME 2221 01:29:16,680 --> 01:29:16,920 STUDIES. 2222 01:29:16,920 --> 01:29:19,200 ONE OF THE THINGS THINKING ABOUT 2223 01:29:19,200 --> 01:29:23,760 TRYING TO IMPLEMENT IN SHIFT 2224 01:29:23,760 --> 01:29:25,200 WORKERS, THE SHIFT IS MUCH MORE 2225 01:29:25,200 --> 01:29:28,000 WIDELY DID I PERCENTED, SHOWN 2226 01:29:28,000 --> 01:29:32,200 HERE IN THIS GRAPH BY CHANG, A 2227 01:29:32,200 --> 01:29:36,080 RADIAL PLOT, AND BARS FROM THE 2228 01:29:36,080 --> 01:29:39,560 CENTRE 2229 01:29:39,560 --> 01:29:45,160 -- STERILE STRAIGHT TIMING 2230 01:29:45,160 --> 01:29:51,840 IN SHIFT WORKERS, FARTHER OUT IS 2231 01:29:51,840 --> 01:29:53,280 MORE SUBJECTS, RANGES GO IN THE 2232 01:29:53,280 --> 01:29:55,240 AFTERNOON HOURS UNTIL THE 2233 01:29:55,240 --> 01:29:56,120 MORNING HOURS. 2234 01:29:56,120 --> 01:29:58,400 IF WE'RE TRYING TO TIME FOOD 2235 01:29:58,400 --> 01:29:59,720 INTAKE RELATIVE TO CIRCADIAN 2236 01:29:59,720 --> 01:30:03,440 TIMING IN SHIFT WORKERS WE NEED 2237 01:30:03,440 --> 01:30:07,640 A BIOMARKER TO DETERMINE THAT 2238 01:30:07,640 --> 01:30:09,880 BECAUSE OF THE DISTRIBUTION. 2239 01:30:09,880 --> 01:30:10,560 NEXT SLIDE. 2240 01:30:10,560 --> 01:30:14,760 AND I'M GOING TO END WITH 2241 01:30:14,760 --> 01:30:17,480 OPPORTUNITIES IN FUTURE 2242 01:30:17,480 --> 01:30:18,800 DIRECTIONS. 2243 01:30:18,800 --> 01:30:20,040 AND WE'VE HEARD ABOUT MOTHER'S 2244 01:30:20,040 --> 01:30:21,520 MILK, TRYING TO UNDERSTAND THAT 2245 01:30:21,520 --> 01:30:22,840 AND COMPONENTS OF THAT. 2246 01:30:22,840 --> 01:30:25,680 AND I WANT TO HIGHLIGHT HERE 2247 01:30:25,680 --> 01:30:28,560 THAT THE TIME OF DAY IMPACTS THE 2248 01:30:28,560 --> 01:30:30,480 COMPONENTS OF BREAST MILK. 2249 01:30:30,480 --> 01:30:32,880 WHEN WE THINK ABOUT WHEN AN 2250 01:30:32,880 --> 01:30:35,960 INFANT IS FEEDING, IF THEY ARE 2251 01:30:35,960 --> 01:30:39,240 BREASTFEEDING, THEY ARE GETTING 2252 01:30:39,240 --> 01:30:40,120 APPROPRIATE TIME CUES 2253 01:30:40,120 --> 01:30:42,040 THEORETICALLY DURING THE DAY AND 2254 01:30:42,040 --> 01:30:43,520 HAS DIFFERENT COMPOSITION IN 2255 01:30:43,520 --> 01:30:46,400 TERMS OF MOLECULES COMPARED TO 2256 01:30:46,400 --> 01:30:46,840 NIGHTTIME. 2257 01:30:46,840 --> 01:30:51,440 IF MOTHERS ARE PUMPING MILK, AND 2258 01:30:51,440 --> 01:30:52,960 THAT'S PROVIDED TO A CHILD AT 2259 01:30:52,960 --> 01:30:54,560 THE DIFFERENT TIME FROM WHAT THE 2260 01:30:54,560 --> 01:30:56,360 MILK WAS PUMPED IN TERMS OF 2261 01:30:56,360 --> 01:30:58,240 BIOLOGICAL PUMPING THAT COULD 2262 01:30:58,240 --> 01:31:00,480 HAVE IMPLICATIONS FOR HEALTH OF 2263 01:31:00,480 --> 01:31:04,760 THE INFANT, AN OPEN AREA TO 2264 01:31:04,760 --> 01:31:07,040 EXPLORE CHRONONUTRITION. 2265 01:31:07,040 --> 01:31:07,840 NEXT SLIDE. 2266 01:31:07,840 --> 01:31:10,600 I WANT TO HIGHLIGHT ONE OTHER 2267 01:31:10,600 --> 01:31:18,120 AREA OF HEALTH HERE IN TERMS OF 2268 01:31:18,120 --> 01:31:19,000 PREGNANCY, AN INTERVENTION 2269 01:31:19,000 --> 01:31:23,840 LOOKING AT WOMEN WITH 2270 01:31:23,840 --> 01:31:25,680 GESTATIONAL DIABETES, CONTROL. 2271 01:31:25,680 --> 01:31:27,680 THEY DID A CHRONONUTRITION STUDY 2272 01:31:27,680 --> 01:31:30,120 WHERE THEY HAD A GROUP, THE 2273 01:31:30,120 --> 01:31:32,480 INTERVENTION OF NF 33 VERSUS 2274 01:31:32,480 --> 01:31:34,360 CONTROL OF NF 70, REDUCED 2275 01:31:34,360 --> 01:31:36,600 CARBOHYDRATE INTAKE IN THE 2276 01:31:36,600 --> 01:31:37,960 EVENING HOURS, THEY INCREASED 2277 01:31:37,960 --> 01:31:38,960 CARBOHYDRATE INTAKE IN MORNING 2278 01:31:38,960 --> 01:31:40,600 HOURS, THEY HAD THEM EAT 2279 01:31:40,600 --> 01:31:42,400 BREAKFAST 30 MINUTES FROM WAKING 2280 01:31:42,400 --> 01:31:44,400 UP AND EAT DINNER WITHIN 12 2281 01:31:44,400 --> 01:31:48,800 HOURS FROM WAKING UP, AVOID 2282 01:31:48,800 --> 01:31:53,600 EATING CLOSE TO SLEEP. 2283 01:31:53,600 --> 01:31:55,880 THAT SIMPLE INTERVENTION SHOWED 2284 01:31:55,880 --> 01:31:58,880 IT REDUCED MATERNAL RELATIVE 2285 01:31:58,880 --> 01:32:02,320 RISK OF DEVELOPING SUBOPTIMAL 2286 01:32:02,320 --> 01:32:04,840 GLYCEMIC CONTROL, SIGNIFICANTLY, 2287 01:32:04,840 --> 01:32:08,040 .28, ANOTHER OPPORTUNITY HERE. 2288 01:32:08,040 --> 01:32:08,920 NEXT SLIDE. 2289 01:32:08,920 --> 01:32:10,880 THE WANT TO HIGHLIGHT KEY 2290 01:32:10,880 --> 01:32:12,400 THINGS, WE'VE HEARD ALREADY, 2291 01:32:12,400 --> 01:32:14,800 LOOKING AT THE REGULARITY OF THE 2292 01:32:14,800 --> 01:32:18,760 TIMING OF EATING, NOT JUST WHEN, 2293 01:32:18,760 --> 01:32:19,560 THE AMOUNT, MACRONUTRIENTS, 2294 01:32:19,560 --> 01:32:23,240 QUALITY OF FOOD, AS WELL AS 2295 01:32:23,240 --> 01:32:23,640 ADHERENCE. 2296 01:32:23,640 --> 01:32:25,000 AND TO ILLUSTRATE MORE ABOUT 2297 01:32:25,000 --> 01:32:26,680 THAT CHRONONUTRITION BASED ON 2298 01:32:26,680 --> 01:32:29,080 BIOLOGICAL TIMING, IF WE DON'T 2299 01:32:29,080 --> 01:32:31,120 HAVE ACCURATE MARKER OF 2300 01:32:31,120 --> 01:32:32,120 CIRCADIAN PHASE RELATIVE TO WAKE 2301 01:32:32,120 --> 01:32:35,000 TIME AND BEDTIME IS THE FIRST 2302 01:32:35,000 --> 01:32:36,840 PROXY, BUT NOT AS EFFECTIVE. 2303 01:32:36,840 --> 01:32:38,160 IF WE'RE GOING TO MEASURE 2304 01:32:38,160 --> 01:32:41,760 CIRCADIAN TIMING, WE CAN DO IT 2305 01:32:41,760 --> 01:32:45,520 IN PATIENT'S HOMES, BUT IT'S 2306 01:32:45,520 --> 01:32:47,800 MORE OF AN ISSUE OF FEASIBILITY 2307 01:32:47,800 --> 01:32:48,160 SOMETIMES. 2308 01:32:48,160 --> 01:32:49,640 THIS LEADS TO ANOTHER GOAL FOR 2309 01:32:49,640 --> 01:32:53,280 THE STRATEGIC PLAN FROM THE NIH, 2310 01:32:53,280 --> 01:32:54,480 TO DEVELOP CIRCADIAN BIOMARKERS 2311 01:32:54,480 --> 01:32:55,480 USED IN LARGE SCALE CLINICAL 2312 01:32:55,480 --> 01:32:57,200 TRIALS SO THAT WAY WE CAN TAKE 2313 01:32:57,200 --> 01:33:00,200 CIRCADIAN PHASE INTO ACCOUNT IN 2314 01:33:00,200 --> 01:33:01,920 OUR INTERVENTIONS. 2315 01:33:01,920 --> 01:33:04,280 OFTEN THE TRIALS HAVE BEEN SMALL 2316 01:33:04,280 --> 01:33:06,320 SAMPLE SIZES, CLINICAL TRIALS IN 2317 01:33:06,320 --> 01:33:08,960 THIS AREA REQUIRE LARGER SAMPLE 2318 01:33:08,960 --> 01:33:10,520 SIZES AND REPRESENTATION NEEDED. 2319 01:33:10,520 --> 01:33:15,760 AND WHEN WE THINK ABOUT 2320 01:33:15,760 --> 01:33:16,760 TIME-RESTRICTED EATING, TESTED 2321 01:33:16,760 --> 01:33:18,720 IN POPULATION WAS OVERWEIGHT AND 2322 01:33:18,720 --> 01:33:20,000 OBESITY, EFFORTS TO SCREEN AND 2323 01:33:20,000 --> 01:33:22,200 STRATIFY OUTCOMES FOR THOSE WITH 2324 01:33:22,200 --> 01:33:24,400 AND WITHOUT SLEEP APNEA GIVEN 2325 01:33:24,400 --> 01:33:26,600 50% OF PATIENTS WITH OBESITY ARE 2326 01:33:26,600 --> 01:33:27,920 GOING TO HAVE SLEEP APNEA, 2327 01:33:27,920 --> 01:33:30,600 THAT'S GOING TO BE AN IMPACT ON 2328 01:33:30,600 --> 01:33:31,160 METABOLIC OUTCOMES, UNCLEAR 2329 01:33:31,160 --> 01:33:32,240 WHETHER OR NOT TIME-RESTRICTED 2330 01:33:32,240 --> 01:33:34,520 EATING IS GOING TO BE AS 2331 01:33:34,520 --> 01:33:35,800 EFFECTIVE IN THAT POPULATION. 2332 01:33:35,800 --> 01:33:39,400 AND WHETHER OR NOT THE 2333 01:33:39,400 --> 01:33:41,720 COMBINATION OF TREATMENT AND 2334 01:33:41,720 --> 01:33:43,120 EATING HAS BETTER METABOLIC 2335 01:33:43,120 --> 01:33:46,600 HEALTH BENEFITS IN THAT 2336 01:33:46,600 --> 01:33:47,720 POPULATION. 2337 01:33:47,720 --> 01:33:48,520 NEXT SLIDE. 2338 01:33:48,520 --> 01:33:50,560 LASTLY HERE I WANT TO HIGHLIGHT 2339 01:33:50,560 --> 01:33:52,720 NEED FOR CONTINUOUS AND FREQUENT 2340 01:33:52,720 --> 01:33:57,440 SAMPLING OF OUTCOMES ACROSS THE 2341 01:33:57,440 --> 01:34:00,280 24-HOUR DAY, INCLUDING CGM, 2342 01:34:00,280 --> 01:34:01,520 CONTINUOUS BLOOD PRESSURE 2343 01:34:01,520 --> 01:34:02,840 MONITORING, HORMONES, NOT JUST 2344 01:34:02,840 --> 01:34:04,120 MEAL RESPONSE BUT ACROSS THE 2345 01:34:04,120 --> 01:34:08,960 TIME OF DAY BECAUSE NIGHTTIME 2346 01:34:08,960 --> 01:34:10,680 AFFECTS -- ASSESSMENTS ARE 2347 01:34:10,680 --> 01:34:11,080 IMPORTANT. 2348 01:34:11,080 --> 01:34:12,480 ENERGY EXPENDITURE AND OTHER 2349 01:34:12,480 --> 01:34:17,040 MEASURES OF ENERGY METABOLISM, 2350 01:34:17,040 --> 01:34:21,480 AN OPPORTUNITY TO USE OMICS, 2351 01:34:21,480 --> 01:34:23,120 DEVELOPING BIOMARKERS, PROTEOME 2352 01:34:23,120 --> 01:34:25,960 TO UNDERSTAND MECHANISMS IT 2353 01:34:25,960 --> 01:34:26,200 TARGETS. 2354 01:34:26,200 --> 01:34:30,000 I THINK OPPORTUNITIES TO LOOK AT 2355 01:34:30,000 --> 01:34:31,800 INFLAMMATORY PROTEINS, OXIDATIVE 2356 01:34:31,800 --> 01:34:32,760 STRESS, AUTOPHAGY CHANGES 2357 01:34:32,760 --> 01:34:34,640 UNDERLYING MECHANISMS THAT 2358 01:34:34,640 --> 01:34:35,600 CONTRIBUTE TO CARDIOMETABOLIC 2359 01:34:35,600 --> 01:34:38,240 DISEASE AND HOW TIME RESTRICTED 2360 01:34:38,240 --> 01:34:40,720 EATING CAN IMPROVE THESE 2361 01:34:40,720 --> 01:34:42,920 OUTCOMES AS WELL AS MEASURING 2362 01:34:42,920 --> 01:34:46,640 SLEEP AND PERFORMANCE, A NEED TO 2363 01:34:46,640 --> 01:34:50,040 USE GOLD STANDARD ASSESSMENTS, 2364 01:34:50,040 --> 01:34:52,120 USING CLAMPS, TOLERANCE TESTS TO 2365 01:34:52,120 --> 01:34:55,840 GET BETTER ASSESSMENT OF 2366 01:34:55,840 --> 01:34:57,720 METABOLIC STATUS. 2367 01:34:57,720 --> 01:34:59,800 THERE NEEDS TO COMBINE 2368 01:34:59,800 --> 01:35:01,520 CHRONONUTRITION, LOOKING AT 2369 01:35:01,520 --> 01:35:04,240 HEALTHY DIET, MACRONUTRIENT 2370 01:35:04,240 --> 01:35:05,600 TIMING, CALORIC RESTRICTION. 2371 01:35:05,600 --> 01:35:07,560 LASTLY, TIMING AND AMOUNT OF 2372 01:35:07,560 --> 01:35:10,240 PHYSICAL ACTIVITY NEEDED TO 2373 01:35:10,240 --> 01:35:11,160 PROMOTE CARDIOVASCULAR HEALTH, 2374 01:35:11,160 --> 01:35:14,960 CARDIOMETABOLIC HEALTH IN DAY 2375 01:35:14,960 --> 01:35:15,960 WORKERS, ESPECIALLY SHIFT 2376 01:35:15,960 --> 01:35:18,560 WORKERS, IS A CRITICAL NEED, 2377 01:35:18,560 --> 01:35:20,480 UNDERSTANDING OR RECOMMENDATIONS 2378 01:35:20,480 --> 01:35:21,600 FOR PHYSICAL ACTIVITY FOR DAY 2379 01:35:21,600 --> 01:35:23,240 WORKERS MAY NEED TO BE DIFFERENT 2380 01:35:23,240 --> 01:35:25,360 FOR SHIFT WORKERS BECAUSE THEY 2381 01:35:25,360 --> 01:35:27,920 HAVE A HIGHER CARDIOMETABOLIC 2382 01:35:27,920 --> 01:35:30,160 BURDEN THAN DAY WORKERS. 2383 01:35:30,160 --> 01:35:33,440 LASTLY NEEDS TO COMBINE 2384 01:35:33,440 --> 01:35:34,600 CHRONONUTRITION WITH PHYSICAL 2385 01:35:34,600 --> 01:35:38,040 ACTIVITY AND SLEEP AND CIRCADIAN 2386 01:35:38,040 --> 01:35:38,600 PARAMETERS. 2387 01:35:38,600 --> 01:35:38,960 NEXT SLIDE. 2388 01:35:38,960 --> 01:35:40,520 THE LAST THING I WILL SAY IS 2389 01:35:40,520 --> 01:35:43,120 THAT WE NEED TO LOOK AT HEALTH 2390 01:35:43,120 --> 01:35:45,840 ACROSS THE LIFESPAN, DEVELOPING 2391 01:35:45,840 --> 01:35:47,480 INFANTS, TO OLDER ADULTS. 2392 01:35:47,480 --> 01:35:49,920 AS WELL AS AGAIN A NUMBER OF THE 2393 01:35:49,920 --> 01:35:52,120 CONDITIONS THAT WE'VE ALREADY 2394 01:35:52,120 --> 01:35:57,920 TALKED ABOUT, LASTLY I'LL ADD 2395 01:35:57,920 --> 01:36:02,960 PATIENTS IN MEDICAL CARE 2396 01:36:02,960 --> 01:36:03,840 FACILITIES, ENTEROFEEDING, AS 2397 01:36:03,840 --> 01:36:07,800 WELL AS DISORDER WITH NIGHTTIME 2398 01:36:07,800 --> 01:36:09,840 EATING, WE NEED TRIALS. 2399 01:36:09,840 --> 01:36:12,720 WITH THAT I WILL THANK YOU AND 2400 01:36:12,720 --> 01:36:16,360 WE'LL MOVE TO THE FIRST OF OUR 2401 01:36:16,360 --> 01:36:16,880 TALKS. 2402 01:36:16,880 --> 01:36:21,720 WE'LL GO TO THE NEXT SLIDE. 2403 01:36:21,720 --> 01:36:23,960 DR. COURTNEY PETERSON, ASSOCIATE 2404 01:36:23,960 --> 01:36:25,440 PROFESSOR IN NUTRITION, 2405 01:36:25,440 --> 01:36:26,640 UNIVERSITY OF ALABAMA 2406 01:36:26,640 --> 01:36:29,040 BIRMINGHAM, CO-DIRECTOR OF THE 2407 01:36:29,040 --> 01:36:32,680 SLEEP AND CIRCADIAN RESEARCH 2408 01:36:32,680 --> 01:36:33,760 CORE, FOCUSING ON DAILY 2409 01:36:33,760 --> 01:36:35,520 INTERMITTENT FASTING AND 2410 01:36:35,520 --> 01:36:36,760 TIME-RESTRICTED EATING, A P.I. 2411 01:36:36,760 --> 01:36:38,760 FOR SEVERAL CLINICAL TRIALS IN 2412 01:36:38,760 --> 01:36:39,680 THIS AREA INCLUDING THE LARGE 2413 01:36:39,680 --> 01:36:42,000 CLINICAL TRIAL IN PATIENTS WITH 2414 01:36:42,000 --> 01:36:42,960 TYPE 2 DIABETES. 2415 01:36:42,960 --> 01:36:47,440 WE LOOK FORWARD TO HEARING YOUR 2416 01:36:47,440 --> 01:36:47,800 PRESENTATION. 2417 01:36:47,800 --> 01:36:48,560 THANK YOU. 2418 01:36:48,560 --> 01:36:49,200 THAT WAS EXCELLENT. 2419 01:36:49,200 --> 01:36:51,040 THANK YOU FOR SUCH AN 2420 01:36:51,040 --> 01:36:51,960 OUTSTANDING OVERVIEW. 2421 01:36:51,960 --> 01:36:53,840 I COULDN'T AGREE MORE ON 2422 01:36:53,840 --> 01:36:55,240 OPPORTUNITIES AND CHALLENGES. 2423 01:36:55,240 --> 01:36:57,960 I'M GOING TO TALK ABOUT CLINICAL 2424 01:36:57,960 --> 01:37:01,640 TRIALS OF MEAL TIMING AND FOCUS 2425 01:37:01,640 --> 01:37:04,200 ON RANDOMIZED CONTROLLED TRIALS. 2426 01:37:04,200 --> 01:37:04,440 NEXT. 2427 01:37:04,440 --> 01:37:07,040 THE FIELD OF MEAL TIMING IS 2428 01:37:07,040 --> 01:37:07,240 BROAD. 2429 01:37:07,240 --> 01:37:10,640 I'M GOING TO FOCUS ON TWO MAJOR 2430 01:37:10,640 --> 01:37:19,440 TOPICS WITHIN THAT FIELD, 2431 01:37:19,440 --> 01:37:21,280 INTERMITTENT FASTING, AND 2432 01:37:21,280 --> 01:37:22,600 TIME-RESTRICTED EATING. 2433 01:37:22,600 --> 01:37:23,920 AND ALSO TALK ABOUT APPROACHES 2434 01:37:23,920 --> 01:37:26,240 THAT CHANGE THE TIME OF DAY OF 2435 01:37:26,240 --> 01:37:29,200 FOOD INTAKE WITHOUT CHANGING 2436 01:37:29,200 --> 01:37:31,880 THAT FEEDING FASTING DURATION, 2437 01:37:31,880 --> 01:37:32,920 PRIMARILY EATING BREAKFAST LIKE 2438 01:37:32,920 --> 01:37:35,720 A KING BUT OTHER APPROACHES TOO. 2439 01:37:35,720 --> 01:37:36,840 I'LL END BY TALKING ABOUT 2440 01:37:36,840 --> 01:37:39,560 OPPORTUNITIES AND CHALLENGES FOR 2441 01:37:39,560 --> 01:37:41,200 THE FIELD. 2442 01:37:41,200 --> 01:37:41,640 NEXT. 2443 01:37:41,640 --> 01:37:43,600 INTERMITTENT FASTING IS ANY MEAL 2444 01:37:43,600 --> 01:37:44,800 TIMING INTERVENTION OR APPROACH 2445 01:37:44,800 --> 01:37:47,440 THAT ALTERNATES PERIODS OF 2446 01:37:47,440 --> 01:37:49,760 EATING AND EXTENDED FASTING. 2447 01:37:49,760 --> 01:37:51,960 THERE WAS NO SINGLE DEFINITION 2448 01:37:51,960 --> 01:37:54,800 THAT EVERYONE AGREED ON. 2449 01:37:54,800 --> 01:37:57,280 BUT WE'RE CONVERGING TOWARDS A 2450 01:37:57,280 --> 01:37:58,040 14-HOUR DEFINITION IN HUMANS, 2451 01:37:58,040 --> 01:38:02,000 AND I'M A FAN OF 2452 01:38:02,000 --> 01:38:03,200 SPECIES-SPECIFIC DEFINITIONS. 2453 01:38:03,200 --> 01:38:05,280 MYSELF AND OTHER SPEAKERS SIT ON 2454 01:38:05,280 --> 01:38:06,360 AN INTERNATIONAL CONSENSUS 2455 01:38:06,360 --> 01:38:10,760 COMMITTEE THAT'S TRYING TO 2456 01:38:10,760 --> 01:38:11,760 HARMONIZE THESE DEFINITIONS OF 2457 01:38:11,760 --> 01:38:15,000 INTERMITTENT FASTING. 2458 01:38:15,000 --> 01:38:16,440 I LIKE THE 14 HOUR DEFINITION. 2459 01:38:16,440 --> 01:38:20,040 IF YOU LOOK AT SUBSTRATE 2460 01:38:20,040 --> 01:38:24,080 OXIDATION WE DON'T SEE A BIG 2461 01:38:24,080 --> 01:38:27,520 UPREGULATION IN FATTY ACID 2462 01:38:27,520 --> 01:38:28,640 OXIDATION OR GLUCONEOGENESIS 2463 01:38:28,640 --> 01:38:29,240 UNTIL 14 TO 20 HOURS. 2464 01:38:29,240 --> 01:38:35,160 IF YOU LOOK AT DATA FROM NHANES, 2465 01:38:35,160 --> 01:38:36,680 THE AVERAGE FASTING DURATION IS 2466 01:38:36,680 --> 01:38:40,200 ABOUT 12 HOURS A NIGHT SO I'M 2467 01:38:40,200 --> 01:38:46,560 RELUCTANT TO CALL THAT 2468 01:38:46,560 --> 01:38:47,160 INTERMITTENT FASTING. 2469 01:38:47,160 --> 01:38:49,280 I'LL TALK ABOUT THE AVERAGE 2470 01:38:49,280 --> 01:38:51,040 DEFINITION. 2471 01:38:51,040 --> 01:38:52,560 I PREFER THE AVERAGE FASTING 2472 01:38:52,560 --> 01:38:55,280 DEFINITION FOR TWO REASONS. 2473 01:38:55,280 --> 01:39:00,360 THE FIRST ONE IS THE 95% 2474 01:39:00,360 --> 01:39:03,280 CONFIDENCE INTERVAL DEFINITION 2475 01:39:03,280 --> 01:39:04,280 LUMPS TOGETHER BOTH VARIABILITY 2476 01:39:04,280 --> 01:39:06,040 OF EATING AS WELL AS FASTING 2477 01:39:06,040 --> 01:39:07,280 DURATION SO DOESN'T ALLOW US TO 2478 01:39:07,280 --> 01:39:09,760 PARSE OUT THE TWO SEPARATE 2479 01:39:09,760 --> 01:39:10,200 EFFECTS. 2480 01:39:10,200 --> 01:39:14,800 AND SECOND, YOU CAN COME UNWITH 2481 01:39:14,800 --> 01:39:17,320 SCENARIOS WHERE SOMEONE IS DOING 2482 01:39:17,320 --> 01:39:18,560 TIME-RESTRICTED EATING, SIX DAYS 2483 01:39:18,560 --> 01:39:28,360 A WEEK, 6 6 HOUR WINDOW, ONE DA 2484 01:39:28,360 --> 01:39:29,360 14-HOUR WINDOW, ASSIGNED 13% SO 2485 01:39:29,360 --> 01:39:33,080 THEY WOULD LOOK LIKE THEY ARE 2486 01:39:33,080 --> 01:39:36,880 NOT DOING TIME-RESTRICTED AND 2487 01:39:36,880 --> 01:39:37,840 WOULD LOOK INDISTINGUISHABLE, SO 2488 01:39:37,840 --> 01:39:40,920 THERE ARE LIMITATIONS TO BE 2489 01:39:40,920 --> 01:39:48,720 AWARE OF. 2490 01:39:48,720 --> 01:39:52,120 SEVERAL TIMES OF INTERMITTENT 2491 01:39:52,120 --> 01:39:53,880 FASTING ARE HETEROGENEOUS IN 2492 01:39:53,880 --> 01:39:56,040 TERMS OF ADHERENCE, BIOLOGICAL 2493 01:39:56,040 --> 01:39:57,360 EFFECTS, IN SOME CASES 2494 01:39:57,360 --> 01:39:57,680 MECHANISMS. 2495 01:39:57,680 --> 01:39:59,440 TO MAKE SENSE OF THESE DIFFERENT 2496 01:39:59,440 --> 01:40:07,600 APPROACHES I LIKE TO GROUP THEM 2497 01:40:07,600 --> 01:40:10,440 INTO THREE BROAD CATEGORIES. 2498 01:40:10,440 --> 01:40:12,040 FIRST IS PERIODIC FASTING WHERE 2499 01:40:12,040 --> 01:40:19,960 YOU HAVE A COMPLETE 24-HOUR 2500 01:40:19,960 --> 01:40:27,320 WATER ONLY FAST, SUCH AS 2501 01:40:27,320 --> 01:40:29,160 RELIGIOUS TRADITIONS OR 24-HOUR 2502 01:40:29,160 --> 01:40:31,440 WATER ONLY FAST. 2503 01:40:31,440 --> 01:40:33,400 SECOND APPROACHES ARE CALLED 2504 01:40:33,400 --> 01:40:34,120 INTERMITTENT ENERGY RESTRICTION, 2505 01:40:34,120 --> 01:40:36,200 APPROACH WHERE IS INSTEAD OF 2506 01:40:36,200 --> 01:40:38,800 HAVING A 24-HOUR WATER ONLY 2507 01:40:38,800 --> 01:40:40,640 FAST, YOU HAVE A LOW CALORIE 2508 01:40:40,640 --> 01:40:42,840 DIET, LIKE A MODIFIED FASTING 2509 01:40:42,840 --> 01:40:43,440 APPROACH. 2510 01:40:43,440 --> 01:40:51,280 IN THESE APPROACHES YOU HAVE 2511 01:40:51,280 --> 01:40:53,000 MODIFIED OR LOW-CALORIE DAYS, 2512 01:40:53,000 --> 01:40:55,000 ALTERNATE DAYS MODIFIED WHERE 2513 01:40:55,000 --> 01:40:59,800 YOU EAT ONE MEAL A DAY, OR THREE 2514 01:40:59,800 --> 01:41:03,080 TO FIVE DAYS IN A ROW, REPEAT 2515 01:41:03,080 --> 01:41:07,160 THIS CYCLE A FEW TIMES A YEAR. 2516 01:41:07,160 --> 01:41:07,800 NEXT SLIDE. 2517 01:41:07,800 --> 01:41:11,640 I DON'T HAVE TIME TO GO INTO THE 2518 01:41:11,640 --> 01:41:14,160 BROAD CATEGORIES, I'LL REFER YOU 2519 01:41:14,160 --> 01:41:16,560 ALL TO AN NIH WEBCAST THAT I DID 2520 01:41:16,560 --> 01:41:25,440 AS PART OF THE OPNA WEBINAR A 2521 01:41:25,440 --> 01:41:26,400 COUPLE WEEKS AGO. 2522 01:41:26,400 --> 01:41:30,480 PLEASE WATCH THAT IF YOU'RE 2523 01:41:30,480 --> 01:41:30,800 INTERESTED. 2524 01:41:30,800 --> 01:41:33,560 NEXT SLIDE. 2525 01:41:33,560 --> 01:41:36,720 THE THIRD TYPE ARE DAILY 2526 01:41:36,720 --> 01:41:38,680 INTERMITTENT FASTING APPROACHES, 2527 01:41:38,680 --> 01:41:40,360 KNOWN AS TIME-RESTRICTED EATING 2528 01:41:40,360 --> 01:41:42,600 IN HUMANS OR ANIMALS. 2529 01:41:42,600 --> 01:41:44,800 THESE ARE QUITE DIFFERENT FROM 2530 01:41:44,800 --> 01:41:46,800 THE OTHER FORMS OF INTERMITTENT 2531 01:41:46,800 --> 01:41:49,520 FASTING, NOT A SPECIFIC CALORIE 2532 01:41:49,520 --> 01:41:51,920 TARGET, WHETHER WATER ONLY 2533 01:41:51,920 --> 01:41:54,000 FASTING OR LOW CALORIE. 2534 01:41:54,000 --> 01:41:56,400 YOU'RE CONDENSING YOUR FOOD 2535 01:41:56,400 --> 01:42:01,520 INTAKE INTO SHORTER PERIOD EACH 2536 01:42:01,520 --> 01:42:02,120 DAY. 2537 01:42:02,120 --> 01:42:03,320 I'M GOING TO DEFINE 2538 01:42:03,320 --> 01:42:06,640 TIME-RESTRICTED EATING AS WITHIN 2539 01:42:06,640 --> 01:42:07,800 A CONSISTENT 10-HOUR WINDOW, 2540 01:42:07,800 --> 01:42:09,360 APPROXIMATELY SAME TIME EACH 2541 01:42:09,360 --> 01:42:10,280 DAY. 2542 01:42:10,280 --> 01:42:10,880 OR LESS. 2543 01:42:10,880 --> 01:42:13,840 AND THE MOST POPULAR FORM OF 2544 01:42:13,840 --> 01:42:16,440 TIME RESTRICTED EATING STUDIED 2545 01:42:16,440 --> 01:42:20,320 IS WHAT HAS BEEN CALLED 16:8 2546 01:42:20,320 --> 01:42:23,360 DIET, 8 HOUR WINDOWS, THE MOST 2547 01:42:23,360 --> 01:42:25,120 COMMONLY STUDIED. 2548 01:42:25,120 --> 01:42:28,080 WHAT'S UNIQUE RELATIVE TO OTHER 2549 01:42:28,080 --> 01:42:30,400 FORMS OF INTERMITTENT FASTING 2550 01:42:30,400 --> 01:42:33,240 WITH OR WITHOUT CUTTING 2551 01:42:33,240 --> 01:42:34,760 CALORIES, HAS MORE POTENTIAL FOR 2552 01:42:34,760 --> 01:42:36,840 US TO EVENTUALLY FIND SOMETHING 2553 01:42:36,840 --> 01:42:40,000 THAT CAN BE TRANSLATED INTO A 2554 01:42:40,000 --> 01:42:41,320 PUBLIC HEALTH GUIDELINE, MORE 2555 01:42:41,320 --> 01:42:42,280 CUSTOMIZABILITY THERE. 2556 01:42:42,280 --> 01:42:46,360 A LOT OF RESEARCH HAS BEEN QUITE 2557 01:42:46,360 --> 01:42:51,760 INTERESTING BECAUSE OF 2558 01:42:51,760 --> 01:42:53,160 UNIQUENESS, MOST GIVE PEOPLE 2559 01:42:53,160 --> 01:42:55,240 TIMING RULES, WHEN TO EAT, NO 2560 01:42:55,240 --> 01:42:59,480 INSTRUCTIONS ON HOW MUCH OR WHAT 2561 01:42:59,480 --> 01:43:00,480 TO EAT. 2562 01:43:00,480 --> 01:43:02,280 TIME-RESTRICTED CAN BE PRACTICED 2563 01:43:02,280 --> 01:43:05,000 BY EATING EARLY IN THE DAY, 2564 01:43:05,000 --> 01:43:06,280 MIDDLE SUCH AS SKIPPING 2565 01:43:06,280 --> 01:43:08,720 BREAKFAST, OR LATE SUCH AS 2566 01:43:08,720 --> 01:43:10,000 SKIPPING BREAKFAST AND LUNCH. 2567 01:43:10,000 --> 01:43:13,640 I'LL COME BACK TO THAT LATER. 2568 01:43:13,640 --> 01:43:14,200 NEXT SLIDE. 2569 01:43:14,200 --> 01:43:23,800 ONE OF THE FIRST STUDIES WAS 2570 01:43:23,800 --> 01:43:27,040 THIS STUDY IN 2018, THEY TOOK 23 2571 01:43:27,040 --> 01:43:29,000 ADULTS WITH OBESITY, AND HAD 2572 01:43:29,000 --> 01:43:32,600 THEM PRACTICE 8-HOUR 2573 01:43:32,600 --> 01:43:33,240 TIME-RESTRICTED EATING, STARTING 2574 01:43:33,240 --> 01:43:36,080 AT 10 A.M. AND ENDING AT 6 P.M. 2575 01:43:36,080 --> 01:43:37,960 AND THEY COMPARED THIS AGAINST 2576 01:43:37,960 --> 01:43:40,160 HISTORICAL CONTROLS. 2577 01:43:40,160 --> 01:43:43,000 WHAT THEY FOUND OVER A 12-WEEK 2578 01:43:43,000 --> 01:43:46,160 PERIOD THAT PARTICIPANTS WHO 2579 01:43:46,160 --> 01:43:46,800 PRACTICED TIME-RESTRICTED EATING 2580 01:43:46,800 --> 01:43:49,360 LOST 2 1/2% OF THEIR BODY WEIGHT 2581 01:43:49,360 --> 01:43:50,880 DESPITE NO INSTRUCTIONS TO 2582 01:43:50,880 --> 01:43:53,040 REDUCE ENERGY INTAKE OR COUNT 2583 01:43:53,040 --> 01:43:53,320 CALORIES. 2584 01:43:53,320 --> 01:43:58,760 THIS WAS SOME OF THE FIRST 2585 01:43:58,760 --> 01:44:00,320 EVIDENCE THAT TIME-RESTRICTED 2586 01:44:00,320 --> 01:44:01,920 EATING SPONTANEOUSLY REDUCES 2587 01:44:01,920 --> 01:44:04,560 ENERGY INTAKE. 2588 01:44:04,560 --> 01:44:06,400 THEY REPORTED GOOD ADHERENCE, 2589 01:44:06,400 --> 01:44:08,600 PARTICIPANTS ADHERED ABOUT 5 TO 2590 01:44:08,600 --> 01:44:11,000 6 DAYS A WEEK, AND THIS IS 2591 01:44:11,000 --> 01:44:13,720 REPLICATED BY A DOZEN OTHER 2592 01:44:13,720 --> 01:44:15,040 STUDIES, MOST REPORTED ADHERENCE 2593 01:44:15,040 --> 01:44:18,560 LEVELS AROUND FIVE TO SIX DAYS A 2594 01:44:18,560 --> 01:44:19,080 WEEK. 2595 01:44:19,080 --> 01:44:19,400 NEXT. 2596 01:44:19,400 --> 01:44:22,240 SINCE THEN WE'VE HAD NOW MORE 2597 01:44:22,240 --> 01:44:24,360 THAN 55, ALMOST 60 CLINICAL 2598 01:44:24,360 --> 01:44:25,880 TRIALS ON TIME-RESTRICTED EATING 2599 01:44:25,880 --> 01:44:27,240 IN HUMANS, THESE ARE 2600 01:44:27,240 --> 01:44:27,840 INTERVENTIONAL TRIALS. 2601 01:44:27,840 --> 01:44:30,000 WHEN YOU LOOK AT THE FIELD AS A 2602 01:44:30,000 --> 01:44:32,520 WHOLE, UNFORTUNATELY MOST OF 2603 01:44:32,520 --> 01:44:33,960 THESE STUDIES ARE SMALL SINGLE 2604 01:44:33,960 --> 01:44:35,920 ARM OR HAVE A WEAK CONTROL 2605 01:44:35,920 --> 01:44:36,400 GROUP. 2606 01:44:36,400 --> 01:44:37,360 PART WAS JUST BECAUSE YOU ALWAYS 2607 01:44:37,360 --> 01:44:39,080 HAVE TO DO A PILOT STUDY BEFORE 2608 01:44:39,080 --> 01:44:41,480 YOU DO A LARGE SCALE STUDY, BUT 2609 01:44:41,480 --> 01:44:45,680 UNFORTUNATELY THE FIELD IS 2610 01:44:45,680 --> 01:44:47,880 FLOODED WITH THESE LOWER QUALITY 2611 01:44:47,880 --> 01:44:48,200 STUDIES. 2612 01:44:48,200 --> 01:44:50,720 MANY OF THESE HAVE REPORTED 2613 01:44:50,720 --> 01:44:51,320 BENEFITS. 2614 01:44:51,320 --> 01:44:53,960 AND THESE INCLUDE REDUCTIONS IN 2615 01:44:53,960 --> 01:44:55,680 ENERGY INTAKE, IMPROVEMENT IN 2616 01:44:55,680 --> 01:44:58,360 GLYCEMIC CONTROL, IN BLOOD 2617 01:44:58,360 --> 01:44:59,560 PRESSURE, OXIDATIVE STRESS, AND 2618 01:44:59,560 --> 01:45:00,440 QUALITY OF LIFE. 2619 01:45:00,440 --> 01:45:08,120 HOWEVER I WILL SAY PROTOCOLS AE 2620 01:45:08,120 --> 01:45:08,640 HETEROGENEOUS. 2621 01:45:08,640 --> 01:45:12,120 A LOT OF THE MIXED RESULTS MAY 2622 01:45:12,120 --> 01:45:14,440 BE DUE TO DIFFERENCE IN STUDY 2623 01:45:14,440 --> 01:45:19,240 DESIGN AND INTERVENTION ITSELF. 2624 01:45:19,240 --> 01:45:19,440 NEXT. 2625 01:45:19,440 --> 01:45:21,520 AND WHEN YOU LOOK AT THE OUTCOME 2626 01:45:21,520 --> 01:45:25,040 OF WEIGHT LOSS, IF YOU DO A 2627 01:45:25,040 --> 01:45:28,200 SURVEY AND BODY WEIGHT, THEY ARE 2628 01:45:28,200 --> 01:45:30,360 EVENLY MIXED. 2629 01:45:30,360 --> 01:45:32,480 ABOUT HALF REPORTED WEIGHT LOSS 2630 01:45:32,480 --> 01:45:35,400 BENEFIT RELATIVE TO BASELINE OR 2631 01:45:35,400 --> 01:45:36,400 EATING SCHEDULE CONTROL, AND IF 2632 01:45:36,400 --> 01:45:39,440 YOU LOOK AT THOSE STUDIES THE 2633 01:45:39,440 --> 01:45:41,680 MEAN REPORTED WEIGHT LOSS IS 3%. 2634 01:45:41,680 --> 01:45:45,160 THE STUDY DURATION HAS BEEN VERY 2635 01:45:45,160 --> 01:45:46,040 VARIABLE. 2636 01:45:46,040 --> 01:45:52,880 RANGING FROM 6 TO 16 WEEKS. 2637 01:45:52,880 --> 01:45:53,680 INITIALLY, META-ANALYSES 2638 01:45:53,680 --> 01:45:55,680 REPORTED NO IMPROVEMENT IN BODY 2639 01:45:55,680 --> 01:45:56,400 WEIGHT. 2640 01:45:56,400 --> 01:45:58,280 HOWEVER, THE LAST THREE 2641 01:45:58,280 --> 01:45:58,920 META-ANALYSES I'VE SEEN 2642 01:45:58,920 --> 01:46:00,920 PUBLISHED AND I LOOKED ABOUT A 2643 01:46:00,920 --> 01:46:04,600 MONTH AGO ALL FOUND 2644 01:46:04,600 --> 01:46:05,360 STATISTICALLY SIGNIFICANT 2645 01:46:05,360 --> 01:46:07,000 IMPROVEMENTS IN BODY WEIGHT. 2646 01:46:07,000 --> 01:46:09,560 SO HERE'S AN EXAMPLE, FROM ONE, 2647 01:46:09,560 --> 01:46:12,160 IT REPORTED A WEIGHTED MEAN 2648 01:46:12,160 --> 01:46:15,240 DIFFERENCE OF ABOUT 2%, RELATIVE 2649 01:46:15,240 --> 01:46:18,280 TO A CONTROL EATING SCHEDULE. 2650 01:46:18,280 --> 01:46:21,360 MANY OF THESE META-ANALYSES 2651 01:46:21,360 --> 01:46:24,560 REPORTED IMPROVEMENTS IN FASTING 2652 01:46:24,560 --> 01:46:27,840 GLUCOSE BUT THOSE RESULTS HAVE 2653 01:46:27,840 --> 01:46:30,920 NOT NECESSARILY BEEN CONSISTENT. 2654 01:46:30,920 --> 01:46:32,840 I WOULD CHARACTERIZE THIS AS A 2655 01:46:32,840 --> 01:46:36,360 MODEST TO MODERATE EFFECT ON 2656 01:46:36,360 --> 01:46:37,960 BODY WEIGHT. 2657 01:46:37,960 --> 01:46:38,160 NEXT. 2658 01:46:38,160 --> 01:46:42,480 MY LAB TOOK A LOOK AT SOME OF 2659 01:46:42,480 --> 01:46:45,640 THE STUDIES ON WEIGHT LOSS, AND 2660 01:46:45,640 --> 01:46:47,720 REALIZED THREE LARGEST STUDIES 2661 01:46:47,720 --> 01:46:49,640 HAD SOME ISSUES, STUDY DESIGN OR 2662 01:46:49,640 --> 01:46:51,920 STUDY QUALITY, THAT THE 2663 01:46:51,920 --> 01:46:54,000 INTERVENTION WAS NOT 2664 01:46:54,000 --> 01:46:56,080 APPROPRIATELY MATCHED ACROSS 2665 01:46:56,080 --> 01:46:57,160 GROUP, OR THERE WERE 2666 01:46:57,160 --> 01:46:57,720 CONFOUNDERS. 2667 01:46:57,720 --> 01:47:00,920 WE DID A WEIGHT LOSS STUDY IN 90 2668 01:47:00,920 --> 01:47:01,880 ADULTS WITH OBESITY. 2669 01:47:01,880 --> 01:47:04,720 WE WANTED TO SEE IF YOU 2670 01:47:04,720 --> 01:47:05,560 PERFECTLY MATCH VARIABLES, 2671 01:47:05,560 --> 01:47:06,480 WHAT'S THE EFFECT OF 2672 01:47:06,480 --> 01:47:07,640 TIME-RESTRICTED EATING ON WEIGHT 2673 01:47:07,640 --> 01:47:09,960 LOSS AND WHAT'S A MORE ACCURATE 2674 01:47:09,960 --> 01:47:12,920 ESTIMATE OF THE CALORIE DEFICIT 2675 01:47:12,920 --> 01:47:13,160 INDUCED? 2676 01:47:13,160 --> 01:47:16,320 ARE THERE BENEFITS FOR WEIGHT 2677 01:47:16,320 --> 01:47:16,760 LOSS? 2678 01:47:16,760 --> 01:47:18,800 WE RANDOMIZED PATIENTS TO EITHER 2679 01:47:18,800 --> 01:47:20,120 PRACTICE EARLY TIME RESTRICTED 2680 01:47:20,120 --> 01:47:21,800 EATING BY EATING IN AN 8 HOUR 2681 01:47:21,800 --> 01:47:26,040 WINDOW EARLY IN THE DAY OR OVER 2682 01:47:26,040 --> 01:47:27,240 A SELF-SELECTED 12 HOUR OR 2683 01:47:27,240 --> 01:47:29,440 LONGER PERIOD AND BOTH THE 12 2684 01:47:29,440 --> 01:47:31,920 AND 14 WEEK MARK WE DID FIND 2685 01:47:31,920 --> 01:47:33,840 IMPROVEMENTS IN BODY WEIGHT 2686 01:47:33,840 --> 01:47:38,320 RELATIVE TO A CONTROLLED EATING 2687 01:47:38,320 --> 01:47:38,560 SCHEDULE. 2688 01:47:38,560 --> 01:47:41,160 WE DID SOME WEIGHT LOSS 2689 01:47:41,160 --> 01:47:43,920 MODELING, WERE ABLE TO ESTIMATE 2690 01:47:43,920 --> 01:47:46,320 SIZE OF THE CALORIC ESTIMATE, IN 2691 01:47:46,320 --> 01:47:49,680 THE INTENTION-TO-TREAT ANALYSIS 2692 01:47:49,680 --> 01:47:52,320 INDUCED CALORIC DEFICIT OF 214 2693 01:47:52,320 --> 01:47:56,040 CALORIES A DAY, LOOKED AT 2694 01:47:56,040 --> 01:47:57,120 ADHERED PARTICIPANTS, AT LEAST 2695 01:47:57,120 --> 01:47:59,320 FIVE DAYS A WEEK EVERY WEEK, 2696 01:47:59,320 --> 01:48:01,600 EFFECT WAS EVEN LARGER AT 350 2697 01:48:01,600 --> 01:48:03,360 CALORIES A DAY. 2698 01:48:03,360 --> 01:48:05,000 THIS PROVIDES SOME FIRST BEST 2699 01:48:05,000 --> 01:48:07,400 ESTIMATE FROM THE MAGNITUDE OF 2700 01:48:07,400 --> 01:48:08,520 THE CALORIC DEFICIT. 2701 01:48:08,520 --> 01:48:10,680 THAT'S IN GOOD ALIGNMENT WITH 2702 01:48:10,680 --> 01:48:14,160 THE LAST THREE META-ANALYSES I 2703 01:48:14,160 --> 01:48:14,720 MENTIONED. 2704 01:48:14,720 --> 01:48:17,600 MY LAB DID A DIFFERENT STUDY 2705 01:48:17,600 --> 01:48:19,160 PUBLISHED FOUR YEARS AGO, 2706 01:48:19,160 --> 01:48:20,040 INTERESTED IN MECHANISMS BY 2707 01:48:20,040 --> 01:48:22,440 WHICH TIME-RESTRICTED AND OTHER 2708 01:48:22,440 --> 01:48:23,640 FORMS OF INTERMITTENT FASTING 2709 01:48:23,640 --> 01:48:25,600 MAY INDUCE WEIGHT LOSS AND WERE 2710 01:48:25,600 --> 01:48:26,720 INTERESTED IN SEEING WHETHER IT 2711 01:48:26,720 --> 01:48:28,360 WAS DUE TO INCREASES IN ENERGY 2712 01:48:28,360 --> 01:48:32,080 EXPENDITURE OR REDUCTION IN 2713 01:48:32,080 --> 01:48:32,480 APPETITE. 2714 01:48:32,480 --> 01:48:37,880 WE PUT PEOPLE IN A RESPIRATORY 2715 01:48:37,880 --> 01:48:40,120 CHAMBER, TIME RESTRICTED EATING 2716 01:48:40,120 --> 01:48:43,720 DID NOT HAVE EFFECTS, NOT LARGER 2717 01:48:43,720 --> 01:48:49,440 THAN 80 CALORIES A DAY. 2718 01:48:49,440 --> 01:48:52,840 IF THEY ARE, THEY ARE NOT LARGE. 2719 01:48:52,840 --> 01:48:54,320 WE THINK THE PREDOMINANT 2720 01:48:54,320 --> 01:48:56,160 MECHANISM IS REDUCED APPETITE. 2721 01:48:56,160 --> 01:48:58,040 WE DID FIND ALTERATIONS IN 2722 01:48:58,040 --> 01:48:59,000 SUBJECTIVE APPETITE THROUGHOUT 2723 01:48:59,000 --> 01:49:03,240 THE DAY, ALSO CHANGES IN 2724 01:49:03,240 --> 01:49:08,560 APPETITE HORMONES, LOWER GHRELIN 2725 01:49:08,560 --> 01:49:13,680 LEVELS IN THE MORE THAN. 2726 01:49:13,680 --> 01:49:15,720 ONE SURPRISING STUDY WE MEASURED 2727 01:49:15,720 --> 01:49:17,360 SLEEP DURATION BY SELF-REPORT 2728 01:49:17,360 --> 01:49:19,480 AND FOUND EARLY TIME-RESTRICTED 2729 01:49:19,480 --> 01:49:21,000 EATING REDUCED SLEEP DURATION BY 2730 01:49:21,000 --> 01:49:23,400 30 MINUTES, WHICH WE WERE NOT 2731 01:49:23,400 --> 01:49:23,680 EXPECTING. 2732 01:49:23,680 --> 01:49:25,360 WE THOUGHT THIS MUST BE A 2733 01:49:25,360 --> 01:49:26,240 NEGATIVE EFFECT. 2734 01:49:26,240 --> 01:49:27,800 MAYBE PEOPLE ARE HUNGRY AT NIGHT 2735 01:49:27,800 --> 01:49:31,480 SO THEY ARE NOT SLEEPING WELL. 2736 01:49:31,480 --> 01:49:33,000 OR MAYBE NEED MORE TIME TO PREP 2737 01:49:33,000 --> 01:49:34,800 FOOD FOR THE NEXT DAY. 2738 01:49:34,800 --> 01:49:36,320 WE FOUND NO CORRELATION WITH 2739 01:49:36,320 --> 01:49:39,840 HUNGER, FOUND NO EVIDENCE IN OUR 2740 01:49:39,840 --> 01:49:41,080 EXIT INTERVIEWS PEOPLE NEEDED 2741 01:49:41,080 --> 01:49:43,200 MORE FOOD PREP TIME. 2742 01:49:43,200 --> 01:49:46,080 WE DID FIND PEOPLE REPORTED 2743 01:49:46,080 --> 01:49:49,000 HAVING HIGHER ENERGY LEVEL, LESS 2744 01:49:49,000 --> 01:49:50,880 FATIGUE, IDENTICAL SLEEP 2745 01:49:50,880 --> 01:49:52,080 QUALITY, HYPOTHESIZING EARLY 2746 01:49:52,080 --> 01:49:52,920 TIME-RESTRICTED EATING REDUCES 2747 01:49:52,920 --> 01:49:55,480 NEED FOR SLEEP BECAUSE WE SEE 2748 01:49:55,480 --> 01:49:57,400 POSITIVE EFFECTS ON ENERGY LEVEL 2749 01:49:57,400 --> 01:49:58,960 AND FATIGUE, PERHAPS ON A 2750 01:49:58,960 --> 01:50:03,480 SIMPLISTIC LEVEL THAT'S DUE TO A 2751 01:50:03,480 --> 01:50:04,680 LONGER FASTING PERIOD BEFORE 2752 01:50:04,680 --> 01:50:06,120 SLEEP ONSET WHICH MIGHT ALLOW 2753 01:50:06,120 --> 01:50:13,320 MORE TIME FOR REST AND REPAIR. 2754 01:50:13,320 --> 01:50:15,000 VERY INTERESTING INTRIGUING 2755 01:50:15,000 --> 01:50:15,520 HYPOTHESIS. 2756 01:50:15,520 --> 01:50:17,080 THERE'S EVIDENCE TIME-RESTRICTED 2757 01:50:17,080 --> 01:50:19,600 EATING MAY AFFECT OTHER 2758 01:50:19,600 --> 01:50:21,560 ENDPOINTS, ASIDE FROM WEIGHT 2759 01:50:21,560 --> 01:50:24,720 LOSS, SO HERE IS DATA FROM THE 2760 01:50:24,720 --> 01:50:26,360 LARGEST STUDY OF TIME-RESTRICTED 2761 01:50:26,360 --> 01:50:29,360 EATING IN ADULTS WITH TYPE 2 2762 01:50:29,360 --> 01:50:34,160 DIABETESA 12-WEEK TRIAL, 120 2763 01:50:34,160 --> 01:50:36,160 ADULTS OUT OF CHINA, EATING IN A 2764 01:50:36,160 --> 01:50:39,760 10 HOUR PERIOD 8 A.M. TO 6 P.M. 2765 01:50:39,760 --> 01:50:43,360 OR GIVEN NO RESTRICTIONS. 2766 01:50:43,360 --> 01:50:47,720 THEY REPORTED TIME-RESTRICTED 2767 01:50:47,720 --> 01:50:51,280 EATING IMPROVED HEMOGLOBIN 2768 01:50:51,280 --> 01:51:00,680 A1c, FASTING LOWER WEIGHT, AND 2769 01:51:00,680 --> 01:51:04,280 MANY OTHER CONDITIONS INCLUDING 2770 01:51:04,280 --> 01:51:06,000 METABOLIC SYNDROME, PCOS, MS, I 2771 01:51:06,000 --> 01:51:14,240 DO WANT TO HAVE A NICE CALL OUT 2772 01:51:14,240 --> 01:51:15,600 TO THOSE WHO DID THIS IMPORTANT 2773 01:51:15,600 --> 01:51:21,320 SEMINAL WORK IN THE FIELD. 2774 01:51:21,320 --> 01:51:21,680 NEXT. 2775 01:51:21,680 --> 01:51:26,040 MY LAB WAS INTERESTED IN THE 2776 01:51:26,040 --> 01:51:31,160 BIGGER PICTURE QUESTION, ABOUT 2777 01:51:31,160 --> 01:51:34,240 BENEFITS, CAN IT IMPROVE 2778 01:51:34,240 --> 01:51:35,760 CARDIOMETABOLIC HEALTH? 2779 01:51:35,760 --> 01:51:38,080 WE DID A FIVE-WEEK CONTROLLED 2780 01:51:38,080 --> 01:51:39,960 FEEDING CROSSOVER STUDY, MEN 2781 01:51:39,960 --> 01:51:43,680 WITH PREDIABETES, AND THE 2782 01:51:43,680 --> 01:51:46,000 PARTICIPANTS TRIED TWO 2783 01:51:46,000 --> 01:51:47,160 SCHEDULES, SIX HOUR FROM 8 A.M. 2784 01:51:47,160 --> 01:51:52,880 TO 2 P.M. OR A CONTROL PERIOD, 2785 01:51:52,880 --> 01:51:55,440 WE PICKED 12 HOURS TO MIMIC 2786 01:51:55,440 --> 01:51:57,680 AVERAGE AMERICAN EATING HABITS. 2787 01:51:57,680 --> 01:52:00,320 WE FOUND THAT EARLY TIME 2788 01:52:00,320 --> 01:52:07,360 RESTRICTED EATING IMPROVED 2789 01:52:07,360 --> 01:52:08,240 INSULIN RESISTANCE DRAMATICALLY, 2790 01:52:08,240 --> 01:52:10,040 IMPROVEMENTS IN BETA CELL 2791 01:52:10,040 --> 01:52:14,560 RESPONSIVENESS, EFFECTS ON BLOOD 2792 01:52:14,560 --> 01:52:19,000 PRESSURE, HALF PARTICIPANTS WERE 2793 01:52:19,000 --> 01:52:22,040 ON BORDERLINE OF PREDIABETES AND 2794 01:52:22,040 --> 01:52:24,520 DIABETES. 2795 01:52:24,520 --> 01:52:26,720 WE DIDN'T FIND FAVORABLE EFFECTS 2796 01:52:26,720 --> 01:52:28,280 ON LIPIDS OR INFLAMMATORY 2797 01:52:28,280 --> 01:52:28,920 MARKERS. 2798 01:52:28,920 --> 01:52:31,880 THERE HAVE BEEN NINE OTHER 2799 01:52:31,880 --> 01:52:32,640 RANDOMIZED CONTROLLED TRIALS 2800 01:52:32,640 --> 01:52:33,720 THAT TRIED TO ANSWER THE SAME 2801 01:52:33,720 --> 01:52:36,120 QUESTION WHETHER THERE ARE 2802 01:52:36,120 --> 01:52:38,680 BENEFITS INDEPENDENT OF CALORIE 2803 01:52:38,680 --> 01:52:39,440 RESTRICTION. 2804 01:52:39,440 --> 01:52:42,440 EIGHT OF NINE REPORTED BENEFIT. 2805 01:52:42,440 --> 01:52:44,800 WE FEEL THIS HAS BEEN DECENTLY 2806 01:52:44,800 --> 01:52:45,560 WELL REPLICATED. 2807 01:52:45,560 --> 01:52:48,520 THERE'S A GOOD CONSENSUS AMONG 2808 01:52:48,520 --> 01:52:53,800 STUDIES WITH A HIGH DEGREE OF 2809 01:52:53,800 --> 01:52:55,040 CONTROL. 2810 01:52:55,040 --> 01:52:55,760 NEXT. 2811 01:52:55,760 --> 01:52:56,800 THERE'S PROMISING STUDIES. 2812 01:52:56,800 --> 01:52:58,840 HOW DO WE MAKE SENSE? 2813 01:52:58,840 --> 01:53:00,680 THIS IS AN EXAMPLE OF ONE, 2814 01:53:00,680 --> 01:53:04,960 PROBABLY MANY OF YOU KNOW THIS. 2815 01:53:04,960 --> 01:53:07,680 PUBLISHED IN JAMA IN 2020, 2816 01:53:07,680 --> 01:53:11,880 12-WEEK TRIAL ON 116 ADULTS. 2817 01:53:11,880 --> 01:53:13,360 RANDOMIZED TO 8 HOUR TRE 2818 01:53:13,360 --> 01:53:20,840 SCHEDULE, 12 P.M. TO 8 P.M., 2819 01:53:20,840 --> 01:53:22,360 MIDDAY SCHEDULE, WITH BREAKFAST 2820 01:53:22,360 --> 01:53:24,000 SKIPPING. 2821 01:53:24,000 --> 01:53:26,200 THIS IS COMPARED TO A THREE MEAL 2822 01:53:26,200 --> 01:53:27,960 A DAY CONTROL WHERE THE CONTROL 2823 01:53:27,960 --> 01:53:31,640 GROUP WAS REQUIRED TO EAT 2824 01:53:31,640 --> 01:53:31,920 BREAKFAST. 2825 01:53:31,920 --> 01:53:33,640 IN THIS STUDY TIME-RESTRICTED 2826 01:53:33,640 --> 01:53:38,240 WITH BREAKFAST SKIPPING WAS NOT 2827 01:53:38,240 --> 01:53:40,160 BETTER THAN THREE MEALS A DAY. 2828 01:53:40,160 --> 01:53:41,040 NEXT. 2829 01:53:41,040 --> 01:53:43,520 THERE'S A COUPLE STUDIES SHOWING 2830 01:53:43,520 --> 01:53:47,760 THAT LATER IN THE DAY MAY WORK 2831 01:53:47,760 --> 01:53:50,240 IN CARDIOMETABOLIC HEALTH, I'LL 2832 01:53:50,240 --> 01:53:51,720 DEFINE LATE TIME-RESTRICTED 2833 01:53:51,720 --> 01:53:52,960 EATING, SKIPPING BREAKFAST AND 2834 01:53:52,960 --> 01:53:53,680 LUNCH. 2835 01:53:53,680 --> 01:54:00,720 HERE IS DATA FROM MARK 2836 01:54:00,720 --> 01:54:03,840 MATHESON'S LAB, 8-WEEK CROSSOVER 2837 01:54:03,840 --> 01:54:05,120 STUDY, 4-HOUR TIME-RESTRICTED 2838 01:54:05,120 --> 01:54:06,400 EATING SCHEDULE, ABOUT ONE MEAL 2839 01:54:06,400 --> 01:54:09,240 A DAY AT DINNER TIME, BETWEEN 5 2840 01:54:09,240 --> 01:54:13,920 AND 9 P.M., VERSUS THREE MEALS A 2841 01:54:13,920 --> 01:54:15,360 DAY, FOR REQUIRED TO EAT THE 2842 01:54:15,360 --> 01:54:17,440 FIRST MEAL AT BREAKFAST. 2843 01:54:17,440 --> 01:54:20,280 WHAT THEY FOUND IS THAT LATE 2844 01:54:20,280 --> 01:54:27,840 TIME RESTRICTED EATING INCREASED 2845 01:54:27,840 --> 01:54:28,800 POSTPRANDIAL AND GLUCOSE LEVELS. 2846 01:54:28,800 --> 01:54:32,440 AND MOST OF THE STUDIES FINDING 2847 01:54:32,440 --> 01:54:34,320 CHANGES IN GLYCEMIC CONTROL FIND 2848 01:54:34,320 --> 01:54:37,400 THEM AT THE POSTPRANDIAL LEVEL, 2849 01:54:37,400 --> 01:54:39,640 NOT FASTING LEVEL, AS A FIELD 2850 01:54:39,640 --> 01:54:41,880 WE'RE DOING A DISSERVICE WITH 2851 01:54:41,880 --> 01:54:43,360 STUDIES THAT ONLY MEASURE 2852 01:54:43,360 --> 01:54:44,680 FASTING MARKERS. 2853 01:54:44,680 --> 01:54:47,440 EFFECTS ARE LARGER AT 2854 01:54:47,440 --> 01:54:49,840 POSTPRANDIAL LEVEL. 2855 01:54:49,840 --> 01:54:51,600 NEXT. 2856 01:54:51,600 --> 01:54:54,160 WHAT MIGHT EXPLAIN SOME RESULTS 2857 01:54:54,160 --> 01:54:55,360 DIFFERENCES IN FASTING DURATION 2858 01:54:55,360 --> 01:54:57,200 BUT ALSO POTENTIALLY TIME OF DAY 2859 01:54:57,200 --> 01:54:58,760 OF EATING. 2860 01:54:58,760 --> 01:55:01,160 AS WE'VE SEEN, WE ALL KNOW THE 2861 01:55:01,160 --> 01:55:06,280 BODY HAS AN INTERNAL BIOLOGICAL 2862 01:55:06,280 --> 01:55:11,640 CLOCK, CIRCADIAN SYSTEM, 2863 01:55:11,640 --> 01:55:15,800 PRODUCES 24 HOUR RHYTHMS, MOST 2864 01:55:15,800 --> 01:55:19,960 IMPORTANT IS RHYTHM OF GLYCEMIC 2865 01:55:19,960 --> 01:55:20,200 CONTROL. 2866 01:55:20,200 --> 01:55:25,720 IF YOU TOOK A TEST AT 9 A.M., 2867 01:55:25,720 --> 01:55:26,920 AFTERNOON OR EVENING, LEVELS 2868 01:55:26,920 --> 01:55:28,560 SPIKED HIGHER IN THE AFTERNOON 2869 01:55:28,560 --> 01:55:29,200 AND EVENING. 2870 01:55:29,200 --> 01:55:31,800 THIS IS NOT A SMALL EFFECT. 2871 01:55:31,800 --> 01:55:34,360 THIS IS ABOUT A 40-POINT 2872 01:55:34,360 --> 01:55:36,200 DIFFERENCE IN INDIVIDUALS WITH 2873 01:55:36,200 --> 01:55:37,960 NORMAL GLYCEMIC CONTROL. 2874 01:55:37,960 --> 01:55:42,000 SO THIS IS EQUIVALENT TO SAYING 2875 01:55:42,000 --> 01:55:42,640 WE'RE ALMOST METABOLICALLY 2876 01:55:42,640 --> 01:55:44,160 PRE-DIABETIC WHEN WE EAT LATER 2877 01:55:44,160 --> 01:55:46,680 IN THE DAY. 2878 01:55:46,680 --> 01:55:46,880 NEXT. 2879 01:55:46,880 --> 01:55:50,960 AND THERE ARE OTHER RHYTHMS TO 2880 01:55:50,960 --> 01:55:53,480 CONSIDER, THREE STUDIES IN 2881 01:55:53,480 --> 01:55:54,320 RESPIRATORY CHAMBERS FOUND 2882 01:55:54,320 --> 01:55:56,880 EATING EARLIER IN THE DAY 2883 01:55:56,880 --> 01:55:57,960 INCREASES FAT OXIDATION RELATIVE 2884 01:55:57,960 --> 01:56:02,200 TO LATER IN THE DAY. 2885 01:56:02,200 --> 01:56:04,080 POTENTIALLY DIURNAL RHYTHMS, AND 2886 01:56:04,080 --> 01:56:07,680 ALSO THERE'S DATA ON DIURNAL 2887 01:56:07,680 --> 01:56:13,200 RHYTHMS AND BLOOD PRESSURE, SO 2888 01:56:13,200 --> 01:56:15,440 RHYTHMS ON LIPIDS ARE 2889 01:56:15,440 --> 01:56:16,840 HETEROGENEOUS AND VARIABLE. 2890 01:56:16,840 --> 01:56:17,320 NEXT. 2891 01:56:17,320 --> 01:56:20,280 PERFECT, THANK YOU. 2892 01:56:20,280 --> 01:56:24,360 AND CLINICAL INTERVENTIONS, ONE 2893 01:56:24,360 --> 01:56:30,160 OF THE -- BUILDING ON OTHER 2894 01:56:30,160 --> 01:56:31,280 DATA, DANIELLEA AND ORIN FROM 2895 01:56:31,280 --> 01:56:33,720 ISRAEL HAVE DONE GREAT WORK IN 2896 01:56:33,720 --> 01:56:36,080 THIS AREA TESTING THE ADAGE OF 2897 01:56:36,080 --> 01:56:37,760 EATING BREAKFAST LIKE A KING, 2898 01:56:37,760 --> 01:56:41,560 AND ONE STUDY WAS THIS 12-WEEK 2899 01:56:41,560 --> 01:56:52,080 RANDOMIZED CONTROLLED TRIAL, 93 2900 01:56:53,640 --> 01:56:55,360 OVERWEIGHT WOMEN, IN REVERSE 2901 01:56:55,360 --> 01:57:02,760 ORDER ARE LARGE DINNER. 2902 01:57:02,760 --> 01:57:05,400 LARGE BREAKFAST LOST MORE 2903 01:57:05,400 --> 01:57:08,720 WEIGHT, LESS HUNGRY. 2904 01:57:08,720 --> 01:57:11,160 AND FRANK SCHERER'S LAB SHOWED 2905 01:57:11,160 --> 01:57:12,840 EATING EARLY IN THE DAY WAS 2906 01:57:12,840 --> 01:57:15,720 BETTER FOR IMPROVING ENERGY 2907 01:57:15,720 --> 01:57:19,000 EXPENDITURE, REDUCING APPETITE, 2908 01:57:19,000 --> 01:57:22,600 ALSO FAVORABLY AFFECTED BALANCE 2909 01:57:22,600 --> 01:57:26,440 OF LIPOGENICS VERSUS LIPO LYTIC 2910 01:57:26,440 --> 01:57:28,280 GENE EXPRESSION. 2911 01:57:28,280 --> 01:57:30,240 THEY FOLLOWED UP THIS STUDY WITH 2912 01:57:30,240 --> 01:57:31,720 A COUPLE STUDIES FROM THE LAB 2913 01:57:31,720 --> 01:57:35,080 WHERE THEY TESTED THE SAME ADAGE 2914 01:57:35,080 --> 01:57:38,680 EATING BREAKFAST LIKE A KING, 2915 01:57:38,680 --> 01:57:39,760 ENERGY BALANCE, NOT LOSING 2916 01:57:39,760 --> 01:57:42,080 WEIGHT OR MATCHING CALORIE 2917 01:57:42,080 --> 01:57:42,560 INTAKE. 2918 01:57:42,560 --> 01:57:46,040 HERE IS DATA FROM A ONE-WEEK 2919 01:57:46,040 --> 01:57:47,880 CROSSOVER STUDY IN 18 ADULTS 2920 01:57:47,880 --> 01:57:49,520 WITH TYPE 2 DIABETES, AFTER ONE 2921 01:57:49,520 --> 01:57:52,160 WEEK OF EATING A LARGE BREAKFAST 2922 01:57:52,160 --> 01:57:53,200 THIS LOWERED GLUCOSE LEVELS 2923 01:57:53,200 --> 01:57:58,160 ACROSS THE DAY, AS YOU CAN SEE, 2924 01:57:58,160 --> 01:57:59,240 INCREASED INSULIN SECRETION 2925 01:57:59,240 --> 01:58:00,880 ACROSS THE DAY. 2926 01:58:00,880 --> 01:58:03,200 THIS IS ABOUT 15 TO 20%, SO A 2927 01:58:03,200 --> 01:58:05,640 LARGE IMPROVEMENT AFTER ONLY ONE 2928 01:58:05,640 --> 01:58:09,720 WEEK, NO DIFFERENCE IN ENERGY 2929 01:58:09,720 --> 01:58:10,240 INTAKE. 2930 01:58:10,240 --> 01:58:10,560 NEXT. 2931 01:58:10,560 --> 01:58:13,920 AND I THINK WE'RE UP TO ABOUT A 2932 01:58:13,920 --> 01:58:17,320 DOZEN STUDIES TESTING EATING 2933 01:58:17,320 --> 01:58:18,960 BREAKFAST LIKE A KING, OR 2934 01:58:18,960 --> 01:58:21,400 PRINCIPLE OF EATING EARLIER IN 2935 01:58:21,400 --> 01:58:27,200 THE DAY, AND THIS NICE 2936 01:58:27,200 --> 01:58:29,840 META-ANALYSIS SHOWED EATER DOES 2937 01:58:29,840 --> 01:58:32,240 APPEAR TO FACILITATE WEIGHT 2938 01:58:32,240 --> 01:58:37,800 LOSS, REDUCE BODY WEIGHT, 2939 01:58:37,800 --> 01:58:40,320 REDUCES FASTING GLUCOSE AND LDL 2940 01:58:40,320 --> 01:58:40,760 CHOLESTEROL. 2941 01:58:40,760 --> 01:58:43,280 AND THERE ARE ALL KINDS OF 2942 01:58:43,280 --> 01:58:46,880 VARIANTS ON THE TIMING OF FOOD 2943 01:58:46,880 --> 01:58:47,200 INTAKE. 2944 01:58:47,200 --> 01:58:49,040 WE KNOW BASED ON SOME BASIC 2945 01:58:49,040 --> 01:58:52,240 SCIENCE RESEARCH WHICH HAS BEEN 2946 01:58:52,240 --> 01:58:55,560 TERRIFIC THAT DIFFERENT 2947 01:58:55,560 --> 01:58:58,400 MACRONUTRIENTS VERY IN 2948 01:58:58,400 --> 01:59:00,360 EFFECTIVENESS FOR PERIPHERAL 2949 01:59:00,360 --> 01:59:00,920 CLOCKS. 2950 01:59:00,920 --> 01:59:03,960 CARBS, PROTEINS, FATS ARE NOT 2951 01:59:03,960 --> 01:59:04,960 EQUALLY EFFECTIVE. 2952 01:59:04,960 --> 01:59:09,240 THERE HAVE BEEN STUDIES IN 2953 01:59:09,240 --> 01:59:10,840 RODENTS AND HUMANS INDICATING 2954 01:59:10,840 --> 01:59:12,280 INDICATING FATS EARLIER IN THE 2955 01:59:12,280 --> 01:59:15,320 MORNING, CARBS IN THE EVENING, 2956 01:59:15,320 --> 01:59:18,320 REDUCES WEIGHT GAIN AND BODY FAT 2957 01:59:18,320 --> 01:59:24,760 IN RODENTS, IMPROVES SATIETY IN 2958 01:59:24,760 --> 01:59:25,560 HUMANS. 2959 01:59:25,560 --> 01:59:28,040 HOW DO WE PUT INTERMITTENT 2960 01:59:28,040 --> 01:59:30,880 FASTING AND SORT OF TIME OF DAY 2961 01:59:30,880 --> 01:59:35,040 OF INTAKE DATA TOGETHER AND 2962 01:59:35,040 --> 01:59:39,080 RESOLVE BREAKFAST SKIPPING, WHY 2963 01:59:39,080 --> 01:59:40,280 IS IT KROAFERL? 2964 01:59:40,280 --> 01:59:45,520 YOU CAN SKIP BREAKFAST AND DO 2965 01:59:45,520 --> 01:59:47,280 TIME RESTRICTING EATING, ONE 2966 01:59:47,280 --> 01:59:48,400 HYPOTHESIS IS BREAKFAST SKIPPING 2967 01:59:48,400 --> 01:59:51,360 MAY NOT INCREASE RISK OF 2968 01:59:51,360 --> 01:59:52,120 CARDIOMETABOLIC DISEASE UNLESS 2969 01:59:52,120 --> 01:59:53,320 ACCOMPANIED BY LATE NIGHT 2970 01:59:53,320 --> 01:59:53,680 EATING. 2971 01:59:53,680 --> 01:59:55,200 THIS IS ANOTHER IMPORTANT 2972 01:59:55,200 --> 01:59:56,280 QUESTION FOR THE FIELD. 2973 01:59:56,280 --> 01:59:58,800 NICE WORK OUT OF JAPAN SHOWS 2974 01:59:58,800 --> 02:00:02,560 THERE ARE TWO DISTINCT BREAKFAST 2975 02:00:02,560 --> 02:00:03,320 SKIPPING PHENOTYPES. 2976 02:00:03,320 --> 02:00:04,800 HALF SKIP BREAKFAST AND EAT 2977 02:00:04,800 --> 02:00:08,560 DINNER AT REGULAR TIME, OTHER 2978 02:00:08,560 --> 02:00:11,040 HALF EAT LATE. 2979 02:00:11,040 --> 02:00:12,440 THERE ARE BEHAVIORAL PHENOTYPES, 2980 02:00:12,440 --> 02:00:15,080 YOU HAVE TO ASK ABOUT THE WHOLE 2981 02:00:15,080 --> 02:00:15,440 DAY. 2982 02:00:15,440 --> 02:00:16,640 INTERESTINGLY, THOSE WHO SKIP 2983 02:00:16,640 --> 02:00:19,160 BREAKFAST AND ATE LATER HAD 2984 02:00:19,160 --> 02:00:21,320 HIGHER ODDS OF METABOLIC 2985 02:00:21,320 --> 02:00:22,800 SYNDROME, SIMILAR ODDS RATIO FOR 2986 02:00:22,800 --> 02:00:23,960 OBESITY WAS MUCH HIGHER THAN 2987 02:00:23,960 --> 02:00:28,360 THOSE WHO ONLY SKIPPED 2988 02:00:28,360 --> 02:00:28,800 BREAKFAST. 2989 02:00:28,800 --> 02:00:29,680 NEXT. 2990 02:00:29,680 --> 02:00:31,200 AND THE LARGEST TRIAL ON 2991 02:00:31,200 --> 02:00:32,520 BREAKFAST SKIPPING INDICATES IT 2992 02:00:32,520 --> 02:00:34,720 DOES NOT AFFECT BODY WEIGHT, 2993 02:00:34,720 --> 02:00:37,120 BUT, AGAIN, THESE BEHAVIORAL 2994 02:00:37,120 --> 02:00:39,120 PHENOTYPES WEREN'T TAKEN INTO 2995 02:00:39,120 --> 02:00:40,760 ACCOUNT SO TAKE THAT WITH A 2996 02:00:40,760 --> 02:00:42,160 GRAIN OF SALT. 2997 02:00:42,160 --> 02:00:44,920 THIS WAS DONE AS A PUBLIC HEALTH 2998 02:00:44,920 --> 02:00:47,040 RECOMMENDATION TO SKIP OR NOT 2999 02:00:47,040 --> 02:00:47,640 SKIP BREAKFAST. 3000 02:00:47,640 --> 02:00:50,160 THE DEVIL IS IN THE DETAILS. 3001 02:00:50,160 --> 02:00:53,480 THERE'S A PRETTY GOOD CONSENSUS 3002 02:00:53,480 --> 02:00:57,200 IN SKIPPING BREAKFAST ON 24 HOUR 3003 02:00:57,200 --> 02:00:58,600 GLUCOSE LEVELS, A HANDFUL 3004 02:00:58,600 --> 02:01:02,080 LOOKING AT THE EFFECT OF 3005 02:01:02,080 --> 02:01:03,080 SKIPPING BREAKFAST VERSUS EATING 3006 02:01:03,080 --> 02:01:05,720 3 MEALS A DAY, INCREASES IN 3007 02:01:05,720 --> 02:01:07,360 DAYTIME OR 24-HOUR GLUCOSE 3008 02:01:07,360 --> 02:01:07,560 LEVELS. 3009 02:01:07,560 --> 02:01:09,400 THE ONE CAVEAT IS ALL THESE 3010 02:01:09,400 --> 02:01:13,800 STUDIES HAVE BEEN A WEEK OR 3011 02:01:13,800 --> 02:01:16,240 LESS. 3012 02:01:16,240 --> 02:01:18,480 SO THAT MAY NOT BE ENOUGH TIME. 3013 02:01:18,480 --> 02:01:22,320 WE NEED LONGER STUDIES TO ANSWER 3014 02:01:22,320 --> 02:01:22,800 DEFINITIVELY. 3015 02:01:22,800 --> 02:01:23,200 NEXT. 3016 02:01:23,200 --> 02:01:25,720 AND COMING BACK TO SOME OF THE 3017 02:01:25,720 --> 02:01:28,560 MIXED RESULTS ON TIME RESTRICTED 3018 02:01:28,560 --> 02:01:29,240 EATING, IN ADDITION TO 3019 02:01:29,240 --> 02:01:30,560 CONSIDERING THE LENGTH OF THAT 3020 02:01:30,560 --> 02:01:34,160 WINDOW WE NEED TO THINK ABOUT 3021 02:01:34,160 --> 02:01:36,040 WHETHER THAT'S EARLY VERSUS 3022 02:01:36,040 --> 02:01:36,360 LATE. 3023 02:01:36,360 --> 02:01:39,520 WE'RE UP TO HALF A DOZEN 3024 02:01:39,520 --> 02:01:41,720 STUDIES, MOST UNDERPOWERED. 3025 02:01:41,720 --> 02:01:43,240 THE THREE LARGEST COMPARING 3026 02:01:43,240 --> 02:01:46,400 EARLY TIME RESTRICTED EATING TO 3027 02:01:46,400 --> 02:01:50,120 MIDDAY, SO BY SKIPPING 3028 02:01:50,120 --> 02:01:54,920 BREAKFAST, ALL THREE REPORT MORE 3029 02:01:54,920 --> 02:01:55,600 CARDIOMETABOLIC BENEFIT. 3030 02:01:55,600 --> 02:01:58,080 I DON'T THINK WE'RE CLOSE TO 3031 02:01:58,080 --> 02:02:00,720 DEFINITIVE ANSWER ON WHETHER 3032 02:02:00,720 --> 02:02:07,320 EARLY VERSUS MIDDAY 3033 02:02:07,320 --> 02:02:09,240 TIME-RESTRICTED IS MORE EFFECT 3034 02:02:09,240 --> 02:02:12,800 THE FOR WEIGHT LOSS BUT INDICATE 3035 02:02:12,800 --> 02:02:16,200 BENEFITS SUCH AS IMPROVEMENTS IN 3036 02:02:16,200 --> 02:02:18,520 SYSTOLIC BLOOD PRESSURE, MEAN 3037 02:02:18,520 --> 02:02:22,920 GLUCOSE LEVELS, INSULIN AND SO 3038 02:02:22,920 --> 02:02:23,240 FORTH. 3039 02:02:23,240 --> 02:02:25,280 MY PERSPECTIVE ON OPPORTUNITIES 3040 02:02:25,280 --> 02:02:30,920 AND CHALLENGES, THE MOST 3041 02:02:30,920 --> 02:02:32,880 PROMISING EFFECT TO PURSUE, 3042 02:02:32,880 --> 02:02:33,760 WEIGHT LOSS, GLYCEMIC CONTROL, 3043 02:02:33,760 --> 02:02:35,400 BLOOD PRESSURE AND MOOD, LESS IS 3044 02:02:35,400 --> 02:02:41,160 KNOWN ABOUT EFFECTS IN 3045 02:02:41,160 --> 02:02:47,560 PRE-HYPERTENSIVE OR 3046 02:02:47,560 --> 02:02:48,320 HYPERLIPIDEMIC POPULATIONS. 3047 02:02:48,320 --> 02:02:49,960 IT'S IMPORTANT FOR NHLBI TO 3048 02:02:49,960 --> 02:02:50,400 KNOW. 3049 02:02:50,400 --> 02:02:53,200 THERE'S LACK OF TRANSLATION 3050 02:02:53,200 --> 02:02:53,640 THERE. 3051 02:02:53,640 --> 02:02:56,840 IMPORTANT TO FIGURE OUT TO WHAT 3052 02:02:56,840 --> 02:02:59,640 DEGREE RESULTS DEPEND ON CRIT 3053 02:02:59,640 --> 02:03:03,000 AM, AND IMPORTANT TO BE HUMBLE, 3054 02:03:03,000 --> 02:03:05,480 EVEN IF WE SEE ALIGNED RHYTHM 3055 02:03:05,480 --> 02:03:06,920 MAY NOT INDICATE BEST TIME OF 3056 02:03:06,920 --> 02:03:08,480 DAY TO EAT. 3057 02:03:08,480 --> 02:03:10,920 INDIVIDUALS WITH TYPE 2 DIABETES 3058 02:03:10,920 --> 02:03:12,120 TEND TO HAVE BEST SENSITIVITY 3059 02:03:12,120 --> 02:03:14,160 LATER IN THE DAY, YOU MIGHT 3060 02:03:14,160 --> 02:03:16,960 THINK MAYBE THEY SHOULD EAT MORE 3061 02:03:16,960 --> 02:03:21,120 LATER BUT INTERVENTION FOUND THE 3062 02:03:21,120 --> 02:03:25,600 OPPOSITE. 3063 02:03:25,600 --> 02:03:28,120 RHYTHMS MAY BE MALLEABLE. 3064 02:03:28,120 --> 02:03:34,240 INPATIENT WITH NEAR PERFECT 3065 02:03:34,240 --> 02:03:34,520 ADHERENCE. 3066 02:03:34,520 --> 02:03:37,080 WE HAVE GOOD CONSENSUS IN TERMS 3067 02:03:37,080 --> 02:03:38,720 OF WHETHER THERE ARE BENEFITS. 3068 02:03:38,720 --> 02:03:40,840 WE DON'T HAVE ENOUGH STUDIES. 3069 02:03:40,840 --> 02:03:45,000 THESE ARE IMPORTANT TO DETERMINE 3070 02:03:45,000 --> 02:03:45,280 EFFICACY. 3071 02:03:45,280 --> 02:03:49,720 IF I WERE TO TAKE MY TOP FOUR 3072 02:03:49,720 --> 02:03:52,360 FAVORITE LAYERS OF THE ONION TO 3073 02:03:52,360 --> 02:03:54,560 TARGET IN RANDOMIZED CONTROLLED 3074 02:03:54,560 --> 02:03:58,680 TRIALS I WOULD TARGET TRYING TO 3075 02:03:58,680 --> 02:03:59,600 TEASE EFFECT ENERGY RESTRICTION, 3076 02:03:59,600 --> 02:04:01,240 FASTING DURATION, TIME OF DAY 3077 02:04:01,240 --> 02:04:04,040 AND CONSISTENCY OF THE WINDOW, 3078 02:04:04,040 --> 02:04:08,320 MY TOP FOUR LAYERS FOR US TO 3079 02:04:08,320 --> 02:04:13,480 TACKLE, THOSE WHO DO RCTs. 3080 02:04:13,480 --> 02:04:15,440 THE RESULTS WERE MIXED FOR 3081 02:04:15,440 --> 02:04:16,320 LARGER FREE-LIVING STUDIES BUT 3082 02:04:16,320 --> 02:04:18,600 IT'S IMPORTANT TO DO LARGER AND 3083 02:04:18,600 --> 02:04:19,040 LONG TERM. 3084 02:04:19,040 --> 02:04:21,760 WE NEED TO KNOW ABOUT 3085 02:04:21,760 --> 02:04:23,120 EFFECTIVENESS, WHAT ADHERENCE IS 3086 02:04:23,120 --> 02:04:24,840 IN THE LONG TERM, HOW 3087 02:04:24,840 --> 02:04:29,680 FEASIBILITY DEPENDS ON THE 3088 02:04:29,680 --> 02:04:31,320 LENGTH AND TIME. 3089 02:04:31,320 --> 02:04:35,040 WE'RE FLOODED BY LOWER QUALITY 3090 02:04:35,040 --> 02:04:36,600 STUDIES, SAMPLE SIZES ARE LOWER, 3091 02:04:36,600 --> 02:04:39,000 ISSUES WITH STUDY DESIGN. 3092 02:04:39,000 --> 02:04:41,400 UNFORTUNATELY ONE TREND I SEE IS 3093 02:04:41,400 --> 02:04:43,800 MANY ARE DESIGNED BY PEOPLE THAT 3094 02:04:43,800 --> 02:04:44,880 DON'T HAVE -- THERE'S A LOT OF 3095 02:04:44,880 --> 02:04:48,160 ENTHUSIASM BUT ARE DESIGNED BY 3096 02:04:48,160 --> 02:04:50,720 PEOPLE WITHOUT EXPERIENCE IN 3097 02:04:50,720 --> 02:04:52,120 NUTRITION STUDIES OR 3098 02:04:52,120 --> 02:04:53,480 CHRONOBIOLOGY, THERE'S ISSUES 3099 02:04:53,480 --> 02:04:55,320 THAT UNDERMINE THE QUALITY. 3100 02:04:55,320 --> 02:04:57,920 WE NEED A VIRTUAL EDUCATION PATH 3101 02:04:57,920 --> 02:05:00,760 FOR INVESTIGATORS AND MUCH 3102 02:05:00,760 --> 02:05:04,760 LARGER SAMPLE SIZES, A LOT OF 3103 02:05:04,760 --> 02:05:05,720 STUDIES ARE UNDERPOWERED. 3104 02:05:05,720 --> 02:05:13,440 I'D LIKE TO CLOSE AND THANK 3105 02:05:13,440 --> 02:05:16,120 SPONSORS AND COLLABORATORS. 3106 02:05:16,120 --> 02:05:20,640 >>THANK YOU. 3107 02:05:20,640 --> 02:05:23,160 OKAY. 3108 02:05:23,160 --> 02:05:24,720 NEXT SLIDE. 3109 02:05:24,720 --> 02:05:25,800 INTRODUCING PROFESSOR CRISPIM, 3110 02:05:25,800 --> 02:05:30,640 PROFESSOR OF NUTRITION AT THE 3111 02:05:30,640 --> 02:05:32,560 FEDERAL UNIVERSITY IN BRAZIL, 3112 02:05:32,560 --> 02:05:35,880 VISITING RESEARCHER IN THE U.K., 3113 02:05:35,880 --> 02:05:37,080 FOCUSING ON CHRONONUTRITION 3114 02:05:37,080 --> 02:05:39,240 BROADLY WITH EMPHASIS ON SHIFT 3115 02:05:39,240 --> 02:05:42,800 WORKERS AND PREGNANCY AS WELL AS 3116 02:05:42,800 --> 02:05:44,000 FOOD INTAKE AND SLEEP. 3117 02:05:44,000 --> 02:05:48,600 WE LOOK FORWARD TO YOUR 3118 02:05:48,600 --> 02:05:48,920 PRESENTATION. 3119 02:05:48,920 --> 02:05:49,520 >>THANK YOU. 3120 02:05:49,520 --> 02:05:52,640 I'D LIKE TO THANK THE 3121 02:05:52,640 --> 02:05:52,920 ORGANIZERS. 3122 02:05:52,920 --> 02:05:54,160 IT'S A PLEASURE TO BE HERE AND 3123 02:05:54,160 --> 02:05:58,640 TO BE PART OF THIS AMAZING TEAM. 3124 02:05:58,640 --> 02:06:00,280 MY TOPIC IS CIRCADIAN 3125 02:06:00,280 --> 02:06:02,360 MISALIGNMENT AND MEAL TOMORROW 3126 02:06:02,360 --> 02:06:04,440 ON PUBLIC HEALTH, SPECIFIC FOCUS 3127 02:06:04,440 --> 02:06:13,320 ON SHIFT-WORK POPULATION. 3128 02:06:13,320 --> 02:06:15,520 NEXT PLEASE. 3129 02:06:15,520 --> 02:06:17,960 SHIFT WORK IS PREVALENT IN OUR 3130 02:06:17,960 --> 02:06:21,080 SOCIETY, AROUND 20% OF THE WHOLE 3131 02:06:21,080 --> 02:06:24,680 WORKFORCE, THE SHIFT WORK HAS 3132 02:06:24,680 --> 02:06:27,960 BEEN CONSIDERED THE MODEL OF 3133 02:06:27,960 --> 02:06:28,560 CIRCADIAN MISALIGNMENT, MORE 3134 02:06:28,560 --> 02:06:36,520 LIKELY TO DEVELOP MANY DISEASES, 3135 02:06:36,520 --> 02:06:38,280 ESPECIALLY NUTRITIONAL AND 3136 02:06:38,280 --> 02:06:42,800 METABOLIC, SUCH AS OBESITY, 3137 02:06:42,800 --> 02:06:45,080 LIPID DISORDERS, TYPE 2 3138 02:06:45,080 --> 02:06:47,600 DIABETES, AND OTHERS. 3139 02:06:47,600 --> 02:06:53,040 BASED ON THIS, I DIVIDED MY 3140 02:06:53,040 --> 02:06:58,440 PRESENTATION INTO PARTS. 3141 02:06:58,440 --> 02:06:59,320 FIRST EPIDEMIOLOGICAL POINTS, 3142 02:06:59,320 --> 02:07:02,160 CLINICAL APPROACH ON THE SAME 3143 02:07:02,160 --> 02:07:07,920 SUBJECT, GAPS IN KNOWLEDGE, AND 3144 02:07:07,920 --> 02:07:11,560 CONCLUSIONS. 3145 02:07:11,560 --> 02:07:12,200 NEXT. 3146 02:07:12,200 --> 02:07:12,760 NEXT. 3147 02:07:12,760 --> 02:07:13,760 DIETARY INTAKE OF SHIFT WORKERS 3148 02:07:13,760 --> 02:07:16,280 HAS BEEN ADDRESSED BY STUDIES, 3149 02:07:16,280 --> 02:07:20,840 ESPECIALLY IN THE LAST 15 YEARS. 3150 02:07:20,840 --> 02:07:25,120 WE HAVE MORE SYSTEMATIC REVIEWS, 3151 02:07:25,120 --> 02:07:26,040 SOME WITH META-ANALYSIS, 3152 02:07:26,040 --> 02:07:28,960 COMPARING THE FOOD INTAKE AND 3153 02:07:28,960 --> 02:07:30,480 DIETARY INTAKE OF SHIFT WORKERS, 3154 02:07:30,480 --> 02:07:34,200 AND COMPARED WITH DAY WORKERS. 3155 02:07:34,200 --> 02:07:37,600 NEXT PLEASE. 3156 02:07:37,600 --> 02:07:42,120 AND IN GENERAL, THE STUDIES THAT 3157 02:07:42,120 --> 02:07:44,840 WERE INCLUDED IN ALL THIS 3158 02:07:44,840 --> 02:07:47,960 REVEALS ENERGY INTAKE OF SHIFT 3159 02:07:47,960 --> 02:07:51,840 WORKERS, AS FAR AS QUANTITY AND 3160 02:07:51,840 --> 02:07:54,000 QUALITY OF DIET, SNACKING 3161 02:07:54,000 --> 02:08:01,680 BEHAVIOR, EATING FREQUENCY, AND 3162 02:08:01,680 --> 02:08:04,080 IN GENERAL THESE ARTICLES HAVE 3163 02:08:04,080 --> 02:08:07,680 ADDRESSED THE TIME OF MEAL OF 3164 02:08:07,680 --> 02:08:10,680 SHIFT WORKERS, AND WE HAVE 3165 02:08:10,680 --> 02:08:12,320 EVIDENCE THAT THEY EAT AROUND 3166 02:08:12,320 --> 02:08:22,200 THE CLOCK. 3167 02:08:22,200 --> 02:08:27,560 NEXT PLEASE. 3168 02:08:27,560 --> 02:08:32,640 HERE WE COMPARED 6:00 AT NIGHT. 3169 02:08:32,640 --> 02:08:35,000 UP TO 11 P.M. BOTH DAY AND NIGHT 3170 02:08:35,000 --> 02:08:39,680 SHIFT WORKERS TEND TO PRESENT A 3171 02:08:39,680 --> 02:08:41,200 SIMILAR ENERGY INTAKE, AND ALSO 3172 02:08:41,200 --> 02:08:42,800 SIMILAR DISTRIBUTION OF THE 3173 02:08:42,800 --> 02:08:46,800 ENERGY INTAKE THROUGHOUT THE 3174 02:08:46,800 --> 02:08:48,440 DAY. 3175 02:08:48,440 --> 02:08:49,560 HOWEVER, NEXT PLEASE. 3176 02:08:49,560 --> 02:08:52,280 AFTER 11 P.M. SHIFT WORKERS, 3177 02:08:52,280 --> 02:08:55,880 NIGHT WORKERS, THEY TENDED TO 3178 02:08:55,880 --> 02:08:58,760 INTAKE 600 MORE CALORIES THAN 3179 02:08:58,760 --> 02:09:01,160 DAY WORKERS. 3180 02:09:01,160 --> 02:09:01,560 NEXT. 3181 02:09:01,560 --> 02:09:03,880 WHICH REPRESENTED AROUND 20% OF 3182 02:09:03,880 --> 02:09:09,680 THEIR DAILY CALORIC INTAKE. 3183 02:09:09,680 --> 02:09:11,760 NEXT. 3184 02:09:11,760 --> 02:09:15,120 AND HERE IS ANOTHER STUDY WITH 3185 02:09:15,120 --> 02:09:17,560 DIFFERENT SHIFT. 3186 02:09:17,560 --> 02:09:20,720 WE EVALUATED ROTATING SHIFT 3187 02:09:20,720 --> 02:09:21,080 WORKERS. 3188 02:09:21,080 --> 02:09:23,240 THEY WERE MINE WORKERS. 3189 02:09:23,240 --> 02:09:25,880 WE EVALUATED FOOD INTAKE 3190 02:09:25,880 --> 02:09:29,800 THROUGHOUT TEN DAYS, WE HAVE 3191 02:09:29,800 --> 02:09:31,360 HERE DATA FROM 240 CONSECUTIVE 3192 02:09:31,360 --> 02:09:36,040 HOURS OF FOOD RECALL, AND WE CAN 3193 02:09:36,040 --> 02:09:38,800 SEE IN RED SQUARES THAT DURING 3194 02:09:38,800 --> 02:09:44,040 THE NIGHT SHIFT, THE NIGHT SHIFT 3195 02:09:44,040 --> 02:09:47,080 WORKERS, THEY TEND TO PRESENT -- 3196 02:09:47,080 --> 02:09:50,040 TO HAVE MANY EATING OCCASIONS, 3197 02:09:50,040 --> 02:09:54,000 WITH DIFFERENT AMOUNTS OF 3198 02:09:54,000 --> 02:09:54,760 ENERGY. 3199 02:09:54,760 --> 02:09:55,080 NEXT. 3200 02:09:55,080 --> 02:09:57,760 AND THIS REPRESENTED AROUND A 3201 02:09:57,760 --> 02:10:02,120 THOUSAND CALORIES FROM 8 TO 6 3202 02:10:02,120 --> 02:10:04,080 A.M., AROUND 30% OF THE DAILY 3203 02:10:04,080 --> 02:10:06,160 CALORIE INTAKE. 3204 02:10:06,160 --> 02:10:11,960 THIS IS REALLY IMPORTANT WHEN 3205 02:10:11,960 --> 02:10:13,840 YOU THINK ABOUT OBESITY, THOSE 3206 02:10:13,840 --> 02:10:17,640 ARE MORE LIKELY TO PRESENT. 3207 02:10:17,640 --> 02:10:18,400 NEXT. 3208 02:10:18,400 --> 02:10:23,120 THIS IS AN INTERESTING REVIEW 3209 02:10:23,120 --> 02:10:25,960 ARTICLE FROM THE UNIVERSITY OF 3210 02:10:25,960 --> 02:10:28,240 SOUTH AUSTRALIA. 3211 02:10:28,240 --> 02:10:33,560 THE AUTHORS EVALUATED, DISCUSSED 3212 02:10:33,560 --> 02:10:37,480 FACTORS INFLUENCING EATING 3213 02:10:37,480 --> 02:10:39,800 BEHAVIOR OF SHIFT WORKERS, 3214 02:10:39,800 --> 02:10:41,640 WHERE, WHAT, WHEN AND WHY. 3215 02:10:41,640 --> 02:10:43,440 SOMETHING THAT'S INTERESTING TO 3216 02:10:43,440 --> 02:10:46,160 NOTE IS THAT THE MOST FREQUENT 3217 02:10:46,160 --> 02:10:47,560 FACTORS INFLUENCING EATING 3218 02:10:47,560 --> 02:10:49,520 BEHAVIOR OF SHIFT WORKERS 3219 02:10:49,520 --> 02:10:53,480 ESPECIALLY WITH THIS QUESTION, 3220 02:10:53,480 --> 02:10:56,440 WHEN THEY EAT, WERE IRREGULAR 3221 02:10:56,440 --> 02:11:04,840 WORKING HOURS, BREAK 3222 02:11:04,840 --> 02:11:05,840 AVAILABILITY. 3223 02:11:05,840 --> 02:11:06,040 NEXT. 3224 02:11:06,040 --> 02:11:08,240 BUT WHAT I'D LIKE TO HIGHLIGHT 3225 02:11:08,240 --> 02:11:15,840 IN THIS REVIEW, NEXT PLEASE, 3226 02:11:15,840 --> 02:11:17,680 SOMETHING THAT ARE IS IMPORTANT 3227 02:11:17,680 --> 02:11:24,600 IN THIS REVIEW IS THAT 3228 02:11:24,600 --> 02:11:26,320 CROSS-SECTIONAL, 90%, WE KNOW 3229 02:11:26,320 --> 02:11:28,720 THERE ARE MANY IMPORTANT 3230 02:11:28,720 --> 02:11:30,080 LIMITATIONS ON CROSS-SECTIONAL 3231 02:11:30,080 --> 02:11:32,240 STUDIES, WE CANNOT EVALUATE 3232 02:11:32,240 --> 02:11:34,760 CAUSE AND EFFECT RELATIONSHIP, 3233 02:11:34,760 --> 02:11:37,720 WE CANNOT CAPTURE CHANGES OVER 3234 02:11:37,720 --> 02:11:43,600 TIME, AND ONLY THREE OF THESE 30 3235 02:11:43,600 --> 02:11:47,640 WERE EVALUATED TIME OF MEAL, AND 3236 02:11:47,640 --> 02:11:50,400 NO COHORT STUDIES WERE INCLUDED. 3237 02:11:50,400 --> 02:11:52,600 SO I CONSIDER IT AS A VERY 3238 02:11:52,600 --> 02:11:53,600 IMPORTANT LIMITATION FOR THE 3239 02:11:53,600 --> 02:11:55,440 FIELD AND I'M GOING TO ADDRESS 3240 02:11:55,440 --> 02:12:02,200 IT LATER IN MY PRESENTATION. 3241 02:12:02,200 --> 02:12:02,600 NEXT. 3242 02:12:02,600 --> 02:12:04,720 NOW CLINICAL APPROACH ON 3243 02:12:04,720 --> 02:12:07,360 CHRONONUTRITION FOR SHIFT 3244 02:12:07,360 --> 02:12:08,000 WORKERS. 3245 02:12:08,000 --> 02:12:08,440 NEXT. 3246 02:12:08,440 --> 02:12:14,160 I'M GOING TO SHOW YOU SOME 3247 02:12:14,160 --> 02:12:15,120 RANDOMIZED CROSSOVERS THAT WE'VE 3248 02:12:15,120 --> 02:12:16,880 DONE AT OUR UNIVERSITY IN 3249 02:12:16,880 --> 02:12:19,640 BRAZIL, DIFFERENT MEALS DURING 3250 02:12:19,640 --> 02:12:23,280 THE NIGHT SHIFT, SPECIFICALLY 3251 02:12:23,280 --> 02:12:27,040 FOCUSED ON MEASURED INFLUENCE OF 3252 02:12:27,040 --> 02:12:28,520 DIFFERENT MEAL STRETCHES AND 3253 02:12:28,520 --> 02:12:31,920 COMPOSITION ON EATING BEHAVIOR 3254 02:12:31,920 --> 02:12:37,520 THE NEXT DAY. 3255 02:12:37,520 --> 02:12:39,520 NEXT. 3256 02:12:39,520 --> 02:12:42,440 AND THESE TWO ARTICLES, WE 3257 02:12:42,440 --> 02:12:44,160 TESTED THE SAME NUTRITIONAL 3258 02:12:44,160 --> 02:12:48,240 PROTOCOL DURING THE NIGHT SHIFT, 3259 02:12:48,240 --> 02:12:55,040 SO IT WAS HIGH PROTEIN MODERATE 3260 02:12:55,040 --> 02:12:59,480 CARB MEAL VERSUS LOW PROTEIN 3261 02:12:59,480 --> 02:13:01,360 HIGH CARBOHYDRATE, RELATED TO 3262 02:13:01,360 --> 02:13:06,080 FOOD INTAKE THE FOLLOWING DAY, 3263 02:13:06,080 --> 02:13:07,800 SECOND ARTICLE WE MEASURED 3264 02:13:07,800 --> 02:13:08,720 POSTPRANDIAL RESPONSE FOLLOWING 3265 02:13:08,720 --> 02:13:11,440 BREAKFAST, INSULIN AND GLUCOSE 3266 02:13:11,440 --> 02:13:11,800 LEVELS. 3267 02:13:11,800 --> 02:13:14,040 WE FOUND IN BOTH STUDIES THE 3268 02:13:14,040 --> 02:13:17,680 COMPOSITION OF MEALS DURING THE 3269 02:13:17,680 --> 02:13:20,960 NIGHT SHIFT DID NOT INFLUENCE 3270 02:13:20,960 --> 02:13:21,720 POSTPRANDIAL METABOLIC RESPONSE 3271 02:13:21,720 --> 02:13:27,280 THE FOLLOWING DAY. 3272 02:13:27,280 --> 02:13:27,640 NEXT. 3273 02:13:27,640 --> 02:13:36,720 THIS IS ANOTHER STUDY OF OURS, 3274 02:13:36,720 --> 02:13:39,120 AND HERE WE RANDOMIZED CROSSOVER 3275 02:13:39,120 --> 02:13:41,680 STUDIES, WITH THREE ARMS. 3276 02:13:41,680 --> 02:13:48,120 FIRST WAS NIGHT SHIFT FASTING, 3277 02:13:48,120 --> 02:13:50,880 HERE THE WORKERS, THE WHOLE 3278 02:13:50,880 --> 02:13:53,360 NIGHT WORKING WITHOUT EATING. 3279 02:13:53,360 --> 02:13:57,880 THEY RECEIVED 100% OF THE ENERGY 3280 02:13:57,880 --> 02:14:00,920 REQUIREMENT UP TO 10 P.M., AND 3281 02:14:00,920 --> 02:14:04,520 SECOND WAS NIGHT SHIFT EATING. 3282 02:14:04,520 --> 02:14:06,840 SO THEY RECEIVED 7% OF THE 3283 02:14:06,840 --> 02:14:12,320 ENERGY INTAKE UP TO 10 P.M. 3284 02:14:12,320 --> 02:14:14,440 AND 30% AT 2 A.M., DURING THE 3285 02:14:14,440 --> 02:14:16,000 NIGHT SHIFT. 3286 02:14:16,000 --> 02:14:20,720 IT WAS A BALANCED DIET. 3287 02:14:20,720 --> 02:14:22,360 BALANCED MEALS, SORRY. 3288 02:14:22,360 --> 02:14:25,440 THE CONDITION WAS REGULAR NIGHT 3289 02:14:25,440 --> 02:14:26,200 SLEEP. 3290 02:14:26,200 --> 02:14:27,320 NEXT PLEASE. 3291 02:14:27,320 --> 02:14:28,960 SURPRISINGLY WE FOUND THAT THE 3292 02:14:28,960 --> 02:14:30,600 FASTING DURING THE NIGHT SHIFT 3293 02:14:30,600 --> 02:14:34,840 LED TO HIGHER INTAKE OF ENERGY 3294 02:14:34,840 --> 02:14:36,400 AND MICRONUTRIENTS THE NEXT DAY, 3295 02:14:36,400 --> 02:14:39,320 IN GENERAL WE CAN SEE IN THIS 3296 02:14:39,320 --> 02:14:43,840 TABLE THAT THE NIGHT SHIFT 3297 02:14:43,840 --> 02:14:47,200 FASTING CONDITION, IN THIS 3298 02:14:47,200 --> 02:14:49,200 CONDITION THEY ATE AROUND A 3299 02:14:49,200 --> 02:14:51,560 THOUSAND CALORIES MORE THAN THE 3300 02:14:51,560 --> 02:14:58,760 OTHER TWO CONDITIONS. 3301 02:14:58,760 --> 02:15:00,680 OF COURSE, WE DON'T KNOW IF 3302 02:15:00,680 --> 02:15:02,760 REPLICATED IN LONG TERM FOR 3303 02:15:02,760 --> 02:15:05,160 EXAMPLE BUT PROBLEMATIC BECAUSE 3304 02:15:05,160 --> 02:15:07,320 WE KNOW THESE WORKERS ARE MORE 3305 02:15:07,320 --> 02:15:11,640 LIKELY TO HAVE OBESITY, FOR 3306 02:15:11,640 --> 02:15:12,840 EXAMPLE. 3307 02:15:12,840 --> 02:15:13,040 NEXT. 3308 02:15:13,040 --> 02:15:15,120 MAYBE THE POINT, THE QUESTION 3309 02:15:15,120 --> 02:15:23,440 HERE, DID WE USE THESE FINDINGS, 3310 02:15:23,440 --> 02:15:25,880 SO FAR IN LITERATURE, TO DIVIDE 3311 02:15:25,880 --> 02:15:30,360 SHIFT WORKERS AND UNFORTUNATELY 3312 02:15:30,360 --> 02:15:31,880 WE CANNOT BECAUSE, AGAIN, THIS 3313 02:15:31,880 --> 02:15:38,120 IS STUDIES CAN SHORT TERM, THESE 3314 02:15:38,120 --> 02:15:42,840 THREE WE TESTED ONLY TWO DAYS OF 3315 02:15:42,840 --> 02:15:44,360 INTERVENTIONS. 3316 02:15:44,360 --> 02:15:45,440 NEXT. 3317 02:15:45,440 --> 02:15:53,240 AND WE REALLY NEED LONG-TERM 3318 02:15:53,240 --> 02:15:54,000 INTERVENTION. 3319 02:15:54,000 --> 02:15:55,840 HERE, WE HAVE FOUR REVIEWS OF 3320 02:15:55,840 --> 02:16:00,440 THE LITERATURE ON THE TOPIC 3321 02:16:00,440 --> 02:16:01,240 ADDRESSING INTERVENTIONS, 3322 02:16:01,240 --> 02:16:05,600 HEALTHY NUTRITION FOR SHIFT 3323 02:16:05,600 --> 02:16:05,920 WORKERS. 3324 02:16:05,920 --> 02:16:06,720 AND NEXT. 3325 02:16:06,720 --> 02:16:14,120 IN GENERAL WE CAN SEE THAT MOST 3326 02:16:14,120 --> 02:16:17,640 OF THESE STUDIES INCLUDED A FEW 3327 02:16:17,640 --> 02:16:19,440 NUMBERS OF LONG-TERM 3328 02:16:19,440 --> 02:16:20,200 INTERVENTION. 3329 02:16:20,200 --> 02:16:26,520 SO TO ONE, TWO, FIVE, FOUR, AND 3330 02:16:26,520 --> 02:16:27,080 NEXT. 3331 02:16:27,080 --> 02:16:29,280 AND RESULTING PART HIGHLIGHTED 3332 02:16:29,280 --> 02:16:32,440 VAST MAJORITY OF THESE STUDIES 3333 02:16:32,440 --> 02:16:34,080 FOCUS ON PROMOTING EATING -- 3334 02:16:34,080 --> 02:16:36,160 HEALTHY EATING HABITS IN 3335 02:16:36,160 --> 02:16:37,520 PATIENTS, SOMETHING THAT'S 3336 02:16:37,520 --> 02:16:39,000 REALLY IMPORTANT BUT VAST 3337 02:16:39,000 --> 02:16:40,760 MAJORITY OF THE DISEASE DOES NOT 3338 02:16:40,760 --> 02:16:42,400 ADDRESS MEAL TIME AS IMPORTANT 3339 02:16:42,400 --> 02:16:46,560 PART OF THE INTERVENTION. 3340 02:16:46,560 --> 02:16:53,240 SO, AGAIN, WE NEED MORE FOCUS ON 3341 02:16:53,240 --> 02:16:54,440 THIS SUBJECT. 3342 02:16:54,440 --> 02:16:55,040 NEXT. 3343 02:16:55,040 --> 02:16:59,080 FIRST I HAVE ALSO GOOD NEWS, 3344 02:16:59,080 --> 02:17:00,680 SUCH AMAZING RESEARCH BEING DONE 3345 02:17:00,680 --> 02:17:05,160 ON DIFFERENT PARTS OF THE WORLD, 3346 02:17:05,160 --> 02:17:08,760 FIRST ONE IS FROM A PROFESSOR 3347 02:17:08,760 --> 02:17:10,960 HERE WITH US, TESTING THE 3348 02:17:10,960 --> 02:17:12,840 TIME-RESTRICTED EATING IN SHIFT 3349 02:17:12,840 --> 02:17:23,320 WORKERS AND ALSO TWO OTHERS. 3350 02:17:26,680 --> 02:17:27,040 NEXT. 3351 02:17:27,040 --> 02:17:33,320 IN GENERAL WE OBSERVE MEAL TIME 3352 02:17:33,320 --> 02:17:36,880 FOR SHIFT WORKERS, FEASIBLE, 3353 02:17:36,880 --> 02:17:39,520 SOMETHING THAT'S REALLY 3354 02:17:39,520 --> 02:17:40,080 IMPORTANT. 3355 02:17:40,080 --> 02:17:45,200 POSITIVE METABOLIC OUTCOMES. 3356 02:17:45,200 --> 02:17:48,000 MAYBE IMPROVEMENT HAS BEEN LIKE 3357 02:17:48,000 --> 02:17:52,160 STILL LIMITED BECAUSE THE 3358 02:17:52,160 --> 02:17:54,800 DURATION OF THE INTERVENTIONS IS 3359 02:17:54,800 --> 02:17:59,640 LIKE FROM 80 TO 12 A WEEK -- 8 3360 02:17:59,640 --> 02:18:02,000 TO 12 WEEKS, MAYBE NEED TO FOCUS 3361 02:18:02,000 --> 02:18:05,400 ON LONGER INTERVENTIONS. 3362 02:18:05,400 --> 02:18:06,080 NEXT. 3363 02:18:06,080 --> 02:18:09,120 SOME GAPS IN KNOWLEDGE. 3364 02:18:09,120 --> 02:18:09,680 NEXT. 3365 02:18:09,680 --> 02:18:17,000 I BELIEVE NUTRITION GUIDELINE 3366 02:18:17,000 --> 02:18:18,320 FOR SHIFT WORKERS, HIGH DEGREE 3367 02:18:18,320 --> 02:18:21,720 OF RECOMMENDATION AND STRENGTH 3368 02:18:21,720 --> 02:18:27,480 OF EVIDENCE MAIN GOAL ADVISE 3369 02:18:27,480 --> 02:18:31,440 THESE WORKERS, BUT I THINK WE'RE 3370 02:18:31,440 --> 02:18:37,120 TOO FAR FROM THIS OBJECTIVE. 3371 02:18:37,120 --> 02:18:37,560 NEXT. 3372 02:18:37,560 --> 02:18:40,280 BECAUSE WHEN YOU -- WE SEE 3373 02:18:40,280 --> 02:18:42,720 HIERARCHY OF EVIDENCE FOR 3374 02:18:42,720 --> 02:18:44,480 CLINICAL DECISION MAKING WE CAN 3375 02:18:44,480 --> 02:18:53,240 KNOW TO HAVE SYSTEMATIC REVIEW, 3376 02:18:53,240 --> 02:18:55,760 GUIDELINES, WE NEED TO HAVE A 3377 02:18:55,760 --> 02:18:57,400 GOOD NUMBER OF RANDOMIZED 3378 02:18:57,400 --> 02:19:01,280 CONTROLLED TRIALS AND COHORTS. 3379 02:19:01,280 --> 02:19:04,240 AND SO FAR THIS IS VERY LIMITED 3380 02:19:04,240 --> 02:19:12,600 FOR SHIFT WORKERS AND 3381 02:19:12,600 --> 02:19:13,480 CHRONONUTRITION. 3382 02:19:13,480 --> 02:19:14,160 NEXT. 3383 02:19:14,160 --> 02:19:15,040 LONG-TERM RANDOMIZED CLINICAL 3384 02:19:15,040 --> 02:19:16,680 TRIALS I THINK SOMETHING THAT'S 3385 02:19:16,680 --> 02:19:21,040 REALLY IMPORTANT TO TEST THE 3386 02:19:21,040 --> 02:19:23,880 MINIMUM OR MAXIMUM ONE, INTAKE 3387 02:19:23,880 --> 02:19:26,080 REQUIRED DURING NIGHT SHIFT, 3388 02:19:26,080 --> 02:19:29,000 CONSIDERING FOR EXAMPLE HEDONIC 3389 02:19:29,000 --> 02:19:31,440 SENSATIONS, SOCIAL INTERACTIONS, 3390 02:19:31,440 --> 02:19:34,160 SAFETY, VARIABLES CLOSELY 3391 02:19:34,160 --> 02:19:35,840 RELATED TO FOOD INTAKE DURING 3392 02:19:35,840 --> 02:19:40,960 THE NIGHT SHIFT. 3393 02:19:40,960 --> 02:19:41,960 NEXT. 3394 02:19:41,960 --> 02:19:48,720 WE HAVE SOME DATA THAT SHOWS 10% 3395 02:19:48,720 --> 02:19:51,920 OF DAILY ENERGY CAN ALLEVIATE 3396 02:19:51,920 --> 02:19:59,480 HUNGER IN THE NIGHT SHIFT, BUT 3397 02:19:59,480 --> 02:20:02,400 THIS IS FROM STUDIES, WE NEED 3398 02:20:02,400 --> 02:20:06,160 LONG-TERM EVIDENCE ITSELF. 3399 02:20:06,160 --> 02:20:07,800 NEXT. 3400 02:20:07,800 --> 02:20:09,440 I BELIEVE THAT A CHRONONUTRITION 3401 02:20:09,440 --> 02:20:11,640 INTERVENTION FOR SHIFT WORKERS 3402 02:20:11,640 --> 02:20:13,400 SHOULD INVOLVE DIFFERENT 3403 02:20:13,400 --> 02:20:14,800 STAKEHOLDERS, SO SHIFT WORKERS 3404 02:20:14,800 --> 02:20:21,600 BUT ALSO THE COMPANY, THE FAMILY 3405 02:20:21,600 --> 02:20:22,320 ACADEMICS, SPECIALIZED HEALTH 3406 02:20:22,320 --> 02:20:23,560 CARE TEAM. 3407 02:20:23,560 --> 02:20:25,080 NEXT. 3408 02:20:25,080 --> 02:20:34,160 MAYBE WE CAN CALL IT A 3409 02:20:34,160 --> 02:20:36,360 CHRONOTEAM, BECAUSE 3410 02:20:36,360 --> 02:20:41,600 CHRONOBIOLOGY APPROACH MUST BE 3411 02:20:41,600 --> 02:20:43,720 IMPORTANT ON SLEEP HYGIENE AND 3412 02:20:43,720 --> 02:20:45,640 EXERCISE TIME. 3413 02:20:45,640 --> 02:20:45,880 NEXT. 3414 02:20:45,880 --> 02:20:48,280 AND THIS TOPIC, CIRCADIAN 3415 02:20:48,280 --> 02:20:50,160 HYGIENE INTERVENTION, HAS 3416 02:20:50,160 --> 02:20:53,000 EMERGED IN LITERATURE, IN RECENT 3417 02:20:53,000 --> 02:20:53,440 YEARS. 3418 02:20:53,440 --> 02:20:55,720 AND I THINK IT SOUNDS QUITE 3419 02:20:55,720 --> 02:20:59,040 EXCITING AND INTERESTING FOR 3420 02:20:59,040 --> 02:21:01,120 SHIFT WORKERS AS WELL. 3421 02:21:01,120 --> 02:21:05,360 BETWEEN DIFFERENT SECTORS AND 3422 02:21:05,360 --> 02:21:07,360 BEHAVIORS IN THESE INTERVENTIONS 3423 02:21:07,360 --> 02:21:09,200 WE HAVE TIME OF LIGHT, EATING 3424 02:21:09,200 --> 02:21:15,600 TIME, TIME OF PHYSICAL ACTIVITY, 3425 02:21:15,600 --> 02:21:18,520 SOCIAL TIME. 3426 02:21:18,520 --> 02:21:18,720 NEXT. 3427 02:21:18,720 --> 02:21:20,800 HERE IS SOME POTENTIAL QUESTIONS 3428 02:21:20,800 --> 02:21:22,440 FOR COHORT STUDIES TO EVALUATE 3429 02:21:22,440 --> 02:21:24,200 CHRONIC EFFECT OF SHIFT WORK ON 3430 02:21:24,200 --> 02:21:27,680 EATING HABITS AND TIME OF 3431 02:21:27,680 --> 02:21:28,400 EATING. 3432 02:21:28,400 --> 02:21:30,240 ALSO SHIFT SCHEDULE ASSOCIATED 3433 02:21:30,240 --> 02:21:32,320 WITH WORSENING EATING HABITS 3434 02:21:32,320 --> 02:21:33,520 OVER TIME. 3435 02:21:33,520 --> 02:21:34,720 ASSOCIATION BETWEEN CHANGING 3436 02:21:34,720 --> 02:21:37,920 MEAL TIMES AND WEIGHT GAIN OVER 3437 02:21:37,920 --> 02:21:38,760 TIME. 3438 02:21:38,760 --> 02:21:42,280 WE KNOW THAT SHIFT WORKERS 3439 02:21:42,280 --> 02:21:44,880 USUALLY GAIN WEIGHT AFTER 3440 02:21:44,880 --> 02:21:46,200 WORKING SHIFT. 3441 02:21:46,200 --> 02:21:49,360 BUT WE DON'T KNOW THE DYNAMICS 3442 02:21:49,360 --> 02:21:58,040 OF THIS PROCESS, SUCH AS WHAT IS 3443 02:21:58,040 --> 02:22:00,680 THE EFFECT OF MEALTIME, FOR 3444 02:22:00,680 --> 02:22:01,440 EXAMPLE. 3445 02:22:01,440 --> 02:22:03,640 ALSO FINALLY EFFECT ALSO OF 3446 02:22:03,640 --> 02:22:06,920 ADDITIONAL VARIABLES RELATED TO 3447 02:22:06,920 --> 02:22:11,960 OUTCOMES, CHRONOTYPE AND 3448 02:22:11,960 --> 02:22:13,160 CIRCADIAN MISALIGNMENT. 3449 02:22:13,160 --> 02:22:13,600 NEXT. 3450 02:22:13,600 --> 02:22:16,000 NEXT. 3451 02:22:16,000 --> 02:22:16,320 NEXT. 3452 02:22:16,320 --> 02:22:18,080 THANK YOU. 3453 02:22:18,080 --> 02:22:20,400 FUTURE DIRECTIONS, I THINK 3454 02:22:20,400 --> 02:22:21,360 POPULATION-BASED STUDIES SHOULD 3455 02:22:21,360 --> 02:22:23,320 INCLUDE MORE INFORMATION ON 3456 02:22:23,320 --> 02:22:30,680 SHIFT WORKERS' MEAL TIMES OR 3457 02:22:30,680 --> 02:22:32,960 HAVE SOME EXAMPLES OF SOME 3458 02:22:32,960 --> 02:22:34,960 SURVEYS THAT INCLUDE THIS 3459 02:22:34,960 --> 02:22:37,920 INFORMATION SUCH AS NHANES, BUT 3460 02:22:37,920 --> 02:22:42,960 I REALLY NEEDED SOMETHING TO 3461 02:22:42,960 --> 02:22:44,080 PROVIDE VERY IMPORTANT 3462 02:22:44,080 --> 02:22:45,800 INFORMATION ON THIS SUBJECT. 3463 02:22:45,800 --> 02:22:52,960 WE ALSO NEED LARGER AND 3464 02:22:52,960 --> 02:22:54,440 LONG-TERM RANDOMIZED CLINICAL 3465 02:22:54,440 --> 02:22:55,040 TRIALS. 3466 02:22:55,040 --> 02:22:59,640 AND WE ALSO HAVE MANY CHALLENGES 3467 02:22:59,640 --> 02:23:01,240 AND BARRIERS TO ACHIEVE, AND 3468 02:23:01,240 --> 02:23:03,240 MONEY IS ONE IMPORTANT ONE 3469 02:23:03,240 --> 02:23:08,280 BECAUSE FOR EXAMPLE I CAME FROM 3470 02:23:08,280 --> 02:23:10,200 A DEVELOPING COUNTRY, IT'S BEEN 3471 02:23:10,200 --> 02:23:13,960 CHALLENGING FOR US TO DO 3472 02:23:13,960 --> 02:23:16,360 RESEARCH IN RECENT YEARS. 3473 02:23:16,360 --> 02:23:18,440 AND ENGAGING AND HOLDING 3474 02:23:18,440 --> 02:23:20,160 COMPANIES ACCOUNTABLE, I THINK 3475 02:23:20,160 --> 02:23:22,040 COMPANIES MUST BE RESPONSIBLE 3476 02:23:22,040 --> 02:23:28,920 FOR THE WORKERS AND ALSO THEIR 3477 02:23:28,920 --> 02:23:29,240 HEALTH. 3478 02:23:29,240 --> 02:23:29,440 NEXT. 3479 02:23:29,440 --> 02:23:39,120 I'D LIKE TO THANK MY TEAM FROM 3480 02:23:39,120 --> 02:23:41,440 FEDERAL UNIVERSITY. 3481 02:23:41,440 --> 02:23:44,400 AND THE PARTNERSHIP IN RESEARCH, 3482 02:23:44,400 --> 02:23:47,760 WORKING ON NOWADAYS. 3483 02:23:47,760 --> 02:23:50,760 THANK YOU. 3484 02:23:50,760 --> 02:23:54,560 >>THANK YOU. 3485 02:23:54,560 --> 02:23:56,720 NEXT SLIDE PLEASE. 3486 02:23:56,720 --> 02:24:01,760 LET ME INTRODUCE DR. SETH 3487 02:24:01,760 --> 02:24:04,640 CREASEY, UNIVERSITY OF COLORADO, 3488 02:24:04,640 --> 02:24:07,360 ANSCHUTZ MEDICAL SCHOOL, NIH, 3489 02:24:07,360 --> 02:24:08,760 NHLBI CAREER DEVELOPMENT 3490 02:24:08,760 --> 02:24:10,520 AWARDEE, RESEARCH FOCUSES ON 3491 02:24:10,520 --> 02:24:12,040 UNDERSTANDING HOW PATTERNS OF 3492 02:24:12,040 --> 02:24:13,480 PHYSICAL ACTIVITY, SLEEP, AND 3493 02:24:13,480 --> 02:24:17,400 FOOD INTAKE ARE RELATED TO 3494 02:24:17,400 --> 02:24:19,560 WEIGHT LOSS AND METABOLISM 3495 02:24:19,560 --> 02:24:20,320 BROADLY. 3496 02:24:20,320 --> 02:24:20,800 DR. CREASY, THANK YOU. 3497 02:24:20,800 --> 02:24:22,440 >>THANK YOU FOR THE KIND 3498 02:24:22,440 --> 02:24:23,000 INTRODUCTION. 3499 02:24:23,000 --> 02:24:24,840 I WOULD LIKE TO THANK ORGANIZERS 3500 02:24:24,840 --> 02:24:25,600 OF THIS WORKSHOP. 3501 02:24:25,600 --> 02:24:28,240 I'M HONORED TO BE ABLE TO 3502 02:24:28,240 --> 02:24:29,800 PRESENT HERE TODAY. 3503 02:24:29,800 --> 02:24:33,400 I'M GOING TO SPEND 15 OR 20 3504 02:24:33,400 --> 02:24:35,240 MINUTES CONVINCING YOU WHY 3505 02:24:35,240 --> 02:24:36,440 EXERCISE TIMING IS IMPORTANT AND 3506 02:24:36,440 --> 02:24:38,840 WHY IT NEEDS TO BE PART OF THE 3507 02:24:38,840 --> 02:24:43,120 CONVERSATION WITH THIS 3508 02:24:43,120 --> 02:24:43,960 CHRONONUTRITION WORKSHOP. 3509 02:24:43,960 --> 02:24:47,880 FIRST I WANT TO TAKE A QUICK 3510 02:24:47,880 --> 02:24:48,720 DISCLAIMER, EXERCISE AT ANY TIME 3511 02:24:48,720 --> 02:24:50,800 OF THE DAY IS GOOD. 3512 02:24:50,800 --> 02:24:51,920 I DON'T WANT YOU TO TAKE AWAY 3513 02:24:51,920 --> 02:24:53,720 FROM THE TALK IF YOU CAN'T 3514 02:24:53,720 --> 02:24:56,080 EXERCISE AT A PARTICULAR TIME, 3515 02:24:56,080 --> 02:24:57,600 THAT YOU SHOULDN'T EXERCISE. 3516 02:24:57,600 --> 02:24:58,920 EXERCISE WHENEVER YOU CAN. 3517 02:24:58,920 --> 02:25:00,960 WHAT I'M GOING TO FOCUS ON IS 3518 02:25:00,960 --> 02:25:04,080 ARE THERE SPECIFIC TIMES OF THE 3519 02:25:04,080 --> 02:25:05,920 DAY THAT WE CAN PRESCRIBE 3520 02:25:05,920 --> 02:25:08,640 EXERCISE TO ELICIT A CERTAIN 3521 02:25:08,640 --> 02:25:11,280 RESPONSE, WHATEVER THAT 3522 02:25:11,280 --> 02:25:12,160 METABOLIC OR PHYSIOLOGIC 3523 02:25:12,160 --> 02:25:14,360 RESPONSE IS WE WANT, TO TARGET 3524 02:25:14,360 --> 02:25:18,080 DISEASE TREATMENT OR PREVENTION. 3525 02:25:18,080 --> 02:25:18,840 NEXT SLIDE. 3526 02:25:18,840 --> 02:25:20,480 FIRST I WANT TO HIGHLIGHT 3527 02:25:20,480 --> 02:25:21,760 IMPORTANCE OF EXERCISE AND 3528 02:25:21,760 --> 02:25:25,520 PHYSICAL ACTIVITY, A NICE FIGURE 3529 02:25:25,520 --> 02:25:27,840 FROM THE 2018 GUIDELINES. 3530 02:25:27,840 --> 02:25:28,920 TWO THINGS. 3531 02:25:28,920 --> 02:25:30,440 NUMBER ONE, THIS IS ON THE 3532 02:25:30,440 --> 02:25:33,560 Y-AXIS IS RISK OF MORTALITY, 3533 02:25:33,560 --> 02:25:34,480 CARDIOVASCULAR DISEASE, TYPE 2 3534 02:25:34,480 --> 02:25:34,760 DIABETES. 3535 02:25:34,760 --> 02:25:37,480 ON THE X-AXIS IS PHYSICAL 3536 02:25:37,480 --> 02:25:40,600 ACTIVITY, VOLUME OF PHYSICAL 3537 02:25:40,600 --> 02:25:40,880 ACTIVITY. 3538 02:25:40,880 --> 02:25:44,040 NUMBER ONE, THE MORE YOU DO, THE 3539 02:25:44,040 --> 02:25:45,240 GREATER RISK REDUCTION YOU'RE 3540 02:25:45,240 --> 02:25:47,200 GETTING IN ALL THESE AREAS. 3541 02:25:47,200 --> 02:25:48,720 SO THAT'S NUMBER ONE. 3542 02:25:48,720 --> 02:25:51,000 THE OTHER THING I WANT TO POINT 3543 02:25:51,000 --> 02:25:53,320 OUT, STRIKING IN THIS FIGURE, ON 3544 02:25:53,320 --> 02:25:55,640 THE FAR LEFT SIDE YOU SEE THE 3545 02:25:55,640 --> 02:25:58,160 BIGGEST BANG FOR YOUR BUCK OR 3546 02:25:58,160 --> 02:25:59,800 RISK REDUCTION IS GOING FROM 3547 02:25:59,800 --> 02:26:01,880 NOTHING, DOING NO ACTIVITY, TO 3548 02:26:01,880 --> 02:26:02,400 DOING SOMETHING. 3549 02:26:02,400 --> 02:26:05,800 THIS IS A REALLY IMPORTANT 3550 02:26:05,800 --> 02:26:08,200 MESSAGE FOR PEOPLE WORKING WITH 3551 02:26:08,200 --> 02:26:08,880 PATIENT-FACING POPULATIONS, 3552 02:26:08,880 --> 02:26:11,200 TRYING TO GET PEOPLE TO BE MORE 3553 02:26:11,200 --> 02:26:11,600 ACTIVE. 3554 02:26:11,600 --> 02:26:13,680 THE FIRST STEP IS OFTEN THE MOST 3555 02:26:13,680 --> 02:26:15,000 IMPORTANT STEP. 3556 02:26:15,000 --> 02:26:16,200 AND THE MOST EFFECTIVE STEP. 3557 02:26:16,200 --> 02:26:19,360 I WANT TO POINT THAT OUT. 3558 02:26:19,360 --> 02:26:19,960 NEXT SLIDE. 3559 02:26:19,960 --> 02:26:22,040 NOW I'M GOING TO TALK ABOUT WHY 3560 02:26:22,040 --> 02:26:24,000 THE PATTERNS OF EXERCISE AND 3561 02:26:24,000 --> 02:26:25,640 PHYSICAL ACTIVITY MAY MATTER. 3562 02:26:25,640 --> 02:26:29,320 AND THIS IS A BUSY SLIDE. 3563 02:26:29,320 --> 02:26:31,880 THESE ARE THE PHYSICAL ACTIVITY 3564 02:26:31,880 --> 02:26:35,480 PATTERNS FROM A WEARABLE 3565 02:26:35,480 --> 02:26:37,880 THIGH-WORN ACCELEROMETER FROM 3566 02:26:37,880 --> 02:26:40,520 THREE SUBJECTS. 3567 02:26:40,520 --> 02:26:42,160 AND WHAT EACH REPRESENTS, LIKE A 3568 02:26:42,160 --> 02:26:44,600 CLOCK, AT THE TOP IS MIDNIGHT, 3569 02:26:44,600 --> 02:26:48,960 FAR RIGHT IS 6 A.M., BOTTOM IS 3570 02:26:48,960 --> 02:26:52,240 NOON, FAR LEFT IS 6 P.M. 3571 02:26:52,240 --> 02:26:53,960 AND EACH OF THESE RINGS 3572 02:26:53,960 --> 02:26:58,360 REPRESENTS ONE DAY OF WEAR TIME. 3573 02:26:58,360 --> 02:27:00,240 BLUE INDICATES SLEEP BEHAVIOR. 3574 02:27:00,240 --> 02:27:01,640 YELLOW IS SITTING BEHAVIOR. 3575 02:27:01,640 --> 02:27:03,640 GREEN IS STANDING. 3576 02:27:03,640 --> 02:27:04,920 RED IS WALKING BEHAVIOR. 3577 02:27:04,920 --> 02:27:08,000 IF YOU LOOK AT ALL THREE, 3578 02:27:08,000 --> 02:27:09,400 PARTICIPANTS FROM OUR RESEARCH 3579 02:27:09,400 --> 02:27:11,280 STUDIES, IF YOU JUST LOOK AT 3580 02:27:11,280 --> 02:27:13,880 SIMPLE VOLUME OF PHYSICAL 3581 02:27:13,880 --> 02:27:15,640 ACTIVITY, WHICH IS TRADITIONALLY 3582 02:27:15,640 --> 02:27:17,800 WHAT WE LOOK AT, ALL THREE ARE 3583 02:27:17,800 --> 02:27:21,600 DOING GREAT, 10,000 STEPS PER 3584 02:27:21,600 --> 02:27:22,080 DAY. 3585 02:27:22,080 --> 02:27:25,720 HOWEVER, THE PATTERNS, LOOK AT 3586 02:27:25,720 --> 02:27:27,080 THE DETAILS, PATTERNS IS 3587 02:27:27,080 --> 02:27:27,640 STRIKINGLY DIFFERENT. 3588 02:27:27,640 --> 02:27:31,240 IF YOU LOOK AT THE FIRST PERSON, 3589 02:27:31,240 --> 02:27:32,080 CLICK NEXT. 3590 02:27:32,080 --> 02:27:35,560 THEY HAVE REALLY NO PATTERN OF 3591 02:27:35,560 --> 02:27:36,920 PHYSICAL ACTIVITY. 3592 02:27:36,920 --> 02:27:38,640 SO THEY HAVE INTERMITTENT 3593 02:27:38,640 --> 02:27:40,080 STANDING THROUGHOUT THE DAY, 3594 02:27:40,080 --> 02:27:41,480 WALKING AT VARIOUS TIMES 3595 02:27:41,480 --> 02:27:43,360 THROUGHOUT THE DAY. 3596 02:27:43,360 --> 02:27:45,000 DIFFERENT WALKING BOUTS AT 3597 02:27:45,000 --> 02:27:46,960 RANDOM, DIFFERENT TIMES. 3598 02:27:46,960 --> 02:27:49,040 THEY HAVE ABOUT 20 WALKING BOUTS 3599 02:27:49,040 --> 02:27:51,880 OVER THE 14-DAY WEAR PERIOD WE 3600 02:27:51,880 --> 02:27:54,400 CAN SEE HERE. 3601 02:27:54,400 --> 02:27:57,160 THE NEXT PERSON IN THE MIDDLE 3602 02:27:57,160 --> 02:27:58,920 HAS A STRIKING MORNING EXERCISE 3603 02:27:58,920 --> 02:27:59,680 PATTERN. 3604 02:27:59,680 --> 02:28:03,000 YOU CAN SEE THIS PERSON 3605 02:28:03,000 --> 02:28:04,600 EXERCISES REGULARLY AROUND 9 3606 02:28:04,600 --> 02:28:08,000 P.M., FOR ABOUT AN HOUR EACH 3607 02:28:08,000 --> 02:28:08,520 TIME. 3608 02:28:08,520 --> 02:28:11,080 ACROSS THE 14-DAY OBSERVATION, 3609 02:28:11,080 --> 02:28:13,040 THEY EXERCISE THE EIGHT DAYS. 3610 02:28:13,040 --> 02:28:15,280 THEY ALSO HAVE QUITE A BIT OF 3611 02:28:15,280 --> 02:28:17,080 STANDING BEHAVIOR THROUGHOUT THE 3612 02:28:17,080 --> 02:28:17,840 DAY. 3613 02:28:17,840 --> 02:28:19,680 WHICH IS DIFFERENT THAN MOST 3614 02:28:19,680 --> 02:28:20,160 PEOPLE. 3615 02:28:20,160 --> 02:28:22,240 CLICK NEXT. 3616 02:28:22,240 --> 02:28:24,800 THE LAST PERSON HAS STRONG 3617 02:28:24,800 --> 02:28:27,200 EVENING EXERCISE PATTERN. 3618 02:28:27,200 --> 02:28:28,480 THIS PERSON ACTUALLY GETS VERY 3619 02:28:28,480 --> 02:28:30,120 LITTLE ACTIVITY DURING THE DAY, 3620 02:28:30,120 --> 02:28:32,440 SITTING MOST OF THE DAY, 3621 02:28:32,440 --> 02:28:34,840 SOMETHING WE ALL PROBABLY DO. 3622 02:28:34,840 --> 02:28:35,600 AND THIS PERSON EXERCISES AT THE 3623 02:28:35,600 --> 02:28:38,880 END OF THE DAY, ACTUALLY THE 3624 02:28:38,880 --> 02:28:42,520 EVENING CLOSER TO 4 TO 5 P.M., 3625 02:28:42,520 --> 02:28:44,320 EXERCISING ABOUT FOUR DAYS PER 3626 02:28:44,320 --> 02:28:47,120 WEEK, AND FOR ABOUT AN HOUR. 3627 02:28:47,120 --> 02:28:48,880 THE MANNER IN WHICH THE THREE 3628 02:28:48,880 --> 02:28:50,560 PEOPLE ARE GETTING EXERCISE OR 3629 02:28:50,560 --> 02:28:51,960 PHYSICAL ACTIVITY IS VERY 3630 02:28:51,960 --> 02:28:53,360 DIFFERENT. 3631 02:28:53,360 --> 02:28:57,840 THAT MAY HAVE PHYSIOLOGICAL 3632 02:28:57,840 --> 02:28:58,800 IMPLICATIONS. 3633 02:28:58,800 --> 02:28:59,200 NEXT. 3634 02:28:59,200 --> 02:29:00,800 THESE TALKS HAVE HIGHLIGHTED THE 3635 02:29:00,800 --> 02:29:01,800 IMPORTANCE OF THE CIRCADIAN 3636 02:29:01,800 --> 02:29:02,000 SYSTEM. 3637 02:29:02,000 --> 02:29:05,200 THIS IS JUST THE FIGURE TO SHOW 3638 02:29:05,200 --> 02:29:10,480 DIFFERENT PEAKS IN HUER HORMOND 3639 02:29:10,480 --> 02:29:11,280 PHYSIOLOGIC PROCESS ACROSS THE 3640 02:29:11,280 --> 02:29:11,720 DAY. 3641 02:29:11,720 --> 02:29:15,240 I WANT YOU TO THINK IF YOU 3642 02:29:15,240 --> 02:29:17,320 IMPOSE EXERCISE AT THESE TIMES 3643 02:29:17,320 --> 02:29:19,960 OF THE DAY, NOT ONLY EXERCISE 3644 02:29:19,960 --> 02:29:22,120 AFFECTS EVERY SYSTEM IN THE 3645 02:29:22,120 --> 02:29:26,040 BODY, YOU'LL AFFECT THOSE 3646 02:29:26,040 --> 02:29:27,200 HORMONES AND PROCESSES AT THE 3647 02:29:27,200 --> 02:29:30,360 TIME OF EXERCISE, THERE WAS AN 3648 02:29:30,360 --> 02:29:36,040 AFTER EFFECT, OR NEXT DAY EFFECT 3649 02:29:36,040 --> 02:29:38,640 AS THE SYSTEM IS PREPARING, IT 3650 02:29:38,640 --> 02:29:41,360 MAY BE DIFFERENT IF SOMEBODY 3651 02:29:41,360 --> 02:29:43,920 EXERCISES ESPECIALLY SAT SAME 3652 02:29:43,920 --> 02:29:44,360 TIME OF DAY. 3653 02:29:44,360 --> 02:29:46,560 ONE OF MY JOBS WAS TO TALK ABOUT 3654 02:29:46,560 --> 02:29:49,720 THE CLINICAL DATA IN THIS 3655 02:29:49,720 --> 02:29:51,480 EXERCISE SPACE, EXERCISE TIMING 3656 02:29:51,480 --> 02:29:51,800 SPACE. 3657 02:29:51,800 --> 02:29:54,960 WE ARE I WOULD SAY WAY BEHIND 3658 02:29:54,960 --> 02:29:55,880 THE NUTRITION, CHRONONUTRITION 3659 02:29:55,880 --> 02:29:58,720 SIDE OF THINGS. 3660 02:29:58,720 --> 02:30:00,400 HOWEVER, I WILL GIVE PROPS TO 3661 02:30:00,400 --> 02:30:03,320 THE FIELD BECAUSE I THINK WE'RE 3662 02:30:03,320 --> 02:30:05,160 STARTING TO INVESTIGATE THIS 3663 02:30:05,160 --> 02:30:07,640 MORE BECAUSE OF ALL OF THE FOCUS 3664 02:30:07,640 --> 02:30:08,400 ON CHRONONUTRITION RECENTLY. 3665 02:30:08,400 --> 02:30:11,040 AND SO THIS IS ONE STUDY THAT 3666 02:30:11,040 --> 02:30:12,920 I'M GOING TO HIGHLIGHT, I'LL 3667 02:30:12,920 --> 02:30:14,880 HIGHLIGHT A FEW TO GIVE YOU A 3668 02:30:14,880 --> 02:30:17,120 FLAVOR WHERE THINGS ARE IN THE 3669 02:30:17,120 --> 02:30:18,080 EXERCISE TIMING SPACE. 3670 02:30:18,080 --> 02:30:19,840 THIS WAS JUST PUBLISHED THIS 3671 02:30:19,840 --> 02:30:20,160 YEAR. 3672 02:30:20,160 --> 02:30:24,760 THIS WAS U.K. BIOBANK DATA. 3673 02:30:24,760 --> 02:30:26,240 AND THEY HAD OVER 90,000 -- 3674 02:30:26,240 --> 02:30:27,960 ALMOST 90,000 PARTICIPANTS. 3675 02:30:27,960 --> 02:30:29,840 THEY LOOK AT DIFFERENT PHYSICAL 3676 02:30:29,840 --> 02:30:31,160 ACTIVITY PATTERNS IN THESE FOLKS 3677 02:30:31,160 --> 02:30:34,520 AND HAD 6 TO 8 YEARS OF 3678 02:30:34,520 --> 02:30:35,160 FOLLOW-UP DATA. 3679 02:30:35,160 --> 02:30:36,960 THE GROUP A MORNING EXERCISE 3680 02:30:36,960 --> 02:30:39,480 GROUP OR MORNING PHYSICALLY 3681 02:30:39,480 --> 02:30:42,120 ACTIVE GROUP, THEY HAVE 16% 3682 02:30:42,120 --> 02:30:52,600 REDUCTION IN CORONARY ARTERY 3683 02:30:56,560 --> 02:30:57,560 DISEASE SUGGESTING MAYBE MORNING 3684 02:30:57,560 --> 02:30:59,000 EXERCISE IS IMPORTANT. 3685 02:30:59,000 --> 02:31:01,320 THE NEXT WAS PUBLISHED IN 2016, 3686 02:31:01,320 --> 02:31:03,520 FROM THE WOMEN'S HEALTH STUDY. 3687 02:31:03,520 --> 02:31:07,200 AGAIN LOOKED AT PHYSICAL 3688 02:31:07,200 --> 02:31:09,480 ACTIVITY PATTERNS AND TIMING, 3689 02:31:09,480 --> 02:31:14,520 HOW IT WAS RELATED TO OBESITY 3690 02:31:14,520 --> 02:31:14,720 RISK. 3691 02:31:14,720 --> 02:31:15,680 WOMEN LESS ACTIVE IN THE 3692 02:31:15,680 --> 02:31:17,000 MORNING, NOT ACTIVE IN THE 3693 02:31:17,000 --> 02:31:19,240 MORNING, HAD HIGHER RISK FOR 3694 02:31:19,240 --> 02:31:20,920 OBESITY RISK. 3695 02:31:20,920 --> 02:31:23,520 AND SO, AGAIN, THIS SUGGESTED 3696 02:31:23,520 --> 02:31:25,320 MAYBE MORNING ACTIVITY IS 3697 02:31:25,320 --> 02:31:27,680 BENEFICIAL FOR WEIGHT 3698 02:31:27,680 --> 02:31:28,120 MANAGEMENT. 3699 02:31:28,120 --> 02:31:29,320 CLICK NEXT. 3700 02:31:29,320 --> 02:31:32,520 THOSE WERE TWO OBSERVATIONAL 3701 02:31:32,520 --> 02:31:33,920 STUDIES, LARGER SCALE STUDIES. 3702 02:31:33,920 --> 02:31:37,760 WHERE IS THE CLINICAL DATA 3703 02:31:37,760 --> 02:31:38,600 INTERVENTIONAL STUDY? 3704 02:31:38,600 --> 02:31:40,080 NUMBER ONE, THERE'S A HUGE LACK 3705 02:31:40,080 --> 02:31:41,600 OF CLINICAL DATA. 3706 02:31:41,600 --> 02:31:43,360 THAT'S MY FIRST CALL. 3707 02:31:43,360 --> 02:31:45,640 WE NEED MORE STUDIES IN THIS 3708 02:31:45,640 --> 02:31:47,520 SPACE, RANDOMIZED TRIALS IN 3709 02:31:47,520 --> 02:31:48,200 PARTICULAR. 3710 02:31:48,200 --> 02:31:50,720 MOST ARE UNDERPOWERED OR SMALL. 3711 02:31:50,720 --> 02:31:54,320 THIS WAS A QUASI-EXPERIMENTAL 3712 02:31:54,320 --> 02:31:56,200 STUDY, SELF-COLLECTING GROUPS OF 3713 02:31:56,200 --> 02:31:58,080 MORNING AND EVENING EXERCISERS. 3714 02:31:58,080 --> 02:31:59,240 I WANTED TO HIGHLIGHT THIS. 3715 02:31:59,240 --> 02:32:01,680 IT WAS ONE OF THE FIRST TO LOOK 3716 02:32:01,680 --> 02:32:04,440 AT EXERCISE TIME OF DAY ON 3717 02:32:04,440 --> 02:32:05,800 WEIGHT LOSS. 3718 02:32:05,800 --> 02:32:08,880 IT WAS POST MENOPAUSAL WOMEN, 3719 02:32:08,880 --> 02:32:10,840 MEAN AGE 53, EXERCISED IN 3720 02:32:10,840 --> 02:32:13,800 MORNING OR EVENING FOR 12 WEEKS, 3721 02:32:13,800 --> 02:32:17,720 200 MINUTES PER WEEK. 3722 02:32:17,720 --> 02:32:19,480 CLICK NEXT. 3723 02:32:19,480 --> 02:32:20,920 THEY SAW THESE WOMEN REDUCED 3724 02:32:20,920 --> 02:32:22,600 THEIR FAT MASS IF THEY EXERCISED 3725 02:32:22,600 --> 02:32:25,720 IN THE EVENING MORE SO THAN 3726 02:32:25,720 --> 02:32:25,960 MORNING. 3727 02:32:25,960 --> 02:32:27,400 CLICK NEXT. 3728 02:32:27,400 --> 02:32:30,560 THEY ALSO INCREASED FITNESS 3729 02:32:30,560 --> 02:32:31,880 LEVELS, EVENING EXERCISERS, MORE 3730 02:32:31,880 --> 02:32:34,400 SO THAN THE MORNING EXERCISERS. 3731 02:32:34,400 --> 02:32:35,160 CLICK NEXT. 3732 02:32:35,160 --> 02:32:38,040 THE OTHER REASON I WANTED TO 3733 02:32:38,040 --> 02:32:40,880 POINT OUT THIS STUDY, THEY FOUND 3734 02:32:40,880 --> 02:32:42,840 THAT THESE EVENING EXERCISEERS 3735 02:32:42,840 --> 02:32:44,720 STARTED TO SHIFT TIMING OF MEALS 3736 02:32:44,720 --> 02:32:46,560 EVEN THOUGH THEY WEREN'T 3737 02:32:46,560 --> 02:32:47,960 PRESCRIBING CHANGES TO MEALS, 3738 02:32:47,960 --> 02:32:49,200 THESE EVENING EXERCISERS STARTED 3739 02:32:49,200 --> 02:32:50,960 TO EAT LESS IN THE EVENING AND 3740 02:32:50,960 --> 02:32:53,000 EAT MORE IN THE MORNING, AND 3741 02:32:53,000 --> 02:32:55,400 THAT MIGHT HAVE BEEN ONE OF THE 3742 02:32:55,400 --> 02:32:57,200 REASONS WHY WE SEE THIS 3743 02:32:57,200 --> 02:32:59,800 REDUCTION IN FAT MASS FOR THE 3744 02:32:59,800 --> 02:33:03,200 EVENING EXERCISEERS. 3745 02:33:03,200 --> 02:33:04,280 CLICK NEXT. 3746 02:33:04,280 --> 02:33:06,880 THE NEXT WAS A STUDY I WAS PART 3747 02:33:06,880 --> 02:33:09,720 OF SO THIS WAS A SECONDARY 3748 02:33:09,720 --> 02:33:15,240 ANALYSIS OF THE MIDWEST EXERCISE 3749 02:33:15,240 --> 02:33:15,440 TRIAL. 3750 02:33:15,440 --> 02:33:19,920 THIS IS OUT OF UNIVERSITY OF 3751 02:33:19,920 --> 02:33:20,280 KANSAS. 3752 02:33:20,280 --> 02:33:21,880 HIGHLY CONTROLLED EXERCISE STUDY 3753 02:33:21,880 --> 02:33:23,520 IN YOUNG ADULTS LOOKING AT 3754 02:33:23,520 --> 02:33:25,600 EFFECTS OF HIGH DOSES OF 3755 02:33:25,600 --> 02:33:27,160 EXERCISE ON WEIGHT LOSS, LOOKING 3756 02:33:27,160 --> 02:33:29,840 IN BOTH MALES AND FEMALES. 3757 02:33:29,840 --> 02:33:31,080 THE PRIMARY OBJECTIVE WAS TO 3758 02:33:31,080 --> 02:33:32,200 LOOK AT SEX DIFFERENCES IN 3759 02:33:32,200 --> 02:33:36,360 WEIGHT LOSS WITH HIGH AMOUNT OF 3760 02:33:36,360 --> 02:33:36,680 EXERCISE. 3761 02:33:36,680 --> 02:33:38,760 THERE WAS HIGH AMOUNT OF 3762 02:33:38,760 --> 02:33:39,960 EXERCISE, NO PRESCRIPTION ON 3763 02:33:39,960 --> 02:33:40,280 DIET. 3764 02:33:40,280 --> 02:33:42,000 THEY ASKED PEOPLE TO NOT CHANGE 3765 02:33:42,000 --> 02:33:44,760 THE DIET ACROSS THE COURSE OF 3766 02:33:44,760 --> 02:33:45,520 THE STUDY. 3767 02:33:45,520 --> 02:33:46,520 AND ANOTHER THING I WANT TO 3768 02:33:46,520 --> 02:33:48,560 POINT OUT THESE PEOPLE HAD TO 3769 02:33:48,560 --> 02:33:50,240 REMAIN ADHERENT TO THE EXERCISE 3770 02:33:50,240 --> 02:33:51,440 PROTOCOL, KICKED OUT OF THE 3771 02:33:51,440 --> 02:33:57,440 STUDY IF THEY DROPPED BELOW 90% 3772 02:33:57,440 --> 02:33:57,800 ADHERENCE. 3773 02:33:57,800 --> 02:34:00,520 I'M ONLY SHOWING PEOPLE WHO DID 3774 02:34:00,520 --> 02:34:01,520 THE EXERCISE. 3775 02:34:01,520 --> 02:34:04,160 DID THE TIME OF DAY MATTER? 3776 02:34:04,160 --> 02:34:05,800 WE DID THE SECONDARY ANALYSIS 3777 02:34:05,800 --> 02:34:09,840 LOOKING AT TIME OF DAY THAT 3778 02:34:09,840 --> 02:34:14,880 PEOPLE DID MAJORITY OF EXERCISE. 3779 02:34:14,880 --> 02:34:16,720 CLICK NEXT. 3780 02:34:16,720 --> 02:34:17,480 WE FOUND MORNING EXERCISERS, 3781 02:34:17,480 --> 02:34:19,560 THIS GROUP OF PEOPLE THAT DID 3782 02:34:19,560 --> 02:34:21,200 THE MAJORITY OF EXERCISE BEFORE 3783 02:34:21,200 --> 02:34:24,840 NOON, HOW WE CLASSIFIED FOR THIS 3784 02:34:24,840 --> 02:34:26,800 STUDY, LOST 7% OF BODY WEIGHT 3785 02:34:26,800 --> 02:34:29,640 OVER 10 MONTHS, A HUGE AMOUNT 3786 02:34:29,640 --> 02:34:31,800 WITH JUST EXERCISE ALONE, 3787 02:34:31,800 --> 02:34:33,600 SIMILAR MAGNITUDE TO DIET, 3788 02:34:33,600 --> 02:34:35,840 STANDARD BEHAVIORAL WEIGHT LOSS 3789 02:34:35,840 --> 02:34:37,000 INTERVENTION WITH CALORIC 3790 02:34:37,000 --> 02:34:39,160 RESTRICTION AND EXERCISE. 3791 02:34:39,160 --> 02:34:40,360 EVENING EXERCISERS LOST 2% EVER 3792 02:34:40,360 --> 02:34:41,640 BODY WEIGHT. 3793 02:34:41,640 --> 02:34:43,520 THIS IS DESPITE DOING THE SAME 3794 02:34:43,520 --> 02:34:44,760 AMOUNT OF EXERCISE, ALL 3795 02:34:44,760 --> 02:34:46,600 ADHERENT, SO THE QUESTION IS WHY 3796 02:34:46,600 --> 02:34:48,480 ARE WE SEEING STRIKING 3797 02:34:48,480 --> 02:34:50,120 DIFFERENCES IN MORNING VERSUS 3798 02:34:50,120 --> 02:34:53,360 EVENING EXERCISERS IN THIS 3799 02:34:53,360 --> 02:34:53,920 STUDY? 3800 02:34:53,920 --> 02:34:54,120 NEXT. 3801 02:34:54,120 --> 02:34:55,760 WE HAD INFORMATION ON THIS. 3802 02:34:55,760 --> 02:34:59,160 THIS IS AGAIN DATA FROM THE SAME 3803 02:34:59,160 --> 02:35:02,560 SECONDARY ANALYSIS. 3804 02:35:02,560 --> 02:35:05,320 WE HAD ENERGY EXPENDITURE WITH 3805 02:35:05,320 --> 02:35:07,040 WATER, YOU CAN SEE PERHAPS SOME 3806 02:35:07,040 --> 02:35:08,160 EVIDENCE THAT THE MORNING 3807 02:35:08,160 --> 02:35:09,880 EXERCISERS WERE BURNING MORE 3808 02:35:09,880 --> 02:35:12,320 CALORIES ACROSS 24 HOURS 3809 02:35:12,320 --> 02:35:14,040 COMPARED TO EVENING EXERCISERS. 3810 02:35:14,040 --> 02:35:15,840 ONE THING THAT'S IMPORTANT, 3811 02:35:15,840 --> 02:35:17,920 EXERCISE ENERGY EXPENDITURE WAS 3812 02:35:17,920 --> 02:35:18,240 CONTROLLED. 3813 02:35:18,240 --> 02:35:19,680 THIS POTENTIAL DIFFERENCE WOULD 3814 02:35:19,680 --> 02:35:21,400 BE SUGGESTIVE IT WAS 3815 02:35:21,400 --> 02:35:24,920 NON-EXERCISE BEHAVIOR, COULD BE 3816 02:35:24,920 --> 02:35:26,880 SLEEP, SEDENTARY BEHAVIOR, 3817 02:35:26,880 --> 02:35:27,720 NON-EXERCISE PHYSICAL ACTIVITY 3818 02:35:27,720 --> 02:35:28,880 THAT WAS DIFFERENT BETWEEN 3819 02:35:28,880 --> 02:35:29,920 MORNING AND EVENING GROUPS. 3820 02:35:29,920 --> 02:35:33,160 WE LOOKED AT ENERGY INTAKE, A 3821 02:35:33,160 --> 02:35:34,760 SNAPSHOT AT THE END OF THE 3822 02:35:34,760 --> 02:35:35,080 INTERVENTION. 3823 02:35:35,080 --> 02:35:37,280 IT LOOKED LIKE THE MORNING 3824 02:35:37,280 --> 02:35:39,160 EXERCISERS WERE REPORTING EATING 3825 02:35:39,160 --> 02:35:40,920 LESS AND EVENING EXERCISERS WERE 3826 02:35:40,920 --> 02:35:43,760 REPORTING EATING MORE. 3827 02:35:43,760 --> 02:35:46,160 AGAIN, SHOWING MAYBE THIS TIME 3828 02:35:46,160 --> 02:35:48,040 OF EXERCISE IS HAVING AN 3829 02:35:48,040 --> 02:35:51,440 INTERACTION EFFECT ON ENERGY 3830 02:35:51,440 --> 02:35:51,680 INTAKE. 3831 02:35:51,680 --> 02:35:52,840 CLICK NEXT PLEASE. 3832 02:35:52,840 --> 02:35:54,480 I WOULD BE REMISS TO NOT 3833 02:35:54,480 --> 02:35:57,520 HIGHLIGHT SOME OF THE TIMING OF 3834 02:35:57,520 --> 02:35:59,720 EXERCISE DATA ON GLYCEMIC 3835 02:35:59,720 --> 02:36:00,080 CONTROL. 3836 02:36:00,080 --> 02:36:02,240 THERE'S OTHER STUDIES IN THIS 3837 02:36:02,240 --> 02:36:05,200 SPACE, I'M GOING TO POINT OUT 3838 02:36:05,200 --> 02:36:08,280 JUST THIS ONE. 3839 02:36:08,280 --> 02:36:10,800 THIS WAS CROSSOVER STUDY IN 11 3840 02:36:10,800 --> 02:36:12,880 MALES I BELIEVE WITH TYPE 2 3841 02:36:12,880 --> 02:36:13,160 DIABETES. 3842 02:36:13,160 --> 02:36:17,360 WHAT THEY DID, A CROSSOVER 3843 02:36:17,360 --> 02:36:18,800 STUDY, THE GRAY -- GLUCOSE OVER 3844 02:36:18,800 --> 02:36:20,040 24 HOURS. 3845 02:36:20,040 --> 02:36:23,680 GRAY BAR IS BASELINE PRIOR TO 3846 02:36:23,680 --> 02:36:23,920 EXERCISE. 3847 02:36:23,920 --> 02:36:25,680 AND YOU CAN SEE, YOU KNOW, WHAT 3848 02:36:25,680 --> 02:36:29,080 IT LOOKS LIKE OVER 24 HOURS. 3849 02:36:29,080 --> 02:36:32,040 THEN THEY HAVE THESE MALES DO A 3850 02:36:32,040 --> 02:36:33,920 WEEK OF HIGH INTENSITY EXERCISE 3851 02:36:33,920 --> 02:36:36,560 TRAINING IN THE MORNING, YOU CAN 3852 02:36:36,560 --> 02:36:40,120 SEE THAT THE MORNING HAD ILL 3853 02:36:40,120 --> 02:36:41,920 EFFECTS ON GLUCOSE, IT WAS 3854 02:36:41,920 --> 02:36:44,200 HIGHER COMPARED TO BASELINE WHEN 3855 02:36:44,200 --> 02:36:46,400 EXERCISING IN THE MORNING. 3856 02:36:46,400 --> 02:36:47,480 THE EVENING EXERCISE ACTUALLY 3857 02:36:47,480 --> 02:36:49,360 RESULTED IN A DROP IN GLUCOSE. 3858 02:36:49,360 --> 02:36:50,640 THEY LOOK AT THESE RESULTS AFTER 3859 02:36:50,640 --> 02:36:52,840 ONE WEEK OF TRAINING AND TWO 3860 02:36:52,840 --> 02:36:53,760 WEEKS OF TRAINING. 3861 02:36:53,760 --> 02:36:57,120 THEY SAW THE SAME THING. 3862 02:36:57,120 --> 02:36:59,520 ESSENTIALLY MORNING EXERCISE 3863 02:36:59,520 --> 02:37:00,920 INCREASED GLUCOSE ABSOLUTELY, 3864 02:37:00,920 --> 02:37:01,480 EVENING EXERCISE DROPPED 3865 02:37:01,480 --> 02:37:03,320 GLUCOSE, WHAT YOU WANT HERE. 3866 02:37:03,320 --> 02:37:06,080 I'M PRESENTING DIFFERENT DATA 3867 02:37:06,080 --> 02:37:06,280 HERE. 3868 02:37:06,280 --> 02:37:09,560 PERHAPS THE TIME OF DAY OF 3869 02:37:09,560 --> 02:37:11,000 EXERCISE, WHAT WE SHOULD 3870 02:37:11,000 --> 02:37:12,760 RECOMMEND DEPENDS ON THE DISEASE 3871 02:37:12,760 --> 02:37:14,320 TARGET THAT WE'RE TRYING TO 3872 02:37:14,320 --> 02:37:17,800 PREVENT OR TREAT. 3873 02:37:17,800 --> 02:37:19,240 CLICK NEXT. 3874 02:37:19,240 --> 02:37:20,640 WHAT ARE SOME LIMITATIONS OF 3875 02:37:20,640 --> 02:37:22,200 PRIOR RESEARCH IN THIS SPACE? 3876 02:37:22,200 --> 02:37:24,920 NUMBER ONE, I WANT TO HIGHLIGHT, 3877 02:37:24,920 --> 02:37:26,880 I PRESENTED A COUPLE STUDIES, 3878 02:37:26,880 --> 02:37:28,440 AGAIN THERE ARE OTHERS THAT I 3879 02:37:28,440 --> 02:37:30,480 DID NOT HIGHLIGHT. 3880 02:37:30,480 --> 02:37:32,600 FOR THE MOST PART, SO FAR WE'VE 3881 02:37:32,600 --> 02:37:34,320 BEEN COMPARING APPLES TO ORANGES 3882 02:37:34,320 --> 02:37:36,280 IF WE TRY TO COMPARE ACROSS 3883 02:37:36,280 --> 02:37:37,200 STUDIES. 3884 02:37:37,200 --> 02:37:39,280 WE'VE HAD REALLY UNDERPOWERED 3885 02:37:39,280 --> 02:37:40,720 TRIALS OR NON-RANDOMIZED, THAT'S 3886 02:37:40,720 --> 02:37:45,960 MY FIRST CALL, WE NEED 3887 02:37:45,960 --> 02:37:47,920 ADEQUATELY POWERED TRIALS, 3888 02:37:47,920 --> 02:37:49,760 RANDOMIZED IN THIS SPACE. 3889 02:37:49,760 --> 02:37:50,000 NEXT. 3890 02:37:50,000 --> 02:37:52,840 THE STUDIES HAVE BEEN IN VARIOUS 3891 02:37:52,840 --> 02:37:54,040 STUDY POPULATIONS, ANOTHER 3892 02:37:54,040 --> 02:37:56,000 REASON WHY WE'VE SEEN DIFFERENT 3893 02:37:56,000 --> 02:37:57,240 RESULTS DEPENDING ON WHICH STUDY 3894 02:37:57,240 --> 02:37:58,840 WE'RE LOOKING AT. 3895 02:37:58,840 --> 02:38:00,840 SOME IN YOUNGER ADULTS, SOME IN 3896 02:38:00,840 --> 02:38:02,480 OLDER ADULTS, SOME MALES ONLY, 3897 02:38:02,480 --> 02:38:03,800 SOME FEMALES ONLY. 3898 02:38:03,800 --> 02:38:07,320 SO THERE'S A REAL NEED TO BE 3899 02:38:07,320 --> 02:38:09,120 RECRUITING THESE DIVERSE 3900 02:38:09,120 --> 02:38:11,240 POPULATIONS AND STUDYING 3901 02:38:11,240 --> 02:38:12,520 DIFFERENT POPULATIONS. 3902 02:38:12,520 --> 02:38:13,360 NEXT. 3903 02:38:13,360 --> 02:38:15,920 STUDIES HAVE USED DIFFERENT 3904 02:38:15,920 --> 02:38:17,400 EXERCISE STIMULI, AND TIMING. 3905 02:38:17,400 --> 02:38:21,160 SO IT'S REALLY HARD OR DIFFICULT 3906 02:38:21,160 --> 02:38:22,120 TO COMPARE ACROSS STUDIES 3907 02:38:22,120 --> 02:38:24,760 BECAUSE SOME ARE HIGH INTENSITY 3908 02:38:24,760 --> 02:38:25,840 EXERCISE TRAINING, SOME THREE 3909 02:38:25,840 --> 02:38:29,880 DAYS A WEEK, SOME FIVE, SOME 3910 02:38:29,880 --> 02:38:32,200 AEROBIC ONLY, SOME AEROBIC AND 3911 02:38:32,200 --> 02:38:33,480 RESISTANCE. 3912 02:38:33,480 --> 02:38:37,800 THE TIMING IS VARIABLE. 3913 02:38:37,800 --> 02:38:39,920 SOME SAY MORE THAN IS PRIOR TO 3914 02:38:39,920 --> 02:38:43,600 NOON, SOME SAY 6 TO 10 P.M., ET 3915 02:38:43,600 --> 02:38:43,840 CETERA. 3916 02:38:43,840 --> 02:38:46,440 THESE HAVE ALL BEEN LIMITED WITH 3917 02:38:46,440 --> 02:38:47,840 OUTCOME MEASURES, HARD TO 3918 02:38:47,840 --> 02:38:49,160 UNDERSTAND WHAT IS THE MECHANISM 3919 02:38:49,160 --> 02:38:50,720 BECAUSE WE HAVEN'T HAD ALL OF 3920 02:38:50,720 --> 02:38:53,200 THE MEASURES IN THESE STUDIES 3921 02:38:53,200 --> 02:38:56,360 PUBLISHED TO DATE. 3922 02:38:56,360 --> 02:38:56,560 NEXT. 3923 02:38:56,560 --> 02:38:59,240 THERE'S ALSO BEEN A LACK OF 3924 02:38:59,240 --> 02:39:00,760 CONTROL FOR CONFOUNDING SO I 3925 02:39:00,760 --> 02:39:04,640 THINK MANY HAVE BEEN THESE RCT 3926 02:39:04,640 --> 02:39:06,600 STUDIES BUT WE HAVEN'T -- AS FAR 3927 02:39:06,600 --> 02:39:09,000 AS EXERCISE TIMING IS CONCERNED 3928 02:39:09,000 --> 02:39:11,280 WE HAVEN'T HAD CONTROLS STUDIES 3929 02:39:11,280 --> 02:39:14,040 WHERE WE CAN HONE ON IN ON 3930 02:39:14,040 --> 02:39:17,120 EFFECT OF TIME OF DAY OF 3931 02:39:17,120 --> 02:39:17,680 EXERCISE. 3932 02:39:17,680 --> 02:39:22,000 THE LAST THING I'LL HIGHLIGHT IS 3933 02:39:22,000 --> 02:39:23,640 THESE STUDIES SUFFER FROM 3934 02:39:23,640 --> 02:39:24,880 INDIVIDUAL VARIABILITY IN 3935 02:39:24,880 --> 02:39:25,520 RESPONSE TO EXERCISE AT 3936 02:39:25,520 --> 02:39:27,600 DIFFERENT TIMES OF THE DAY. 3937 02:39:27,600 --> 02:39:29,240 SO AGAIN IN THESE CONTROLLED 3938 02:39:29,240 --> 02:39:32,080 STUDIES THERE'S A NEED FOR 3939 02:39:32,080 --> 02:39:33,520 CROSSOVER TRIALS WHERE WE'RE 3940 02:39:33,520 --> 02:39:34,760 RANDOMIZING SOMEBODY TO MORNING 3941 02:39:34,760 --> 02:39:36,800 EXERCISE, AND HAVE A WASHOUT 3942 02:39:36,800 --> 02:39:38,880 PERIOD AND LOOK AT THEIR 3943 02:39:38,880 --> 02:39:44,040 RESPONSE TO EVENING EXERCISE AS 3944 02:39:44,040 --> 02:39:44,360 WELL. 3945 02:39:44,360 --> 02:39:47,120 OPPORTUNITIES AND FUTURE 3946 02:39:47,120 --> 02:39:48,440 DIRECTIONS FOR THIS RESEARCH, 3947 02:39:48,440 --> 02:39:49,400 CLICK NEXT. 3948 02:39:49,400 --> 02:39:51,920 NUMBER ONE, HOPEFULLY I'VE 3949 02:39:51,920 --> 02:39:57,840 CONVINCED YOU THAT ACTIVITY 3950 02:39:57,840 --> 02:39:59,040 BELONGS IN THE CHRONOTRINITY 3951 02:39:59,040 --> 02:40:00,160 I'LL CALL IT OF RESEARCH 3952 02:40:00,160 --> 02:40:00,480 THERAPY. 3953 02:40:00,480 --> 02:40:04,600 WE NEED TO LOOK AT ALL OF THESE 3954 02:40:04,600 --> 02:40:05,600 THREE PILLARS, AND WHY THE 3955 02:40:05,600 --> 02:40:08,440 TIMING OF ALL OF THEM ARE 3956 02:40:08,440 --> 02:40:08,800 IMPORTANT. 3957 02:40:08,800 --> 02:40:10,760 IN PARTICULAR FOR EXERCISE 3958 02:40:10,760 --> 02:40:13,840 TIMING RESEARCH, WE HAVE NOT 3959 02:40:13,840 --> 02:40:16,040 LOOKED AT FASTED VERSUS FED 3960 02:40:16,040 --> 02:40:18,880 EXERCISE, IS IT A TIME-DEPENDENT 3961 02:40:18,880 --> 02:40:21,280 RESPONSE OR JUST NUTRIENT DEPEND 3962 02:40:21,280 --> 02:40:21,560 RESPONSE? 3963 02:40:21,560 --> 02:40:22,880 NUMBER TWO, HARMONIZING 3964 02:40:22,880 --> 02:40:25,320 MEASUREMENT AND METRICS. 3965 02:40:25,320 --> 02:40:27,840 AGAIN, WE NOW HAVE TECHNOLOGY TO 3966 02:40:27,840 --> 02:40:32,480 BE LOOKING AT SLEEP TIME, MEAL 3967 02:40:32,480 --> 02:40:33,960 TIME, EXERCISE OR PHYSICAL 3968 02:40:33,960 --> 02:40:35,520 ACTIVITY TIME, HARMONIZE TO 3969 02:40:35,520 --> 02:40:38,600 MEASURE WHAT IS IT THE MOST 3970 02:40:38,600 --> 02:40:41,800 POTENT VARIABLE THAT'S CHANGING 3971 02:40:41,800 --> 02:40:43,520 OUR OUTCOMES. 3972 02:40:43,520 --> 02:40:45,480 NEXT. 3973 02:40:45,480 --> 02:40:46,960 THE OTHER THING IS, IS 3974 02:40:46,960 --> 02:40:47,680 CONSISTENCY IMPORTANT? 3975 02:40:47,680 --> 02:40:50,640 THIS IS AN INTERESTING QUESTION 3976 02:40:50,640 --> 02:40:52,640 FROM AN EXERCISE TIMING 3977 02:40:52,640 --> 02:40:54,560 STANDPOINT AND MEAL TIMING. 3978 02:40:54,560 --> 02:40:56,520 FOR EXERCISE IN PARTICULAR MOST 3979 02:40:56,520 --> 02:40:58,080 PEOPLE DON'T EXERCISE SEVEN DAYS 3980 02:40:58,080 --> 02:41:02,120 A WEEK. 3981 02:41:02,120 --> 02:41:02,600 PARTICULARLY THEY DON'TS 3982 02:41:02,600 --> 02:41:03,640 EXERCISE AT THE SAME TIME OF 3983 02:41:03,640 --> 02:41:05,160 DAY. 3984 02:41:05,160 --> 02:41:09,760 MAYBE THEY HAVE A 3985 02:41:09,760 --> 02:41:11,200 MONDAY-WEDNESDAY-FRIDAY PATTERN, 3986 02:41:11,200 --> 02:41:12,280 OR TUESDAY AND THURSDAY EVENING 3987 02:41:12,280 --> 02:41:15,160 BECAUSE THAT'S WHEN THE CLASS 3988 02:41:15,160 --> 02:41:16,360 IS, OR WEEKEND WARRIORS. 3989 02:41:16,360 --> 02:41:20,440 WE NEED TO FIGURE OUT IS 3990 02:41:20,440 --> 02:41:23,880 CONSISTENCY AN IMPORTANT 3991 02:41:23,880 --> 02:41:24,680 VARIABLE. 3992 02:41:24,680 --> 02:41:25,240 NEXT. 3993 02:41:25,240 --> 02:41:27,520 ANOTHER THING TO POINT OUT, WE 3994 02:41:27,520 --> 02:41:30,400 NEED BOTH ACUTE AND CHRONIC 3995 02:41:30,400 --> 02:41:30,720 STUDIES. 3996 02:41:30,720 --> 02:41:32,920 WE NEED HIGHLY CONTROLLED 3997 02:41:32,920 --> 02:41:34,000 STUDIES, WHAT IS ACUTE RESPONSE 3998 02:41:34,000 --> 02:41:36,400 AT CERTAIN TIMES OF DAY TO 3999 02:41:36,400 --> 02:41:37,160 EXERCISE. 4000 02:41:37,160 --> 02:41:38,680 MUCH OF THE PRE-CLINICAL DATA 4001 02:41:38,680 --> 02:41:41,320 HAS BEEN MORE OF ACUTE RESPONSE. 4002 02:41:41,320 --> 02:41:44,600 AND THEN WHAT IS THE TRAINING 4003 02:41:44,600 --> 02:41:45,600 RESPONSE, IF WE CONSISTENTLY 4004 02:41:45,600 --> 02:41:47,800 EXERCISE AT CERTAIN TIME OF DAY 4005 02:41:47,800 --> 02:41:51,840 WHAT IS RESPONSE, IS THAT ACUTE 4006 02:41:51,840 --> 02:41:56,080 AFTER TRAINING DIFFERENT? 4007 02:41:56,080 --> 02:41:56,280 NEXT. 4008 02:41:56,280 --> 02:41:57,080 ONE MORE. 4009 02:41:57,080 --> 02:41:59,120 THERE'S A NEED FOR MECHANISTIC 4010 02:41:59,120 --> 02:42:01,480 STUDIES, WE'RE TRYING TO 4011 02:42:01,480 --> 02:42:02,880 UNDERSTAND WHY OR WHAT IS 4012 02:42:02,880 --> 02:42:05,600 AFFECTED BY EXERCISE TIME OF 4013 02:42:05,600 --> 02:42:06,120 DAY. 4014 02:42:06,120 --> 02:42:06,600 NEXT. 4015 02:42:06,600 --> 02:42:09,320 THERE'S ALSO A NEED FOR BOTH 4016 02:42:09,320 --> 02:42:10,400 EFFICACY AND EFFECTIVENESS 4017 02:42:10,400 --> 02:42:11,120 TRIALS, WE DON'T NECESSARILY 4018 02:42:11,120 --> 02:42:13,360 NEED TO LOOK UNDER THE HOOD. 4019 02:42:13,360 --> 02:42:14,800 WE JUST NEED TO KNOW DOES IT 4020 02:42:14,800 --> 02:42:15,000 WORK. 4021 02:42:15,000 --> 02:42:17,000 IF IT DOES WORK HOW DO WE 4022 02:42:17,000 --> 02:42:20,960 TRANSLATE THAT TO THE LARGER 4023 02:42:20,960 --> 02:42:22,240 POPULATION. 4024 02:42:22,240 --> 02:42:23,120 AND ONE MORE. 4025 02:42:23,120 --> 02:42:24,840 THE LAST OPPORTUNITY OR FUTURE 4026 02:42:24,840 --> 02:42:28,720 DIRECTION IS WE NEED TO BE 4027 02:42:28,720 --> 02:42:30,200 STUDYING HEALTHY POPULATIONS AND 4028 02:42:30,200 --> 02:42:30,800 DISEASE POPULATIONS. 4029 02:42:30,800 --> 02:42:33,960 I'LL MAKE A CALL IF WE'RE TRYING 4030 02:42:33,960 --> 02:42:35,880 TO UNDERSTAND HOW THESE 4031 02:42:35,880 --> 02:42:37,480 CHRONOTHERAPIES WORK, WE NEED TO 4032 02:42:37,480 --> 02:42:38,760 STUDY THE POPULATIONS WHO ARE 4033 02:42:38,760 --> 02:42:40,960 GOING TO BE IMPACTED BY THESE, 4034 02:42:40,960 --> 02:42:43,800 SO WE NEED TO STUDY POPULATION 4035 02:42:43,800 --> 02:42:45,240 WAS OVERWEIGHT AND OBESITY TO 4036 02:42:45,240 --> 02:42:47,640 SEE WHAT IS THEIR RESPONSE AND 4037 02:42:47,640 --> 02:42:49,960 WHAT IS OPTIMAL RESPONSE. 4038 02:42:49,960 --> 02:42:50,240 NEXT. 4039 02:42:50,240 --> 02:42:53,120 I THINK WHERE IS THIS MOVING? 4040 02:42:53,120 --> 02:42:56,200 HOPEFULLY WE'RE ALL MOVING 4041 02:42:56,200 --> 02:42:56,960 TOWARDS PRECISION LIFESTYLE 4042 02:42:56,960 --> 02:42:58,280 MEDICINE, IN PARTICULAR FOR 4043 02:42:58,280 --> 02:43:01,320 EXERCISE TIMING, I THINK THAT 4044 02:43:01,320 --> 02:43:02,840 TARGET MIGHT MOVE DEPENDING 4045 02:43:02,840 --> 02:43:09,680 WHETHER WE'RE TRYING TO TREAT 4046 02:43:09,680 --> 02:43:11,720 OVERWEIGHT OBESITY, OR DIABETES 4047 02:43:11,720 --> 02:43:13,040 OR CARDIOVASCULAR DISEASE, THE 4048 02:43:13,040 --> 02:43:14,120 TIMING MIGHT BE DIFFERENT BUT 4049 02:43:14,120 --> 02:43:15,880 WE'RE TRYING TO HONE IN ON WHAT 4050 02:43:15,880 --> 02:43:17,440 IS THE TARGET FIRST. 4051 02:43:17,440 --> 02:43:18,280 ONE MORE. 4052 02:43:18,280 --> 02:43:22,480 WITH THAT I'D LIKE TO THANK MY 4053 02:43:22,480 --> 02:43:24,640 MENTORS, STUDY TEAM, COLLEAGUES, 4054 02:43:24,640 --> 02:43:26,840 AND FUNDING. 4055 02:43:26,840 --> 02:43:28,160 4056 02:43:28,160 --> 02:43:31,560 >>THANK YOU VERY MUCH, DR. 4057 02:43:31,560 --> 02:43:31,800 CREASY. 4058 02:43:31,800 --> 02:43:35,400 IF WE CAN GO AHEAD AND MOVE THE 4059 02:43:35,400 --> 02:43:38,360 SLIDES AND LET'S PUT UP THE 4060 02:43:38,360 --> 02:43:38,680 DISCUSSION. 4061 02:43:38,680 --> 02:43:49,160 WE'RE GOING TO EXTEND TO 3:05. 4062 02:43:50,480 --> 02:43:51,600 I'M GOING TO START. 4063 02:43:51,600 --> 02:43:53,680 FANTASTIC QUESTIONS IN THE Q&A. 4064 02:43:53,680 --> 02:43:55,880 STARTING WITH COMBINING A COUPLE 4065 02:43:55,880 --> 02:43:57,200 HERE FOR OUR SPEAKERS, 4066 02:43:57,200 --> 02:43:58,800 INDIVIDUAL DIFFERENCES IN THE 4067 02:43:58,800 --> 02:44:00,840 RESPONSE TO INTERVENTIONS WE 4068 02:44:00,840 --> 02:44:01,680 TALKED ABOUT. 4069 02:44:01,680 --> 02:44:03,640 IN PARTICULAR IF THERE'S ANY 4070 02:44:03,640 --> 02:44:06,280 DATA LOOKING AT THINGS SUCH AS 4071 02:44:06,280 --> 02:44:07,840 CHRONOTYPE, SEX DIFFERENCES OR 4072 02:44:07,840 --> 02:44:12,080 AGE DIFFERENCES IN OUTCOMES. 4073 02:44:12,080 --> 02:44:13,280 4074 02:44:13,280 --> 02:44:17,760 DR. PETERSON, DO YOU WANT TO 4075 02:44:17,760 --> 02:44:18,120 START OFF? 4076 02:44:18,120 --> 02:44:18,840 >>SURE. 4077 02:44:18,840 --> 02:44:23,000 THERE'S NOT A LOT OF RESEARCH ON 4078 02:44:23,000 --> 02:44:24,760 SEX-SPECIFIC DIFFERENCES, NOT IN 4079 02:44:24,760 --> 02:44:25,200 HUMAN INTERVENTIONS. 4080 02:44:25,200 --> 02:44:28,560 THERE'S A LITTLE BIT OF WORK IN 4081 02:44:28,560 --> 02:44:30,680 ANIMAL MODELS, AND THERE'S SOME 4082 02:44:30,680 --> 02:44:34,600 EVIDENCE SUGGESTING THERE MAY BE 4083 02:44:34,600 --> 02:44:37,360 OPTIMAL FASTING DURATIONS FOR 4084 02:44:37,360 --> 02:44:38,240 MALES VERSUS FEMALES. 4085 02:44:38,240 --> 02:44:42,280 IF WE THINK ABOUT ANOTHER ANGLE, 4086 02:44:42,280 --> 02:44:43,160 METABOLIC FLEXIBILITY, SOMEONE 4087 02:44:43,160 --> 02:44:46,560 WITH OBESITY MAY BE MORE -- OR 4088 02:44:46,560 --> 02:44:47,880 LESS METABOLICALLY FLEXIBLE, 4089 02:44:47,880 --> 02:44:48,520 MAYBE LEAD LONGER FASTING 4090 02:44:48,520 --> 02:44:49,480 DURATION, I DON'T KNOW. 4091 02:44:49,480 --> 02:44:50,920 THAT'S A REALLY IMPORTANT 4092 02:44:50,920 --> 02:44:51,200 QUESTION. 4093 02:44:51,200 --> 02:44:53,000 PERSONALLY IN OUR CLINICAL 4094 02:44:53,000 --> 02:44:55,840 TRIALS WE HAVEN'T SEEN AFFECT OF 4095 02:44:55,840 --> 02:44:56,000 AGE. 4096 02:44:56,000 --> 02:44:56,920 ONE SUPER INTERESTING FIND WE 4097 02:44:56,920 --> 02:44:59,760 DID HAVE ONE PERSON IN OUR STUDY 4098 02:44:59,760 --> 02:45:01,200 WHO TECHNICALLY WASN'T A CURRENT 4099 02:45:01,200 --> 02:45:05,920 SHIFT WORKER BUT HAD A 20-YEAR 4100 02:45:05,920 --> 02:45:07,240 HISTORY OF NIGHT SHIFT WORK AND 4101 02:45:07,240 --> 02:45:09,040 THE ONLY PERSON THAT GOT 4102 02:45:09,040 --> 02:45:12,960 DRAMATICALLY WORSE ON THE TIME 4103 02:45:12,960 --> 02:45:15,240 RESTRICTED SCHEDULE, QUITE 4104 02:45:15,240 --> 02:45:16,160 STARK, DEFINITELY 4105 02:45:16,160 --> 02:45:16,880 PERSONALIZATION AND 4106 02:45:16,880 --> 02:45:18,520 CUSTOMIZATION THERE. 4107 02:45:18,520 --> 02:45:19,720 WE'RE VERY UNDERDEVELOPED AS A 4108 02:45:19,720 --> 02:45:24,200 FIELD FOR ANSWERING THESE 4109 02:45:24,200 --> 02:45:24,480 QUESTIONS. 4110 02:45:24,480 --> 02:45:25,520 VERY LITTLE EVIDENCE. 4111 02:45:25,520 --> 02:45:29,160 >>DR. CRISPIN, ANYTHING TO 4112 02:45:29,160 --> 02:45:29,320 ADD? 4113 02:45:29,320 --> 02:45:32,200 >>I THINK REALLY INTERESTING 4114 02:45:32,200 --> 02:45:33,440 QUESTION, IMPORTANT PROBLEM IN 4115 02:45:33,440 --> 02:45:35,840 THE SHIFT WORK FIELD, ESPECIALLY 4116 02:45:35,840 --> 02:45:38,040 WHEN YOU THINK ABOUT CROSSOVER 4117 02:45:38,040 --> 02:45:40,440 INTO CLINICAL TRIALS THAT WE 4118 02:45:40,440 --> 02:45:41,960 HAVE SO FAR. 4119 02:45:41,960 --> 02:45:45,960 WE HAVE A LARGER NUMBER OF 4120 02:45:45,960 --> 02:45:50,640 STUDIES WITH MEALS, WHEN YOU 4121 02:45:50,640 --> 02:45:53,080 THINK ABOUT EATING FOCUSED ON 4122 02:45:53,080 --> 02:46:00,240 HEALTH EATING HABITS FOR EXAMPLE 4123 02:46:00,240 --> 02:46:02,320 WE HAVE GOOD EVIDENCE OF 4124 02:46:02,320 --> 02:46:04,080 (INDISCERNIBLE) A VERY IMPORTANT 4125 02:46:04,080 --> 02:46:05,680 PART OF LIMITATION, THE 4126 02:46:05,680 --> 02:46:07,480 INFORMATION I SHOWED FOR EXAMPLE 4127 02:46:07,480 --> 02:46:11,840 IN MY PRESENTATION, MOST OF THEM 4128 02:46:11,840 --> 02:46:18,120 ARE FROM STUDIES WITH MALES. 4129 02:46:18,120 --> 02:46:19,080 >>DR. CREASY? 4130 02:46:19,080 --> 02:46:22,120 >>YEAH, I COMMENTED BUT WE'RE 4131 02:46:22,120 --> 02:46:23,040 EVEN MORE UNDERDEVELOPED ON THE 4132 02:46:23,040 --> 02:46:26,400 NUTRITION SIDE OF THINGS. 4133 02:46:26,400 --> 02:46:28,800 WE HAVE ONE STUDY IN A CERTAIN 4134 02:46:28,800 --> 02:46:29,880 POPULATION, AND WE HAVEN'T HAD, 4135 02:46:29,880 --> 02:46:32,240 YOU KNOW, LIKE I SAID THIS 4136 02:46:32,240 --> 02:46:33,400 STIMULUS THAT BE DIFFERENT 4137 02:46:33,400 --> 02:46:35,840 ACROSS THE POPULATIONS SO IT'S 4138 02:46:35,840 --> 02:46:37,080 HARD TO COMPARE ACROSS STUDIES. 4139 02:46:37,080 --> 02:46:38,560 THERE'S BEEN A LITTLE BIT OF 4140 02:46:38,560 --> 02:46:42,360 WORK ON IMPORTANCE OF CHRONOTYPE 4141 02:46:42,360 --> 02:46:45,600 WITH EXERCISE TIMING, AND HOW 4142 02:46:45,600 --> 02:46:46,880 CHRONOTYPE MIGHT AFFECT HOW 4143 02:46:46,880 --> 02:46:50,400 EXERCISE TIME OF DAY SHIFTS 4144 02:46:50,400 --> 02:46:51,440 CIRCADIAN CLOCK, AND ALSO A 4145 02:46:51,440 --> 02:46:54,080 FELLOW IN OUR GROUP IS VERY 4146 02:46:54,080 --> 02:46:55,840 INTERESTED, DO WE LOOK AT 4147 02:46:55,840 --> 02:46:56,920 EXERCISE IN CHRONOTYPE, IF 4148 02:46:56,920 --> 02:46:59,480 YOU'RE A MORNING TYPE DOING 4149 02:46:59,480 --> 02:47:01,080 MORNING EXERCISE VERSUS EVENING 4150 02:47:01,080 --> 02:47:04,720 TYPE DOING EVEN EXERCISE, OR 4151 02:47:04,720 --> 02:47:07,120 VICE VERSA. 4152 02:47:07,120 --> 02:47:09,880 THERE ARE EFFECTS POTENTIALLY 4153 02:47:09,880 --> 02:47:11,720 CHRONOTYPE SPECIFIC ALIGN WITH 4154 02:47:11,720 --> 02:47:13,360 YOUR CHRONOTYPE MAY BE 4155 02:47:13,360 --> 02:47:14,880 BENEFICIAL BUT EARLY PILOT WORK 4156 02:47:14,880 --> 02:47:16,120 IN THAT SPACE. 4157 02:47:16,120 --> 02:47:18,520 >>ONE MORE QUICK COMMENT. 4158 02:47:18,520 --> 02:47:21,280 LOOKING AT EFFECT OF CHRONOTYPE 4159 02:47:21,280 --> 02:47:23,320 AT ADHERENCE, WE FOUND NO 4160 02:47:23,320 --> 02:47:25,720 RELATIONSHIP BETWEEN CHRONOTYPE 4161 02:47:25,720 --> 02:47:30,760 AND ADHERENCE TO EARLY 4162 02:47:30,760 --> 02:47:31,400 TIME-RESTRICTED RESTRICTED, 4163 02:47:31,400 --> 02:47:33,280 OTHER FACTORS DICTATE MORE THAN 4164 02:47:33,280 --> 02:47:36,480 CHRONOTYPE AT LEAST IN OUR HANDS 4165 02:47:36,480 --> 02:47:37,400 IN THESE STUDIES. 4166 02:47:37,400 --> 02:47:39,960 >>SOUNDS LIKE ADDITIONAL 4167 02:47:39,960 --> 02:47:41,520 OPPORTUNITY TO EXPLORE SOME OF 4168 02:47:41,520 --> 02:47:43,600 THESE DIFFERENCES AND RESPONSE 4169 02:47:43,600 --> 02:47:46,120 TO INTERVENTIONS AND POTENTIALLY 4170 02:47:46,120 --> 02:47:47,920 ADHERENCE AS WE FOCUS ON THIS AS 4171 02:47:47,920 --> 02:47:52,680 A COMPONENT OF PRECISION 4172 02:47:52,680 --> 02:47:53,200 MEDICINE. 4173 02:47:53,200 --> 02:47:54,840 SO NEXT I'LL OPEN UP TO WHOEVER 4174 02:47:54,840 --> 02:47:57,400 WOULD LIKE TO ANSWER, THINKING 4175 02:47:57,400 --> 02:47:58,600 ABOUT MACRONUTRIENT COMPONENT OF 4176 02:47:58,600 --> 02:48:02,760 MEALS AND HOW THAT MAY IMPACT 4177 02:48:02,760 --> 02:48:04,520 THE RECOMMENDATIONS, NOT ONLY 4178 02:48:04,520 --> 02:48:08,160 TIMING OF MEAL INTAKE BUT ALSO, 4179 02:48:08,160 --> 02:48:09,480 YOU KNOW, THE MACRONUTRIENT 4180 02:48:09,480 --> 02:48:17,240 COMPONENT OR EVEN FASTING PRIOR 4181 02:48:17,240 --> 02:48:18,760 TO EXERCISE. 4182 02:48:18,760 --> 02:48:19,240 DR. CREASY? 4183 02:48:19,240 --> 02:48:23,040 >>I'LL COMMENT ON THIS FASTING 4184 02:48:23,040 --> 02:48:24,680 VERSUS EXERCISE QUESTION. 4185 02:48:24,680 --> 02:48:26,560 AGAIN, I THINK WE'RE VERY 4186 02:48:26,560 --> 02:48:27,320 UNDERDEVELOPED IN THE SPACE 4187 02:48:27,320 --> 02:48:28,040 RIGHT NOW. 4188 02:48:28,040 --> 02:48:29,720 I DO THINK THAT'S WHERE WE NEED 4189 02:48:29,720 --> 02:48:30,840 TO GO. 4190 02:48:30,840 --> 02:48:35,320 THAT'S WHY I THINK I WANTED TO 4191 02:48:35,320 --> 02:48:36,640 TALK ABOUT EXERCISE TIMING 4192 02:48:36,640 --> 02:48:36,840 TODAY. 4193 02:48:36,840 --> 02:48:39,360 AS WE MOVE THE TIMING FIELD 4194 02:48:39,360 --> 02:48:44,000 FORWARD WE NEED TO LOOK IN TERMS 4195 02:48:44,000 --> 02:48:46,720 OF NUTRITION AND SAY IS IT -- 4196 02:48:46,720 --> 02:48:48,800 ARE THEY TIME DEPENDENT OR 4197 02:48:48,800 --> 02:48:49,600 NUTRIENT DEPENDENT EFFECTS. 4198 02:48:49,600 --> 02:48:51,600 ON TOP OF THAT IS THERE EATING A 4199 02:48:51,600 --> 02:48:53,760 SPECIFIC TYPE OF FOOD PRIOR TO 4200 02:48:53,760 --> 02:48:55,800 EXERCISE, HOW DOES THAT ELICIT A 4201 02:48:55,800 --> 02:48:56,560 CERTAIN RESPONSE. 4202 02:48:56,560 --> 02:48:59,520 WE'VE NOT MOVED INTO THAT SPACE 4203 02:48:59,520 --> 02:49:04,000 YET BUT IT'S AN OPPORTUNITY IN 4204 02:49:04,000 --> 02:49:05,120 THE VERY NEAR FUTURE. 4205 02:49:05,120 --> 02:49:06,560 >>HOW ABOUT SHIFT WORKERS? 4206 02:49:06,560 --> 02:49:09,640 WHEN YOU THINK ABOUT MEALS, ANY 4207 02:49:09,640 --> 02:49:11,640 RECOMMENDATIONS OR DATA SHOWING 4208 02:49:11,640 --> 02:49:12,480 THAT THE MACRONUTRIENT 4209 02:49:12,480 --> 02:49:13,680 COMPOSITION OF MEALS PRIOR TO 4210 02:49:13,680 --> 02:49:15,520 NIGHT SHIFT OR IF PEOPLE ARE 4211 02:49:15,520 --> 02:49:17,080 GOING TO EAT ON NIGHT SHIFT THAT 4212 02:49:17,080 --> 02:49:19,640 PLAYS A ROLE IN OUTCOMES? 4213 02:49:19,640 --> 02:49:23,400 >> A QUITE EXCITING TOPIC. 4214 02:49:23,400 --> 02:49:26,480 I'M AFRAID WE DON'T HAVE -- 4215 02:49:26,480 --> 02:49:28,000 ACTUALLY WE HAVE NOT STUDIED 4216 02:49:28,000 --> 02:49:29,560 SPECIFICALLY ON THIS SUBJECT. 4217 02:49:29,560 --> 02:49:33,400 WE HAVE SOME DATA SHOWING THAT 4218 02:49:33,400 --> 02:49:37,320 HIGH INTAKE OF CARBOHYDRATE 4219 02:49:37,320 --> 02:49:40,040 BEFORE SHIFT, FOR EXAMPLE, CAN 4220 02:49:40,040 --> 02:49:43,440 IMPROVE SLEEPINESS BUT SOMETHING 4221 02:49:43,440 --> 02:49:45,120 NEEDED, IT'S AN OPPORTUNITY FOR 4222 02:49:45,120 --> 02:49:46,640 THE FUTURE AS WELL. 4223 02:49:46,640 --> 02:49:48,880 >>THANK YOU. 4224 02:49:48,880 --> 02:49:50,080 FOR PEOPLE WHO HAVE BREAKFAST 4225 02:49:50,080 --> 02:49:52,600 WHAT SHOULD THEY BE HAVING FOR 4226 02:49:52,600 --> 02:49:52,880 BREAKFAST? 4227 02:49:52,880 --> 02:49:54,120 >>GREAT QUESTION. 4228 02:49:54,120 --> 02:50:01,760 WE HAVE SO LITTLE EVIDENCE. 4229 02:50:01,760 --> 02:50:03,600 WE'VE BEEN COMBINING APPROACHES 4230 02:50:03,600 --> 02:50:05,400 WITH GLYCEMIC AND FOUND GOOD 4231 02:50:05,400 --> 02:50:07,360 EFFECTS, BREAKFAST THEY HAVE 4232 02:50:07,360 --> 02:50:10,000 BEEN TESTING ARE LOW PROTEIN, 4233 02:50:10,000 --> 02:50:12,480 CAN'T THINK OF GOOD ROBUST 4234 02:50:12,480 --> 02:50:14,360 EVIDENCE OTHER THAN COUPLE 4235 02:50:14,360 --> 02:50:17,080 STUDIES IN MY TALK SHOWING 4236 02:50:17,080 --> 02:50:18,840 FRONT-LOADING FAT TO EARLY IN 4237 02:50:18,840 --> 02:50:21,320 THE DAY MAY IMPROVE SATIETY AS 4238 02:50:21,320 --> 02:50:23,960 OPPOSED TO LATER IN THE DAY, 4239 02:50:23,960 --> 02:50:24,640 THAT'S WORTH FOLLOWING, BUT 4240 02:50:24,640 --> 02:50:26,280 THERE ARE ONLY A COUPLE STUDIES 4241 02:50:26,280 --> 02:50:27,360 IN THE SPACE. 4242 02:50:27,360 --> 02:50:32,320 ONE THING THAT IS QUITE 4243 02:50:32,320 --> 02:50:33,600 INTERESTING, NOT MACRONUTRIENT 4244 02:50:33,600 --> 02:50:35,920 BUT DIETARY COMPOSITION, WE TALK 4245 02:50:35,920 --> 02:50:37,440 ABOUT GLYCEMIC INDEX, LOAD AND 4246 02:50:37,440 --> 02:50:39,880 NUTRITION, WHICH IS ONE MEASURE 4247 02:50:39,880 --> 02:50:42,960 OF DIET QUALITY. 4248 02:50:42,960 --> 02:50:44,600 INTERESTINGLY, THOSE DIFFERENCES 4249 02:50:44,600 --> 02:50:46,800 IN GLYCEMIC LOAD APPEAR TO BE 4250 02:50:46,800 --> 02:50:48,280 FAR MORE IMPORTANT LATER IN THE 4251 02:50:48,280 --> 02:50:48,520 DAY. 4252 02:50:48,520 --> 02:50:50,480 SAID ANOTHER WAY, THERE'S BEEN A 4253 02:50:50,480 --> 02:50:53,000 COUPLE ELEGANT STUDIES SHOWING 4254 02:50:53,000 --> 02:50:54,880 THAT THE GLYCEMIC EXCURSION IN 4255 02:50:54,880 --> 02:50:56,880 THE MORE THAN BETWEEN GOOD AND 4256 02:50:56,880 --> 02:50:59,040 BAD FOODS FROM G.I. PERSPECTIVE 4257 02:50:59,040 --> 02:51:01,880 IS SMALL, IT'S HUGE LATER IN THE 4258 02:51:01,880 --> 02:51:02,240 DAY. 4259 02:51:02,240 --> 02:51:04,640 THERE'S LIKE A TIME BY GLYCEMIC 4260 02:51:04,640 --> 02:51:10,120 INDEX EFFECT GOING ON WHICH IS 4261 02:51:10,120 --> 02:51:10,400 FASCINATING. 4262 02:51:10,400 --> 02:51:13,520 >>SO WE'VE HEARD THROUGHOUT 4263 02:51:13,520 --> 02:51:14,440 THE WORKSHOP ABOUT EATING TOO 4264 02:51:14,440 --> 02:51:17,600 LATE IN THE DAY IS NOT GOOD. 4265 02:51:17,600 --> 02:51:19,080 THERE'S CLEAR EVIDENCE THERE. 4266 02:51:19,080 --> 02:51:20,400 ONE THING WE HAVEN'T 4267 02:51:20,400 --> 02:51:22,800 HIGHLIGHTED, I WANT TO ADD HERE, 4268 02:51:22,800 --> 02:51:24,120 UNDER CONDITIONS OF INSUFFICIENT 4269 02:51:24,120 --> 02:51:25,680 SLEEP PEOPLE SEND TO EAT MORE 4270 02:51:25,680 --> 02:51:27,640 LATER AT NIGHT. 4271 02:51:27,640 --> 02:51:28,880 THERE'S A SIGNIFICANT SHIFT, EAT 4272 02:51:28,880 --> 02:51:30,360 MORE AFTER DINNER FOR EXAMPLE 4273 02:51:30,360 --> 02:51:33,120 THAN AT ANY MEAL ACROSS THE DAY. 4274 02:51:33,120 --> 02:51:34,840 I THINK THAT'S A PRETTY CLEAR 4275 02:51:34,840 --> 02:51:36,480 THING IN TERMS OF NOT EATING 4276 02:51:36,480 --> 02:51:38,000 LATER AT NIGHT. 4277 02:51:38,000 --> 02:51:40,400 WHEN WE GET TO EXERCISE, HOW 4278 02:51:40,400 --> 02:51:42,960 LATE IS TOO LATE? 4279 02:51:42,960 --> 02:51:45,000 DR. CREASY, THERE'S SOME 4280 02:51:45,000 --> 02:51:47,320 RECOMMENDATIONS OUT THERE IN THE 4281 02:51:47,320 --> 02:51:48,280 CLINICAL WORLD SAYING DON'T 4282 02:51:48,280 --> 02:51:51,440 EXERCISE TOO CLOSE TO BEDTIME. 4283 02:51:51,440 --> 02:51:53,120 IT MAY DISTURB SLEEP. 4284 02:51:53,120 --> 02:51:54,080 FROM YOUR PERSPECTIVE HOW GOOD 4285 02:51:54,080 --> 02:51:57,480 IS STRENGTH OF THAT EVIDENCE AND 4286 02:51:57,480 --> 02:51:59,320 WHAT ARE OPPORTUNITIES WHETHER 4287 02:51:59,320 --> 02:52:01,960 WHEN IT COMES TO SLEEP AS 4288 02:52:01,960 --> 02:52:02,200 OUTCOME? 4289 02:52:02,200 --> 02:52:07,320 >>REQUEST OF GOOD DID -- GOOD 4290 02:52:07,320 --> 02:52:13,360 QUESTION. . 4291 02:52:13,360 --> 02:52:19,400 IT'S VIGOROUS EXERCISE CLOSE TO 4292 02:52:19,400 --> 02:52:23,640 BEDTIME THAT MIGHT BE 4293 02:52:23,640 --> 02:52:24,320 DETRIMENTAL, EXERCISE HELPS 4294 02:52:24,320 --> 02:52:29,680 PROMOTE BETTER SLEEP. 4295 02:52:29,680 --> 02:52:31,000 THERE'S OPPORTUNITY LOOKING AT 4296 02:52:31,000 --> 02:52:33,160 CROSSOVER STUDIES IN THE 4297 02:52:33,160 --> 02:52:35,880 MORNING, EVENING, HOW DOES THAT 4298 02:52:35,880 --> 02:52:39,200 AFFECT SLEEP, ACTUALLY AFFECT 4299 02:52:39,200 --> 02:52:40,280 NOCTURNAL METABOLISM IS AN 4300 02:52:40,280 --> 02:52:42,280 INTERESTING AREA FOR RESEARCH AS 4301 02:52:42,280 --> 02:52:42,480 WELL. 4302 02:52:42,480 --> 02:52:45,680 I DON'T THINK THERE'S ENOUGH 4303 02:52:45,680 --> 02:52:46,960 EVIDENCE IN THIS SPACE, AND AT 4304 02:52:46,960 --> 02:52:49,840 LEAST RIGHT NOW I WOULD STILL 4305 02:52:49,840 --> 02:52:50,920 RECOMMEND EXERCISING. 4306 02:52:50,920 --> 02:52:55,040 I WOULDN'T SAY DON'T EXERCISE. 4307 02:52:55,040 --> 02:52:56,400 THAT PROBABLY OVERPOWERS THE 4308 02:52:56,400 --> 02:52:59,240 EFFECT IF IT DISRUPTS SLEEP 4309 02:52:59,240 --> 02:52:59,520 POTENTIALLY. 4310 02:52:59,520 --> 02:53:02,200 >>WE HAVE A QUESTION FROM THE 4311 02:53:02,200 --> 02:53:04,480 AUDIENCE ABOUT CULTURAL 4312 02:53:04,480 --> 02:53:10,520 DIFFERENCES IN EATING PATTERNS. 4313 02:53:10,520 --> 02:53:12,120 SPAIN WAS AN EXAMPLE OF LATE 4314 02:53:12,120 --> 02:53:12,480 EATERS. 4315 02:53:12,480 --> 02:53:17,400 SPAIN IS ON A TIME ZONE ONE HOUR 4316 02:53:17,400 --> 02:53:19,160 EAST, IF THEY WERE ON 4317 02:53:19,160 --> 02:53:20,920 APPROPRIATE WOULD BE AN HOUR 4318 02:53:20,920 --> 02:53:22,920 WEST WHICH WOULD REDUCE LATE 4319 02:53:22,920 --> 02:53:25,000 DIFFERENCES TO HIGHLIGHT THAT. 4320 02:53:25,000 --> 02:53:32,440 PERHAPS DR. CRISPIM CAN COMMENT 4321 02:53:32,440 --> 02:53:36,200 IN BRAZIL OR OTHER CULTURES. 4322 02:53:36,200 --> 02:53:39,120 >>THIS IS QUITING TOPIC AS 4323 02:53:39,120 --> 02:53:39,880 WELL. 4324 02:53:39,880 --> 02:53:44,160 IN BRAZIL I HAVE EVALUATED NOW 4325 02:53:44,160 --> 02:53:46,360 THE -- SURVEYED A REPRESENTATIVE 4326 02:53:46,360 --> 02:53:51,400 SURVEY FROM COUNTRY, AND WE HAVE 4327 02:53:51,400 --> 02:53:55,240 SEEN THAT BRAZILIANS USUALLY EAT 4328 02:53:55,240 --> 02:53:57,040 EARLY, TIME OF BREAKFAST FOR 4329 02:53:57,040 --> 02:54:01,440 EXAMPLE IS LIKE 7 TO 8 A.M., 4330 02:54:01,440 --> 02:54:06,280 FROM MIDDAY TO 1 P.M. THEY 4331 02:54:06,280 --> 02:54:09,440 USUALLY HAVE THE LUNCH, AND 4332 02:54:09,440 --> 02:54:13,640 AROUND 7 P.M. THE LUNCH. 4333 02:54:13,640 --> 02:54:17,040 THIS IS NOT VERY LATE. 4334 02:54:17,040 --> 02:54:18,800 AND WE HAVE A VERY IMPORTANT 4335 02:54:18,800 --> 02:54:20,840 PROBLEM WITH OVERWEIGHT AND 4336 02:54:20,840 --> 02:54:24,000 OBESITY IN THE COUNTRY, AND WE 4337 02:54:24,000 --> 02:54:26,000 HAVE MORE THAN 60% OF THE 4338 02:54:26,000 --> 02:54:29,520 POPULATION WITH SOME DEGREE OF 4339 02:54:29,520 --> 02:54:34,000 OVERWEIGHT OR OBESITY. 4340 02:54:34,000 --> 02:54:34,800 OF COURSE, MAYBE IMPORTANT 4341 02:54:34,800 --> 02:54:36,880 OPPORTUNITY AND CHALLENGE FOR 4342 02:54:36,880 --> 02:54:40,680 THE FUTURE TO UNDERSTAND HOW 4343 02:54:40,680 --> 02:54:45,520 THIS CULTURAL ASPECT CAN RELATE 4344 02:54:45,520 --> 02:54:50,000 TO THE DISEASE AND TO MANY OTHER 4345 02:54:50,000 --> 02:54:56,280 EXPOSURES YOU HAVE, BECAUSE ON 4346 02:54:56,280 --> 02:54:59,440 THE OTHER HANDS WE HAVE A VERY 4347 02:54:59,440 --> 02:55:00,960 PROBLEMATIC PATTERN OF QUALITY 4348 02:55:00,960 --> 02:55:04,240 OF DIET IN THE COUNTRY. 4349 02:55:04,240 --> 02:55:06,640 TO CONTROL ALL THESE 4350 02:55:06,640 --> 02:55:09,480 INTERACTIONS IT'S SOMETHING VERY 4351 02:55:09,480 --> 02:55:12,120 WE NEED TO FOCUS, SPECIFICALLY 4352 02:55:12,120 --> 02:55:16,720 EPIDEMIOLOGIC RESEARCH ON THIS 4353 02:55:16,720 --> 02:55:17,400 SUBJECT, I THINK. 4354 02:55:17,400 --> 02:55:21,840 >>LAST WORD HERE FOR US? 4355 02:55:21,840 --> 02:55:26,600 >>SURE, DIFFERENCES BY COUNTRY 4356 02:55:26,600 --> 02:55:29,240 AND CULTURE, AND SOMEBODY ELSE 4357 02:55:29,240 --> 02:55:30,640 CAN COMMENT ON SPAIN. 4358 02:55:30,640 --> 02:55:32,280 THERE WAS A NICE STUDY SHOWING 4359 02:55:32,280 --> 02:55:36,640 MEDIAN TIME FOR LUNCH IS 2:45 4360 02:55:36,640 --> 02:55:37,400 P.M., QUITE LATE. 4361 02:55:37,400 --> 02:55:39,480 LET ME POINT OUT ONE OTHER 4362 02:55:39,480 --> 02:55:42,000 DIFFERENCE THAT MIGHT NOT BE 4363 02:55:42,000 --> 02:55:43,200 CONSIDERED CULTURAL BUT 4364 02:55:43,200 --> 02:55:44,000 GENERATIONAL. 4365 02:55:44,000 --> 02:55:45,200 THERE'S DATA SUGGESTING YOUNGER 4366 02:55:45,200 --> 02:55:47,040 AMERICANS EAT OVER A MUCH LONGER 4367 02:55:47,040 --> 02:55:50,760 EATING WINDOW AND HAVE MORE 4368 02:55:50,760 --> 02:55:54,680 ERRATIC EATING PATTERNS, AND ONE 4369 02:55:54,680 --> 02:55:56,480 INTERESTING IN FREE LIVING 4370 02:55:56,480 --> 02:55:58,960 STUDIES, A NUMBER OF PEOPLE HAVE 4371 02:55:58,960 --> 02:56:01,600 NO INTEREST IN DOING 4372 02:56:01,600 --> 02:56:02,800 TIME-RESTRICTED EATING. 4373 02:56:02,800 --> 02:56:05,080 WE'RE PREACHING TO THE CHOIR 4374 02:56:05,080 --> 02:56:06,160 BECAUSE WE'RE EXCITED ABOUT 4375 02:56:06,160 --> 02:56:07,720 CHRONONUTRITION BUT WE NEED TO 4376 02:56:07,720 --> 02:56:09,240 TEST A VARIETY OF 4377 02:56:09,240 --> 02:56:09,800 CHRONONUTRITION APPROACHES 4378 02:56:09,800 --> 02:56:11,120 BECAUSE SOME PEOPLE JUST CAN'T 4379 02:56:11,120 --> 02:56:13,000 CHANGE THE TIMES OF THEIR MEALS. 4380 02:56:13,000 --> 02:56:15,600 CAN WE ADOPT SOME OTHER 4381 02:56:15,600 --> 02:56:17,000 APPROACHES SHIFTING 4382 02:56:17,000 --> 02:56:21,720 MACRONUTRIENTS, DISTRIBUTION OF 4383 02:56:21,720 --> 02:56:22,840 CALORIES TO MEET PEOPLE WHERE 4384 02:56:22,840 --> 02:56:23,520 THEY ARE. 4385 02:56:23,520 --> 02:56:25,280 WE NEED TO BROADLY TEST 4386 02:56:25,280 --> 02:56:28,080 FEASIBILITY ACROSS A RANGE OF 4387 02:56:28,080 --> 02:56:32,520 APPROACHES AND FIND OUT HOW TO 4388 02:56:32,520 --> 02:56:34,000 PRESCRIBE INTERVENTIONS BASED ON 4389 02:56:34,000 --> 02:56:36,960 CULTURAL AND OTHER BEHAVIORAL 4390 02:56:36,960 --> 02:56:37,520 CONTEXTS. 4391 02:56:37,520 --> 02:56:38,960 IT MATTERS WHETHER YOU HAVE 4392 02:56:38,960 --> 02:56:42,160 YOUNG KIDS AT HOME AND WE SEE 4393 02:56:42,160 --> 02:56:46,400 THAT IN EXIT INTERVIEWS. 4394 02:56:46,400 --> 02:56:48,520 >>HELP ME THANK THE SPEAKERS 4395 02:56:48,520 --> 02:56:52,560 FOR EXCELLENT PRESENTATIONS AND 4396 02:56:52,560 --> 02:56:53,120 DISCUSSION HERE. 4397 02:56:53,120 --> 02:56:57,360 AND WE'LL TURN IT BACK OVER TO 4398 02:56:57,360 --> 02:56:58,480 OUR CO-CHAIRS AND I THINK WE 4399 02:56:58,480 --> 02:57:02,200 HAVE A SHORT BREAK NOW. 4400 02:57:02,200 --> 02:57:04,600 >>WE'LL TAKE A FIVE-MINUTE 4401 02:57:04,600 --> 02:57:10,520 BREAK, COME BACK AT 3:12. 4402 02:57:10,520 --> 02:57:14,040 >>WELCOME BACK. 4403 02:57:14,040 --> 02:57:17,880 WE'LL TAKE AN HOUR, MOVING 4404 02:57:17,880 --> 02:57:18,640 CHRONONUTRITION TO CLINICAL 4405 02:57:18,640 --> 02:57:25,320 PRACTICE, IF I COULD SHARE MY 4406 02:57:25,320 --> 02:57:27,440 SLIDES. 4407 02:57:27,440 --> 02:57:29,800 I WANT TO GIVE A BRIEF, BRIEF 4408 02:57:29,800 --> 02:57:31,880 OVERVIEW OF THE HIGH PRIORITY 4409 02:57:31,880 --> 02:57:33,120 RESEARCH AREAS THAT WERE 4410 02:57:33,120 --> 02:57:38,160 HIGHLIGHTED BY THE PREVIOUS 4411 02:57:38,160 --> 02:57:40,120 SPEAKERS, NEEDING INFORMATION 4412 02:57:40,120 --> 02:57:42,200 FROM VARIOUS INTERVENTION 4413 02:57:42,200 --> 02:57:44,960 STUDIES, USING VARIOUS METHODS 4414 02:57:44,960 --> 02:57:49,080 LIKE CGM, DR. WRIGHT HIGHLIGHTED 4415 02:57:49,080 --> 02:57:50,520 IMPORTANCE OF EXAMINING 4416 02:57:50,520 --> 02:57:52,040 SUBSTRATE METABOLISM, OVERNIGHT, 4417 02:57:52,040 --> 02:57:56,760 NOT JUST TAKING DAYTIME 4418 02:57:56,760 --> 02:57:58,680 ASSESSMENTS, A RECURRING THEME, 4419 02:57:58,680 --> 02:58:00,040 SUBSTRATES AND OUTCOMES ACROSS 4420 02:58:00,040 --> 02:58:04,080 MULTIPLE TIME POINTS OVER A DAY. 4421 02:58:04,080 --> 02:58:07,000 KEY AREA HIGHLIGHTED SHIFT 4422 02:58:07,000 --> 02:58:09,640 WORKERS, CONDUCTING ASSESSMENTS 4423 02:58:09,640 --> 02:58:10,640 TO COGNITIVE PERFORMANCE RELATED 4424 02:58:10,640 --> 02:58:14,480 TO EATING IN THE NIGHT, 4425 02:58:14,480 --> 02:58:15,920 DISTRIBUTING CIRCADIAN SPACE, 4426 02:58:15,920 --> 02:58:16,800 WIDELY DISPERSED AMONG SHIFT 4427 02:58:16,800 --> 02:58:19,200 WORKERS AND TIMING OF FOOD 4428 02:58:19,200 --> 02:58:23,120 INTAKE CANNOT BE UNIVERSALLY 4429 02:58:23,120 --> 02:58:25,200 DETERMINED WERE CONCLUSIONS. 4430 02:58:25,200 --> 02:58:26,520 VARIOUS FUTURE DIRECTIONS 4431 02:58:26,520 --> 02:58:29,680 HIGHLIGHTED BY DR. WRIGHT, TIME 4432 02:58:29,680 --> 02:58:31,240 OF DAY, IMPACTING BREAST MILK 4433 02:58:31,240 --> 02:58:32,640 COMPOSITION, SOMETHING THAT CAME 4434 02:58:32,640 --> 02:58:37,440 UP FROM DR. LYNCH AS WELL, WE 4435 02:58:37,440 --> 02:58:39,280 KNOW NUTRIENT COMPOSITION OF 4436 02:58:39,280 --> 02:58:42,040 STRAWBERRIES BUT NOT SO MUCH 4437 02:58:42,040 --> 02:58:43,240 BREAST MILK, AND FUTURE 4438 02:58:43,240 --> 02:58:48,400 DIRECTIONS THAT CAME OUT OF THIS 4439 02:58:48,400 --> 02:58:49,600 PRESENTATION. 4440 02:58:49,600 --> 02:58:51,240 DR. PETERSON'S TALK WE HEARD 4441 02:58:51,240 --> 02:58:53,840 ABOUT CHRONONUTRITION, TIME 4442 02:58:53,840 --> 02:58:55,840 RESTRICTED EATING, INTERMITTENT 4443 02:58:55,840 --> 02:58:57,440 FASTING, PROVIDING DEFINITIONS 4444 02:58:57,440 --> 02:58:59,520 FOR THIS, PROVIDING INFORMATION 4445 02:58:59,520 --> 02:59:03,080 RELATED TO LIMITATIONS OF 4446 02:59:03,080 --> 02:59:05,000 CURRENT STUDIES SMALL SINGLE ARM 4447 02:59:05,000 --> 02:59:12,000 WITH WEAK CONTROL GROUPS, 4448 02:59:12,000 --> 02:59:14,640 HETEROGENEOUS PROTOCOLS, NEED TO 4449 02:59:14,640 --> 02:59:18,040 TAKE POSTPRANDIAL MEASURES, NOT 4450 02:59:18,040 --> 02:59:20,560 JUST FASTING ASSESSMENTS, LONGER 4451 02:59:20,560 --> 02:59:22,000 TERM STUDIES. 4452 02:59:22,000 --> 02:59:25,480 DR. CRISPIM TALKED ABOUT SHIFT 4453 02:59:25,480 --> 02:59:29,440 WORK, EATING AT NIGHT, 4454 02:59:29,440 --> 02:59:31,040 UNDERSTANDS WHAT, WHEN, WHERE 4455 02:59:31,040 --> 02:59:32,120 AND WHY, SHIFTING AND 4456 02:59:32,120 --> 02:59:33,080 POTENTIALLY PROVIDING MEALS IN 4457 02:59:33,080 --> 02:59:36,440 THE MIDDLE OF THE NIGHT CAN 4458 02:59:36,440 --> 02:59:38,760 INFLUENCE OUTCOMES AND INFLUENCE 4459 02:59:38,760 --> 02:59:40,600 INTAKE THE FOLLOWING DAY. 4460 02:59:40,600 --> 02:59:41,920 AND FINALLY DR. CREASY TALKED 4461 02:59:41,920 --> 02:59:42,840 ABOUT PATTERNS OF PHYSICAL SHIFT 4462 02:59:42,840 --> 02:59:46,760 THAT NEED TO BE PART OF THE 4463 02:59:46,760 --> 02:59:47,960 CONVERSATION RELATED TO 4464 02:59:47,960 --> 02:59:49,960 CHRONONUTRITION AND PATTERNS OF 4465 02:59:49,960 --> 02:59:51,800 PHYSICAL ACTIVITY ARE IMPORTANT 4466 02:59:51,800 --> 02:59:53,760 AND MAY INFLUENCE FOOD INTAKE 4467 02:59:53,760 --> 02:59:56,040 THE NEXT DAY HIGHLIGHTING 4468 02:59:56,040 --> 03:00:03,960 MULTIPLE LIMITATIONS OF STUDIES, 4469 03:00:03,960 --> 03:00:04,480 BEING UNDERPOWERED, 4470 03:00:04,480 --> 03:00:05,640 NON-RANDOMIZED, HETEROGENEOUS 4471 03:00:05,640 --> 03:00:08,200 POPULATION IN TIMING, LIMITED 4472 03:00:08,200 --> 03:00:08,640 OUTCOME MEASURES, 4473 03:00:08,640 --> 03:00:11,920 INTERINDIVIDUAL VARIABILITY. 4474 03:00:11,920 --> 03:00:15,320 HE BROUGHT UP THIS CHRONOTRINITY 4475 03:00:15,320 --> 03:00:21,120 TERM OF EVALUATING 4476 03:00:21,120 --> 03:00:21,440 CHRONOTHERAPY 4477 03:00:21,440 --> 03:00:22,520 RELATED TO PHYSICAL ACTIVITY AND 4478 03:00:22,520 --> 03:00:23,200 SLEEP. 4479 03:00:23,200 --> 03:00:24,840 I WANT TO START THE DISCUSSION 4480 03:00:24,840 --> 03:00:29,360 FOR THE PANEL TODAY TO ADDRESS 4481 03:00:29,360 --> 03:00:30,880 THESE HIGH-LEVEL QUESTIONS THAT 4482 03:00:30,880 --> 03:00:36,040 WE'VE HIGHLIGHTED FOR THIS 4483 03:00:36,040 --> 03:00:36,440 WORKSHOP. 4484 03:00:36,440 --> 03:00:39,520 TO ADDRESS PRIORITIES AND 4485 03:00:39,520 --> 03:00:40,960 BALANCING, CLINICAL INTERVENTION 4486 03:00:40,960 --> 03:00:42,360 RESEARCH, MOST URGENT BASIC 4487 03:00:42,360 --> 03:00:44,560 SCIENCE NEEDED TO INFORM 4488 03:00:44,560 --> 03:00:46,800 APPLICATION OF TIME-RESTRICTED 4489 03:00:46,800 --> 03:00:47,880 IN CLINICAL RESEARCH, WOULD LIKE 4490 03:00:47,880 --> 03:00:51,480 TO HEAR YOUR THOUGHTS ON 4491 03:00:51,480 --> 03:00:53,000 DEFINING SHORT VERSUS LONG-TERM 4492 03:00:53,000 --> 03:00:54,960 OPPORTUNITIES, MOST IMMEDIATE 4493 03:00:54,960 --> 03:00:55,840 OPPORTUNITIES TO APPLY 4494 03:00:55,840 --> 03:00:57,960 CHRONONUTRITION, WHAT CAN BE 4495 03:00:57,960 --> 03:00:59,720 DONE NOW, KNOWING WHAT WE KNOW, 4496 03:00:59,720 --> 03:01:04,600 ALSO WHAT DO WE NEED TO LEARN TO 4497 03:01:04,600 --> 03:01:07,560 PROMOTE FUTURE RESEARCH AND 4498 03:01:07,560 --> 03:01:09,120 LONG-TERM ASSESSMENTS. 4499 03:01:09,120 --> 03:01:12,880 WHAT ASPECTS OF CHRONONUTRITION 4500 03:01:12,880 --> 03:01:13,680 REQUIRE MORE LONG-TERM RESEARCH 4501 03:01:13,680 --> 03:01:15,240 INVESTMENT AND WHAT IS THE 4502 03:01:15,240 --> 03:01:17,000 SINGLE MOST IMPORTANT GOAL OR 4503 03:01:17,000 --> 03:01:18,960 MILESTONE FOR RESEARCH AND IF 4504 03:01:18,960 --> 03:01:22,920 THERE IS A DEFINITIVE EAVED 4505 03:01:22,920 --> 03:01:23,360 -- 4506 03:01:23,360 --> 03:01:25,320 EVIDENCE-BASED THAT CAN BE DONE, 4507 03:01:25,320 --> 03:01:26,760 WHAT RESEARCH IS NEEDED AND WHAT 4508 03:01:26,760 --> 03:01:30,920 NEEDS TO BE DEFINED BEFORE THIS 4509 03:01:30,920 --> 03:01:33,320 TRIAL CAN BE DONE. 4510 03:01:33,320 --> 03:01:39,320 I'LL STOP SHARING AND BRING UP 4511 03:01:39,320 --> 03:01:41,040 THE PANELISTS. 4512 03:01:41,040 --> 03:01:44,840 >>WE'D LIKE TO OPEN FOR 4513 03:01:44,840 --> 03:01:47,440 COMMENTS FROM ALL OF YOU, ALL OF 4514 03:01:47,440 --> 03:01:48,760 US HERE, PANELISTS FROM 4515 03:01:48,760 --> 03:01:50,720 YESTERDAY'S SESSIONS AS WELL AS 4516 03:01:50,720 --> 03:01:52,160 TODAY'S SESSIONS, ABOUT 4517 03:01:52,160 --> 03:01:53,120 ADDRESSING THESE VARIOUS 4518 03:01:53,120 --> 03:01:53,560 QUESTIONS. 4519 03:01:53,560 --> 03:01:58,080 WHAT DO WE NEED FIRST OF ALL IN 4520 03:01:58,080 --> 03:02:01,760 TERMS OF MECHANISMS, BALANCING 4521 03:02:01,760 --> 03:02:02,880 BASIC SCIENCE, CLINICAL SCIENCE, 4522 03:02:02,880 --> 03:02:06,040 TO MOVE THE FIELD FORWARD. 4523 03:02:06,040 --> 03:02:12,040 4524 03:02:12,040 --> 03:02:14,680 4525 03:02:14,680 --> 03:02:15,800 >>I'D LIKE TO START WITH A 4526 03:02:15,800 --> 03:02:18,200 QUESTION FOR PEOPLE ON THE 4527 03:02:18,200 --> 03:02:20,520 CLINICAL SIDE DOING THESE 4528 03:02:20,520 --> 03:02:21,840 PRELIMINARY RANDOMIZED CLINICAL 4529 03:02:21,840 --> 03:02:22,800 TRIALS. 4530 03:02:22,800 --> 03:02:26,280 WE HEARD A LOT ABOUT DIFFERENT 4531 03:02:26,280 --> 03:02:28,360 KINDS OF OUTCOMES AND WHICH 4532 03:02:28,360 --> 03:02:31,240 OUTCOMES ARE STRONGEST, ET 4533 03:02:31,240 --> 03:02:31,480 CETERA. 4534 03:02:31,480 --> 03:02:34,920 I DIDN'T HEAR A LOT ABOUT THE 4535 03:02:34,920 --> 03:02:36,280 LONG-TERM EFFECTIVENESS. 4536 03:02:36,280 --> 03:02:40,640 SO, AFTER THE TRIALS CONCLUDED, 4537 03:02:40,640 --> 03:02:42,960 HOW LONG THOSE RESULTS ARE 4538 03:02:42,960 --> 03:02:43,240 MAINTAINED. 4539 03:02:43,240 --> 03:02:45,800 WE KNOW A LOT OF WEIGHT LOSS 4540 03:02:45,800 --> 03:02:47,320 TRIALS ARE VERY EFFECTIVE, AND 4541 03:02:47,320 --> 03:02:49,600 YET SIX MONTHS LATER OR A YEAR 4542 03:02:49,600 --> 03:02:54,560 LATER THEIR EFFECTIVE INs I 4543 03:02:54,560 --> 03:02:57,400 S -- EFFECTIVENESS IS GONE. 4544 03:02:57,400 --> 03:02:59,880 HOW WELL AS A BEHAVIOR CHANGE, 4545 03:02:59,880 --> 03:03:03,520 TO CHANGE TIMING OF EATING, IS 4546 03:03:03,520 --> 03:03:03,840 MAINTAINED. 4547 03:03:03,840 --> 03:03:05,840 >>VERY IMPORTANT QUESTION. 4548 03:03:05,840 --> 03:03:07,560 DO WE EVEN TRYING AFTER THE 4549 03:03:07,560 --> 03:03:12,520 STUDY IS DONE? 4550 03:03:12,520 --> 03:03:14,360 WE DO TIME-RESTRICTED EATING 4551 03:03:14,360 --> 03:03:15,160 INTERVENTION AND STOP 4552 03:03:15,160 --> 03:03:16,760 ASSESSMENTS, THAT'S THE END. 4553 03:03:16,760 --> 03:03:18,640 DO WE KNOW IF INDIVIDUALS 4554 03:03:18,640 --> 03:03:21,720 CONTINUE ON TO THESE BEHAVIORS 4555 03:03:21,720 --> 03:03:22,600 AND ADOPT BEHAVIORS LONG-TERM? 4556 03:03:22,600 --> 03:03:23,600 I DON'T THINK WE HAVE THAT 4557 03:03:23,600 --> 03:03:25,840 INFORMATION. 4558 03:03:25,840 --> 03:03:31,880 4559 03:03:31,880 --> 03:03:41,920 4560 03:03:45,360 --> 03:03:48,040 >>EVEN ONE OR TWO YEARS ARE 4561 03:03:48,040 --> 03:03:49,920 ENCOURAGED BUT DIDN'T GO BEYOND 4562 03:03:49,920 --> 03:03:51,680 4 OR 8 WEEKS, 12 WEEKS WERE THE 4563 03:03:51,680 --> 03:03:54,720 LONGEST FOR A LONG DURATION OF 4564 03:03:54,720 --> 03:03:54,920 TIME. 4565 03:03:54,920 --> 03:03:56,920 WE'LL SEE ANSWERS IN THE NEXT 4566 03:03:56,920 --> 03:03:59,520 FEW YEARS. 4567 03:03:59,520 --> 03:03:59,640 4568 03:03:59,640 --> 03:04:02,560 >>SPECIFICALLY I THINK WE HAVE 4569 03:04:02,560 --> 03:04:05,720 THREE ONE-YEAR-LONG STUDIES ON 4570 03:04:05,720 --> 03:04:07,280 TIME-RESTRICTED EATING. 4571 03:04:07,280 --> 03:04:11,000 RESULTS ARE MIXED ON WHETHER 4572 03:04:11,000 --> 03:04:12,640 WEIGHT LOSS IS CONCERNED BUT ONE 4573 03:04:12,640 --> 03:04:14,280 OF THOSE I HAVE CONCERNS ABOUT 4574 03:04:14,280 --> 03:04:14,880 STUDY QUALITY. 4575 03:04:14,880 --> 03:04:16,600 THERE'S NO ALMOST NO DATA ON 4576 03:04:16,600 --> 03:04:20,440 LONG-TERM FOLLOW-UP. 4577 03:04:20,440 --> 03:04:23,160 >>SPEAKING WITH MY COLLEAGUES 4578 03:04:23,160 --> 03:04:24,680 WHO DO CLINICAL TRIALS, THIS IS 4579 03:04:24,680 --> 03:04:26,320 AN OPPORTUNITY FOR THIS AREA 4580 03:04:26,320 --> 03:04:30,280 WHETHER REGARDLESS OF HOW THE 4581 03:04:30,280 --> 03:04:32,600 WEIGHT LOSS OCCURS, CAN WE USE 4582 03:04:32,600 --> 03:04:35,320 TIME-RESTRICTED FEEDING AS A 4583 03:04:35,320 --> 03:04:36,680 METHOD OF MAINTAINING, THAT 4584 03:04:36,680 --> 03:04:38,680 WOULD BE A CRITICAL TRIAL WHERE 4585 03:04:38,680 --> 03:04:40,480 WE COULD SEE WHAT IS 4586 03:04:40,480 --> 03:04:41,160 EFFECTIVENESS TO MAINTAIN THIS 4587 03:04:41,160 --> 03:04:45,320 AS A BEHAVIOR. 4588 03:04:45,320 --> 03:04:49,320 THAT MAY BE EASIER THAN 4589 03:04:49,320 --> 03:04:50,360 RETAINING CALORIC 4590 03:04:50,360 --> 03:04:52,440 RESTRICTION/PHYSICAL ACTIVITY 4591 03:04:52,440 --> 03:04:52,760 PARADIGM. 4592 03:04:52,760 --> 03:04:53,760 THAT'S A USEFUL TRIAL TO 4593 03:04:53,760 --> 03:05:00,560 CONSIDER. 4594 03:05:00,560 --> 03:05:03,720 >>ONE PROBLEM, YOU CANNOT 4595 03:05:03,720 --> 03:05:06,160 CHANGE YOUR EATING TIMING 4596 03:05:06,160 --> 03:05:08,640 WITHOUT IMPACTING YOUR 4597 03:05:08,640 --> 03:05:09,600 ENVIRONMENT. 4598 03:05:09,600 --> 03:05:11,160 THE FAMILY, THE FRIENDS, SOCIAL 4599 03:05:11,160 --> 03:05:11,360 LIFE. 4600 03:05:11,360 --> 03:05:14,560 SO I THINK THIS IS ALSO AN 4601 03:05:14,560 --> 03:05:15,880 IMPORTANT QUESTION BECAUSE THE 4602 03:05:15,880 --> 03:05:19,280 IDEA IS NOT TO INSULATE YOURSELF 4603 03:05:19,280 --> 03:05:20,760 BECAUSE YOU ARE THE ONE WHO 4604 03:05:20,760 --> 03:05:23,320 WANTS TO CHANGE YOUR HABITS. 4605 03:05:23,320 --> 03:05:24,840 YOU NEED TO BE IN THE COMMUNITY. 4606 03:05:24,840 --> 03:05:28,440 SO I THINK IT'S ALSO AN 4607 03:05:28,440 --> 03:05:30,520 IMPORTANT QUESTION IN BEHAVIORAL 4608 03:05:30,520 --> 03:05:33,480 CHANGES IN THE LONG TERM. 4609 03:05:33,480 --> 03:05:35,360 >>THIS IS SOMETHING THAT BEV 4610 03:05:35,360 --> 03:05:37,440 BROUGHT UP AS WELL, 4611 03:05:37,440 --> 03:05:39,040 INCORPORATING STAKEHOLDERS FOR 4612 03:05:39,040 --> 03:05:40,920 SHIFT WORKERS. 4613 03:05:40,920 --> 03:05:42,240 THE FAMILY, SOCIAL ENVIRONMENT, 4614 03:05:42,240 --> 03:05:45,080 THE WORK ENVIRONMENT, BEING VERY 4615 03:05:45,080 --> 03:05:46,720 IMPORTANT TO HEALTH CARE TEAM 4616 03:05:46,720 --> 03:05:50,520 THAT CARES FOR THESE INDIVIDUALS 4617 03:05:50,520 --> 03:05:54,040 ALSO HAVING SOMETHING TO SAY. 4618 03:05:54,040 --> 03:05:54,680 FRANK, A COMMENT? 4619 03:05:54,680 --> 03:05:59,080 >>YEAH, I WAS THINKING ABOUT 4620 03:05:59,080 --> 03:06:01,280 THIS, ABOUT THE -- I THINK IT 4621 03:06:01,280 --> 03:06:05,440 RELATES TO WHAT KEN BROUGHT UP 4622 03:06:05,440 --> 03:06:09,440 AND RESPONDED TO, WHICH IS THE 4623 03:06:09,440 --> 03:06:11,080 DISTINCTION BETWEEN FOLLOWING A 4624 03:06:11,080 --> 03:06:14,640 DIET VERSUS CHANGING YOUR 4625 03:06:14,640 --> 03:06:16,040 HABITUAL LIFESTYLE. 4626 03:06:16,040 --> 03:06:21,480 A DIET IS SOMETHING PEOPLE CAN'T 4627 03:06:21,480 --> 03:06:21,840 SUSTAIN. 4628 03:06:21,840 --> 03:06:23,800 GENERALLY SPEAKING SHORTER 4629 03:06:23,800 --> 03:06:24,480 INTERVENTION. 4630 03:06:24,480 --> 03:06:25,320 WHEREAS, MARTA CAN SPEAK TO THIS 4631 03:06:25,320 --> 03:06:30,480 BET ISSUE THAN -- BETTER, BUT U 4632 03:06:30,480 --> 03:06:33,200 CAN CHANGE PEOPLE'S HABITS AND 4633 03:06:33,200 --> 03:06:34,840 ADDRESS ADDRESS THE INDIVIDUAL 4634 03:06:34,840 --> 03:06:37,040 ROAD BLOCKS THAT THEY PERSONALLY 4635 03:06:37,040 --> 03:06:39,560 MAY HAVE, TO MAKE IT WORK FOR 4636 03:06:39,560 --> 03:06:41,760 THEM, AND I THINK IT BRINGS IT 4637 03:06:41,760 --> 03:06:45,120 BACK TO QUESTION ONE, BECAUSE IN 4638 03:06:45,120 --> 03:06:47,000 ORDER TO KNOW -- MAYBE EMILY 4639 03:06:47,000 --> 03:06:48,440 SAID IT. 4640 03:06:48,440 --> 03:06:53,240 IN ORDER TO KNOW HOW YOU CAN 4641 03:06:53,240 --> 03:06:57,280 ADOPT IT, IT WAS MENTIONED 4642 03:06:57,280 --> 03:06:58,040 NUTRIENTS COMPOSITION, ET 4643 03:06:58,040 --> 03:06:59,240 CETERA, MAYBE FOR SOME PEOPLE 4644 03:06:59,240 --> 03:07:00,480 CHANGING WHEN THEY EAT IS 4645 03:07:00,480 --> 03:07:01,760 IMPOSSIBLE BECAUSE THEY ARE AT 4646 03:07:01,760 --> 03:07:03,520 WORK, THEY ONLY HAVE THAT SLOT, 4647 03:07:03,520 --> 03:07:06,480 AND THEY WANT TO EAT WITH THEIR 4648 03:07:06,480 --> 03:07:07,920 FAMILY WHEN THEY ARRIVE HOME AND 4649 03:07:07,920 --> 03:07:10,120 THERE IS ONLY ONE TIME THAT 4650 03:07:10,120 --> 03:07:13,200 EVERYBODY CAN DO THAT, AND SO I 4651 03:07:13,200 --> 03:07:16,200 THINK THAT BRINGS US BACK TO 4652 03:07:16,200 --> 03:07:19,400 QUESTION 1, REALLY WHAT 4653 03:07:19,400 --> 03:07:20,720 MECHANISMS ARE MOST IMPORTANT, 4654 03:07:20,720 --> 03:07:22,480 AND IT'S NOT ONE. 4655 03:07:22,480 --> 03:07:25,440 AND WHICH COMBINATION OF FACTORS 4656 03:07:25,440 --> 03:07:27,840 ARE WE CHANGING? 4657 03:07:27,840 --> 03:07:30,800 SO IN OTHER WORDS ADVOCATING FOR 4658 03:07:30,800 --> 03:07:35,840 REALLY BETTER UNDERSTANDING 4659 03:07:35,840 --> 03:07:36,960 FUNDAMENTAL MECHANISTIC 4660 03:07:36,960 --> 03:07:38,040 UNDERPINNINGS OF ONION SLICES 4661 03:07:38,040 --> 03:07:41,960 OR -- HOW DO YOU CALL THEM, 4662 03:07:41,960 --> 03:07:42,440 LEAVES? 4663 03:07:42,440 --> 03:07:52,040 SUCH THAT YOU CAN MAKE THE 4664 03:07:52,040 --> 03:07:52,960 APPROACH INDIVIDUALLY EFFECTIVE 4665 03:07:52,960 --> 03:07:54,880 AND INTEGRATE IT, AS MARTA SAID, 4666 03:07:54,880 --> 03:07:56,400 IN THEIR EVERYDAY LIFE. 4667 03:07:56,400 --> 03:07:59,920 I WANTED TO MAKE A QUICK COMMENT 4668 03:07:59,920 --> 03:08:02,320 THAT I THINK THE SPEAKER VIEW 4669 03:08:02,320 --> 03:08:04,720 ONLY SHOWS SPEAKERS OF JUST NOW. 4670 03:08:04,720 --> 03:08:08,720 I'M FINE WITH THAT BUT NOT ALL 4671 03:08:08,720 --> 03:08:09,920 THE PANELISTS ARE VISIBLE TO THE 4672 03:08:09,920 --> 03:08:18,000 ATTENDEES. 4673 03:08:18,000 --> 03:08:22,040 4674 03:08:22,040 --> 03:08:24,040 >>I AGREE, I LIKE THE IDEA OF 4675 03:08:24,040 --> 03:08:27,040 PEELING THE ONION APART. 4676 03:08:27,040 --> 03:08:27,840 ADDITIONAL PERSPECTIVE, THAT'S 4677 03:08:27,840 --> 03:08:32,280 ONE PATH WE NEED TO TAKE. 4678 03:08:32,280 --> 03:08:34,200 ANOTHER IS THINKING ABOUT 4679 03:08:34,200 --> 03:08:35,560 COMBINED INTERVENTIONS. 4680 03:08:35,560 --> 03:08:39,680 I'M SHARING A CLINICAL TRIAL 4681 03:08:39,680 --> 03:08:40,960 GUIDELINE FOR CIRCADIAN RHYTHM 4682 03:08:40,960 --> 03:08:41,360 DISORDERS. 4683 03:08:41,360 --> 03:08:46,480 WHEN WE LOOK AT MOST EFFECTIVE 4684 03:08:46,480 --> 03:08:50,200 TREATMENT FOR STRATEGIES, JET 4685 03:08:50,200 --> 03:08:51,720 LOG, COMBINED COUNTERMEASURES, 4686 03:08:51,720 --> 03:08:52,920 LOOKING AT COMBINATION OF TIMED 4687 03:08:52,920 --> 03:08:55,880 FOOD AND PHYSICAL ACTIVITY, IN 4688 03:08:55,880 --> 03:08:58,280 THIS CASE NOT THE TRIALS, I'D 4689 03:08:58,280 --> 03:08:59,640 LIKE TO ENCOURAGE US TO CONSIDER 4690 03:08:59,640 --> 03:09:03,440 TRIALS THAT DON'T TRY TO GET AT 4691 03:09:03,440 --> 03:09:04,320 SPECIFIC MECHANISMS BUT TAKE 4692 03:09:04,320 --> 03:09:05,960 WHAT WE KNOW FROM A VARIETY OF 4693 03:09:05,960 --> 03:09:08,360 STRATEGIES WHEN WE'RE READY FOR 4694 03:09:08,360 --> 03:09:09,480 THAT AND COMBINE THESE 4695 03:09:09,480 --> 03:09:10,880 INTERVENTION STRATEGIES TO GET 4696 03:09:10,880 --> 03:09:14,600 LARGER IMPACTS ON OUR OUTCOMES 4697 03:09:14,600 --> 03:09:19,840 THAN JUST FOCUSING ON ONE ASPECT 4698 03:09:19,840 --> 03:09:20,440 OF IT. 4699 03:09:20,440 --> 03:09:22,160 >>YEAH, ONE MORE QUICK THING 4700 03:09:22,160 --> 03:09:23,000 TO ADD. 4701 03:09:23,000 --> 03:09:24,880 I AGREE WITH EVERYTHING THAT WAS 4702 03:09:24,880 --> 03:09:28,400 SAID, BUT I THINK THERE'S TWO 4703 03:09:28,400 --> 03:09:33,240 PIECES, TIME-RESTRICTED MIGHT 4704 03:09:33,240 --> 03:09:34,800 NOT WORK FOR EVERYONE. 4705 03:09:34,800 --> 03:09:38,200 IT MIGHT BE ONE OF MANY, LIKE 4706 03:09:38,200 --> 03:09:42,160 SOME MIGHT HAVE TO BE DIFFERENT 4707 03:09:42,160 --> 03:09:43,800 SHIFTS OR THERE'S MANY WAYS TO 4708 03:09:43,800 --> 03:09:45,760 LIVE A HEALTHY LIFE. 4709 03:09:45,760 --> 03:09:50,160 FIGURING OUT IF IT IS ANOTHER 4710 03:09:50,160 --> 03:09:52,120 SUSTAINABLE OPTION THAT MAYBE 4711 03:09:52,120 --> 03:09:54,440 YOU CANNOT DO CALORIC, NOT IN 4712 03:09:54,440 --> 03:09:56,640 ADDITION JUST ANOTHER HEALTHY 4713 03:09:56,640 --> 03:09:59,800 TASK, THAT GETS BACK TO OTHER 4714 03:09:59,800 --> 03:10:01,760 QUESTIONS BEING ABLE TO IDENTIFY 4715 03:10:01,760 --> 03:10:04,280 WHO IS RESPONSIVE, SOME MIGHT BE 4716 03:10:04,280 --> 03:10:05,000 UNDERSTANDING WHAT SCHEDULE 4717 03:10:05,000 --> 03:10:06,600 LIMITATIONS ARE AND USING THAT 4718 03:10:06,600 --> 03:10:08,800 AS A GUIDE THEN CHOOSING WHICH 4719 03:10:08,800 --> 03:10:10,680 COMBINATIONS OF TREATMENTS TO 4720 03:10:10,680 --> 03:10:13,600 USE. 4721 03:10:13,600 --> 03:10:16,320 >>THAT'S VERY IMPORTANT, 4722 03:10:16,320 --> 03:10:17,920 TARGETING INTERVENTIONS TO THE 4723 03:10:17,920 --> 03:10:19,640 PROPER GROUPS. 4724 03:10:19,640 --> 03:10:20,920 AND THAT'S SOMETHING THAT I 4725 03:10:20,920 --> 03:10:23,000 THINK WE NEED TO CONSIDER ALSO 4726 03:10:23,000 --> 03:10:26,400 IS THAT WHAT ARE OUR 4727 03:10:26,400 --> 03:10:27,960 PARTICIPANTS ALREADY DOING AND 4728 03:10:27,960 --> 03:10:30,680 WHETHER WE'RE INDUCING OR NOT 4729 03:10:30,680 --> 03:10:32,000 INDUCING A CHANGE, SO 4730 03:10:32,000 --> 03:10:33,000 TIME-RESTRICTED EATING MAY BE 4731 03:10:33,000 --> 03:10:38,240 BENEFICIAL IF PEOPLE HAVE A LONG 4732 03:10:38,240 --> 03:10:40,000 EATING WINDOW BUT IF YOU ALREADY 4733 03:10:40,000 --> 03:10:43,400 HAVE A SHORT WINDOW THAT'S NOT 4734 03:10:43,400 --> 03:10:43,720 HELPFUL. 4735 03:10:43,720 --> 03:10:45,880 AT THAT POINT TIMING OF EATING 4736 03:10:45,880 --> 03:10:49,080 WINDOW RATHER THAN DURATION OF 4737 03:10:49,080 --> 03:10:51,360 THE EATING WINDOW, AND SOME WORK 4738 03:10:51,360 --> 03:10:53,560 THAT WAS PRESENTED, COURTNEY, 4739 03:10:53,560 --> 03:10:56,520 RELATED TO EARLY VERSUS LATE 4740 03:10:56,520 --> 03:10:58,360 TIME-RESTRICTED EATING OR LATE 4741 03:10:58,360 --> 03:10:59,680 EATING WINDOW OR EARLY WINDOW 4742 03:10:59,680 --> 03:11:02,320 WITH GREATER BANG FOR YOUR BUCK, 4743 03:11:02,320 --> 03:11:05,160 BASE EQUALLY, IF THE FEEDING 4744 03:11:05,160 --> 03:11:06,600 WINDOW IS EARLIER. 4745 03:11:06,600 --> 03:11:15,560 SOMETHING TO CONSIDER AS WELL. 4746 03:11:15,560 --> 03:11:18,200 >>MAYBE TO KIND OF FOLLOW UP 4747 03:11:18,200 --> 03:11:20,360 ON KEN'S POINT, WHICH I THINK IS 4748 03:11:20,360 --> 03:11:23,080 IMPORTANT, WHICH IS REALLY TO 4749 03:11:23,080 --> 03:11:26,920 CONSIDER NOT JUST IN ISOLATION 4750 03:11:26,920 --> 03:11:29,120 TIMING OF DIET, AND I THINK, 4751 03:11:29,120 --> 03:11:32,840 SETH, YOUR POINT WAS VERY WELL 4752 03:11:32,840 --> 03:11:35,920 TAKEN, WHICH IS THAT IF YOU HAVE 4753 03:11:35,920 --> 03:11:38,520 EXERCISE GOING AT A DIFFERENT 4754 03:11:38,520 --> 03:11:42,880 TIME YOUR MEAL TIMING MAY 4755 03:11:42,880 --> 03:11:44,720 SYSTEMATICICALLY CHANGE, AND SO 4756 03:11:44,720 --> 03:11:49,120 YOU DON'T KNOW WHAT IT'S CAUSED 4757 03:11:49,120 --> 03:11:49,280 BY. 4758 03:11:49,280 --> 03:11:52,880 WE CAN ONLY DO ONE OF THE THREE 4759 03:11:52,880 --> 03:11:54,480 MAIN THINGS, EAT, SLEEP OR 4760 03:11:54,480 --> 03:11:54,880 EXERCISE. 4761 03:11:54,880 --> 03:11:56,920 MOST PEOPLE CAN'T DO ALL THREE 4762 03:11:56,920 --> 03:11:58,000 AT ONCE. 4763 03:11:58,000 --> 03:11:59,320 SO, OBVIOUSLY IF YOU CHANGE ONE, 4764 03:11:59,320 --> 03:12:02,360 THE OTHER IS GOING TO CHANGE. 4765 03:12:02,360 --> 03:12:09,040 WE NEED TO BE COGNIZANT OF THAT 4766 03:12:09,040 --> 03:12:09,920 AND LEVERAGE THAT. 4767 03:12:09,920 --> 03:12:12,200 >>WE'VE BEEN TALKING ABOUT 4768 03:12:12,200 --> 03:12:13,560 CARDIOMETABOLIC RISK FACTORS BUT 4769 03:12:13,560 --> 03:12:15,080 SOMETHING THAT COMES UP THEN IS 4770 03:12:15,080 --> 03:12:17,400 WHAT'S THE IMPACT ON SLEEP. 4771 03:12:17,400 --> 03:12:21,440 WHAT'S THE IMPACT ON SLEEP OF 4772 03:12:21,440 --> 03:12:23,840 SHIFTING EATING WINDOW, SHIFTING 4773 03:12:23,840 --> 03:12:26,560 TIMING OF NUTRIENT INTAKE, 4774 03:12:26,560 --> 03:12:28,280 SHIFTING TIMING OF EXERCISE. 4775 03:12:28,280 --> 03:12:29,840 AND SHOULD WE TALK ABOUT 4776 03:12:29,840 --> 03:12:31,120 DIFFERENT TYPES OF EXERCISE? 4777 03:12:31,120 --> 03:12:35,720 SOMETHING THAT SETH AND I TALKED 4778 03:12:35,720 --> 03:12:36,120 ABOUT. 4779 03:12:36,120 --> 03:12:37,960 DOING EFFECTIVE ACTIVITIES OR 4780 03:12:37,960 --> 03:12:39,880 PREFERRED DIFFERENT ACTIVITIES 4781 03:12:39,880 --> 03:12:42,840 AT DIFFERENT TIMES OF DAY, ALSO 4782 03:12:42,840 --> 03:12:43,960 PREFERRING DIFFERENT NUTRIENT AT 4783 03:12:43,960 --> 03:12:47,240 DIFFERENT TIMES TO IMPROVE 4784 03:12:47,240 --> 03:12:49,200 SLEEP, TO LEVERAGE THAT TO HELP 4785 03:12:49,200 --> 03:12:51,200 PEOPLE ADHERE BETTER TO DIETARY 4786 03:12:51,200 --> 03:12:52,440 GUIDELINES TO EXERCISE 4787 03:12:52,440 --> 03:13:00,400 GUIDELINES AND OTHER HELPFUL 4788 03:13:00,400 --> 03:13:02,120 BEHAVIORS. 4789 03:13:02,120 --> 03:13:05,640 I WANT TO BRING UP THE SECOND 4790 03:13:05,640 --> 03:13:12,080 QUESTION ABOUT SHORT VERSUS 4791 03:13:12,080 --> 03:13:12,840 LONG-TERM OPPORTUNITIES, RIGHT 4792 03:13:12,840 --> 03:13:14,600 NOW AND HOW CAN WE LEVERAGE WHAT 4793 03:13:14,600 --> 03:13:16,680 WE KNOW RIGHT NOW TO THINK ABOUT 4794 03:13:16,680 --> 03:13:19,760 VARIOUS OPPORTUNITIES TO STUDY 4795 03:13:19,760 --> 03:13:21,480 AND APPLY CHRONONUTRITION. 4796 03:13:21,480 --> 03:13:23,240 ARE WE READY TO MAKE 4797 03:13:23,240 --> 03:13:24,600 RECOMMENDATIONS OR NOT THERE 4798 03:13:24,600 --> 03:13:25,040 YET? 4799 03:13:25,040 --> 03:13:27,200 IF WE'RE NOT THERE TO MAKE 4800 03:13:27,200 --> 03:13:30,680 RECOMMENDATIONS WHAT DO WE NEED 4801 03:13:30,680 --> 03:13:39,120 TO GET THERE? 4802 03:13:39,120 --> 03:13:40,880 >> I COULD START ONE THING. 4803 03:13:40,880 --> 03:13:42,400 I MENTIONED IN THE DISCUSSION IN 4804 03:13:42,400 --> 03:13:44,600 THE LAST SECTION THAT EATING 4805 03:13:44,600 --> 03:13:46,480 LATER IN THE EVENING HOURS FOR 4806 03:13:46,480 --> 03:13:48,200 DAY WORKERS IS SOMETHING THAT WE 4807 03:13:48,200 --> 03:13:49,640 CAN CLEARLY RECOMMEND RIGHT NOW. 4808 03:13:49,640 --> 03:13:51,880 I DON'T THINK THERE'S ANY 4809 03:13:51,880 --> 03:13:53,680 EVIDENCE OUT THERE TO SAY EATING 4810 03:13:53,680 --> 03:13:55,360 LATE IS GOOD FOR OUR HEALTH. 4811 03:13:55,360 --> 03:13:57,640 I THINK THAT IS A RECOMMENDATION 4812 03:13:57,640 --> 03:13:59,480 THAT WE CAN ACTUALLY START TO 4813 03:13:59,480 --> 03:14:01,600 EDUCATE IN THE GENERAL PUBLIC, 4814 03:14:01,600 --> 03:14:09,680 AND ALSO TRY TO INCORPORATE THAT 4815 03:14:09,680 --> 03:14:11,280 INTO, YOU KNOW, RECOMMENDATIONS 4816 03:14:11,280 --> 03:14:14,680 IN SOCIETIES THAT ALL OF US ARE 4817 03:14:14,680 --> 03:14:17,240 PART OF. 4818 03:14:17,240 --> 03:14:21,160 I THINK LOW-HANGING FRUIT, I 4819 03:14:21,160 --> 03:14:25,160 THINK WE'VE HEARD TRYING TO 4820 03:14:25,160 --> 03:14:27,760 BETTER ARTICULATE HOW WE'RE 4821 03:14:27,760 --> 03:14:29,080 DEFINING THINGS AS LOW-HANGING 4822 03:14:29,080 --> 03:14:30,640 FRUIT, IT'S BETTER TO GO AHEAD 4823 03:14:30,640 --> 03:14:32,240 AND DO THINGS RELATED TO 4824 03:14:32,240 --> 03:14:34,240 BIOLOGICAL TIME WHETHER WE START 4825 03:14:34,240 --> 03:14:36,200 JUST BY OUR TIME-RESTRICTED 4826 03:14:36,200 --> 03:14:40,560 EATING STUDIES AND PHYSICAL 4827 03:14:40,560 --> 03:14:42,440 ACTIVITY STUDIES RELATIVE TO 4828 03:14:42,440 --> 03:14:43,920 BEDTIME, RATHER THAN CLOCK ON 4829 03:14:43,920 --> 03:14:46,800 THE WALL, A LOW-HANGING FRUIT TO 4830 03:14:46,800 --> 03:14:49,960 INCORPORATE MORE NOW, AS WE GET 4831 03:14:49,960 --> 03:14:52,040 MORE SOPHISTICATED DOING THINGS 4832 03:14:52,040 --> 03:14:53,800 RELATED TO CIRCADIAN TIME. 4833 03:14:53,800 --> 03:14:56,560 SO WE CAN TAKE VARIOUS STEPS 4834 03:14:56,560 --> 03:14:59,960 RIGHT NOW, SOME IMMEDIATE 4835 03:14:59,960 --> 03:15:02,120 LONG-TERM THINGS. 4836 03:15:02,120 --> 03:15:03,200 THE OTHER LOW-HANGING FRUIT TO 4837 03:15:03,200 --> 03:15:06,240 MENTION WE NEED TO THINK ABOUT 4838 03:15:06,240 --> 03:15:10,320 WHEN WE THINK OF CIRCADIAN TIME 4839 03:15:10,320 --> 03:15:13,160 WE FOCUS ON DOMO, THE MOST 4840 03:15:13,160 --> 03:15:14,680 COMMONLY USED STANDARD BUT 4841 03:15:14,680 --> 03:15:18,760 THERE'S MORE EVIDENCE NOW FROM 4842 03:15:18,760 --> 03:15:22,840 VARIETY OF LABORATORIES SHOWING 4843 03:15:22,840 --> 03:15:25,360 TIMING BIOLOGY ENDS AT NIGHT IS 4844 03:15:25,360 --> 03:15:26,120 IMPORTANT, ESPECIALLY TALKING 4845 03:15:26,120 --> 03:15:28,320 WHEN DO WE START EATING OR 4846 03:15:28,320 --> 03:15:30,960 BECOMING PHYSICALLY ACTIVE. 4847 03:15:30,960 --> 03:15:34,320 IN OUR HANDS, MELATONIN ONSET 4848 03:15:34,320 --> 03:15:37,680 TURNS OFF AFTER WAIT TIME MORE 4849 03:15:37,680 --> 03:15:39,360 THAN AN HOUR IN 25%, MORE IN THE 4850 03:15:39,360 --> 03:15:41,000 HOUR AFTER WE WAKE UP. 4851 03:15:41,000 --> 03:15:42,520 WE WANT TO THINK ABOUT THOSE 4852 03:15:42,520 --> 03:15:48,120 THINGS TOO IN TERMS OF HOW WE 4853 03:15:48,120 --> 03:15:48,800 TIME OUR STUDIES. 4854 03:15:48,800 --> 03:15:52,600 >>I'D LIKE TO FOLLOW UP. 4855 03:15:52,600 --> 03:15:53,920 HOW LATE IS LATE? 4856 03:15:53,920 --> 03:15:56,320 THIS WAS BROUGHT UP YESTERDAY. 4857 03:15:56,320 --> 03:15:57,560 WE'RE LOOKING AT FASTING. 4858 03:15:57,560 --> 03:16:00,480 DO WE WANT TO TALK ABOUT NUMBER 4859 03:16:00,480 --> 03:16:02,200 OF CALORIES BEING CONSUMED AFTER 4860 03:16:02,200 --> 03:16:05,400 5 P.M., 8 P.M., WITHIN AN HOUR 4861 03:16:05,400 --> 03:16:08,240 BEFORE GOING TO BED, TWO OR 4862 03:16:08,240 --> 03:16:11,080 THREE HOURS BEFORE GOING TO BED? 4863 03:16:11,080 --> 03:16:16,440 WHAT ARE OUR PARAMETERS THERE IN 4864 03:16:16,440 --> 03:16:17,520 TERMS OF RECOMMENDATIONS? 4865 03:16:17,520 --> 03:16:19,200 >>I'LL JUST ADD SOMETHING AS 4866 03:16:19,200 --> 03:16:20,280 WELL. 4867 03:16:20,280 --> 03:16:25,000 MORE RELATED TO OBSERVATIONAL 4868 03:16:25,000 --> 03:16:27,320 RESEARCH, THINKING OF IMPORTANT 4869 03:16:27,320 --> 03:16:29,840 OPPORTUNITIES FOR STUDIES, DIET 4870 03:16:29,840 --> 03:16:32,440 AND ONGOING, A LOT OF 4871 03:16:32,440 --> 03:16:33,680 CARDIOVASCULAR DISEASE FOCUS 4872 03:16:33,680 --> 03:16:36,000 COHORT STUDIES ARE OVERDUE FOR 4873 03:16:36,000 --> 03:16:36,720 DIET ASSESSMENT, AND I THINK 4874 03:16:36,720 --> 03:16:39,040 IT'S GOING TO BE IMPORTANT TO 4875 03:16:39,040 --> 03:16:42,920 MAKE SURE THAT IN ANCILLARY 4876 03:16:42,920 --> 03:16:45,160 STUDIES THERE IS SOME MEASURE OF 4877 03:16:45,160 --> 03:16:51,560 WHEN WE EAT AND NOT JUST WHAT WE 4878 03:16:51,560 --> 03:16:52,200 EAT. 4879 03:16:52,200 --> 03:16:54,080 ANOTHER IMPORTANT OPPORTUNITY IS 4880 03:16:54,080 --> 03:16:57,360 PROBABLY MORE INNOVATION AND 4881 03:16:57,360 --> 03:16:58,160 DIETARY ASSESSMENT METHODS. 4882 03:16:58,160 --> 03:17:01,120 THE DREAM WOK TO HAVE A TOOL 4883 03:17:01,120 --> 03:17:04,040 THAT IS JUST LIKE ASA 24 4884 03:17:04,040 --> 03:17:07,960 PUBLICLY AVAILABLE, WIDELY 4885 03:17:07,960 --> 03:17:09,160 AVAILABLE, FREE. 4886 03:17:09,160 --> 03:17:11,200 AND VALIDATE IT BUT ALSO WORKS 4887 03:17:11,200 --> 03:17:13,000 LIKE COMMERCIAL APPS WHERE 4888 03:17:13,000 --> 03:17:15,000 PEOPLE CAN TAKE PICTURES OR SCAN 4889 03:17:15,000 --> 03:17:16,800 AND THERE'S NOT AS MUCH 4890 03:17:16,800 --> 03:17:18,040 PARTICIPANT BURDEN. 4891 03:17:18,040 --> 03:17:21,440 I THINK THAT WILL MAKE DIETARY 4892 03:17:21,440 --> 03:17:23,200 ASSESSMENT MUCH EASIER, ALSO 4893 03:17:23,200 --> 03:17:26,360 MAKES SELF-MONITORING EASIER 4894 03:17:26,360 --> 03:17:27,600 WHICH CAN IMPROVE LONG-TERM 4895 03:17:27,600 --> 03:17:36,120 OUTCOMES FOR CLINICAL TRIALS. 4896 03:17:36,120 --> 03:17:37,720 >>THANK YOU. 4897 03:17:37,720 --> 03:17:39,560 >>I'LL ADD ANOTHER LOW-HANGING 4898 03:17:39,560 --> 03:17:42,240 FRUIT, TO ELABORATE SOMETHING ON 4899 03:17:42,240 --> 03:17:45,640 DR. WRIGHT MENTIONED, 4900 03:17:45,640 --> 03:17:48,280 APPLICATION OF CHRONONUTRITION 4901 03:17:48,280 --> 03:17:52,320 IN A CLINICAL SITTING, A LOT OF 4902 03:17:52,320 --> 03:17:57,120 PATIENTS WHO RECEIVE ENTERAL 4903 03:17:57,120 --> 03:17:59,680 TUBE FEEDS OR PARENTERAL ARE FED 4904 03:17:59,680 --> 03:18:02,840 OVERNIGHT OR ACROSS 24 HOURS, 4905 03:18:02,840 --> 03:18:05,440 AND THERE'S REALLY NO REASON FOR 4906 03:18:05,440 --> 03:18:06,880 THAT TO HAPPEN AROUND 4907 03:18:06,880 --> 03:18:08,400 CONVENIENCE. 4908 03:18:08,400 --> 03:18:11,560 THAT'S A HUGE OPPORTUNITY TO 4909 03:18:11,560 --> 03:18:13,560 START INTERVENING IN A CLINICAL 4910 03:18:13,560 --> 03:18:14,600 SETTING, APPLYING 4911 03:18:14,600 --> 03:18:16,080 CHRONONUTRITION IN A MEDICAL 4912 03:18:16,080 --> 03:18:19,000 SETTING, TO SEE WHAT EFFECTS 4913 03:18:19,000 --> 03:18:21,640 OPTIMIZE TIMING OF THOSE FEEDS 4914 03:18:21,640 --> 03:18:26,400 ON NOT ONLY SLEEP AND OUTCOMES 4915 03:18:26,400 --> 03:18:31,840 BUT ALSO ENDPOINTS THAT ARE 4916 03:18:31,840 --> 03:18:32,880 IMPORTANT FOR A HOSPITAL. 4917 03:18:32,880 --> 03:18:35,880 THERE ARE ONGOING TRIALS ON THIS 4918 03:18:35,880 --> 03:18:42,000 BUT THE GENERAL APPLICATION OF 4919 03:18:42,000 --> 03:18:42,760 CHRONONUTRITION INTO MEDICAL 4920 03:18:42,760 --> 03:18:43,040 SETTINGS. 4921 03:18:43,040 --> 03:18:44,520 >> I TEND TO TAKE MORE OF A 4922 03:18:44,520 --> 03:18:48,160 CONSERVATIVE VIEW ON WHEN WE 4923 03:18:48,160 --> 03:18:49,960 TRANSLATE THINGS INTO CLINICAL 4924 03:18:49,960 --> 03:18:50,280 GUIDELINES. 4925 03:18:50,280 --> 03:18:53,040 I THINK ONE OF THE QUESTIONS NOW 4926 03:18:53,040 --> 03:18:53,800 IS ADHERENCE. 4927 03:18:53,800 --> 03:19:04,480 WE'VE SEEN IN GREAT SHORT-TERM 4928 03:19:04,480 --> 03:19:05,640 ADHERENCE EVAPORATES AT ONE 4929 03:19:05,640 --> 03:19:06,040 YEAR. 4930 03:19:06,040 --> 03:19:07,600 WE'LL BE READY IN MAYBE TWO TO 4931 03:19:07,600 --> 03:19:10,880 FIVE YEARS BUT THERE'S LAYERS OF 4932 03:19:10,880 --> 03:19:16,240 THE ONION TO TEASE APART AND 4933 03:19:16,240 --> 03:19:19,960 UNDERSTAND WHAT WORTH TESTING IN 4934 03:19:19,960 --> 03:19:21,360 A MULTI-CENTER TRIAL, AND 4935 03:19:21,360 --> 03:19:26,080 ENDPOINT WEIGHT LOSS PERHAPS THE 4936 03:19:26,080 --> 03:19:28,400 MOST STUDIED ENDPOINT OR PICK 4937 03:19:28,400 --> 03:19:30,320 PREVENTING REGRESSION FROM 4938 03:19:30,320 --> 03:19:33,320 PREDIABETES TO TYPE 2 DIABETES 4939 03:19:33,320 --> 03:19:35,200 OR SAME THING WITH BLOOD 4940 03:19:35,200 --> 03:19:36,960 PRESSURE AND PRE-HYPERTENSION TO 4941 03:19:36,960 --> 03:19:37,720 HYPERTENSION, SOMETHING ALONG 4942 03:19:37,720 --> 03:19:38,080 THOSE LINES. 4943 03:19:38,080 --> 03:19:41,000 I DON'T KNOW YET WHAT WOULD BE 4944 03:19:41,000 --> 03:19:44,160 THE RIGHT PRIMARY ENDPOINT FOR A 4945 03:19:44,160 --> 03:19:45,040 LARGE MULTI-CENTER TRIAL. 4946 03:19:45,040 --> 03:19:48,240 I THINK WE SHOULD BE READY FOR 4947 03:19:48,240 --> 03:19:49,280 THE ONE-YEAR-LONG STUDIES. 4948 03:19:49,280 --> 03:19:52,200 I ALMOST WANT TO SEE, BACK TO 4949 03:19:52,200 --> 03:19:53,640 FRANK AND OTHER PANELIST POINTS, 4950 03:19:53,640 --> 03:19:56,960 CAN WE BETTER TEASE APART WHICH 4951 03:19:56,960 --> 03:19:58,440 LAYERS ARE MOST IMPORTANT. 4952 03:19:58,440 --> 03:20:04,600 IS IT THE CONSISTENCY OF MEAL 4953 03:20:04,600 --> 03:20:05,440 TIMES, FASTING TIME, MEAL 4954 03:20:05,440 --> 03:20:08,280 DURATION, IF WE PROCEED TO A 4955 03:20:08,280 --> 03:20:10,160 MULTI-CENTER STUDY WE ALREADY 4956 03:20:10,160 --> 03:20:14,000 KNOW WE -- IT'S LIKE A PHARMA 4957 03:20:14,000 --> 03:20:15,200 TRIAL, THE RIGHT DOSE, IN THIS 4958 03:20:15,200 --> 03:20:17,160 CASE THE RIGHT DESIGN OF MEAL 4959 03:20:17,160 --> 03:20:18,360 TIMING INTERVENTION. 4960 03:20:18,360 --> 03:20:20,320 DO WE KNOW WHAT THE RIGHT NUMBER 4961 03:20:20,320 --> 03:20:22,200 OF HOURS OF DIFFERENCE WE WANT 4962 03:20:22,200 --> 03:20:25,720 BETWEEN THE CONTROL GROUP AND 4963 03:20:25,720 --> 03:20:27,760 TRE GROUP, 8 VERSUS 12 HOURS, WE 4964 03:20:27,760 --> 03:20:29,840 HAVE A LOT OF OPEN QUESTIONS WE 4965 03:20:29,840 --> 03:20:36,400 NEED TO DO TO FIGURE OUT MORE 4966 03:20:36,400 --> 03:20:38,840 ANSWERS BEFORE WE PROCEED TO 4967 03:20:38,840 --> 03:20:39,920 NUMBER 3, DEFINITIVE 4968 03:20:39,920 --> 03:20:41,200 EVIDENCE-BASED CLINICAL TRIAL. 4969 03:20:41,200 --> 03:20:43,440 WE'RE CERTAINLY READY TO PROCEED 4970 03:20:43,440 --> 03:20:44,960 TO A ONE-YEAR-LONG TRIAL THAT 4971 03:20:44,960 --> 03:20:48,320 MIGHT BE A SINGLE SITE OR 4972 03:20:48,320 --> 03:20:48,680 TWO-CITED STUDY. 4973 03:20:48,680 --> 03:20:53,120 >>I AGREE WITH YOU, COURTNEY. 4974 03:20:53,120 --> 03:20:57,200 ONE RISK THE COMMUNITY FACES IS 4975 03:20:57,200 --> 03:20:58,960 THAT IF THIS IS PRESENTED AS 4976 03:20:58,960 --> 03:21:01,760 BEING THE DEFINITIVE TRIAL AND 4977 03:21:01,760 --> 03:21:04,840 WE HAVEN'T WORKED OUT THE KINKS 4978 03:21:04,840 --> 03:21:07,800 AND IT LAUNCHES, EITHER DUE TO 4979 03:21:07,800 --> 03:21:11,400 CHALLENGES WITH ADHERENCE OR DUE 4980 03:21:11,400 --> 03:21:14,360 TO CONFOUNDERS, THE TRIAL ENDS 4981 03:21:14,360 --> 03:21:17,760 UP BEING NEGATIVE OR NEGATIVE, 4982 03:21:17,760 --> 03:21:20,720 YOU KNOW, ADVERSE, THEN WE'RE 4983 03:21:20,720 --> 03:21:23,760 BACK, YOU KNOW, DECADES. 4984 03:21:23,760 --> 03:21:26,920 I THINK THERE IS A REAL RISK OF 4985 03:21:26,920 --> 03:21:29,680 MOVING TOO FAST, AND SO IT FEELS 4986 03:21:29,680 --> 03:21:32,520 LIKE THINGS MAY BE MOVING SLOW 4987 03:21:32,520 --> 03:21:33,520 FOR CERTAIN PEOPLE. 4988 03:21:33,520 --> 03:21:34,480 BUT I THINK THERE'S A GOOD 4989 03:21:34,480 --> 03:21:36,920 REASON FOR THAT. 4990 03:21:36,920 --> 03:21:39,080 IT'S BECAUSE IT'S COMPLEX. 4991 03:21:39,080 --> 03:21:42,480 IT'S NOT JUST -- MANY ASPECT OF 4992 03:21:42,480 --> 03:21:44,040 NUTRITION ITSELF, ALL ITS 4993 03:21:44,040 --> 03:21:45,960 FACETS, BUT AS WE DISCUSSED 4994 03:21:45,960 --> 03:21:51,320 THERE ARE MANY OTHER BEHAVIORS 4995 03:21:51,320 --> 03:21:55,400 THAT ARE TIED IN TO ANY 4996 03:21:55,400 --> 03:21:58,440 MANIPULATION AND SO ANY OTHER 4997 03:21:58,440 --> 03:22:06,360 ASPECT, PERSONALIZED ASPECT, 4998 03:22:06,360 --> 03:22:08,560 IT'S GENETICS, WORK AND SCHOOL 4999 03:22:08,560 --> 03:22:11,160 SCHEDULE, ENVIRONMENT, AGE AND 5000 03:22:11,160 --> 03:22:11,400 DISEASE. 5001 03:22:11,400 --> 03:22:13,880 YEAH, I SHARE YOUR CAUTIOUS 5002 03:22:13,880 --> 03:22:20,240 NATURE THAT WE CERTAINLY -- A 5003 03:22:20,240 --> 03:22:21,560 YEAR, YES, BUT DEFINITIVE NOT 5004 03:22:21,560 --> 03:22:26,680 FROM MY PERSPECTIVE. 5005 03:22:26,680 --> 03:22:31,640 >>A GREAT EXAMPLE IS 5006 03:22:31,640 --> 03:22:32,320 BREAKFASTER CONSUMPTION, 5007 03:22:32,320 --> 03:22:35,680 RELUCTANT TO ISSUE A SIMPLE 5008 03:22:35,680 --> 03:22:37,640 GUIDELINES ON EAT BREAKFAST OR 5009 03:22:37,640 --> 03:22:40,960 NOT, NOT KNOWING OTHER 5010 03:22:40,960 --> 03:22:41,240 CONFOUNDERS. 5011 03:22:41,240 --> 03:22:42,280 >>GREAT POINTS. 5012 03:22:42,280 --> 03:22:45,760 WE CAN MAYBE LEVERAGE SOME OF 5013 03:22:45,760 --> 03:22:46,600 THE REALLY TIGHTLY CONTROLLED 5014 03:22:46,600 --> 03:22:48,720 TRIALS THAT I WAS SORT OF 5015 03:22:48,720 --> 03:22:50,440 ALLUDING TO TO TEASE APART, BUT 5016 03:22:50,440 --> 03:22:55,920 ALSO BEFORE THE LARGE SCALE 5017 03:22:55,920 --> 03:22:57,360 TRIAL WE NEED EVIDENCE FOR 5018 03:22:57,360 --> 03:23:00,640 MULTIPLE LINES, SO NOT ONLY LIKE 5019 03:23:00,640 --> 03:23:03,520 THE ONE-YEAR TYPES OF TRIALS BUT 5020 03:23:03,520 --> 03:23:09,080 SHORTER-TERM ONE TO TWO WEEK 5021 03:23:09,080 --> 03:23:12,160 TRIALS, MAYBE EPIDEMIOLOGIC 5022 03:23:12,160 --> 03:23:15,320 EVIDENCE, CONVERGING ON THE SAME 5023 03:23:15,320 --> 03:23:17,160 IDEA, WHAT IS THE ACTUAL PRIMARY 5024 03:23:17,160 --> 03:23:22,000 ENDPOINT WE WANT TO LOOK AT. 5025 03:23:22,000 --> 03:23:24,640 I AGREE IT MIGHT BE FRUSTRATING 5026 03:23:24,640 --> 03:23:27,040 TO GO SLOW BUT WISE TO GO SLOW 5027 03:23:27,040 --> 03:23:28,880 BEFORE WE TRIP OURSELVES UP 5028 03:23:28,880 --> 03:23:32,280 GETTING TOO FAR AHEAD OF 5029 03:23:32,280 --> 03:23:33,080 OURSELVES. 5030 03:23:33,080 --> 03:23:40,360 >>I COULD MAKE ONE COMMENT ON 5031 03:23:40,360 --> 03:23:40,720 THAT. 5032 03:23:40,720 --> 03:23:43,960 I THINK WE HAVE TO HAVE LONG 5033 03:23:43,960 --> 03:23:46,280 TERM GOALS AND NEEDS TO MAKE 5034 03:23:46,280 --> 03:23:48,240 STRONG RECOMMENDATIONS IN THE 5035 03:23:48,240 --> 03:23:51,000 FUTURE, BUT I ALSO THINK WE HAVE 5036 03:23:51,000 --> 03:23:52,520 OPPORTUNITIES NOW WITH THE 5037 03:23:52,520 --> 03:23:55,680 INTEREST NOT ONLY BY THE NIH BUT 5038 03:23:55,680 --> 03:23:57,440 ALSO BY THE PUBLIC, CONCEPT OF 5039 03:23:57,440 --> 03:23:59,000 TIMING OF THINGS THESE DAYS 5040 03:23:59,000 --> 03:24:01,160 WHERE WE CAN MAKE GENERAL 5041 03:24:01,160 --> 03:24:01,920 RECOMMENDATIONS. 5042 03:24:01,920 --> 03:24:07,440 IT DOESN'T MEAN WE'LL BE 100% 5043 03:24:07,440 --> 03:24:11,640 CAN BEING -- ACCURATE. 5044 03:24:11,640 --> 03:24:15,200 SMOKING IS BAD BASED ON EVIDENCE 5045 03:24:15,200 --> 03:24:16,840 OVER THE YEARS, WE CAN START NOW 5046 03:24:16,840 --> 03:24:18,160 AND EVIDENCE MAY CHANGE. 5047 03:24:18,160 --> 03:24:20,200 I'LL USE BLOOD PRESSURE AS AN 5048 03:24:20,200 --> 03:24:20,480 EXAMPLE. 5049 03:24:20,480 --> 03:24:26,120 IT USED TO BE OVER 200 TO BE 5050 03:24:26,120 --> 03:24:28,960 SYSTOLIC, THAT'S NOT THE CASE 5051 03:24:28,960 --> 03:24:29,200 ANYMORE. 5052 03:24:29,200 --> 03:24:31,720 AGAIN, BACK TO THERE ARE MAYBE 5053 03:24:31,720 --> 03:24:34,760 LOW-HANGING FRUIT THAT WE CAN 5054 03:24:34,760 --> 03:24:36,280 MAKE SOME TRANSLATION SO WORK 5055 03:24:36,280 --> 03:24:38,400 ELEGANTLY SHOWED IF YOU JUST 5056 03:24:38,400 --> 03:24:39,720 HAVE EARLIER TIMED FOOD INTAKE 5057 03:24:39,720 --> 03:24:41,480 IN WEIGHT LOSS PROGRAMS THAT'S A 5058 03:24:41,480 --> 03:24:43,760 RECOMMENDATION THAT WE CAN START 5059 03:24:43,760 --> 03:24:47,280 WITH NOW TO GO AHEAD AND 5060 03:24:47,280 --> 03:24:50,000 TRANSLATE TO THE PUBLIC, 5061 03:24:50,000 --> 03:24:52,120 MESSAGES THAT EARLIER TIMING IS 5062 03:24:52,120 --> 03:24:55,960 A HEALTHIER PATTERN HERE. 5063 03:24:55,960 --> 03:24:58,240 AND THEN LET THE SCIENCE BUILD 5064 03:24:58,240 --> 03:24:58,600 FROM THERE. 5065 03:24:58,600 --> 03:25:01,520 >> I AGREE. 5066 03:25:01,520 --> 03:25:03,240 VERY LOW-HANGING FRUIT. 5067 03:25:03,240 --> 03:25:04,880 THE OTHER THING NOT ALWAYS 5068 03:25:04,880 --> 03:25:08,280 UNDERSTOOD IN THE PUBLIC OR 5069 03:25:08,280 --> 03:25:10,840 OUTSIDE BIOLOGY IS CONCEPT WE 5070 03:25:10,840 --> 03:25:13,880 BROUGHT UP, IT'S NOT JUST THE 5071 03:25:13,880 --> 03:25:16,280 WALL, RELATIVE EARLIER EATING 5072 03:25:16,280 --> 03:25:17,600 FOR YOU, SOMETIMES PEOPLE PUSH 5073 03:25:17,600 --> 03:25:19,240 TOO EARLY OR TOO LATE. 5074 03:25:19,240 --> 03:25:21,240 THEY THINK IT HAS TO BE 6 A.M. 5075 03:25:21,240 --> 03:25:24,720 IF THEY WAKE UP AT 7 OR 8 THAT 5076 03:25:24,720 --> 03:25:27,920 MAKES NO SENSE. 5077 03:25:27,920 --> 03:25:28,880 PUSHING OUT GOOD CONTEXTUAL 5078 03:25:28,880 --> 03:25:30,840 INFORMATION ABOUT WHAT WE MEAN 5079 03:25:30,840 --> 03:25:32,800 BY EARLIER IS AN IMPORTANT THING 5080 03:25:32,800 --> 03:25:42,360 TO DO AS WELL. 5081 03:25:42,360 --> 03:25:46,280 >>BRINGING IN BASIC SCIENCE, 5082 03:25:46,280 --> 03:25:47,680 TALKING ABOUT CLINICAL RESEARCH, 5083 03:25:47,680 --> 03:25:49,720 HOW CAN WE LEVERAGE ANIMAL 5084 03:25:49,720 --> 03:25:52,960 RESEARCH TO HELP US GET CLOSER 5085 03:25:52,960 --> 03:25:57,560 TO OUR GOALS FOR MAKING 5086 03:25:57,560 --> 03:26:03,920 RECOMMENDATIONS AND ADDRESSING 5087 03:26:03,920 --> 03:26:05,360 MECHANISMS? 5088 03:26:05,360 --> 03:26:05,560 FRANK? 5089 03:26:05,560 --> 03:26:08,200 >>YEAH, I THINK ONE -- TWO BIG 5090 03:26:08,200 --> 03:26:11,480 BENEFITS OF ANIMAL EXPERIMENTAL 5091 03:26:11,480 --> 03:26:14,840 WORK IS, ONE, DEPTH OF 5092 03:26:14,840 --> 03:26:16,480 MECHANISTIC QUESTIONS, HOW WE 5093 03:26:16,480 --> 03:26:18,600 CAN ADDRESS THOSE IS EASIER IN 5094 03:26:18,600 --> 03:26:20,320 ANIMAL EXPERIMENTAL WORK 5095 03:26:20,320 --> 03:26:24,320 COMPARED TO HUMANS. 5096 03:26:24,320 --> 03:26:27,040 THE OTHER IS THIS AMOUNT OF 5097 03:26:27,040 --> 03:26:30,400 TIME, EFFORT, AND MONEY IT TAKES 5098 03:26:30,400 --> 03:26:31,720 TO -- ESPECIALLY IF ONE MOVES 5099 03:26:31,720 --> 03:26:35,680 NOT JUST TO RODENT STUDIES BUT 5100 03:26:35,680 --> 03:26:40,200 LET'S SAY DROSOPHILA MODELS OR 5101 03:26:40,200 --> 03:26:42,960 OTHER ANIMAL MODELS THAT ARE -- 5102 03:26:42,960 --> 03:26:46,320 HAVE A SHORTER LIFESPAN, REQUIRE 5103 03:26:46,320 --> 03:26:50,280 MUCH LESS HOUSING THAN A HUMAN 5104 03:26:50,280 --> 03:26:52,480 IN CONTROLLED STUDIES OR IN 5105 03:26:52,480 --> 03:26:54,240 FIELD-BASED STUDIES. 5106 03:26:54,240 --> 03:26:57,840 SO I THINK THOSE TWO -- CIRCLING 5107 03:26:57,840 --> 03:26:59,840 BACK TO CHRIS' POINT, YES, I 5108 03:26:59,840 --> 03:27:00,920 THINK THAT'S EXACTLY WHAT I 5109 03:27:00,920 --> 03:27:03,200 THINK AS WELL. 5110 03:27:03,200 --> 03:27:04,960 IF WE HAVE EVIDENCE FROM 5111 03:27:04,960 --> 03:27:06,960 MULTIPLE ANGLES, THINKING ABOUT 5112 03:27:06,960 --> 03:27:10,440 ANIMAL EXPERIMENTAL WORK, 5113 03:27:10,440 --> 03:27:13,960 CONTROLLED HUMAN TRIALS, EPI 5114 03:27:13,960 --> 03:27:18,680 WORK, IDEALLY LONGITUDINAL EPI, 5115 03:27:18,680 --> 03:27:21,520 THEN WE STRENGTHEN OUR OWN 5116 03:27:21,520 --> 03:27:24,920 CONVICTION THIS IS A SOLID 5117 03:27:24,920 --> 03:27:25,280 INTERVENTION. 5118 03:27:25,280 --> 03:27:29,400 AND SO, YOU KNOW, JOE'S WORK 5119 03:27:29,400 --> 03:27:31,800 WHERE HE CLEANLY LAID OUT THE 5120 03:27:31,800 --> 03:27:34,520 SEPARATE CONTRIBUTIONS OF 5121 03:27:34,520 --> 03:27:35,840 CALORIE RESTRICTION, DURATION 5122 03:27:35,840 --> 03:27:39,200 AND TIMING, IS ONE EXAMPLE OF 5123 03:27:39,200 --> 03:27:42,360 HOW AS A FIELD WORKING TOGETHER 5124 03:27:42,360 --> 03:27:44,920 WE CAN MAKE GREAT ADVANCES. 5125 03:27:44,920 --> 03:27:47,120 AND SO, YEAH, I CERTAINLY THINK 5126 03:27:47,120 --> 03:27:49,200 THERE'S IMPORTANT ROLE FOR 5127 03:27:49,200 --> 03:27:49,680 ANIMAL EXPERIMENTAL WORK 5128 03:27:49,680 --> 03:27:54,120 RECOGNIZING US A -- AS ALWAYS, 5129 03:27:54,120 --> 03:28:03,960 WITH ANY APPROACH, THERE ARE 5130 03:28:03,960 --> 03:28:04,280 LIMITATIONS. 5131 03:28:04,280 --> 03:28:05,800 >>ANYTHING ELSE? 5132 03:28:05,800 --> 03:28:06,000 MATT? 5133 03:28:06,000 --> 03:28:08,200 >>I ALLUDED TO THIS BRIEFLY 5134 03:28:08,200 --> 03:28:09,640 YESTERDAY ABOUT THE ISSUE OF 5135 03:28:09,640 --> 03:28:12,800 BODY SIZE AND HOW THAT AFFECTS 5136 03:28:12,800 --> 03:28:14,760 OUR METABOLISM. 5137 03:28:14,760 --> 03:28:16,760 AND WHEN WE THINK ABOUT THIS 5138 03:28:16,760 --> 03:28:19,400 FAST WE IMPOSE ON ANIMALS, WE DO 5139 03:28:19,400 --> 03:28:23,120 NEED TO BE CAREFUL WE'RE NOT 5140 03:28:23,120 --> 03:28:25,720 USING -- I THINK TYPICAL ANIMAL 5141 03:28:25,720 --> 03:28:27,800 EXPERIMENTS ARE OFTEN 12-HOUR 5142 03:28:27,800 --> 03:28:29,240 FAST, 12-HOUR FEEDING, IN THIS 5143 03:28:29,240 --> 03:28:31,720 DOMAIN AT LEAST. 5144 03:28:31,720 --> 03:28:33,160 AND THOSE 12-HOUR FASTS ARE LONG 5145 03:28:33,160 --> 03:28:35,760 FOR THE MICE. 5146 03:28:35,760 --> 03:28:39,280 THERE HAVE BEEN RECOMMENDATIONS 5147 03:28:39,280 --> 03:28:40,200 FROM THE NUTRITION 5148 03:28:40,200 --> 03:28:41,240 ENDOCRINOLOGIST THAT WE 5149 03:28:41,240 --> 03:28:42,560 SHOULDN'T BE DOING OVERNIGHT 5150 03:28:42,560 --> 03:28:46,080 FASTS FOR MICE, IF WE WANT TO 5151 03:28:46,080 --> 03:28:49,920 LOOK AT FASTING GLUCOSE OR 5152 03:28:49,920 --> 03:28:51,440 GLUCOSE OR INSULIN TOLERANCE 5153 03:28:51,440 --> 03:28:54,600 TESTS, THAT'S TOO LONG, WE'RE 5154 03:28:54,600 --> 03:28:57,000 GETTING TO STARVATION PROTECTION 5155 03:28:57,000 --> 03:28:58,040 MECHANISM MODE. 5156 03:28:58,040 --> 03:29:00,520 SOME WORK WITH ANIMALS WHERE WE 5157 03:29:00,520 --> 03:29:05,680 TRY AND REDUCE FASTING INTERVALS 5158 03:29:05,680 --> 03:29:06,840 TO GET ESSENTIALLY METABOLIC 5159 03:29:06,840 --> 03:29:11,120 CUES TO LOOK A LITTLE BIT MORE 5160 03:29:11,120 --> 03:29:12,520 LIKE WHAT HUMANS ARE 5161 03:29:12,520 --> 03:29:14,640 EXPERIENCING OVER A 12 OR 5162 03:29:14,640 --> 03:29:17,360 14-HOUR FAST WOULD HAVE GOOD 5163 03:29:17,360 --> 03:29:17,720 REPERCUSSIONS. 5164 03:29:17,720 --> 03:29:28,200 OF COURSE I BRING THIS UP, WE 5165 03:29:29,160 --> 03:29:30,760 USE PELLET FEEDERS TO MIMIC, 5166 03:29:30,760 --> 03:29:32,840 THEY ARE EATING 2/3 OR 3/4 IN 5167 03:29:32,840 --> 03:29:35,800 THE LAB AT NIGHT, A THIRD DURING 5168 03:29:35,800 --> 03:29:37,760 THE DAY. 5169 03:29:37,760 --> 03:29:38,640 THOSE NATURAL INTAKE PATTERNS 5170 03:29:38,640 --> 03:29:47,280 TURN OUT TO BE FAIRLY WEAK, AND 5171 03:29:47,280 --> 03:29:49,160 THE UNDERLYING METABOLIC CUES 5172 03:29:49,160 --> 03:29:54,800 MIGHT BE A GOOD MODEL FOR THE 5173 03:29:54,800 --> 03:29:57,560 METABOLIC CUES LEADING TO 5174 03:29:57,560 --> 03:29:58,120 HUMANS. 5175 03:29:58,120 --> 03:30:02,480 THINKING ABOUT WHAT THE 5176 03:30:02,480 --> 03:30:03,240 EFFECTIVE FOOD PRESENTATION 5177 03:30:03,240 --> 03:30:05,560 SCHEDULE THAT WOULD BEST INFORM 5178 03:30:05,560 --> 03:30:07,640 US ABOUT THE HUMAN EXPERIENCE, I 5179 03:30:07,640 --> 03:30:12,440 THINK WOULD BE A GOOD LINE OF 5180 03:30:12,440 --> 03:30:12,680 RESEARCH. 5181 03:30:12,680 --> 03:30:16,920 >>ARE THERE WAYS TO 5182 03:30:16,920 --> 03:30:21,880 LEVERAGE -- WE'VE BEEN TALKING 5183 03:30:21,880 --> 03:30:23,520 ABOUT LEVERAGING MULTIPLE 5184 03:30:23,520 --> 03:30:24,120 BEHAVIORS, CHRONONUTRITION, 5185 03:30:24,120 --> 03:30:25,600 EXERCISE, SLEEP. 5186 03:30:25,600 --> 03:30:29,760 ARE THERE MODELS WE COULD DO, DO 5187 03:30:29,760 --> 03:30:32,200 THIS, ANIMAL MODELS BASICALLY, I 5188 03:30:32,200 --> 03:30:33,600 DON'T DO ANIMAL RESEARCH. 5189 03:30:33,600 --> 03:30:37,520 IS THIS A GOOD FIRST STEP TO USE 5190 03:30:37,520 --> 03:30:38,880 ANIMAL MODELS FOR THIS? 5191 03:30:38,880 --> 03:30:41,680 >>I THINK THERE ARE EXCELLENT 5192 03:30:41,680 --> 03:30:43,760 OPPORTUNITIES I FORGET WHO 5193 03:30:43,760 --> 03:30:46,640 SHOWED THE SLIDE TODAY OF WORK 5194 03:30:46,640 --> 03:30:49,560 FROM MOLLY BRAY, JUST TESTING 5195 03:30:49,560 --> 03:30:56,360 FAT DURING THE DAY AND CHOW 5196 03:30:56,360 --> 03:30:58,560 DURING THE NIGHT, WAYS OF 5197 03:30:58,560 --> 03:31:02,160 MODELING CHANGES IN DIETARY 5198 03:31:02,160 --> 03:31:03,720 INTAKE, NUTRITION INTAKE HUMANS 5199 03:31:03,720 --> 03:31:05,440 MAY EXPERIENCE WITH TRE LOOKING 5200 03:31:05,440 --> 03:31:09,840 AT ANIMAL MODELS FROM LOADING 5201 03:31:09,840 --> 03:31:12,800 FAT, TRYING TO UNDERSTAND GOING 5202 03:31:12,800 --> 03:31:15,080 BACK TO YESTERDAY, THE 5203 03:31:15,080 --> 03:31:16,640 HOMEOSTATIC VERSUS HEDONIC FOOD, 5204 03:31:16,640 --> 03:31:17,640 HOW THAT'S BEING AFFECTED. 5205 03:31:17,640 --> 03:31:20,480 THOSE ARE THINGS THAT CAN BE 5206 03:31:20,480 --> 03:31:21,800 DONE IN SHORT TERM ANIMAL MODELS 5207 03:31:21,800 --> 03:31:24,840 TO AT LEAST GIVE A GOOD SENSE 5208 03:31:24,840 --> 03:31:25,840 FOR TESTABLE HYPOTHESES IN 5209 03:31:25,840 --> 03:31:28,120 HUMANS. 5210 03:31:28,120 --> 03:31:31,560 5211 03:31:31,560 --> 03:31:35,480 >>YESTERDAY WE TALKED ABOUT 5212 03:31:35,480 --> 03:31:38,080 THIS CIRCADIAN OVERALL HEALTH 5213 03:31:38,080 --> 03:31:39,280 SCORE, FOR PEOPLE, THAT THAT'S 5214 03:31:39,280 --> 03:31:42,680 ANOTHER THING THAT COULD BE DONE 5215 03:31:42,680 --> 03:31:43,800 IN ANIMALS. 5216 03:31:43,800 --> 03:31:47,800 WE CAN IN SOME WAYS IN A TIGHTLY 5217 03:31:47,800 --> 03:31:48,640 CONTROLLED ENVIRONMENT MEASURE A 5218 03:31:48,640 --> 03:31:50,040 LOT OF THINGS. 5219 03:31:50,040 --> 03:31:51,040 THE BLOOD SAMPLING IS DIFFICULT 5220 03:31:51,040 --> 03:31:52,800 IN A MOUSE BUT THAT COULD BE 5221 03:31:52,800 --> 03:31:55,080 DONE IN RATS. 5222 03:31:55,080 --> 03:31:59,120 I THINK RATS ARE UNDERVALUED AS 5223 03:31:59,120 --> 03:32:00,320 A RESEARCH MODEL. 5224 03:32:00,320 --> 03:32:02,520 THEY ACTUALLY SOLVE SOME OF THE 5225 03:32:02,520 --> 03:32:06,280 PROBLEMS THAT MATT BROUGHT UP 5226 03:32:06,280 --> 03:32:07,560 ACTUALLY WITH THE METABOLIC 5227 03:32:07,560 --> 03:32:07,760 RATE. 5228 03:32:07,760 --> 03:32:09,960 THE OTHER THING THAT'S ALARMING 5229 03:32:09,960 --> 03:32:12,200 TO ME, MATT, WITH FASTING TIMES 5230 03:32:12,200 --> 03:32:14,680 WITH THE MOUSE STUDIES, A LOT OF 5231 03:32:14,680 --> 03:32:15,800 THEM AREN'T 12-HOUR FASTS, THEY 5232 03:32:15,800 --> 03:32:18,440 ARE EVEN GREATER THAN THAT. 5233 03:32:18,440 --> 03:32:23,320 YEAH, AND WHEN YOU LOOKED AT 5234 03:32:23,320 --> 03:32:23,960 OSCILLATOR, ANTICIPATORY 5235 03:32:23,960 --> 03:32:25,520 ACTIVITIES DONE, CONTINUE TO BE 5236 03:32:25,520 --> 03:32:28,120 DONE, THOSE ARE EXTREMELY SHORT 5237 03:32:28,120 --> 03:32:29,400 4-HOUR FOOD ACCESS INTERVALS 5238 03:32:29,400 --> 03:32:32,320 DURING THE INACTIVE PERIOD. 5239 03:32:32,320 --> 03:32:35,240 SO THOSE ARE GREAT POINTS. 5240 03:32:35,240 --> 03:32:39,120 I WOULD ADD ONE ADVANTAGE OF 5241 03:32:39,120 --> 03:32:40,520 MECHANISM THAT FRANK HINTED AT 5242 03:32:40,520 --> 03:32:43,360 IS ABILITY TO LOOK AT SPECIFIC 5243 03:32:43,360 --> 03:32:47,400 ORGANS AND THEIR MOLECULAR AND 5244 03:32:47,400 --> 03:32:49,480 PHYSIOLOGICAL RESPONSES ARE 5245 03:32:49,480 --> 03:32:50,880 OBVIOUSLY VERY DIFFICULT, 5246 03:32:50,880 --> 03:32:54,720 IMPOSSIBLE, UNETHICAL TO DO IN 5247 03:32:54,720 --> 03:32:54,960 PEOPLE. 5248 03:32:54,960 --> 03:32:59,320 >>MAYBE JUST TO ADD ONE OTHER 5249 03:32:59,320 --> 03:33:01,440 CONSIDERATION, WHEN MAKING 5250 03:33:01,440 --> 03:33:05,080 TRANSLATION AS MATT SAID BETWEEN 5251 03:33:05,080 --> 03:33:08,520 ANIMAL AND HUMAN PHYSIOLOGY IS 5252 03:33:08,520 --> 03:33:09,200 THE ACTUAL EXPERIMENTAL 5253 03:33:09,200 --> 03:33:11,080 CONDITIONS, IN THE SENSE THAT 5254 03:33:11,080 --> 03:33:12,360 RODENT STUDIES ARE GENERALLY 5255 03:33:12,360 --> 03:33:14,560 DONE AT ROOM TEMPERATURE, WHICH 5256 03:33:14,560 --> 03:33:17,880 IS FAR AWAY FROM THE MORE 5257 03:33:17,880 --> 03:33:18,280 NEUTRALITY. 5258 03:33:18,280 --> 03:33:20,840 SO THERE'S A BIG METABOLIC 5259 03:33:20,840 --> 03:33:23,600 CHALLENGE THAT THE RODENTS ARE 5260 03:33:23,600 --> 03:33:25,960 UNDER THROUGHOUT THOSE STUDIES. 5261 03:33:25,960 --> 03:33:28,160 THAT'S UNLIKE HUMANS WHERE MOST 5262 03:33:28,160 --> 03:33:37,320 OF US ARE IN A NEUTRAL -- AT A 5263 03:33:37,320 --> 03:33:38,040 THERMONEUTRAL TEMPERATURE. 5264 03:33:38,040 --> 03:33:39,680 >>WE REDUCED TEMPERATURE NOT 5265 03:33:39,680 --> 03:33:46,640 ALL THE WAY TO NEUTRALITY, BUT 5266 03:33:46,640 --> 03:33:48,080 THE HUMAN METABOLIC COST IS 5267 03:33:48,080 --> 03:33:51,120 HORRIBLE WORKING IN THAT ROOM. 5268 03:33:51,120 --> 03:33:51,400 >>RIGHT. 5269 03:33:51,400 --> 03:33:56,520 >>MATT, DO YOU HAVE -- MARTA, 5270 03:33:56,520 --> 03:33:57,440 A COMMENT? 5271 03:33:57,440 --> 03:33:59,680 >>MELATONIN AND EATING, THAT 5272 03:33:59,680 --> 03:34:02,440 IS A BIG THING. 5273 03:34:02,440 --> 03:34:09,080 THERE IS PLENTY OF STUDIES THAT 5274 03:34:09,080 --> 03:34:10,960 SHOW EFFECT OF MELATONIN, AND 5275 03:34:10,960 --> 03:34:12,800 THIS IS TOTALLY DIFFERENT IN 5276 03:34:12,800 --> 03:34:16,880 HUMANS, SO THIS IS VERY 5277 03:34:16,880 --> 03:34:18,840 IMPORTANT TO HIGHLIGHT BECAUSE I 5278 03:34:18,840 --> 03:34:22,760 FEEL MANY PAPERS COMING ON ABOUT 5279 03:34:22,760 --> 03:34:24,320 THE PROPERTIES OF MELATONIN AND 5280 03:34:24,320 --> 03:34:27,040 IT'S TOTALLY DIFFERENT IN 5281 03:34:27,040 --> 03:34:27,320 HUMANS. 5282 03:34:27,320 --> 03:34:31,840 WE CAN GET TO TOTALLY OPPOSITE 5283 03:34:31,840 --> 03:34:32,080 RESULTS. 5284 03:34:32,080 --> 03:34:33,720 >>EXCELLENT POINT, FOR TWO 5285 03:34:33,720 --> 03:34:33,960 REASONS. 5286 03:34:33,960 --> 03:34:36,440 MANY MOUSE MODELS DON'T EVEN 5287 03:34:36,440 --> 03:34:40,640 MAKE MELATONIN. 5288 03:34:40,640 --> 03:34:42,400 OF COURSE, IN HUMANS, MELATONIN 5289 03:34:42,400 --> 03:34:45,120 IS HIGH WHEN WE FAST, IN RATS 5290 03:34:45,120 --> 03:34:48,720 AND HUMANS IT'S HIGH WHEN THEY 5291 03:34:48,720 --> 03:34:49,240 EAT. 5292 03:34:49,240 --> 03:34:51,120 THANKS FOR BRINGING THAT UP, 5293 03:34:51,120 --> 03:34:51,320 MARTA. 5294 03:34:51,320 --> 03:34:56,600 >>I THINK ONE OF THE THINGS IN 5295 03:34:56,600 --> 03:34:58,160 ROADENED STUDIES, DURATIONAL 5296 03:34:58,160 --> 03:35:00,880 FASTING, IF YOU DO LESS THAN 5297 03:35:00,880 --> 03:35:07,680 8-HOUR INTERVAL THEY WON'T EAT 5298 03:35:07,680 --> 03:35:18,160 THE SAME AMOUNT OF CALORIES. 5299 03:35:20,040 --> 03:35:23,040 THAT'S CRUCIAL AS WELL. 5300 03:35:23,040 --> 03:35:24,480 SEEMS LIKE EXACT DURATION WOULD 5301 03:35:24,480 --> 03:35:28,160 BE DIFFERENT FOR OBVIOUSLY A 5302 03:35:28,160 --> 03:35:29,720 MOUSE THAN HUMAN. 5303 03:35:29,720 --> 03:35:31,720 STILL DEEP INSIGHT INTO 5304 03:35:31,720 --> 03:35:35,440 MECHANISMS THAT ARE RELATED TO 5305 03:35:35,440 --> 03:35:39,600 FASTING DURATION. 5306 03:35:39,600 --> 03:35:43,640 >>SO AT THE RISK OF MOVING 5307 03:35:43,640 --> 03:35:45,080 INTO A DIFFERENT AREA, I WANT TO 5308 03:35:45,080 --> 03:35:48,320 FOLLOW UP ON WHAT KAREN 5309 03:35:48,320 --> 03:35:50,080 MENTIONED ABOUT ABILITY TO 5310 03:35:50,080 --> 03:35:53,920 MONITOR CLOCK CHANGE PHASE IN 5311 03:35:53,920 --> 03:35:54,160 ANIMALS. 5312 03:35:54,160 --> 03:35:55,680 AND ASK ABOUT, YOU KNOW, WHAT'S 5313 03:35:55,680 --> 03:35:58,960 THE RELEVANCE OF THAT IF WE CAN 5314 03:35:58,960 --> 03:36:00,160 NEVER ACTUALLY MEASURE PHASE IN 5315 03:36:00,160 --> 03:36:02,240 ANY OF THE HUMAN TISSUES? 5316 03:36:02,240 --> 03:36:05,000 YOU KNOW, THERE HAVE BEEN A 5317 03:36:05,000 --> 03:36:06,520 COUPLE VERY NICE STUDIES LOOKING 5318 03:36:06,520 --> 03:36:11,840 AT CHANGES IN FOOD TIMING IN 5319 03:36:11,840 --> 03:36:17,800 TERMS OF BLOOD CHANGES, 5320 03:36:17,800 --> 03:36:18,680 METABOLITES AND PROTEOMIC 5321 03:36:18,680 --> 03:36:20,520 STUDIES AGAIN IN BLOOD SHOWING 5322 03:36:20,520 --> 03:36:22,480 SOME THINGS ARE VERY SENSITIVE 5323 03:36:22,480 --> 03:36:25,320 TO FOOD SCHEDULES OR WORK 5324 03:36:25,320 --> 03:36:26,920 SCHEDULES, SOME THINGS 5325 03:36:26,920 --> 03:36:28,840 COMPLETELY INSENSITIVE. 5326 03:36:28,840 --> 03:36:31,560 WHAT ARE THE BARRIERS TO 5327 03:36:31,560 --> 03:36:33,240 ACTUALLY BEING ABLE TO MEASURE 5328 03:36:33,240 --> 03:36:38,160 PERIPHERAL TISSUE PHASE? 5329 03:36:38,160 --> 03:36:39,560 ARE THERE EXOSOMES WE ATTRIBUTE 5330 03:36:39,560 --> 03:36:41,400 TO PARTICULAR TISSUES? 5331 03:36:41,400 --> 03:36:43,280 ARE THERE PARTICULAR BLOOD 5332 03:36:43,280 --> 03:36:45,360 METABOLITES THAT ARE GOING TO 5333 03:36:45,360 --> 03:36:50,080 BE -- THAT WE CAN RELIABLY 5334 03:36:50,080 --> 03:36:54,680 ATTRIBUTE TO TAKE ORGAN 5335 03:36:54,680 --> 03:36:59,400 SECRETING IT IN THERE HAVE BEEN 5336 03:36:59,400 --> 03:37:00,440 WORKSHOPS ON CIRCADIAN 5337 03:37:00,440 --> 03:37:02,960 BIOMARKERS BUT IT'S AN AREA TO 5338 03:37:02,960 --> 03:37:04,520 PUSH FORWARD TO SEE HOW 5339 03:37:04,520 --> 03:37:06,080 CIRCADIAN DISRUPTION IS 5340 03:37:06,080 --> 03:37:09,360 OCCURRING AT THE LEVEL OF THE 5341 03:37:09,360 --> 03:37:09,560 HUMAN. 5342 03:37:09,560 --> 03:37:11,560 >>I'M HAPPY TO JUMP IN HERE, 5343 03:37:11,560 --> 03:37:12,640 MATT, BECAUSE WE WRESTLED WITH 5344 03:37:12,640 --> 03:37:15,200 THIS A FEW YEARS AGO AND 5345 03:37:15,200 --> 03:37:17,600 SUBMITTED A GRANT TO THE DoD 5346 03:37:17,600 --> 03:37:20,000 BEFORE IT WAS FUNDED. 5347 03:37:20,000 --> 03:37:22,640 TRYING TO LOOK AT PERIPHERAL 5348 03:37:22,640 --> 03:37:24,160 CLOCKS, WANTED TO DO BIOPSIES, 5349 03:37:24,160 --> 03:37:25,920 IT WAS OUT OF THE QUESTION. 5350 03:37:25,920 --> 03:37:27,520 AND SO WE KIND OF DEBATED 5351 03:37:27,520 --> 03:37:32,560 BETWEEN DO YOU GO WITH MOLECULAR 5352 03:37:32,560 --> 03:37:36,320 MARKER OR A NET PHYSIOLOGIC OR 5353 03:37:36,320 --> 03:37:37,400 METABOLIC CLOCK, EXAMPLE COULD 5354 03:37:37,400 --> 03:37:40,880 BE -- WHAT WE DID FOR THIS 5355 03:37:40,880 --> 03:37:42,600 STUDY, A CONSTANT GLUCOSE INFUSE 5356 03:37:42,600 --> 03:37:44,480 PROCEDURE TO DEFINE A NET 5357 03:37:44,480 --> 03:37:45,480 GLYCEMIC CLOCK. 5358 03:37:45,480 --> 03:37:47,400 YOU COULD DO SOMETHING SIMILAR 5359 03:37:47,400 --> 03:37:49,440 WITH BLOOD PRESSURE, LIPID 5360 03:37:49,440 --> 03:37:51,480 RHYTHMS, THINGS LIKE THAT. 5361 03:37:51,480 --> 03:37:54,120 MY PERSONAL BIAS, I TENDED TO 5362 03:37:54,120 --> 03:37:56,840 NOW MOVE TOWARDS THE OUTCOME 5363 03:37:56,840 --> 03:38:01,120 ITSELF, IN UNDERSTANDING THAT 5364 03:38:01,120 --> 03:38:02,000 RHYTHM. 5365 03:38:02,000 --> 03:38:03,280 BUT IT'S IMPERFECT EITHER WAY. 5366 03:38:03,280 --> 03:38:04,640 THAT'S THE DIRECTION I'VE HEADED 5367 03:38:04,640 --> 03:38:07,040 IN BECAUSE IT'S JUST REALLY HARD 5368 03:38:07,040 --> 03:38:08,680 TO CORRELATE THOSE RHYTHMS WITH 5369 03:38:08,680 --> 03:38:09,720 SOMETHING THAT'S SCALABLE AT THE 5370 03:38:09,720 --> 03:38:14,560 LEVEL WE WOULD NEED TO ANSWER 5371 03:38:14,560 --> 03:38:17,480 SOME OF THESE PRECISION 5372 03:38:17,480 --> 03:38:18,720 NUTRITION QUESTIONS. 5373 03:38:18,720 --> 03:38:21,400 >>ONE OF THE THINGS WOULD BE, 5374 03:38:21,400 --> 03:38:24,640 YOU COULD COMPARE TO SLEEP/WAKE, 5375 03:38:24,640 --> 03:38:26,080 SOMETHING ANYONE CAN DO WITHOUT 5376 03:38:26,080 --> 03:38:27,480 PAYING FOR AN EXPENSIVE TOOL OR 5377 03:38:27,480 --> 03:38:30,000 HAVE AC STOWS A CLINIC, EVEN 5378 03:38:30,000 --> 03:38:31,440 GETTING TO THE POINT ONE DAY OF 5379 03:38:31,440 --> 03:38:34,160 HOPEFULLY BEING ABLE TO PUT THIS 5380 03:38:34,160 --> 03:38:35,280 ON A PUBLIC RECOMMENDATION. 5381 03:38:35,280 --> 03:38:38,200 WE NEED SOME KIND OF WAY TO GIVE 5382 03:38:38,200 --> 03:38:39,640 A RECOMMENDATION THAT DOESN'T 5383 03:38:39,640 --> 03:38:41,400 REQUIRE SUPER HIGH TECH INFO. 5384 03:38:41,400 --> 03:38:43,360 THAT BEING SAID OBVIOUSLY TOOLS 5385 03:38:43,360 --> 03:38:46,560 ON THE SMALLER SCALE WOULD BE 5386 03:38:46,560 --> 03:38:50,000 EXTREMELY INFORMATIVE. 5387 03:38:50,000 --> 03:38:52,400 >>FRANK? 5388 03:38:52,400 --> 03:38:57,680 >>YEAH, I THINK THE QUESTION, 5389 03:38:57,680 --> 03:38:59,320 IT'S SO CHALLENGING IN HUMANS TO 5390 03:38:59,320 --> 03:38:59,560 DO. 5391 03:38:59,560 --> 03:39:05,560 THE OTHER AS YOU SAY WHAT IS THE 5392 03:39:05,560 --> 03:39:06,280 RELEVANCE? 5393 03:39:06,280 --> 03:39:07,320 PART IS RELEVANCE TO TRANSLATE 5394 03:39:07,320 --> 03:39:10,280 TO HUMANS BUT THE SECOND, WE 5395 03:39:10,280 --> 03:39:14,440 DON'T EVEN UNDERSTAND TO WHAT 5396 03:39:14,440 --> 03:39:15,640 DEGREE INTERNAL CIRCADIAN 5397 03:39:15,640 --> 03:39:17,640 MISALIGNMENT IS CONTRIBUTING TO 5398 03:39:17,640 --> 03:39:18,760 ADVERSE EFFECTS. 5399 03:39:18,760 --> 03:39:21,680 IT'S NOT JUST WE CAN'T MEASURE 5400 03:39:21,680 --> 03:39:21,960 IT. 5401 03:39:21,960 --> 03:39:23,120 WE DON'T EVEN UNDERSTAND WELL 5402 03:39:23,120 --> 03:39:25,280 HOW IT WORKS. 5403 03:39:25,280 --> 03:39:26,920 THE EVIDENCE IS INDIRECT, 5404 03:39:26,920 --> 03:39:27,680 INTERNAL CIRCADIAN MISALIGNMENT 5405 03:39:27,680 --> 03:39:31,080 PLAYS A ROLE. 5406 03:39:31,080 --> 03:39:33,400 WE DO KNOW BEHAVIORAL 5407 03:39:33,400 --> 03:39:35,160 MISALIGNMENT, WHAT I MEAN IS 5408 03:39:35,160 --> 03:39:41,600 MISALIGNMENT OF LET'S SAY 5409 03:39:41,600 --> 03:39:42,400 EATING-FASTING CYCLE RELEVANT TO 5410 03:39:42,400 --> 03:39:43,880 CENTRAL CLOCK IS OF IMPORTANCE 5411 03:39:43,880 --> 03:39:46,000 BUT DON'T KNOW -- WE KNOW THE 5412 03:39:46,000 --> 03:39:48,880 LIVER CAN BE UNCOUPLED FROM THE 5413 03:39:48,880 --> 03:39:51,560 CENTRAL CLOCK BUT DON'T KNOW IF 5414 03:39:51,560 --> 03:39:53,680 THAT IS A CAUSAL -- TO WHAT 5415 03:39:53,680 --> 03:39:57,040 DEGREE IT PLAYS A CAUSAL ROLE IN 5416 03:39:57,040 --> 03:39:57,960 ADVERSE EFFECTS. 5417 03:39:57,960 --> 03:40:00,160 IT'S VERY MUCH A WORKING 5418 03:40:00,160 --> 03:40:03,280 HYPOTHESIS IN THE FIELD AS OF 5419 03:40:03,280 --> 03:40:05,200 NOW. 5420 03:40:05,200 --> 03:40:07,280 >>YEAH, MAYBE JUST ADD TO THE 5421 03:40:07,280 --> 03:40:09,440 CONCEPT, THINKING ABOUT THE 5422 03:40:09,440 --> 03:40:11,080 TIMING OF SLEEP, FIRST ACTIVITY, 5423 03:40:11,080 --> 03:40:12,960 AND NUTRITION, TRYING TO FIGURE 5424 03:40:12,960 --> 03:40:15,280 OUT WHICH OF THOSE IN 5425 03:40:15,280 --> 03:40:17,760 COMBINATION MIGHT BE MOST 5426 03:40:17,760 --> 03:40:19,160 IMPINGING ON SOME PERIPHERAL 5427 03:40:19,160 --> 03:40:19,400 CLOCKS. 5428 03:40:19,400 --> 03:40:23,360 IF THAT MATTERS AND IN 5429 03:40:23,360 --> 03:40:25,480 COMBINATION HOW THOSE MIGHT 5430 03:40:25,480 --> 03:40:27,320 INFLUENCE CARDIOMETABOLIC HEALTH 5431 03:40:27,320 --> 03:40:27,680 OUTCOMES. 5432 03:40:27,680 --> 03:40:29,360 THAT'S PROBABLY ANYBODY'S -- WE 5433 03:40:29,360 --> 03:40:32,560 CAN MAKE AN EDUCATED GUESS NOW 5434 03:40:32,560 --> 03:40:34,600 BUT THAT'S PROBABLY THE BEST WE 5435 03:40:34,600 --> 03:40:34,920 CAN DO. 5436 03:40:34,920 --> 03:40:37,040 >>WE'RE GETTING SLEEP 5437 03:40:37,040 --> 03:40:39,240 MISTIMING AND EATING MISTIMING. 5438 03:40:39,240 --> 03:40:41,840 BRIEFLY SHOWED A SLIDE ON THAT. 5439 03:40:41,840 --> 03:40:44,280 THAT WAS THE EXACT QUESTION. 5440 03:40:44,280 --> 03:40:44,600 >>RIGHT. 5441 03:40:44,600 --> 03:40:47,880 >>SO THE DATA THERE SUGGEST 5442 03:40:47,880 --> 03:40:52,040 THAT EATING TIME OR EATING 5443 03:40:52,040 --> 03:40:53,520 MISTIMING IS MORE IMPORTANT 5444 03:40:53,520 --> 03:40:54,480 DRIVER, FOR THE MEASURES WE 5445 03:40:54,480 --> 03:40:55,400 LOOKED AT. 5446 03:40:55,400 --> 03:40:59,800 OF COURSE WE JUST LOOKED AT 5447 03:40:59,800 --> 03:41:03,080 GLYCEMIC CONTROL, WE LOOKED AT 5448 03:41:03,080 --> 03:41:05,480 DEPRESSIVE ANXIETY-LIKE MOOD, WE 5449 03:41:05,480 --> 03:41:07,800 LOOKED AT INTERNAL MISALIGNMENT 5450 03:41:07,800 --> 03:41:10,840 IN HUMANS, AND UNPUBLISHED WE 5451 03:41:10,840 --> 03:41:12,440 ALSO ARE LOOKING AT 5452 03:41:12,440 --> 03:41:14,240 CARDIOVASCULAR-RELATED MEASURES. 5453 03:41:14,240 --> 03:41:16,640 ALL OF THESE SUGGEST THE MEAL 5454 03:41:16,640 --> 03:41:18,760 TIMING IS MORE IMPORTANT THAN 5455 03:41:18,760 --> 03:41:23,680 THE MISTIMING OF THE SLEEP-WAKE 5456 03:41:23,680 --> 03:41:23,880 CYCLE. 5457 03:41:23,880 --> 03:41:28,120 THE BEHAVIORAL ASPECT WE CAN 5458 03:41:28,120 --> 03:41:28,400 UNCOUPLE. 5459 03:41:28,400 --> 03:41:29,480 INTERNAL MISALIGNMENT BETWEEN 5460 03:41:29,480 --> 03:41:31,880 CLOCKS THROUGHOUT THE BODY IS A 5461 03:41:31,880 --> 03:41:36,560 TOUGHER NUT TO CRACK AT LEAST IN 5462 03:41:36,560 --> 03:41:36,800 HUMANS. 5463 03:41:36,800 --> 03:41:39,560 >>AS WE THINK ABOUT TIMING, 5464 03:41:39,560 --> 03:41:42,480 MISTIMING OF EATING BEING MORE 5465 03:41:42,480 --> 03:41:43,800 IMPORTANT THAN MISTIMING OF 5466 03:41:43,800 --> 03:41:44,120 SLEEP. 5467 03:41:44,120 --> 03:41:47,160 COURTNEY, HAD YOU A COMMENT? 5468 03:41:47,160 --> 03:41:49,480 >>YEAH, ONE THING A WE 5469 03:41:49,480 --> 03:41:50,800 COLLECTIVELY AS A COMMUNITY 5470 03:41:50,800 --> 03:41:52,760 TACKLE QUESTIONS ABOUT INTERNAL 5471 03:41:52,760 --> 03:42:01,080 MISALIGNMENT OF PERIPHERAL 5472 03:42:01,080 --> 03:42:02,920 ORGANS IT TAKES LONGER TO TRAIN 5473 03:42:02,920 --> 03:42:04,400 THAN IT DOES TO DELIVER. 5474 03:42:04,400 --> 03:42:07,720 IF I REMEMBER, FOUR WEEKS IN ONE 5475 03:42:07,720 --> 03:42:08,320 RODENT STUDY. 5476 03:42:08,320 --> 03:42:10,560 HOW LONG DOES IT TAKE IN HUMANS, 5477 03:42:10,560 --> 03:42:12,960 IF WE NEED TO DO STUDIES UNDER 5478 03:42:12,960 --> 03:42:14,600 SUCH GREAT INPATIENT OR IN-LAB 5479 03:42:14,600 --> 03:42:17,400 CONTROL WE HAVE TO MAKE SURE WE 5480 03:42:17,400 --> 03:42:18,960 HAVE SUFFICIENT DURATION OF 5481 03:42:18,960 --> 03:42:20,840 THOSE INTERVENTIONS SUCH THE 5482 03:42:20,840 --> 03:42:22,840 ORGANS CAN ADAPT OR ENTRAIN TO 5483 03:42:22,840 --> 03:42:23,600 THE SCHEDULES. 5484 03:42:23,600 --> 03:42:28,480 THAT'S GOING TO BE CHALLENGING 5485 03:42:28,480 --> 03:42:29,480 TO FIGURE OUT. 5486 03:42:29,480 --> 03:42:38,560 >>I WANT TO REITERATE, IT'S 5487 03:42:38,560 --> 03:42:39,840 IMPORTANT, YESTERDAY WE TALKED 5488 03:42:39,840 --> 03:42:42,720 ABOUT FOOD IS A GREAT 5489 03:42:42,720 --> 03:42:44,920 IN-TRAINING STIMULUS FOR CERTAIN 5490 03:42:44,920 --> 03:42:49,920 OSCILLATORS, BUT IT'S WEAK FOR 5491 03:42:49,920 --> 03:42:50,480 OTHERS. 5492 03:42:50,480 --> 03:42:52,880 KEEPING IN MIND THAT IN 5493 03:42:52,880 --> 03:42:55,520 ADDITION, THERE ARE CENTRAL 5494 03:42:55,520 --> 03:42:56,640 OSCILLATORS OUTSIDE OF SBN, I 5495 03:42:56,640 --> 03:43:02,720 THINK MATT SHOWED THIS IN HIS 5496 03:43:02,720 --> 03:43:05,920 INTRO, THAT ENTRAIN TO FOOD VERY 5497 03:43:05,920 --> 03:43:07,120 SLIGHTLY AND STRONGLY, STRONGLY 5498 03:43:07,120 --> 03:43:10,480 COUPLED TO TIMING OF FOOD, NOT 5499 03:43:10,480 --> 03:43:11,360 SCN OSCILLATORS, STILL IN THE 5500 03:43:11,360 --> 03:43:13,040 BRAIN AND CONTROL THINGS 5501 03:43:13,040 --> 03:43:14,680 IMPORTANT TO THIS TOPIC. 5502 03:43:14,680 --> 03:43:15,960 THAT NUMBER ONE IS IMPORTANT 5503 03:43:15,960 --> 03:43:17,520 REASON TO DO ANIMAL RESEARCH BUT 5504 03:43:17,520 --> 03:43:21,000 NUMBER TWO, WHEN WE THINK ABOUT 5505 03:43:21,000 --> 03:43:22,560 ENTRAINING STIMULI AND THE POINT 5506 03:43:22,560 --> 03:43:24,520 COURTNEY MADE WE HAVE TO TAKE 5507 03:43:24,520 --> 03:43:27,680 INTO ACCOUNT COUPLING STRENGTH 5508 03:43:27,680 --> 03:43:29,000 FOR THE DIFFERENT RHYTHMS THAT 5509 03:43:29,000 --> 03:43:33,920 WE'RE WISHING TO MEASURE OR 5510 03:43:33,920 --> 03:43:34,160 OBSERVE. 5511 03:43:34,160 --> 03:43:36,880 >>WE HAVE TEN MINUTES LEFT 5512 03:43:36,880 --> 03:43:37,320 HERE. 5513 03:43:37,320 --> 03:43:38,640 I'D LIKE TO KNOW, GIVEN WHAT 5514 03:43:38,640 --> 03:43:40,840 WE'VE SEEN OVER THE LAST TWO 5515 03:43:40,840 --> 03:43:44,680 DAYS WHERE DO WE NEED TO GO FROM 5516 03:43:44,680 --> 03:43:46,200 HERE TO MOVE CHRONONUTRITION 5517 03:43:46,200 --> 03:43:47,400 INTO CLINICAL PRACTICE? 5518 03:43:47,400 --> 03:43:55,600 WHAT INFORMATION DO WE NEED TO 5519 03:43:55,600 --> 03:43:55,840 GATHER? 5520 03:43:55,840 --> 03:43:59,240 >>RELATED TO YOUR QUESTION, 5521 03:43:59,240 --> 03:44:00,520 HIGHLIGHTING ONE OF THE 5522 03:44:00,520 --> 03:44:02,400 QUESTIONS IN THE CHAT, WHICH IS 5523 03:44:02,400 --> 03:44:04,800 ONE OF THE THINGS WE NEED 5524 03:44:04,800 --> 03:44:07,560 PROBABLY TO COLLABORATE WITH 5525 03:44:07,560 --> 03:44:09,200 IMPLEMENTATION SCIENCE EXPERTS 5526 03:44:09,200 --> 03:44:13,040 TO APPLY IMPLEMENTATION SCIENCE 5527 03:44:13,040 --> 03:44:14,360 FRAME WORKS AND COLLECT 5528 03:44:14,360 --> 03:44:15,240 INFORMATION TO DESIGN 5529 03:44:15,240 --> 03:44:16,320 INTERVENTIONS THAT WORK IN REAL 5530 03:44:16,320 --> 03:44:26,800 SETTINGS FOR A LONG TIME. 5531 03:44:32,440 --> 03:44:34,600 >>EVERYONE ON THIS CALL KNOWS 5532 03:44:34,600 --> 03:44:35,480 TIMING IS IMPORTANT. 5533 03:44:35,480 --> 03:44:35,800 RIGHT? 5534 03:44:35,800 --> 03:44:37,240 BUT THIS IS A MESSAGE THAT NEEDS 5535 03:44:37,240 --> 03:44:40,200 TO GET TO EVERY OTHER ASPECT OF 5536 03:44:40,200 --> 03:44:41,280 THE NIH. 5537 03:44:41,280 --> 03:44:42,600 WHEN THINGS ARE MEASURED, WE 5538 03:44:42,600 --> 03:44:44,760 NEED TO GET THE METADATA TO KNOW 5539 03:44:44,760 --> 03:44:46,320 WHEN IT WAS DONE, NEED TO KNOW 5540 03:44:46,320 --> 03:44:48,080 WHEN IT WAS DONE RELATIVE TO 5541 03:44:48,080 --> 03:44:49,720 WHEN THE PERSON SLEPT, WHEN IT 5542 03:44:49,720 --> 03:44:52,680 WAS DONE RELATIVE TO WHEN THE 5543 03:44:52,680 --> 03:44:53,560 PERSON ATE. 5544 03:44:53,560 --> 03:44:56,720 AND IF WE CAN HAVE A CHANGE IN 5545 03:44:56,720 --> 03:44:59,440 PERSPECTIVE HERE AND ADDING THAT 5546 03:44:59,440 --> 03:45:01,640 TIMING INFORMATION INTO ALL 5547 03:45:01,640 --> 03:45:04,720 TRIALS DONE, THAT WILL HELP MOVE 5548 03:45:04,720 --> 03:45:05,920 THIS FIELD FORWARD. 5549 03:45:05,920 --> 03:45:09,800 AS WE FOCUS ON THIS AREA OF 5550 03:45:09,800 --> 03:45:10,400 CHRONONUTRITION, AND 5551 03:45:10,400 --> 03:45:12,920 CHRONOEVERYTHING, IF YOU WILL, 5552 03:45:12,920 --> 03:45:13,120 HERE. 5553 03:45:13,120 --> 03:45:13,400 >>RIGHT. 5554 03:45:13,400 --> 03:45:15,280 >>THAT HAS TO BE A MESSAGE, 5555 03:45:15,280 --> 03:45:16,080 IMPORTANT MESSAGE. 5556 03:45:16,080 --> 03:45:17,880 >>I DON'T THINK IT'S 5557 03:45:17,880 --> 03:45:22,400 SUFFICIENT ANYMORE TO SAY THAT 5558 03:45:22,400 --> 03:45:25,920 WE'VE COLLECTED SAMPLES, THE 5559 03:45:25,920 --> 03:45:36,200 FASTED CONDITION. 5560 03:45:48,080 --> 03:45:50,520 >>HOW FREQUENTLY BLOOD 5561 03:45:50,520 --> 03:45:52,520 SAMPLING TO OCCUR TO BALANCE 5562 03:45:52,520 --> 03:45:54,920 BURDEN WITH BEING ABLE TO 5563 03:45:54,920 --> 03:46:01,240 CHARACTERIZE THESE SORT OF 5564 03:46:01,240 --> 03:46:01,960 CIRCADIAN PATTERNS BIOMARKERS 5565 03:46:01,960 --> 03:46:03,760 ARE OSCILLATING ON AS WE START 5566 03:46:03,760 --> 03:46:05,080 TO MOVE IN THAT DIRECTION. 5567 03:46:05,080 --> 03:46:12,520 WHICH I THINK IS REALLY 5568 03:46:12,520 --> 03:46:19,760 IMPORTANT, IF WE'RE STUDYING 5569 03:46:19,760 --> 03:46:20,640 HEMATOPOISES DON'T SEE 5570 03:46:20,640 --> 03:46:22,240 DIFFERENCE IN TERMS OF 5571 03:46:22,240 --> 03:46:23,360 CIRCULATING MONOCYTES EARLY IN 5572 03:46:23,360 --> 03:46:25,080 THE DAY BUT LATER IN THE DAY SEE 5573 03:46:25,080 --> 03:46:27,720 DIFFERENCE, WITHIN THE SAME DAY. 5574 03:46:27,720 --> 03:46:30,480 AND SO IT SORT OF UNDERSCORES 5575 03:46:30,480 --> 03:46:34,520 THE IMPORTANCE OF REALLY GETTING 5576 03:46:34,520 --> 03:46:37,360 THE DIURNAL OR CIRCADIAN 5577 03:46:37,360 --> 03:46:40,080 PATTERNS OF BIOMARKERS. 5578 03:46:40,080 --> 03:46:41,400 >>IT'S SOMETHING HIGHLIGHTED 5579 03:46:41,400 --> 03:46:45,360 ACROSS THE AFTERNOON, GOING 5580 03:46:45,360 --> 03:46:46,040 BEYOND FASTING MEASURES, 5581 03:46:46,040 --> 03:46:47,040 POSTPRANDIAL MEASURES. 5582 03:46:47,040 --> 03:46:50,040 WE KNOW PEOPLE EAT AROUND THE 5583 03:46:50,040 --> 03:46:50,680 CLOCK. 5584 03:46:50,680 --> 03:46:52,680 IF THEY ARE IN POSTPRANDIAL 5585 03:46:52,680 --> 03:46:55,720 STATE MOST OF THE DAY WHY ARE WE 5586 03:46:55,720 --> 03:46:59,160 FOCUSING ON FASTED MEASURES? 5587 03:46:59,160 --> 03:47:01,400 TAKING THOSE MEASURES, PEAKING 5588 03:47:01,400 --> 03:47:02,400 ATTEND TO POSTPRANDIAL PERIOD, 5589 03:47:02,400 --> 03:47:05,560 TO OVERNIGHT PERIOD AS WELL, 5590 03:47:05,560 --> 03:47:06,560 TAKING SAMPLES ACROSS THE 5591 03:47:06,560 --> 03:47:09,280 24-HOUR PERIOD TO BE ABLE TO 5592 03:47:09,280 --> 03:47:12,240 LOOK AT THOSE EFFECTS OF 5593 03:47:12,240 --> 03:47:12,600 INTERVENTION. 5594 03:47:12,600 --> 03:47:13,880 >>YEAH, AND KEN MADE THIS 5595 03:47:13,880 --> 03:47:16,960 POINT WELL EARLIER THAT WE NEED 5596 03:47:16,960 --> 03:47:18,240 24 HOUR ASSESSMENTS, JUST FOR 5597 03:47:18,240 --> 03:47:20,040 REFERENCE WE FOUND EVEN IF WE 5598 03:47:20,040 --> 03:47:21,520 ONLY MEASURE AT THE POSTPRANDIAL 5599 03:47:21,520 --> 03:47:22,800 LEVELS IN THE MORNING WE STILL 5600 03:47:22,800 --> 03:47:27,880 ARE MISSING MOST OF THE EFFECT. 5601 03:47:27,880 --> 03:47:31,160 IT'S LATER IN THE DAY AT LEAST 5602 03:47:31,160 --> 03:47:31,960 FOR TIME-RESTRICTED EATING. 5603 03:47:31,960 --> 03:47:33,920 >>IT DIFFERS BY MARKER. 5604 03:47:33,920 --> 03:47:38,400 >>ABSOLUTELY, I'M SURE IT 5605 03:47:38,400 --> 03:47:44,720 DOES. 5606 03:47:44,720 --> 03:47:45,480 >>ANYONE ELSE? 5607 03:47:45,480 --> 03:47:47,960 >>YES, I THINK ANOTHER 5608 03:47:47,960 --> 03:47:54,040 IMPORTANT CONCEPT IS THE IDEA OF 5609 03:47:54,040 --> 03:47:56,800 EVENING TYPE OR MORNING TYPE FOR 5610 03:47:56,800 --> 03:47:59,880 CLINICAL SETTING BECAUSE I THINK 5611 03:47:59,880 --> 03:48:03,120 THIS IS SOMETHING TO UNDERSTAND, 5612 03:48:03,120 --> 03:48:05,440 MANY PEOPLE KNOW THERE ARE MORE 5613 03:48:05,440 --> 03:48:07,080 EVENING OR MORNING, AND 5614 03:48:07,080 --> 03:48:09,280 THERAPIES SHOULD BE DIFFERENT, 5615 03:48:09,280 --> 03:48:11,640 AT LEAST THOSE RELATED TO 5616 03:48:11,640 --> 03:48:13,360 BEHAVIORAL CHANGES. 5617 03:48:13,360 --> 03:48:17,400 FOR EXAMPLE WE JUST PUBLISHED A 5618 03:48:17,400 --> 03:48:19,200 PAPER WITH FRANK ABOUT HOW 5619 03:48:19,200 --> 03:48:24,320 EVENING TYPE ARE MORE EMOTIONAL 5620 03:48:24,320 --> 03:48:26,840 PEOPLE, AND HAVE MORE SENSE OF 5621 03:48:26,840 --> 03:48:30,040 GUILT OR CRAVING FOR SPECIFIC 5622 03:48:30,040 --> 03:48:32,440 FOOD, THAN MORNING TIMES. 5623 03:48:32,440 --> 03:48:39,120 I THINK THAT'S IMPORTANT FOR 5624 03:48:39,120 --> 03:48:41,720 EXAMPLE FOR EATING THEY PERHAPS 5625 03:48:41,720 --> 03:48:43,200 FIND MORE DIFFICULTIES OR 5626 03:48:43,200 --> 03:48:48,160 CRAVING INCREASES WHEN THEY HAVE 5627 03:48:48,160 --> 03:48:50,880 TO BE IN A VERY BEHAVIOR, 5628 03:48:50,880 --> 03:48:52,600 EVENING TYPE OR MORNING TYPE IS 5629 03:48:52,600 --> 03:48:55,640 A CONCEPT, AND THE OTHER THING 5630 03:48:55,640 --> 03:48:59,840 KEN WRIGHT SAYS THAT EATING 5631 03:48:59,840 --> 03:49:06,280 AROUND SLEEP OR DOING ALL THIS 5632 03:49:06,280 --> 03:49:08,040 HIGHLIGHT SO WE SHOULD AVOID TO 5633 03:49:08,040 --> 03:49:09,080 DO THINGS AT NIGHT THAT SHOULD 5634 03:49:09,080 --> 03:49:12,080 BE DURING THE DAY SO THOSE 5635 03:49:12,080 --> 03:49:17,120 THINGS ARE VERY EASY TO 5636 03:49:17,120 --> 03:49:17,400 UNDERSTAND. 5637 03:49:17,400 --> 03:49:18,960 >>I WAS GOING TO CHANGE THE 5638 03:49:18,960 --> 03:49:20,720 TOPIC BUT TO BUILD ON WHAT MARTA 5639 03:49:20,720 --> 03:49:24,440 SAID DO YOU WANT TO GO FIRST? 5640 03:49:24,440 --> 03:49:25,640 >>YEAH, I WANTED TO MENTION 5641 03:49:25,640 --> 03:49:28,200 THE FACT THAT ONE OF THE GREAT 5642 03:49:28,200 --> 03:49:30,120 RESULTS FROM KEN'S WORK IN 5643 03:49:30,120 --> 03:49:33,640 RECENT YEARS IS THE FACT THAT 5644 03:49:33,640 --> 03:49:36,040 CHRONOTYPE CAN POTENTIALLY BE 5645 03:49:36,040 --> 03:49:36,840 EXPLAINED BY SENSITIVITY TO, FOR 5646 03:49:36,840 --> 03:49:39,120 EXAMPLE, LIGHT IN THE EVENING. 5647 03:49:39,120 --> 03:49:46,120 AND I WOULDN'T BE SURPRISED IF 5648 03:49:46,120 --> 03:49:47,680 THERE'S SIMILAR CHRONOTYPE 5649 03:49:47,680 --> 03:49:51,160 PHENOMENA, MAYBE IT'S NOT 5650 03:49:51,160 --> 03:49:52,280 SLEEP-WAKE, MAYBE IT'S 5651 03:49:52,280 --> 03:49:54,120 METABOLISM, THAT COULD BE 5652 03:49:54,120 --> 03:49:57,320 SIMILARLY IMPACTED BY TIMING OF 5653 03:49:57,320 --> 03:49:57,960 FOOD. 5654 03:49:57,960 --> 03:50:00,920 SO MAYBE ONE OF THE EFFECTS OF 5655 03:50:00,920 --> 03:50:04,320 TRE IS TO KIND OF BRING THE 5656 03:50:04,320 --> 03:50:06,720 CLOCKS BACK INTO RESONANCE IN A 5657 03:50:06,720 --> 03:50:09,240 WAY THAT SUPPORTS HEALTH, AND 5658 03:50:09,240 --> 03:50:12,200 SORT OF CHANGING THESE -- THERE 5659 03:50:12,200 --> 03:50:14,080 MIGHT BE -- DELETERIOUS EFFECTS 5660 03:50:14,080 --> 03:50:18,080 MIGHT BE A KNOCK-ON FROM THIS 5661 03:50:18,080 --> 03:50:19,320 LIKE MISTIMING JUST BASED ON 5662 03:50:19,320 --> 03:50:23,680 CIRCADIAN PROPERTIES OF HOW THEY 5663 03:50:23,680 --> 03:50:23,920 ENTRAIN. 5664 03:50:23,920 --> 03:50:25,440 >>I'M GOING TO CHANGE THE 5665 03:50:25,440 --> 03:50:28,160 TOPIC TO A GREAT POINT THAT WAS 5666 03:50:28,160 --> 03:50:28,800 BROUGHT UP YESTERDAY. 5667 03:50:28,800 --> 03:50:30,360 ONE OF THE THINGS THAT'S BEEN 5668 03:50:30,360 --> 03:50:32,120 VERY CHALLENGING FOR THOSE WHO 5669 03:50:32,120 --> 03:50:33,400 DO HUMAN RESEARCH, ALMOST 5670 03:50:33,400 --> 03:50:35,160 EVERYONE WHO DOES HUMAN RESEARCH 5671 03:50:35,160 --> 03:50:37,600 HERE DOES FAIRLY WELL CONTROLLED 5672 03:50:37,600 --> 03:50:40,840 OR INPATIENT OR IN-LAB STUDIES, 5673 03:50:40,840 --> 03:50:46,680 WITH ABOLISHMENT OF FUNDING FOR 5674 03:50:46,680 --> 03:50:48,200 GCRC IT'S BEEN DIFFICULT TO 5675 03:50:48,200 --> 03:50:52,280 MAINTAIN A POOL OF NURSES TO 5676 03:50:52,280 --> 03:50:55,120 CARRY OUT STUDIES, AS WAS SAID 5677 03:50:55,120 --> 03:50:56,000 YESTERDAY, SEVEN DAYS INPATIENT 5678 03:50:56,000 --> 03:50:57,080 IS HARD TO DO. 5679 03:50:57,080 --> 03:51:00,560 IF I THINK ABOUT WHAT NHLBI AND 5680 03:51:00,560 --> 03:51:01,440 OTHER INSTITUTES CAN DO TO HELP 5681 03:51:01,440 --> 03:51:04,600 US FIND A WAY TO MAKE THESE 5682 03:51:04,600 --> 03:51:08,200 SUSTAINABLE, FOR EXAMPLE KAREN 5683 03:51:08,200 --> 03:51:10,000 GAMBLE AND I COBBLED TOGETHER 5684 03:51:10,000 --> 03:51:11,600 THROUGH THE LUCK OF GRANT 5685 03:51:11,600 --> 03:51:12,960 FUNDING, FOUR OF US 5686 03:51:12,960 --> 03:51:15,880 INVESTIGATORS ARE FIVE TRIALS 5687 03:51:15,880 --> 03:51:18,440 THAT REQUIRE INPATIENT TESTING, 5688 03:51:18,440 --> 03:51:22,600 HAVE BEEN ABLE TO ASSEMBLE 5689 03:51:22,600 --> 03:51:23,520 NURSES, IT'S BEEN DIFFICULT, 5690 03:51:23,520 --> 03:51:26,320 TOOK TWO YEARS TO PULL OFF. 5691 03:51:26,320 --> 03:51:28,160 WE DON'T HAVE STABILITY TO DO 5692 03:51:28,160 --> 03:51:29,480 THESE STUDIES, MAYBE CENTER 5693 03:51:29,480 --> 03:51:31,960 FUNDING FOR A FEW SELECT CENTERS 5694 03:51:31,960 --> 03:51:36,720 TO SUSTAIN THIS TYPE OF 5695 03:51:36,720 --> 03:51:37,520 RESEARCH. 5696 03:51:37,520 --> 03:51:40,200 I HAD MY FORMER MENTOR SAY WE'LL 5697 03:51:40,200 --> 03:51:42,920 SEE IF YOU SURVIVE WITHOUT A 5698 03:51:42,920 --> 03:51:44,880 GCRC, THAT TELLS YOU THE STATE 5699 03:51:44,880 --> 03:51:47,960 OF HOW DIFFICULT IT IS TO DO 5700 03:51:47,960 --> 03:51:48,440 THESE STUDIES. 5701 03:51:48,440 --> 03:51:53,040 >>COURTNEY, THAT CAME UP 5702 03:51:53,040 --> 03:51:54,680 YESTERDAY FROM ANOTHER, I FORGET 5703 03:51:54,680 --> 03:51:56,080 WHO, ANOTHER INSTITUTION. 5704 03:51:56,080 --> 03:51:58,680 THAT'S AN ISSUE. 5705 03:51:58,680 --> 03:52:02,000 THE FUNDING IN GENERAL PRETTY 5706 03:52:02,000 --> 03:52:03,320 TRANSLATIONAL, WE'VE HAD FOR A 5707 03:52:03,320 --> 03:52:06,160 LONG TIME, ALSO GOING DOWN ON 5708 03:52:06,160 --> 03:52:08,960 TOP OF THAT. 5709 03:52:08,960 --> 03:52:11,080 SO, YEAH. 5710 03:52:11,080 --> 03:52:13,120 >>I WOULD LIKE TO ECHO 5711 03:52:13,120 --> 03:52:13,520 COURTNEY'S POINT. 5712 03:52:13,520 --> 03:52:17,960 I THINK IT WAS INDEED SAID 5713 03:52:17,960 --> 03:52:19,760 MULTIPLE TIMES. 5714 03:52:19,760 --> 03:52:22,600 YES, THE -- CONDUCTING INTENSIVE 5715 03:52:22,600 --> 03:52:25,760 IN-LAB STUDIES HAS BECOME 5716 03:52:25,760 --> 03:52:27,520 INCREASINGLY DIFFICULT, AND SO 5717 03:52:27,520 --> 03:52:29,360 HAVING SOME STABILITY AND LIKE 5718 03:52:29,360 --> 03:52:34,320 YOU SAID IN YOUR EXAMPLE, 5719 03:52:34,320 --> 03:52:35,520 COURTNEY, IT REALLY REQUIRES A 5720 03:52:35,520 --> 03:52:38,320 LARGER TEAM TO MAKE IT HAPPEN. 5721 03:52:38,320 --> 03:52:40,760 IF YOU HAVE A SINGLE P.I. IT'S 5722 03:52:40,760 --> 03:52:44,000 ALMOST IMPOSSIBLE TO MAKE IT -- 5723 03:52:44,000 --> 03:52:48,960 TO COVER 24/7 COVER COVERAGE. 5724 03:52:48,960 --> 03:52:50,960 ONLY BY THE LUCK OF HAVING 5725 03:52:50,960 --> 03:52:52,240 MULTIPLE P.I.s IN THE SAME 5726 03:52:52,240 --> 03:52:54,000 SPACE CAN YOU MAKE IT WORK, 5727 03:52:54,000 --> 03:52:55,440 WHICH MAYBE THERE'S SOME 5728 03:52:55,440 --> 03:52:55,720 EXCEPTIONS. 5729 03:52:55,720 --> 03:52:59,120 YOU'RE ABLE TO PULL IT OFF 5730 03:52:59,120 --> 03:52:59,360 SOMEHOW. 5731 03:52:59,360 --> 03:53:02,080 BUT YOU'RE ONE OF THE FEW. 5732 03:53:02,080 --> 03:53:05,280 BUT FOR ALL OF US, IT HAS BECOME 5733 03:53:05,280 --> 03:53:08,600 INCREASINGLY DIFFICULT. 5734 03:53:08,600 --> 03:53:10,320 HAVING A STABLE CENTER FUNDING 5735 03:53:10,320 --> 03:53:12,120 OR OTHERWISE WOULD BE VERY 5736 03:53:12,120 --> 03:53:14,440 HELPFUL INDEED. 5737 03:53:14,440 --> 03:53:16,320 I WANTED TO CIRCLE BACK TO A 5738 03:53:16,320 --> 03:53:19,240 COMMENT MARTA BROUGHT UP ABOUT 5739 03:53:19,240 --> 03:53:19,800 CHRONOTYPE. 5740 03:53:19,800 --> 03:53:20,160 THREE THINGS. 5741 03:53:20,160 --> 03:53:22,880 IT WOULD BE GREAT TO MEASURE 5742 03:53:22,880 --> 03:53:23,280 CHRONOTYPE. 5743 03:53:23,280 --> 03:53:24,400 PEOPLE'S SLEEP. 5744 03:53:24,400 --> 03:53:28,880 AND THEN SOCIAL JET LAG. 5745 03:53:28,880 --> 03:53:30,240 SO USING THE SHORT REGRESSION 5746 03:53:30,240 --> 03:53:32,200 CAN DO ALL THREE. 5747 03:53:32,200 --> 03:53:35,520 AND SO I MEAN YOU WOULD NEED DAY 5748 03:53:35,520 --> 03:53:37,240 BY DAY DIARY IF YOU WANT IT DAY 5749 03:53:37,240 --> 03:53:41,600 BY DAY BUT AT LEAST IN THE SHORT 5750 03:53:41,600 --> 03:53:43,560 MUNICH CHRONOTYPE QUESTIONNAIRE, 5751 03:53:43,560 --> 03:53:44,880 GAVE YOU HABITUAL SLEEP-WAKE 5752 03:53:44,880 --> 03:53:48,040 CYCLE, CAN GIVE YOU CHRONOTYPE, 5753 03:53:48,040 --> 03:53:51,120 CAN GIVE YOU SOCIAL JET LAG, 5754 03:53:51,120 --> 03:53:54,800 SOMETHING WE'RE BUILDING INTO 5755 03:53:54,800 --> 03:53:57,120 STROKED TRIALS NOW WITH CLINICAL 5756 03:53:57,120 --> 03:53:57,320 TEAMS. 5757 03:53:57,320 --> 03:54:00,080 AND I THINK THIS IS MAYBE 5758 03:54:00,080 --> 03:54:04,120 SOMETHING SUITABLE TO RECOMMEND 5759 03:54:04,120 --> 03:54:06,360 FOR IMPLEMENTATION IN ALL LARGE 5760 03:54:06,360 --> 03:54:09,920 TRIALS. 5761 03:54:09,920 --> 03:54:14,120 >>I'D LIKE TO CLOSE OUT THIS 5762 03:54:14,120 --> 03:54:16,120 DISCUSSION SESSION FOR THIS 5763 03:54:16,120 --> 03:54:22,280 AFTERNOON AND TURN IT OVER TO 5764 03:54:22,280 --> 03:54:24,560 SHILPY DIXIT FOR THE WRAP-UP. 5765 03:54:24,560 --> 03:54:27,560 WE'VE HAD A LIVELY DISCUSSION, 5766 03:54:27,560 --> 03:54:28,400 GREAT INFORMATION. 5767 03:54:28,400 --> 03:54:29,720 HOPEFULLY THE -- I'M SURE THE 5768 03:54:29,720 --> 03:54:34,440 NIH IS LISTENING IN TO OUR NEEDS 5769 03:54:34,440 --> 03:54:41,320 TO HELP MOVE THE FIELD FORWARD. 5770 03:54:41,320 --> 03:54:45,800 WE CAN'T HEAR YOU, SHILPY. 5771 03:54:45,800 --> 03:54:46,680 YOUR MICROPHONE? 5772 03:54:46,680 --> 03:54:49,520 >>I TURNED IT ALL THE WAY DOWN 5773 03:54:49,520 --> 03:54:51,160 JUST TO BE SURE. 5774 03:54:51,160 --> 03:54:53,360 FROM THE NATIONAL CENTER ON 5775 03:54:53,360 --> 03:54:54,160 SLEEP DISORDERS RESEARCH AND 5776 03:54:54,160 --> 03:54:58,960 NHLBI I WANT TO THANK ALL OF THE 5777 03:54:58,960 --> 03:55:02,360 PANELISTS, SESSION CHAIRS, 5778 03:55:02,360 --> 03:55:03,400 FACILITATORS AROUND CO-CHAIRS, 5779 03:55:03,400 --> 03:55:07,040 MARIE-PIERRE AND KAREN, 5780 03:55:07,040 --> 03:55:08,120 EXCELLENT TWO DALES OF VALUABLE 5781 03:55:08,120 --> 03:55:08,440 INFORMATION. 5782 03:55:08,440 --> 03:55:11,000 I WANT TO THANK YOU FOR TAKING 5783 03:55:11,000 --> 03:55:13,600 THE TIME TO HELP US UNDERSTAND 5784 03:55:13,600 --> 03:55:17,000 BETTER WHAT'S NEEDED TO TAKE 5785 03:55:17,000 --> 03:55:18,520 CHRONONUTRITION AND 5786 03:55:18,520 --> 03:55:20,080 CHRONOBIOLOGY OVERALL INTO 5787 03:55:20,080 --> 03:55:23,040 CLINICAL PRACTICE AND MEDICINE. 5788 03:55:23,040 --> 03:55:24,720 HOUSEKEEPING THINGS. 5789 03:55:24,720 --> 03:55:27,320 THERE'S A LINK FOR A SURVEY IN 5790 03:55:27,320 --> 03:55:27,760 THE CHAT. 5791 03:55:27,760 --> 03:55:29,760 THIS WILL BE SENT OUT VIA E-MAIL 5792 03:55:29,760 --> 03:55:31,480 TO ALL WHO REGISTERED. 5793 03:55:31,480 --> 03:55:33,360 THE RECORDING OF THIS WORKSHOP 5794 03:55:33,360 --> 03:55:36,200 WILL BE AVAILABLE ON NIH 5795 03:55:36,200 --> 03:55:37,520 VIDEOCAST NEXT WEEK. 5796 03:55:37,520 --> 03:55:41,040 WE'LL HAVE THE EXECUTIVE SUMMARY 5797 03:55:41,040 --> 03:55:42,760 POSTED ON THE NHLBI EVENT PAGE 5798 03:55:42,760 --> 03:55:45,920 IN THE NEXT SIX WEEKS. 5799 03:55:45,920 --> 03:55:46,840 AND HOPEFULLY THE WORKSHOP 5800 03:55:46,840 --> 03:55:48,760 REPORT BY THE END OF THE YEAR. 5801 03:55:48,760 --> 03:55:50,440 AS ALWAYS, WE WANT TO THANK YOU 5802 03:55:50,440 --> 03:55:51,400 FOR JOINING USED THAT. 5803 03:55:51,400 --> 03:55:53,280 AND WE HOPE YOU HAVE A WONDERFUL 5804 03:55:53,280 --> 03:55:53,920 REST OF THE WEEK. 5805 03:55:53,920 --> 00:00:00,000 THANK YOU SO MUCH.