1
00:00:06,644 --> 00:00:11,616
WELCOME TO DAY TWO.

2
00:00:11,616 --> 00:00:13,451
WE HAD AN INTELLECTUALLY 

3
00:00:13,451 --> 00:00:14,786
STIMULATING DAY YESTERDAY.

4
00:00:14,786 --> 00:00:18,690
WE HEARD FROM A NUMBER OF 

5
00:00:18,690 --> 00:00:20,792
OUTSTANDING SPEAKERS WHO 

6
00:00:20,792 --> 00:00:23,194
FOCUSSED ON EPIDEMIOLOGICAL 

7
00:00:23,194 --> 00:00:24,829
EVIDENCE AS WELL AS MECHANISMS 

8
00:00:24,829 --> 00:00:27,432
AND ALSO THE GLOBAL CRISIS WE'RE

9
00:00:27,432 --> 00:00:28,566
AWARE OF FOR CLIMATE CHANGE AND 

10
00:00:28,566 --> 00:00:31,436
THE IMPACT ON FOOD PRODUCTION, 

11
00:00:31,436 --> 00:00:34,305
THE LIFE CYCLE OF FOOD 

12
00:00:34,305 --> 00:00:34,839
CONSUMPTION AND WASTE AND 

13
00:00:34,839 --> 00:00:36,040
DISEASE.

14
00:00:36,040 --> 00:00:40,678
I WANT TO TURN IT OVER TO YOU 

15
00:00:40,678 --> 00:00:41,446
DR. GARCIA-LARSEN TO GIVE US A 

16
00:00:41,446 --> 00:00:48,486
RECAP.

17
00:00:48,486 --> 00:00:50,855
>> THANK YOU AND HELLO
EVERYONE 

18
00:00:50,855 --> 00:00:55,426
WELCOME TO DAY TWO OF THE 

19
00:00:55,426 --> 00:00:57,795
ADVANCING NUTRITION RESEARCH FOR

20
00:00:57,795 --> 00:01:00,565
RESPIRATORY HEALTH IN ADULTS.

21
00:01:00,565 --> 00:01:04,769
WE HAD AN EXCITING FIRST DAY 

22
00:01:04,769 --> 00:01:07,071
PACKED WITH VERY INFORMATIVE 

23
00:01:07,071 --> 00:01:10,508
TALKS ADDRESSING VARIOUS ASPECTS

24
00:01:10,508 --> 00:01:14,078
OF NUTRITION AND RESPIRATORY 

25
00:01:14,078 --> 00:01:14,345
RESEARCH.

26
00:01:14,345 --> 00:01:19,217
TODAY WE'RE ORGANIZED INTO THREE

27
00:01:19,217 --> 00:01:19,484
SESSIONS.

28
00:01:19,484 --> 00:01:20,952
WE'LL START WITH THE PREVALENCE 

29
00:01:20,952 --> 00:01:24,822
AND MORTALITY FOR RESPIRATORY 

30
00:01:24,822 --> 00:01:27,058
DISEASES WORLDWIDE FROM AN 

31
00:01:27,058 --> 00:01:30,762
EPIDEMIOLOGICAL APPROACH AND 

32
00:01:30,762 --> 00:01:34,866
THEN TALKS ON VARIOUS NUTRITION 

33
00:01:34,866 --> 00:01:35,633
RESEARCH IN RELATION TO 

34
00:01:35,633 --> 00:01:38,169
RESPIRATORY OUTCOMES.

35
00:01:38,169 --> 00:01:39,203
WE REVIEWED THE EVIDENCE ON 

36
00:01:39,203 --> 00:01:44,175
DIETARY PATTERNS.

37
00:01:44,175 --> 00:01:51,282
WE DISGUST AND MODULATE THE RISK

38
00:01:51,282 --> 00:01:55,620
OF CHRONIC RESPIRATORY DISEASES 

39
00:01:55,620 --> 00:01:57,889
AND MICRONUTRIENTS.

40
00:01:57,889 --> 00:02:03,261
AND PRETTY MUCH THE EVIDENCE IS 

41
00:02:03,261 --> 00:02:07,498
EMERGING IS CONSISTENT AND WE 

42
00:02:07,498 --> 00:02:09,534
HAVE SCIENTIFIC GAPS WE'LL NEED 

43
00:02:09,534 --> 00:02:10,001
TO ADDRESS.

44
00:02:10,001 --> 00:02:12,070
WE HAVE THE OPPORTUNITY TO 

45
00:02:12,070 --> 00:02:14,238
DISCUSS THEIR ROLE OF CLIMATE 

46
00:02:14,238 --> 00:02:14,472
CHANGE.

47
00:02:14,472 --> 00:02:17,775
THE IMPACT OF CLIMATE CHANGE ON 

48
00:02:17,775 --> 00:02:20,912
FOOD SYSTEMS AS A WHOLE.

49
00:02:20,912 --> 00:02:22,513
THE ROLE OF GLOBAL WARMING AS 

50
00:02:22,513 --> 00:02:23,648
WELL AS AND IN THE AFTERNOON WE 

51
00:02:23,648 --> 00:02:26,050
HAVE A VERY EXCITING SESSION ON 

52
00:02:26,050 --> 00:02:28,553
THE MECHANISMS UNDERLYING 

53
00:02:28,553 --> 00:02:31,456
NUTRITION AND DIET IMPACT ON 

54
00:02:31,456 --> 00:02:32,790
RESPIRATORY HEALTH AND DISEASE 

55
00:02:32,790 --> 00:02:35,626
WHERE WE LOOKED INTO MORE 

56
00:02:35,626 --> 00:02:37,395
DETAILS ABOUT THE SPECIFIC 

57
00:02:37,395 --> 00:02:39,831
ASPECT OF NUTRITION TO BE 

58
00:02:39,831 --> 00:02:42,500
INVOLVED IN THE PATHOGENESIS OF 

59
00:02:42,500 --> 00:02:43,568
RESPIRATORY DISEASES.

60
00:02:43,568 --> 00:02:44,902
AND PERHAPS MORE IMPORTANTLY THE

61
00:02:44,902 --> 00:02:47,638
CAPACITY OF THESE MECHANISMS TO 

62
00:02:47,638 --> 00:02:49,373
HAVE A BENEFICIAL IMPACT AGAINST

63
00:02:49,373 --> 00:02:59,917
A PROGRESSION OF DISEASE AND BY 

64
00:03:02,987 --> 00:03:07,625
REMARKS WE PUT TOGETHER 

65
00:03:07,625 --> 00:03:15,633
YESTER

66
00:03:15,633 --> 00:03:18,369
YESTERDAY.

67
00:03:18,369 --> 00:03:23,641
SO WE LISTENED TO SEVERAL COMMON

68
00:03:23,641 --> 00:03:24,942
THEMES, NUTRITION AND DIET IN 

69
00:03:24,942 --> 00:03:26,978
GENERAL ARE VERY INCLUSIVE IN 

70
00:03:26,978 --> 00:03:28,846
TERMS OF ASCERTAINING WHICH 

71
00:03:28,846 --> 00:03:30,515
SPECIFIC COMPONENTS MIGHT BE 

72
00:03:30,515 --> 00:03:32,917
RELATED TO HEALTH AND DISEASE.

73
00:03:32,917 --> 00:03:38,956
WE LISTENED TO SEVERAL DIETARY 

74
00:03:38,956 --> 00:03:43,494
GROUPS, INDICES AND WHETHER IT 

75
00:03:43,494 --> 00:03:46,564
WAS HELPFUL TO LOOK AT CERTAIN 

76
00:03:46,564 --> 00:03:48,633
NUTRIENTS OR WHOLE FOODS AND THE

77
00:03:48,633 --> 00:03:49,934
SCIENTIFIC EVIDENCE OF THE 

78
00:03:49,934 --> 00:03:50,434
ASSOCIATION OF DIET AND 

79
00:03:50,434 --> 00:03:54,739
RESPIRATORY DISEASES.

80
00:03:54,739 --> 00:03:56,340
WE ADVANCED THE SCIENTIFIC 

81
00:03:56,340 --> 00:04:02,446
AGENDA IN TERMS OF ELUCIDATIEIN 

82
00:04:02,446 --> 00:04:05,683
THE MECHANISMS AND THE ROLE OF 

83
00:04:05,683 --> 00:04:06,417
INFLAMMATION WHICH INFLUENCE THE

84
00:04:06,417 --> 00:04:08,786
ROLE OF NUTRITION AND 

85
00:04:08,786 --> 00:04:09,687
RESPIRATORY HEALTH.

86
00:04:09,687 --> 00:04:11,622
THERE WERE SEVERAL OPPORTUNITIES

87
00:04:11,622 --> 00:04:13,124
HIGHLIGHTED PARTICULARLY FOR 

88
00:04:13,124 --> 00:04:15,193
ASTHMA AND COPD AND WE ALSO 

89
00:04:15,193 --> 00:04:16,961
DISCUSSED THE POTENTIAL FOR 

90
00:04:16,961 --> 00:04:24,235
NUTRITION TO HAVE A PRETENDIVE 

91
00:04:24,235 --> 00:04:27,438
 -- PREVENTIVE ROLE IN THE 

92
00:04:27,438 --> 00:04:28,906
PROGRESSION OF DISEASE AND 

93
00:04:28,906 --> 00:04:31,309
EXPANDING WHAT WE CONSIDER TO BE

94
00:04:31,309 --> 00:04:32,310
HEALTHY LIVES.

95
00:04:32,310 --> 00:04:35,613
WE ALSO CONSIDERED THE ISSUE OF 

96
00:04:35,613 --> 00:04:37,515
UNDERSTANDING ENVIRONMENTAL 

97
00:04:37,515 --> 00:04:38,983
SOCIAL INFLUENCES AROUND 

98
00:04:38,983 --> 00:04:40,785
NUTRITION AND RESPIRATORY HEALTH

99
00:04:40,785 --> 00:04:43,554
AND THE POTENTIAL TO CONSIDER 

100
00:04:43,554 --> 00:04:45,223
THE REST OF LIFE RELATED FACTORS

101
00:04:45,223 --> 00:04:47,992
AS THEY'RE INVOLVED IN WHAT WE 

102
00:04:47,992 --> 00:04:52,663
EAT AND HOW WE UNDERSTAND 

103
00:04:52,663 --> 00:04:53,731
NUTRITION FROM A RESEARCH POINT 

104
00:04:53,731 --> 00:04:54,131
OF VIEW.

105
00:04:54,131 --> 00:04:56,634
WE LISTENED TO THE RESEARCH 

106
00:04:56,634 --> 00:04:59,470
METHODOLOGY ASPECTS RELATED TO 

107
00:04:59,470 --> 00:05:01,072
THE ASSESSMENT OF NUTRITION IN 

108
00:05:01,072 --> 00:05:04,308
THE GENERAL POPULATION.

109
00:05:04,308 --> 00:05:05,543
WE DISCUSSED ISSUES AROUND 

110
00:05:05,543 --> 00:05:07,612
STRENGTHENING THE WAY IN WHICH 

111
00:05:07,612 --> 00:05:10,815
WE ASCERTAINED NUTRITION IN 

112
00:05:10,815 --> 00:05:12,416
CLINICAL AND EPIDEMIOLOGICAL 

113
00:05:12,416 --> 00:05:18,189
STUDIES AND THERE'S HUGE ROOM 

114
00:05:18,189 --> 00:05:20,524
HERE TO PROGRESSIVE AND RESEARCH

115
00:05:20,524 --> 00:05:23,494
AGENDA TO EXPAND WHAT WE'RE 

116
00:05:23,494 --> 00:05:28,666
DOING AND STRENGTHEN MORE 

117
00:05:28,666 --> 00:05:31,168
SCIENTIFIC EVIDENCE.

118
00:05:31,168 --> 00:05:33,137
WE HAVE TWO SESSIONS IF WE CAN 

119
00:05:33,137 --> 00:05:34,872
GO TO THE NEXT SLIDE.

120
00:05:34,872 --> 00:05:35,806
WE HAVE TWO SESSIONS.

121
00:05:35,806 --> 00:05:38,342
ONE IN THE MORNING AND ONE IN 

122
00:05:38,342 --> 00:05:40,511
THE AFTERNOON.

123
00:05:40,511 --> 00:05:42,013
TODAY WE'RE GOING TO EXPAND ON 

124
00:05:42,013 --> 00:05:44,548
SOME OF THE EMERGING PRECISIONS 

125
00:05:44,548 --> 00:05:47,385
MEASURES OF DIET AND NUTRITION 

126
00:05:47,385 --> 00:05:49,420
IN EPIDEMIOLOGICAL AND 

127
00:05:49,420 --> 00:05:50,588
INTERVENTIONAL STUDIES OF LUNG 

128
00:05:50,588 --> 00:05:52,556
HEALTH AND DISEASE.

129
00:05:52,556 --> 00:05:57,895
YESTERDAY WE DID TOUCH ON THE 

130
00:05:57,895 --> 00:06:01,499
NEEDS TO EXPAND THE TESTS AND 

131
00:06:01,499 --> 00:06:03,067
THE ACCURACY OF TOOLS THAT WE 

132
00:06:03,067 --> 00:06:07,905
USE FOR THE MEASUREMENT OF 

133
00:06:07,905 --> 00:06:09,173
NUTRITION AND I'M EXCITED TO 

134
00:06:09,173 --> 00:06:11,275
HEAR WHAT EXPERTS ARE GOING TO 

135
00:06:11,275 --> 00:06:11,609
PROPOSE.

136
00:06:11,609 --> 00:06:14,712
WE'RE GOING TO LOOK TO A NUMBER 

137
00:06:14,712 --> 00:06:16,113
OF EMERGING TOOLS AS WELL AS 

138
00:06:16,113 --> 00:06:18,149
NOVEL DIETARY BIOMARKERS AND WE 

139
00:06:18,149 --> 00:06:21,118
HOPE TO ADDRESS THE QUESTION OF 

140
00:06:21,118 --> 00:06:23,120
WHETHER AVAILABLE AND 

141
00:06:23,120 --> 00:06:25,489
NUTRITIONAL BIOMARKERS CAN 

142
00:06:25,489 --> 00:06:27,458
PREDICT LUNG HEALTH AND VARIOUS 

143
00:06:27,458 --> 00:06:37,068
OUTCOMES OF LUNG DISEASES.

144
00:06:37,068 --> 00:06:39,136
IN SESSION 5 THIS AFTERNOON 

145
00:06:39,136 --> 00:06:43,307
WE'RE GOING TO HEAR FROM SEVERAL

146
00:06:43,307 --> 00:06:44,408
WORLDWIDE EXPERTS ON THEMES 

147
00:06:44,408 --> 00:06:46,477
RELATED TO DIETARY AND 

148
00:06:46,477 --> 00:06:48,379
NUTRITIONAL INTERVENTIONS FOR 

149
00:06:48,379 --> 00:06:51,115
THE PREVENTION AND MANAGEMENT OF

150
00:06:51,115 --> 00:06:54,285
RESPIRATORY DISEASES.

151
00:06:54,285 --> 00:06:55,386
QUITE OFTEN WE STRUGGLE AND 

152
00:06:55,386 --> 00:06:56,821
YESTERDAY WE DISCUSSED THIS IN 

153
00:06:56,821 --> 00:06:58,656
SELF OF THE SESSIONS HOW 

154
00:06:58,656 --> 00:07:01,726
SUSTAINABLE IT IS TO DO A FOOD 

155
00:07:01,726 --> 00:07:02,326
INTERVENTION.

156
00:07:02,326 --> 00:07:05,429
CAN WE HAVE PEOPLE, PATIENTS, 

157
00:07:05,429 --> 00:07:08,966
THE GENERAL POPULATION TO 

158
00:07:08,966 --> 00:07:10,801
PARTICIPATE IN TRIALS THAT CAN 

159
00:07:10,801 --> 00:07:11,602
BE SUSTAINABLE OVER TIME.

160
00:07:11,602 --> 00:07:13,504
SO TODAY WE'RE GOING TO HEAR 

161
00:07:13,504 --> 00:07:15,106
MORE ABOUT SOME OF THE STUDIES 

162
00:07:15,106 --> 00:07:18,376
THAT HAVE BEEN CONDUCTED AND 

163
00:07:18,376 --> 00:07:21,112
HOPEFULLY THEY'RE GOING TO HELP 

164
00:07:21,112 --> 00:07:26,384
US ADDRESS THE QUESTION OF 

165
00:07:26,384 --> 00:07:27,952
WHETHER THERE'S DISSEMINATION OF

166
00:07:27,952 --> 00:07:30,488
DIETARY INTERVENTIONS CAN 

167
00:07:30,488 --> 00:07:33,124
SUPPORT RESPIRATORY DISEASE 

168
00:07:33,124 --> 00:07:33,758
PREVENTION AND CONTROL.

169
00:07:33,758 --> 00:07:35,626
SO I THANK YOU ALL FOR JOINING 

170
00:07:35,626 --> 00:07:36,293
US TODAY.

171
00:07:36,293 --> 00:07:38,429
I LOOK FORWARD TO THE 

172
00:07:38,429 --> 00:07:39,530
DISCUSSIONS WE ARE GOING TO HOST

173
00:07:39,530 --> 00:07:39,930
IN THE SECOND DAY.

174
00:07:39,930 --> 00:07:45,803
THANK YOU.

175
00:07:45,803 --> 00:07:47,805
>> THANK YOU SO MUCH, 

176
00:07:47,805 --> 00:07:49,039
DR. GARCIA-LARSEN FOR THE RECAP 

177
00:07:49,039 --> 00:07:51,275
OF YESTERDAY AND THE OVERVIEW OF

178
00:07:51,275 --> 00:07:52,309
WHAT YOU EXPECT TODAY.

179
00:07:52,309 --> 00:07:54,678
IT'S MY GREAT PLEASURE TO 

180
00:07:54,678 --> 00:07:57,615
INTRODUCE MY CO-MODERATOR FOR 

181
00:07:57,615 --> 00:08:01,118
SESSION 4, DR. FELIPE MACHADO.

182
00:08:01,118 --> 00:08:06,657
HE COMPLETED HIS DEGREE IN 

183
00:08:06,657 --> 00:08:09,126
PHYSIO THERAPY IN BRAZIL IN 

184
00:08:09,126 --> 00:08:09,894
2016.

185
00:08:09,894 --> 00:08:11,862
HE WAS A MEMBER OF THE 

186
00:08:11,862 --> 00:08:14,265
LABORATORY OF RESEARCH ON 

187
00:08:14,265 --> 00:08:16,200
RESPIRATORY PHYSIO THERAPY FOR 

188
00:08:16,200 --> 00:08:19,036
THREE YEARS AS AN UNDERGRADUATE 

189
00:08:19,036 --> 00:08:20,504
RESEARCH STUDENT.

190
00:08:20,504 --> 00:08:23,641
AFTER GRADUATION, DR. MACHADO 

191
00:08:23,641 --> 00:08:26,243
CONTINUED HIS ACTIVITIES AT THE 

192
00:08:26,243 --> 00:08:29,013
SAME LAB AS A MASTER STUDENT.

193
00:08:29,013 --> 00:08:30,848
HE OBTAINED HIS MASTER'S DEGREE 

194
00:08:30,848 --> 00:08:34,084
IN REHABILITATION SCIENCES AT 

195
00:08:34,084 --> 00:08:36,620
INDIANA STATE UNIVERSITY IN 

196
00:08:36,620 --> 00:08:36,987
2018.

197
00:08:36,987 --> 00:08:40,524
IN 2020, HE BEGAN HIS Ph.D. AT 

198
00:08:40,524 --> 00:08:42,426
THE DEPARTMENT OF RESPIRATORY 

199
00:08:42,426 --> 00:08:45,162
MEDICINE OF THE SCHOOL OF 

200
00:08:45,162 --> 00:08:51,101
NUTRITION AND TRANSLATIONAL 

201
00:08:51,101 --> 00:08:58,843
RESEARCH IN METABOLISM AT 

202
00:08:58,843 --> 00:09:02,880
HASSETT UNIVERSITY AND LOOKED AT

203
00:09:02,880 --> 00:09:03,581
BODY COMPOSITION AND 

204
00:09:03,581 --> 00:09:06,283
ABNORMALITIES IN PATIENTS AND IS

205
00:09:06,283 --> 00:09:10,387
A POSTDOCTORAL RESEARCHER IN 

206
00:09:10,387 --> 00:09:13,224
BELGIUM FOCUSSING HIS RESEARCH 

207
00:09:13,224 --> 00:09:19,330
ON BODY COMPOSITION AND EXERCISE

208
00:09:19,330 --> 00:09:20,664
PHYSIOLOGY IN INDIVIDUALS WITH 

209
00:09:20,664 --> 00:09:21,499
METABOLIC DISEASES.

210
00:09:21,499 --> 00:09:23,300
NOW I'LL TURN IT OVER TO YOU, 

211
00:09:23,300 --> 00:09:26,170
DR. MACHADO TO INTRODUCE SESSION

212
00:09:26,170 --> 00:09:27,204
4 AND AN OBJECTIVE AND KEY 

213
00:09:27,204 --> 00:09:31,509
QUESTION.

214
00:09:31,509 --> 00:09:32,643
>> THANK YOU VERY MUCH,
DR. MA 

215
00:09:32,643 --> 00:09:34,612
FOR THE INTRODUCTION AND I'D 

216
00:09:34,612 --> 00:09:35,913
LIKE TO THANK THE ORGANIZATIONS 

217
00:09:35,913 --> 00:09:40,584
FOR THE INVITATION.

218
00:09:40,584 --> 00:09:45,356
AND WELCOME ALL TO SECTION 4 

219
00:09:45,356 --> 00:09:47,625
MEASURES OF DIET AND NUTRITION 

220
00:09:47,625 --> 00:09:50,227
IN EPIDEMIOLOGICAL AND 

221
00:09:50,227 --> 00:09:51,228
INTEGRATIONAL STUDIES OF LUNG 

222
00:09:51,228 --> 00:09:54,832
AND LUNG HEALTH AND DISEASES.

223
00:09:54,832 --> 00:09:59,537
WE ARE GOING TO HAVE FOUR 

224
00:09:59,537 --> 00:10:02,806
SPEAKERS AND I'LL INTRODUCE 

225
00:10:02,806 --> 00:10:04,808
DR. SHILPA BHUPATHIRAJU.

226
00:10:04,808 --> 00:10:08,078
SHE'S AN ASSISTANT PROFESSOR OF 

227
00:10:08,078 --> 00:10:09,413
NUTRITION AND MEDICINE AT 

228
00:10:09,413 --> 00:10:12,182
HARVARD UNIVERSITY.

229
00:10:12,182 --> 00:10:15,252
SO THANK YOU, VERY MUCH FOR 

230
00:10:15,252 --> 00:10:19,557
BEING HERE AND I'LL HAND IT TO 

231
00:10:19,557 --> 00:10:19,723
YOU.

232
00:10:19,723 --> 00:10:20,624
>> THANK YOU.

233
00:10:20,624 --> 00:10:26,630
THANKS, DR. MACHADO AND DR. MA.

234
00:10:26,630 --> 00:10:28,098
GOOD MORNING EVERYONE, OR GOOD 

235
00:10:28,098 --> 00:10:28,432
EVENING.

236
00:10:28,432 --> 00:10:30,000
HAPPY FRIDAY.

237
00:10:30,000 --> 00:10:31,235
I'D LIKE TO BEGIN BY THANKING 

238
00:10:31,235 --> 00:10:33,637
THE CHAIRS AND THE CO-CHAIRS FOR

239
00:10:33,637 --> 00:10:37,675
PUT TOGETHER THIS FANTASTIC 

240
00:10:37,675 --> 00:10:37,942
WORKSHOP.

241
00:10:37,942 --> 00:10:40,144
YESTERDAY WAS A REAL TREAT FOR 

242
00:10:40,144 --> 00:10:43,614
ALL OF US WORKING IN THIS AREA.

243
00:10:43,614 --> 00:10:47,618
I WILL SAY THAT I AM NOT A 

244
00:10:47,618 --> 00:10:50,087
RESPIRATORY EPIDEMIOLOGIST BUT I

245
00:10:50,087 --> 00:10:52,289
AM A NUTRITIONAL EPIDEMIOLOGIST 

246
00:10:52,289 --> 00:10:54,425
AND I LOOK AT MEASURING DIET.

247
00:10:54,425 --> 00:10:55,626
TODAY'S TALK WILL FOCUS ON HOW 

248
00:10:55,626 --> 00:10:57,962
WE CAN USE EMERGING BIOMARKERS 

249
00:10:57,962 --> 00:11:01,665
OF DIET AND NUTRITION AND 

250
00:11:01,665 --> 00:11:02,333
OPTIONAL STUDIES AND 

251
00:11:02,333 --> 00:11:06,537
INTERVENTIONAL STUDIES.

252
00:11:06,537 --> 00:11:08,706
I DO NOT HAVE CONFLICTS OF 

253
00:11:08,706 --> 00:11:10,808
INTEREST TO DISCLOSE.

254
00:11:10,808 --> 00:11:13,210
ONE OF THE THINGS WE GRAPPLE 

255
00:11:13,210 --> 00:11:16,280
WITH AS NUTRITIONISTS IS 

256
00:11:16,280 --> 00:11:16,981
ACCURATE DIETARY ASSESSMENT.

257
00:11:16,981 --> 00:11:19,617
THAT'S A HUGE CHALLENGE.

258
00:11:19,617 --> 00:11:22,720
SO TRADITIONAL DIETARY 

259
00:11:22,720 --> 00:11:24,488
ASSESSMENT TOOLS LIKE TREATMENT 

260
00:11:24,488 --> 00:11:26,023
QUESTIONNAIRES OR 24-HOUR 

261
00:11:26,023 --> 00:11:28,759
RECALLS OR NUTRITION THE GOLD 

262
00:11:28,759 --> 00:11:31,228
STANDARD, FOOD DIARIES HAVE ALL 

263
00:11:31,228 --> 00:11:31,695
KIND OF ERRORS.

264
00:11:31,695 --> 00:11:37,501
THE RECALL BIAS IS AN ISSUE AND 

265
00:11:37,501 --> 00:11:39,103
MANY TOOLS DO NOT HAVE ALL TOOLS

266
00:11:39,103 --> 00:11:41,438
AVAILABLE SO WHAT GET ON THE 

267
00:11:41,438 --> 00:11:43,607
FOOD FREQUENCY QUESTIONNAIRE AND

268
00:11:43,607 --> 00:11:45,209
YOU HAVE MEASUREMENT ERROR.

269
00:11:45,209 --> 00:11:55,753
IT CAN BE SYSTEMATIC OR RANDOM.

270
00:11:56,220 --> 00:11:57,821
THIS IS WHERE NUTRITIONAL 

271
00:11:57,821 --> 00:11:59,823
BIOMARKERS COME IN TO REVISIT 

272
00:11:59,823 --> 00:12:02,593
THE DEFINITION OF A NUTRITION 

273
00:12:02,593 --> 00:12:02,860
BIOMARKER.

274
00:12:02,860 --> 00:12:05,963
IT'S A BIOLOGICAL SPECIMEN IN 

275
00:12:05,963 --> 00:12:09,700
ANY FLUID OR IN HAIR OR 

276
00:12:09,700 --> 00:12:10,067
TOENAILS.

277
00:12:10,067 --> 00:12:11,835
WE DO A LOT OF WORK IN TOENAILS 

278
00:12:11,835 --> 00:12:15,639
TO LOOK AT HEAVY METALS BUT ANY 

279
00:12:15,639 --> 00:12:21,378
BIOLOGICAL SPECIMEN AN INTAKER 

280
00:12:21,378 --> 00:12:25,783
AND A FUNCTIONAL OR CLINICAL 

281
00:12:25,783 --> 00:12:33,957
INDICATOR ORE BIO CHEMICAL AND 

282
00:12:33,957 --> 00:12:36,360
IT'S THOUGHT OF THE FOOD YOU 

283
00:12:36,360 --> 00:12:36,593
CONSUME.

284
00:12:36,593 --> 00:12:39,396
AND THE REASON WE RELY ON 

285
00:12:39,396 --> 00:12:40,497
NUTRITIONAL BIOMARKERS IN 

286
00:12:40,497 --> 00:12:42,933
ADDITION TO TRADITIONAL DIETARY 

287
00:12:42,933 --> 00:12:45,202
MARKERS IS YOU'RE REALLY ABLE TO

288
00:12:45,202 --> 00:12:49,239
LOOK AT DIETARY INTAKE 

289
00:12:49,239 --> 00:12:49,807
RETROSPECTIVELY.

290
00:12:49,807 --> 00:12:51,742
IT REFLECTS THE BIO AVAILABILITY

291
00:12:51,742 --> 00:12:55,779
FOR THE TRUE INTERNAL DOSE.

292
00:12:55,779 --> 00:12:58,582
FROM A MEASUREMENT ERROR 

293
00:12:58,582 --> 00:12:59,183
STANDPOINT, BIOMARKERS HAVE 

294
00:12:59,183 --> 00:13:01,618
DIFFERENT SOURCES OF RANDOM 

295
00:13:01,618 --> 00:13:03,420
ERROR FROM TRADITIONAL DIETARY 

296
00:13:03,420 --> 00:13:04,321
ASSESSMENT METHODS.

297
00:13:04,321 --> 00:13:04,955
THAT BECOMES IMPORTANT BECAUSE 

298
00:13:04,955 --> 00:13:07,624
WHEN YOU'RE TRYING TO CALIBRATE 

299
00:13:07,624 --> 00:13:10,360
YOUR DIETARY ASSESSMENT TOOLS 

300
00:13:10,360 --> 00:13:11,962
IT'S CRITICAL YOUR TEST AND YOUR

301
00:13:11,962 --> 00:13:14,098
GOLD STANDARD HAVE VERY 

302
00:13:14,098 --> 00:13:14,498
DIFFERENT ERRORS.

303
00:13:14,498 --> 00:13:17,401
SO THIS WILL ALLOW FOR 

304
00:13:17,401 --> 00:13:19,470
MEASUREMENT ERROR CORRECTION.

305
00:13:19,470 --> 00:13:22,873
MOST IMPORTANTLY NUTRITIONAL 

306
00:13:22,873 --> 00:13:24,141
BIOMARKERS HAVE SMALLER ERRORS 

307
00:13:24,141 --> 00:13:27,144
COMPARED TO RECALLS SO YOU DO 

308
00:13:27,144 --> 00:13:28,946
GET A MORE POWERFUL ESTIMATE 

309
00:13:28,946 --> 00:13:30,714
GIVEN THE SMALLER ERROR AND THEY

310
00:13:30,714 --> 00:13:34,618
CAN BE INDEPENDENTLY USED TO 

311
00:13:34,618 --> 00:13:35,219
CONFIRM RELATIONSHIP BETWEEN 

312
00:13:35,219 --> 00:13:40,858
DIET AND DISEASE RISK.

313
00:13:40,858 --> 00:13:42,126
AND DESPITE THE ADVANTAGES 

314
00:13:42,126 --> 00:13:44,428
YOU'LL BE SHOCKED TO KNOW WE 

315
00:13:44,428 --> 00:13:46,764
REALLY ONLY HAVE ABOUT THREE 

316
00:13:46,764 --> 00:13:51,468
OBJECTIVE DIETARY BIOMARKERS FOR

317
00:13:51,468 --> 00:13:55,439
NUTRITION THAT'S LABELLED FOR 

318
00:13:55,439 --> 00:13:57,608
ENERGY AND URINARY NITROGEN A 

319
00:13:57,608 --> 00:13:59,610
BIOMARKER OF PROTEIN INTAKE AND 

320
00:13:59,610 --> 00:14:02,112
SODIUM AND POTASSIUM FOR THAT 

321
00:14:02,112 --> 00:14:10,354
INTAKE.

322
00:14:10,354 --> 00:14:12,990
SO THERE HAS BEEN A REAL PUSH TO

323
00:14:12,990 --> 00:14:17,461
IDENTIFY MORE OBJECTIVE DIETARY 

324
00:14:17,461 --> 00:14:18,162
BIOMARKERS.

325
00:14:18,162 --> 00:14:21,532
IF YOU THINK ABOUT IDENTIFYING 

326
00:14:21,532 --> 00:14:22,866
DIETARY BIOMARKERS IS SO 

327
00:14:22,866 --> 00:14:25,702
DIFFICULT OR ASSESSING DIET IS 

328
00:14:25,702 --> 00:14:31,608
SO DIFFICULT IS BECAUSE ALL 

329
00:14:31,608 --> 00:14:34,111
CONSUME FOODS HIGHLY COMPLEX AND

330
00:14:34,111 --> 00:14:35,045
VARIABLE AND WE CONSUME NOT 

331
00:14:35,045 --> 00:14:36,513
FOODS BUT PATTERNS.

332
00:14:36,513 --> 00:14:40,751
THE FOODS WE CONSUME HAVE MORE 

333
00:14:40,751 --> 00:14:43,654
THAN 25,000 COMPOUNDS MOST OF 

334
00:14:43,654 --> 00:14:45,155
WHICH ARE METABOLIZED IN THE 

335
00:14:45,155 --> 00:14:49,059
HUMAN BODY.

336
00:14:49,059 --> 00:14:51,495
THE FOOD METABOLOME IS COMPLEX 

337
00:14:51,495 --> 00:14:52,629
AND VARIABLE.

338
00:14:52,629 --> 00:14:55,165
THIS CONSTITUTES A UNIQUE AND 

339
00:14:55,165 --> 00:14:56,834
RICH SOURCE OF INFORMATION ON 

340
00:14:56,834 --> 00:14:59,102
THE HUMAN DIET THAT HAS BARELY 

341
00:14:59,102 --> 00:14:59,603
BEEN EXPLORED.

342
00:14:59,603 --> 00:15:03,473
THIS IS WHERE OMICS COMES IN.

343
00:15:03,473 --> 00:15:09,546
SO, IF WE USE THAT TO 

344
00:15:09,546 --> 00:15:10,814
CHARACTERIZE THE FOOD METABOLOME

345
00:15:10,814 --> 00:15:11,949
SHOULD LOOK AT EXPOSURE AND 

346
00:15:11,949 --> 00:15:16,119
IDENTIFICATION OF FOODS THAT CAN

347
00:15:16,119 --> 00:15:17,688
INFLUENCE DISEASE RISK HERE RISK

348
00:15:17,688 --> 00:15:20,557
OF RESPIRATORY DISEASES IN 

349
00:15:20,557 --> 00:15:22,192
CLINICAL AND EPIDEMIOLOGICAL 

350
00:15:22,192 --> 00:15:22,559
DISEASES.

351
00:15:22,559 --> 00:15:26,697
WHEN WE THINK ABOUT THE PLASMA 

352
00:15:26,697 --> 00:15:29,299
METABOLOME IT'S NOT THE HOST 

353
00:15:29,299 --> 00:15:31,735
METABOLOME AND THE FOOD 

354
00:15:31,735 --> 00:15:34,838
METABOLOME AND THE EXPOSOME.

355
00:15:34,838 --> 00:15:36,306
THINKING ABOUT OMICS OF THE 

356
00:15:36,306 --> 00:15:38,775
TECHNOLOGIES WE HAVE, 

357
00:15:38,775 --> 00:15:40,477
METABOLOMICS HAS HELD THE 

358
00:15:40,477 --> 00:15:43,881
GREATEST PROMISE THUS FAR FOR 

359
00:15:43,881 --> 00:15:45,549
NUTRITIONAL BIOMARKER 

360
00:15:45,549 --> 00:15:47,618
DEVELOPMENT WITH THE INTEGRATION

361
00:15:47,618 --> 00:15:50,387
OF ALL OMICS TECHNOLOGIES AND 

362
00:15:50,387 --> 00:15:52,723
CLOSEST TO THE PHENOTYPE.

363
00:15:52,723 --> 00:15:55,626
THE END GOAL OF IDENTIFYING 

364
00:15:55,626 --> 00:15:56,460
NUTRITIONAL BIOMARKERS OF FOODS 

365
00:15:56,460 --> 00:15:58,962
AND DIETARY PATTERNS IS THIS 

366
00:15:58,962 --> 00:16:01,665
CONCEPT OF PRECISION NUTRITION 

367
00:16:01,665 --> 00:16:03,300
TO USE THE INFORMATION TO 

368
00:16:03,300 --> 00:16:06,703
STRATIFY INDIVIDUALS BASED ON 

369
00:16:06,703 --> 00:16:07,838
THEIR DISEASE RISK, IDENTIFY 

370
00:16:07,838 --> 00:16:10,507
DIETARY BIOMARKERS AND TO 

371
00:16:10,507 --> 00:16:11,975
IDENTIFY RESPONDERS AND 

372
00:16:11,975 --> 00:16:15,712
NON-RESPONDERS TO A GIVEN 

373
00:16:15,712 --> 00:16:20,250
INTERVENTION.

374
00:16:20,250 --> 00:16:24,354
SO MUCH OF MY WORK FOCUSSED ON 

375
00:16:24,354 --> 00:16:25,756
BIOMARKER DISCOVERY IN 

376
00:16:25,756 --> 00:16:27,324
INTERVENTION STUDIES AND 

377
00:16:27,324 --> 00:16:27,824
OBSERVATIONAL DATA.

378
00:16:27,824 --> 00:16:31,662
YOU CAN DISCOVER BIOMARKERS 

379
00:16:31,662 --> 00:16:33,563
USING STUDY DESIGNS.

380
00:16:33,563 --> 00:16:35,632
IN INTERVENTION STUDIES THE 

381
00:16:35,632 --> 00:16:37,968
PIPELINE IS YOU HAVE 

382
00:16:37,968 --> 00:16:39,202
PARTICIPANTS COME FASTED.

383
00:16:39,202 --> 00:16:41,905
YOU DO AN ACUTE INTERVENTION AND

384
00:16:41,905 --> 00:16:45,142
GIVE THEM THE FEST FOOD AND THEN

385
00:16:45,142 --> 00:16:47,311
YOU MEASURE THE BIO FLUIDS AT 

386
00:16:47,311 --> 00:16:48,345
SEVERAL TIME POINTS OVER A 

387
00:16:48,345 --> 00:16:49,947
PERIOD OF A DAY.

388
00:16:49,947 --> 00:16:56,720
AND THEN YOU RUN OMICS ON THESE 

389
00:16:56,720 --> 00:17:01,325
BIOMARK

390
00:17:01,325 --> 00:17:03,593
BIOMARKERS AND LOOK AT THE 

391
00:17:03,593 --> 00:17:08,598
PHARMACO KINETICS AND HOW IT 

392
00:17:08,598 --> 00:17:12,869
CLEARS OUT AND THIS IS ONE THAT 

393
00:17:12,869 --> 00:17:17,908
WAS DONE IN THE INTERMAP STUDY.

394
00:17:17,908 --> 00:17:21,111
YOU CAN SEE THE OBJECTIVE 

395
00:17:21,111 --> 00:17:24,014
BIOMEDICAL FOR CITRUS FOOD 

396
00:17:24,014 --> 00:17:24,748
INTAKE IS CLEARED WITHIN 24 

397
00:17:24,748 --> 00:17:27,584
HOURS AND THE BIOMARKER IS OUT 

398
00:17:27,584 --> 00:17:29,753
AFTER CONSUMPTION.

399
00:17:29,753 --> 00:17:31,221
THIS BECOMES IMPORTANT BECAUSE 

400
00:17:31,221 --> 00:17:36,927
THE RELEVANT EXPOSURE IS THE 

401
00:17:36,927 --> 00:17:37,594
USUAL DIET.

402
00:17:37,594 --> 00:17:39,796
WHAT DO PARTICIPANTS CONSUME ON 

403
00:17:39,796 --> 00:17:45,602
AVERAGE.

404
00:17:45,602 --> 00:17:47,170
MOST OF MY WORK IN BIOMARKER 

405
00:17:47,170 --> 00:17:49,539
DISCOVERY FOCUSSED ON DATA USING

406
00:17:49,539 --> 00:17:50,941
OBSERVATIONAL STUDIES ESPECIALLY

407
00:17:50,941 --> 00:17:53,477
THOSE IN THE HARVARD COHORTS, 

408
00:17:53,477 --> 00:17:56,480
THE NURSES HEALTH STUDY 1 AND 2 

409
00:17:56,480 --> 00:17:58,715
AND FOLLOW-UP STUDY.

410
00:17:58,715 --> 00:18:01,718
SO WE ALREADY HAVE DIET MEASURED

411
00:18:01,718 --> 00:18:02,986
ON A POPULATION USING A 

412
00:18:02,986 --> 00:18:06,156
COMBINATION OF FOOD FREQUENCIES,

413
00:18:06,156 --> 00:18:08,425
24-HOUR RECALLS AND SOME 

414
00:18:08,425 --> 00:18:09,292
RECORDS.

415
00:18:09,292 --> 00:18:10,260
WE CATEGORIZE THEM INTO LOW AND 

416
00:18:10,260 --> 00:18:13,797
HIGH CONSUMERS OF EITHER 

417
00:18:13,797 --> 00:18:15,599
NUTRIENT OF FOOD OR DIETARY 

418
00:18:15,599 --> 00:18:16,733
PATTERN.

419
00:18:16,733 --> 00:18:18,435
ON THE RIGHT YOU SEE THE PIE 

420
00:18:18,435 --> 00:18:21,505
CHART.

421
00:18:21,505 --> 00:18:28,578
THIS IS ACTUALLY A METABOLOMIC 

422
00:18:28,578 --> 00:18:32,249
SIGNATURE AND YOU RUN OMICS ON 

423
00:18:32,249 --> 00:18:33,583
ARCHIVED PLASMA SAMPLES AND YOU 

424
00:18:33,583 --> 00:18:36,019
RUN SAMPLES AND IDENTIFY 

425
00:18:36,019 --> 00:18:41,391
BIOMARKERS AND TEST FOR THE 

426
00:18:41,391 --> 00:18:49,866
SENSITIVITY AND WE IDENTIFIED A 

427
00:18:49,866 --> 00:18:53,670
PANEL OF 63 BIOMARKERS.

428
00:18:53,670 --> 00:18:56,540
THE ADVANTAGE WITH THE 

429
00:18:56,540 --> 00:18:57,207
MULTI-METABOLITE BIOMARKERS CAN 

430
00:18:57,207 --> 00:18:59,276
INCREASE THE ACCURACY AND 

431
00:18:59,276 --> 00:19:02,045
PRECISION OF YOUR DIETARY TOOL.

432
00:19:02,045 --> 00:19:04,848
AND AS I SAID BEFORE IT'S ALSO 

433
00:19:04,848 --> 00:19:06,950
IMPORTANT THESE BIOMARKERS HAVE 

434
00:19:06,950 --> 00:19:08,418
A SUFFICIENT HALF LIFE BECAUSE 

435
00:19:08,418 --> 00:19:11,655
AS YOU RECALL, THE MOST 

436
00:19:11,655 --> 00:19:12,422
IMPORTANT EXPOSURE OF 

437
00:19:12,422 --> 00:19:15,459
EPIDEMIOLOGY IS LONG-TERM DIET.

438
00:19:15,459 --> 00:19:17,027
SO IF YOU HAVE A BIOMARKER THAT 

439
00:19:17,027 --> 00:19:19,529
IS CLEARED FROM YOUR SYSTEM 

440
00:19:19,529 --> 00:19:21,598
WITHIN 24 HOURS YOU WANT 

441
00:19:21,598 --> 00:19:22,132
REPEATED MEASURES OF THIS 

442
00:19:22,132 --> 00:19:24,768
BIOMARKER.

443
00:19:24,768 --> 00:19:28,371
AND ANOTHER THING IS FOODS WE 

444
00:19:28,371 --> 00:19:29,539
CONSUME ARE HIGHLY CORRELATED.

445
00:19:29,539 --> 00:19:31,641
YOU RUN TO THE RISK OF 

446
00:19:31,641 --> 00:19:35,011
IDENTIFYING BIOMARKERS WITH LOW 

447
00:19:35,011 --> 00:19:35,312
SPECIFICITY.

448
00:19:35,312 --> 00:19:37,948
ANOTHER EXAMPLE WAS WHEN WE WERE

449
00:19:37,948 --> 00:19:41,284
LOOKING AT COFFEE BIOMARKERS IN 

450
00:19:41,284 --> 00:19:42,986
OUR SAMPLE AND THE BIOMARKER 

451
00:19:42,986 --> 00:19:49,526
THAT POPPED UP WAS A NICOTINE 

452
00:19:49,526 --> 00:19:49,826
METABOLITE.

453
00:19:49,826 --> 00:19:50,894
IF YOU THINK ABOUT COFFEE AND 

454
00:19:50,894 --> 00:19:52,863
THE BEHAVIORS THAT TRAVEL WITH 

455
00:19:52,863 --> 00:19:55,198
COFFEE, SMOKING IS A BEHAVIOR 

456
00:19:55,198 --> 00:19:57,100
THAT TRAVELS WITH COFFEE.

457
00:19:57,100 --> 00:19:58,401
YOU HAVE TO MAKE SURE YOU 

458
00:19:58,401 --> 00:20:00,937
UNDERSTAND HOW FOODS ARE 

459
00:20:00,937 --> 00:20:02,038
CONSUMED, THE BEHAVIORS THAT 

460
00:20:02,038 --> 00:20:11,381
TRAVEL WOMEN  -- WITH THE IT AND

461
00:20:11,381 --> 00:20:14,584
CONTROL FOR THOSE.

462
00:20:14,584 --> 00:20:16,386
SOME ISSUES USING OMIC 

463
00:20:16,386 --> 00:20:20,690
TECHNIQUES IS THE PARTICIPANT 

464
00:20:20,690 --> 00:20:21,258
METABOLOMIC VARIATION.

465
00:20:21,258 --> 00:20:23,627
THIS CAN BE PERCEIVED AS AN 

466
00:20:23,627 --> 00:20:26,563
ADVANTAGE AS WELL BECAUSE OMICS 

467
00:20:26,563 --> 00:20:28,732
ALLOWS YOU TO CAPTURE THE 

468
00:20:28,732 --> 00:20:29,466
PARTICIPANT VARIATION WHICH 

469
00:20:29,466 --> 00:20:32,035
DIETARY ASSESSMENT TOOLS CANNOT.

470
00:20:32,035 --> 00:20:34,571
AND THEN YOU ALSO HAVE 

471
00:20:34,571 --> 00:20:36,907
BIOMARKERS WHERE THERE ARE 

472
00:20:36,907 --> 00:20:37,841
MODULATIONS AGAINST RELATIVELY 

473
00:20:37,841 --> 00:20:40,310
LOW DOSES OF FOODS OR NEWT 

474
00:20:40,310 --> 00:20:40,677
REPRESENTS.

475
00:20:40,677 --> 00:20:45,615
AGAIN GOING BACK TO THE ISSUE OF

476
00:20:45,615 --> 00:20:48,552
METABOLITES HAVING A SHORT HALF 

477
00:20:48,552 --> 00:20:50,820
LIFE WHICH MAY NOT REPRESENT 

478
00:20:50,820 --> 00:20:53,056
USUAL INTAKE AND ARE THE 

479
00:20:53,056 --> 00:20:54,991
BIOMARKERS SENSITIVE TO THE 

480
00:20:54,991 --> 00:20:55,192
FOOD?

481
00:20:55,192 --> 00:20:56,393
IS THE BIOMARKER SPECIFIC TO THE

482
00:20:56,393 --> 00:20:59,563
FOOD AND LOW SPECIFICITY IS A 

483
00:20:59,563 --> 00:21:01,731
MAJOR ISSUE IN NUTRITIONAL 

484
00:21:01,731 --> 00:21:02,999
EPIDEMIOLOGY BIOMARKER DISCOVERY

485
00:21:02,999 --> 00:21:07,137
AGAIN BECAUSE OF HOW 

486
00:21:07,137 --> 00:21:08,004
INTERCORRELATED FOODS ARE.

487
00:21:08,004 --> 00:21:09,239
THEN IS IT EASY TO MEASURE?

488
00:21:09,239 --> 00:21:11,608
IF YOU LOOK AT THE GRAPH DOWN 

489
00:21:11,608 --> 00:21:15,312
HERE, THIS IS A BIOMARKER FOR 

490
00:21:15,312 --> 00:21:16,813
VITAMIN A AND PLASMA RETINOL AND

491
00:21:16,813 --> 00:21:18,515
YOU CAN SEE IT PLATEAUS.

492
00:21:18,515 --> 00:21:20,217
THERE'S A LINEAR RELATIONSHIP AT

493
00:21:20,217 --> 00:21:21,651
A LOW LEVEL OF INTAKE.

494
00:21:21,651 --> 00:21:25,455
AND IF YOU LOOK AT THE PLATEAU, 

495
00:21:25,455 --> 00:21:26,756
THAT'S THE NORMAL RANGE OF 

496
00:21:26,756 --> 00:21:29,459
INTAKE AND IF YOU USE RETINOL AS

497
00:21:29,459 --> 00:21:31,628
A BIOMARKER FOR VITAMIN A 

498
00:21:31,628 --> 00:21:33,463
SUFFICIENT POPULATION IT'S NOT 

499
00:21:33,463 --> 00:21:34,097
GOING TO WORK BECAUSE ALL YOU 

500
00:21:34,097 --> 00:21:41,371
SEE IS A PLATEAU.

501
00:21:41,371 --> 00:21:43,940
THE OTHER ISSUE OR IMPORTANT 

502
00:21:43,940 --> 00:21:45,775
THING TO DO IS THE BIOMARKERS WE

503
00:21:45,775 --> 00:21:48,545
IDENTIFY FROM OBSERVATIONAL 

504
00:21:48,545 --> 00:21:50,247
STUDIES AND ACUTE FEEDING 

505
00:21:50,247 --> 00:21:52,515
STUDIES HAVE TO BE VALIDATED IN 

506
00:21:52,515 --> 00:21:53,750
MEDIUM AND LONG-TERM 

507
00:21:53,750 --> 00:21:55,418
INTERVENTION STUDIES.

508
00:21:55,418 --> 00:21:56,319
THAT'S CRITICAL BECAUSE WE'RE 

509
00:21:56,319 --> 00:22:01,258
DEALING WITH HIGH DIMENSIONAL 

510
00:22:01,258 --> 00:22:01,458
DATA.

511
00:22:01,458 --> 00:22:03,860
AGAIN URINE OR SERUM SAMPLE 

512
00:22:03,860 --> 00:22:05,695
CANNOT CAPTURE THE TRUE 

513
00:22:05,695 --> 00:22:06,863
VARIATION INDICT AND LONG-TERM 

514
00:22:06,863 --> 00:22:08,431
PATTERNS WHICH IS WHAT WE'RE 

515
00:22:08,431 --> 00:22:12,335
REALLY INTERESTED IN NUTRITIONAL

516
00:22:12,335 --> 00:22:12,669
EPIDEMIOLOGY.

517
00:22:12,669 --> 00:22:14,337
ALSO KNOWING THAT THE 

518
00:22:14,337 --> 00:22:15,605
CONCENTRATIONS OF METABOLITES 

519
00:22:15,605 --> 00:22:18,942
ARE NOT ONLY EFFECTED BY DIET 

520
00:22:18,942 --> 00:22:24,214
BUT BY THE GUT MICROBIOME AND 

521
00:22:24,214 --> 00:22:27,817
UNDERSTANDING THAT VARIABILITY 

522
00:22:27,817 --> 00:22:28,218
IS VERY IMPORTANT.

523
00:22:28,218 --> 00:22:30,754
SO IN THINKING ABOUT THE KEY 

524
00:22:30,754 --> 00:22:33,657
GAPS OR WHERE THE RESEARCH 

525
00:22:33,657 --> 00:22:35,392
SHOULD BE HEADED, MUCH OF WHAT 

526
00:22:35,392 --> 00:22:40,330
WE GET IN TERMS OF OMIC DATA IS 

527
00:22:40,330 --> 00:22:41,798
QUANTIFICATION OF METABOLITES OR

528
00:22:41,798 --> 00:22:45,669
WHATEVER THE OMIC TECHNOLOGY IS.

529
00:22:45,669 --> 00:22:48,505
SO WE LOOK AT ABSOLUTE 

530
00:22:48,505 --> 00:22:49,205
QUANTIFICATION.

531
00:22:49,205 --> 00:22:51,541
GIVEN THIS IT'S HARD TO COMPARE 

532
00:22:51,541 --> 00:22:53,643
BIOMARKERS FROM ONE STUDY TO 

533
00:22:53,643 --> 00:22:55,145
ANOTHER BECAUSE IT'S ALL 

534
00:22:55,145 --> 00:22:55,679
RELATIVE QUANTIFICATION.

535
00:22:55,679 --> 00:22:59,616
SO THERE'S AN URGENT NEED TO 

536
00:22:59,616 --> 00:23:01,618
ESTABLISH REFERENCE INTERVALS 

537
00:23:01,618 --> 00:23:07,724
BASED ON ABSOLUTE QUANTIFICATION

538
00:23:07,724 --> 00:23:08,892
RATHER THAN OTHER QUANTIFICATION

539
00:23:08,892 --> 00:23:13,430
WHEN WE LOOK AT MULTI-METABOLITE

540
00:23:13,430 --> 00:23:15,065
PANELS TEA IMPORTANT TO LOOK AT 

541
00:23:15,065 --> 00:23:16,599
THE SPECIFICITY OF THE BIOMARKER

542
00:23:16,599 --> 00:23:18,535
TO THE FOOD AND WHEN YOU LOOK AT

543
00:23:18,535 --> 00:23:20,570
CERTAIN FOOD IS IT BECAUSE WE'RE

544
00:23:20,570 --> 00:23:23,139
LOOKING AT RICE AS BIOMARKERS OF

545
00:23:23,139 --> 00:23:25,508
RICE IS IT REALLY A BIOMARKER 

546
00:23:25,508 --> 00:23:28,011
BECAUSE YOU'RE CONSUMING MORE 

547
00:23:28,011 --> 00:23:30,480
RICE OR BECAUSE YOU'RE CONSUMING

548
00:23:30,480 --> 00:23:32,182
LESS OF ANOTHER FOOD?

549
00:23:32,182 --> 00:23:34,517
GIVEN THE HIGH DIMENSIONAL 

550
00:23:34,517 --> 00:23:36,519
NATURE OF THE WORK IT'S 

551
00:23:36,519 --> 00:23:40,156
IMPORTANT TO HAVE ADEQUATE 

552
00:23:40,156 --> 00:23:41,358
STATISTICAL POWER WITH 

553
00:23:41,358 --> 00:23:41,958
INDEPENDENT REPLICATION AND 

554
00:23:41,958 --> 00:23:43,226
DIVERSE COHORTS.

555
00:23:43,226 --> 00:23:45,695
OFTEN WE SEE THE SAME BIOMARKER 

556
00:23:45,695 --> 00:23:48,998
THAT WE SEE IN SAY U.S. COHORTS 

557
00:23:48,998 --> 00:23:51,701
WHEN WE REPLICATE THEM AND SAY A

558
00:23:51,701 --> 00:23:53,603
SOUTH ASIAN COHORT IT'S A VERY 

559
00:23:53,603 --> 00:23:57,607
DIFFERENT BIOMARKER.

560
00:23:57,607 --> 00:23:59,642
CASE IN POINT A METABOLITE THAT 

561
00:23:59,642 --> 00:24:02,245
COMES FROM COFFEE CONSUMPTION IN

562
00:24:02,245 --> 00:24:05,615
U.S. COHORTS BUT WHEN WE LOOK AT

563
00:24:05,615 --> 00:24:08,084
IT IN HISPANIC OR SOUTH ASIAN 

564
00:24:08,084 --> 00:24:10,186
POPULATIONS IT COMES FROM 

565
00:24:10,186 --> 00:24:10,420
LEGUMES.

566
00:24:10,420 --> 00:24:12,188
SO UNDERSTANDING AGAIN THE 

567
00:24:12,188 --> 00:24:15,258
SOURCES OF THESE METABOLITES OR 

568
00:24:15,258 --> 00:24:16,960
DIETARY BIOMARKERS IN DIFFERENT 

569
00:24:16,960 --> 00:24:18,762
POPULATIONS AND RECOGNIZING THAT

570
00:24:18,762 --> 00:24:20,130
THEY CAN VARY IS IMPORTANT AND 

571
00:24:20,130 --> 00:24:22,565
FINANCE THIS GOES BACK TO THE 

572
00:24:22,565 --> 00:24:23,633
SPECIFICITY OF THE BIOMARKER TO 

573
00:24:23,633 --> 00:24:29,773
THE FOOD.

574
00:24:29,773 --> 00:24:31,975
AGAIN IT'S IMPORTANT TO LOOK AT 

575
00:24:31,975 --> 00:24:33,810
METHODS AND WE'VE DONE SOME WORK

576
00:24:33,810 --> 00:24:36,813
WITH THIS WITH METABOLOMICS.

577
00:24:36,813 --> 00:24:39,048
WE HAVE MANY PLATFORMS AND 

578
00:24:39,048 --> 00:24:40,917
COMPANIES.

579
00:24:40,917 --> 00:24:42,318
HOW WELL DO THEY COMPARE IF 

580
00:24:42,318 --> 00:24:47,957
YOU'RE LOOKING AT PROTEOMICS AND

581
00:24:47,957 --> 00:24:50,527
HAVE HOW THEY COMPARE AND HOW DO

582
00:24:50,527 --> 00:24:54,798
THE DATA MATCH IS IMPORTANT.

583
00:24:54,798 --> 00:25:00,470
GIVEN THE ERA OF MULTI-OMICS AND

584
00:25:00,470 --> 00:25:04,140
REALIZE COMBINING MORE OMIC 

585
00:25:04,140 --> 00:25:05,875
MEASURES CAN IMPROVE SPECIFICITY

586
00:25:05,875 --> 00:25:07,777
BUT WHAT DO THE DATA MEAN?

587
00:25:07,777 --> 00:25:09,712
UNDERSTANDING WHAT THE MULTI-OME

588
00:25:09,712 --> 00:25:11,614
YOU CAN MEASURES MEAN AND ARE 

589
00:25:11,614 --> 00:25:17,287
THEY EASY TO MEASURE.

590
00:25:17,287 --> 00:25:21,691
AND PUTTING TOGETHER A 

591
00:25:21,691 --> 00:25:29,899
CONSORTIUM IS IMPORTANT.

592
00:25:29,899 --> 00:25:32,836
WE WERE FUNDED BY THE NIDDK AND 

593
00:25:32,836 --> 00:25:34,204
ESTABLISHED THE DIETARY 

594
00:25:34,204 --> 00:25:35,839
BIOMARKER DEVELOPMENT 

595
00:25:35,839 --> 00:25:36,139
CONSORTIUM.

596
00:25:36,139 --> 00:25:37,407
WE HAVE THREE SITES.

597
00:25:37,407 --> 00:25:40,477
THIS IS SIMILAR TO THE FOOTBALL 

598
00:25:40,477 --> 00:25:42,178
CONSORTIUM THE ALLIANCE 

599
00:25:42,178 --> 00:25:45,748
CONSORTIUM IN EUROPE WHICH HAS 

600
00:25:45,748 --> 00:25:46,182
CONCLUDED.

601
00:25:46,182 --> 00:25:51,621
THE DBDC WAS FUNDED BY THE USDA 

602
00:25:51,621 --> 00:25:55,158
AND NIDDK AND WERE TASKED WITH 

603
00:25:55,158 --> 00:25:56,125
IDENTIFYING BIOMARKERS OF FOODS 

604
00:25:56,125 --> 00:25:56,893
FROM ME MY LATE.

605
00:25:56,893 --> 00:25:59,062
AT HARVARD WE'RE LOOKING AT 

606
00:25:59,062 --> 00:26:03,433
DIETARY MARKERS FOR FOUR MAJOR 

607
00:26:03,433 --> 00:26:04,067
CARBOHYDRATE FOODS IN THE 

608
00:26:04,067 --> 00:26:05,935
U.S. AND FOUR MAJOR PROTEIN 

609
00:26:05,935 --> 00:26:08,805
FOODS IN THE U.S.

610
00:26:08,805 --> 00:26:15,478
WE USE THE NHANES TO CHOOSE OUR 

611
00:26:15,478 --> 00:26:15,678
FOODS.

612
00:26:15,678 --> 00:26:20,049
FRED HUTCH IS LOOKING AT A 

613
00:26:20,049 --> 00:26:23,553
DIETARY PATTERN AND DAVIS IS 

614
00:26:23,553 --> 00:26:25,121
FOCUSSING ON FRUITS AND 

615
00:26:25,121 --> 00:26:27,624
VEGETABLES AND DUKE IS OUR DATA 

616
00:26:27,624 --> 00:26:28,057
COORDINATING CENTER.

617
00:26:28,057 --> 00:26:30,093
AND WITH THAT I'M HAPPY TO 

618
00:26:30,093 --> 00:26:31,594
TAKE -- I THINK WE SAVE 

619
00:26:31,594 --> 00:26:32,095
QUESTIONS FOR THE END.

620
00:26:32,095 --> 00:26:38,668
THANK YOU ALL.

621
00:26:38,668 --> 00:26:43,606
>> THANK YOU, DR.
BHUPATHIRAJU 

622
00:26:43,606 --> 00:26:45,875
FOR THE GREAT PRESENTATION OF 

623
00:26:45,875 --> 00:26:47,544
THE CUTTING EDGE SCIENCE AND 

624
00:26:47,544 --> 00:26:48,611
NUTRITION PRECISION MEASURES AS 

625
00:26:48,611 --> 00:26:55,618
THEY MAY BE APPLICABLE TO USE AS

626
00:26:55,618 --> 00:26:57,487
BIOMARKERS TO INDICATE DIETARY 

627
00:26:57,487 --> 00:26:58,888
QUALITY AND COMPOSITION.

628
00:26:58,888 --> 00:27:00,156
I THINK WE'LL TAKE QUESTIONS 

629
00:27:00,156 --> 00:27:02,458
DURING THE PANEL DISCUSSION 

630
00:27:02,458 --> 00:27:02,692
SESSION.

631
00:27:02,692 --> 00:27:04,861
AND WE'LL MOVE TO OUR NEXT 

632
00:27:04,861 --> 00:27:07,597
SPEAKER DR. JUSTIN OLDHAM.

633
00:27:07,597 --> 00:27:09,299
A CLINICAL ASSOCIATE PROFESSOR 

634
00:27:09,299 --> 00:27:10,900
AT UNIVERSITY OF MICHIGAN AND 

635
00:27:10,900 --> 00:27:13,670
HE'S GOING TO TALK TO US ABOUT 

636
00:27:13,670 --> 00:27:15,238
DIETARY METABOLITES PREDICTIVE 

637
00:27:15,238 --> 00:27:23,046
OF LUNG HEALTH AND DISEASE.

638
00:27:23,046 --> 00:27:23,580
>> THANK YOU.

639
00:27:23,580 --> 00:27:27,083
I'M SO LUCKY TO GIVE A TALK 

640
00:27:27,083 --> 00:27:28,117
AFTER DR. BHUPATHIRAJU BECAUSE 

641
00:27:28,117 --> 00:27:29,419
SHE REALLY SET THE STAGE FOR 

642
00:27:29,419 --> 00:27:37,527
WHAT I'M GOING TO TALK ABOUT AND

643
00:27:37,527 --> 00:27:41,764
HOPEFULLY I CAN BUILD ON HER 

644
00:27:41,764 --> 00:27:42,365
FANTASTIC TALK.

645
00:27:42,365 --> 00:27:43,900
I'M AN ASSISTANT PROFESSOR AT 

646
00:27:43,900 --> 00:27:45,768
UNIVERSITY OF MICHIGAN AND 

647
00:27:45,768 --> 00:27:51,608
COMPLETED MY Ph.D. IN 

648
00:27:51,608 --> 00:27:53,576
EPIDEMIOLOGY.

649
00:27:53,576 --> 00:27:57,814
I LIKE TO OPERATE AT THE 

650
00:27:57,814 --> 00:27:59,048
INTERSECTION OF EPIDEMIOLOGY AND

651
00:27:59,048 --> 00:28:03,252
NUTRITION AND TRY NOT TO GO DOWN

652
00:28:03,252 --> 00:28:06,155
THE EPIDEMIOLOGY RABBIT HOLE BUT

653
00:28:06,155 --> 00:28:08,524
FOCUS MORE ON HIGH LEVEL 

654
00:28:08,524 --> 00:28:10,793
METABOLOMIC WORK BEING DONE AND 

655
00:28:10,793 --> 00:28:11,894
INDIVIDUAL METABOLITES AND HOW 

656
00:28:11,894 --> 00:28:13,830
THEY ARE POTENTIALLY INFORMATIVE

657
00:28:13,830 --> 00:28:15,598
FOR PREDICTING LUNG HEALTH AND 

658
00:28:15,598 --> 00:28:25,742
DISEASE.

659
00:28:25,742 --> 00:28:28,244
THESE ARE MY DISCLOSURES.

660
00:28:28,244 --> 00:28:30,346
INTERESTINGLY I'M NOT A 

661
00:28:30,346 --> 00:28:32,382
METABOLOMIC RESEARCH I'M A 

662
00:28:32,382 --> 00:28:33,916
PROTEOMIC RESEARCHER IN FIBROTIC

663
00:28:33,916 --> 00:28:35,585
LUNG DISEASE.

664
00:28:35,585 --> 00:28:39,055
SO I'M NOT GOING TO SHOW MY OWN 

665
00:28:39,055 --> 00:28:42,325
WORK BUT SHOW NICE WORK DONE 

666
00:28:42,325 --> 00:28:44,560
ELSEWHERE AND PULL IN LESSONS 

667
00:28:44,560 --> 00:28:51,768
LEARN FROM MY PROTEOMIC RESEARCH

668
00:28:51,768 --> 00:29:00,910
IN NUTRITION.

669
00:29:00,910 --> 00:29:01,911
AND DR. BHUPATHIRAJU MENTIONED 

670
00:29:01,911 --> 00:29:02,879
THIS AND I'LL TRY TO EXPAND ON 

671
00:29:02,879 --> 00:29:09,152
THIS A LITTLE BIT.

672
00:29:09,152 --> 00:29:10,553
WE'RE INTERESTED IN SOME TRUE 

673
00:29:10,553 --> 00:29:14,223
DIETARY INTAKE AS AN EXPOSURE 

674
00:29:14,223 --> 00:29:15,625
AND OUR OUTCOME BEING SOME 

675
00:29:15,625 --> 00:29:19,896
MEASURE OF LUNG HEALTH.

676
00:29:19,896 --> 00:29:21,664
WE DON'T KNOW THE EXACT DIETARY 

677
00:29:21,664 --> 00:29:21,898
INTAKE.

678
00:29:21,898 --> 00:29:28,671
WHAT WE OFTEN DO IS RELY ON 

679
00:29:28,671 --> 00:29:31,874
INTAKE AND SAW STANDARD 

680
00:29:31,874 --> 00:29:32,508
QUESTIONNAIRE USED IN THE PRIOR 

681
00:29:32,508 --> 00:29:42,618
TALK.

682
00:29:47,390 --> 00:29:48,791
THERE'S MEASUREMENT ERROR BY 

683
00:29:48,791 --> 00:29:54,063
QUESTIONNAIRE AND INTAKE OF ANY 

684
00:29:54,063 --> 00:30:04,607
MEASURE AND SO IT CAN INTRODUCE 

685
00:30:05,141 --> 00:30:07,610
NOISE AND STILL HAS A BIASSED 

686
00:30:07,610 --> 00:30:13,483
EXPOSURE OUTCOME RELATIONSHIP.

687
00:30:13,483 --> 00:30:19,555
THE PROBLEM ARISES WHERE THE 

688
00:30:19,555 --> 00:30:25,762
OUTCOME IMPACTS THE PRESSURE FOR

689
00:30:25,762 --> 00:30:27,597
YOUR INTAKE AND WE DEVELOP 

690
00:30:27,597 --> 00:30:28,998
INFORMATION BIAS.

691
00:30:28,998 --> 00:30:34,837
THIS IS A LESS BENIGN FORM 

692
00:30:34,837 --> 00:30:37,540
WHEREBY YOUR OUTCOME IS 

693
00:30:37,540 --> 00:30:38,541
IMPACTING OUR MEASUREMENT ERROR 

694
00:30:38,541 --> 00:30:41,277
WHICH IS THEN LEADING TO A 

695
00:30:41,277 --> 00:30:43,613
BIASSED RELATIONSHIP BETWEEN 

696
00:30:43,613 --> 00:30:45,915
YOUR EXPOSURE AND OUTCOME.

697
00:30:45,915 --> 00:30:48,751
THIS CAN BIAS YOUR ASSOCIATION 

698
00:30:48,751 --> 00:30:49,352
YOU IDENTIFY TOWARDS OR AWAY 

699
00:30:49,352 --> 00:30:59,595
FROM THE NUL.

700
00:31:02,165 --> 00:31:05,701
SAY WE HAVE FAT INTAKE AS A 

701
00:31:05,701 --> 00:31:09,405
MEASUREMENT WHICH HAS BEEN 

702
00:31:09,405 --> 00:31:15,611
STUDIED AND EMPHYSEMA COWL BE AN

703
00:31:15,611 --> 00:31:16,846
OUTCOME WE'LL LEAVE FOR NOW.

704
00:31:16,846 --> 00:31:19,215
AGAIN WE HAVE OUR REPORTED FAT 

705
00:31:19,215 --> 00:31:19,448
INTAKE.

706
00:31:19,448 --> 00:31:20,917
YOU CAN'T MEASURE EXACTLY WHAT 

707
00:31:20,917 --> 00:31:23,619
THE FAT INTAKE IS BUT RELY ON 

708
00:31:23,619 --> 00:31:27,623
WHAT'S REPORTED AND HAVE THE 

709
00:31:27,623 --> 00:31:29,725
MEASUREMENT ERROR.

710
00:31:29,725 --> 00:31:32,195
WHAT WE KNOW ABOUT EMPHYSEMA IS 

711
00:31:32,195 --> 00:31:35,331
PEOPLE WILL GET HYPOXEMIC AS IT 

712
00:31:35,331 --> 00:31:39,101
PROGRESSES AND IT CAN IMPACT 

713
00:31:39,101 --> 00:31:41,971
YOUR RECALL AND HOW MUCH FAT YOU

714
00:31:41,971 --> 00:31:43,005
TOOK IN BECAUSE WE KNOW BRAIN 

715
00:31:43,005 --> 00:31:49,879
FUNCTION IS NOT AS GOOD WHEN 

716
00:31:49,879 --> 00:31:51,047
HYPOXIC ENVIRONMENTS AND 

717
00:31:51,047 --> 00:31:53,416
DEMENTIA IS HIGHER IN THOSE 

718
00:31:53,416 --> 00:31:54,917
INCIDENTS SO IT'S PLAUSIBLE THIS

719
00:31:54,917 --> 00:31:57,987
OUTCOME OF INTEREST THROUGH THIS

720
00:31:57,987 --> 00:32:01,824
MEDIATOR OF HYPOXEMIA IMPACT OUR

721
00:32:01,824 --> 00:32:06,729
ERROR FOR FOOD INTAKE AFFECTS 

722
00:32:06,729 --> 00:32:09,065
THE EXPOSURE OUTCOME.

723
00:32:09,065 --> 00:32:13,903
THIS PARTICULAR FORM WHICH WAS 

724
00:32:13,903 --> 00:32:20,943
ALLUDED TO IN THE PRIOR TALK AND

725
00:32:20,943 --> 00:32:23,279
BIASSING OUR OUTCOME AND THIS IS

726
00:32:23,279 --> 00:32:23,846
A BIG PROBLEM IN NUTRITION 

727
00:32:23,846 --> 00:32:29,518
RESEARCH.

728
00:32:29,518 --> 00:32:30,686
AND SO INCOME BIOMARKERS AND 

729
00:32:30,686 --> 00:32:33,189
DIETARY METABOLITES IN 

730
00:32:33,189 --> 00:32:34,824
PARTICULAR COULD POTENTIALLY 

731
00:32:34,824 --> 00:32:36,859
OVERCOME SOME OF THIS PROBLEM 

732
00:32:36,859 --> 00:32:39,595
WHEREBY WE HAVE OUR TRUE DIETARY

733
00:32:39,595 --> 00:32:39,829
INTAKE.

734
00:32:39,829 --> 00:32:42,431
WE NOW HAVE RATHER THAN REPORTED

735
00:32:42,431 --> 00:32:44,934
DIETARY INTAKE WE HAVE MEASURED 

736
00:32:44,934 --> 00:32:47,603
DIETARY METABOLITES AND STILL 

737
00:32:47,603 --> 00:32:48,604
HAVE MEASUREMENT ERROR BECAUSE 

738
00:32:48,604 --> 00:32:51,574
THERE'LL BE MEASUREMENT ERROR 

739
00:32:51,574 --> 00:32:56,312
FOR ANYTHING BUT HOPEFULLY A 

740
00:32:56,312 --> 00:32:58,614
MANAGEABLE OF ERROR IN A WAY 

741
00:32:58,614 --> 00:33:01,584
THAT DOES NOT INTRODUCE BIAS 

742
00:33:01,584 --> 00:33:01,817
ITSELF.

743
00:33:01,817 --> 00:33:06,055
SO EVEN THOUGH WE HAVE SOME 

744
00:33:06,055 --> 00:33:06,589
MEASUREMENT ERROR WE'RE 

745
00:33:06,589 --> 00:33:08,024
HOPEFULLY STILL USING THE 

746
00:33:08,024 --> 00:33:11,594
APPROACH OVERCOMING THE RECALL 

747
00:33:11,594 --> 00:33:13,462
BIAS AND OBTAINING UNBIASSED 

748
00:33:13,462 --> 00:33:14,664
MEASURE OF THE RELATIONSHIP.

749
00:33:14,664 --> 00:33:16,832
THERE'S OTHER TYPES OF BIAS THAT

750
00:33:16,832 --> 00:33:18,901
CAN BE INTRODUCED I'LL GET TO IN

751
00:33:18,901 --> 00:33:21,237
A LITTLE BIT BUT THAT'S THE 

752
00:33:21,237 --> 00:33:21,437
IDEA.

753
00:33:21,437 --> 00:33:23,139
SO WHICH DIETARY METABOLITES ARE

754
00:33:23,139 --> 00:33:23,839
WE INTERESTED IN?

755
00:33:23,839 --> 00:33:29,512
SORT ANSWER IS I DON'T KNOW.

756
00:33:29,512 --> 00:33:31,280
THERE'S A LOT PUBLISHED THAT 

757
00:33:31,280 --> 00:33:36,752
CERTAINLY SEEM LIKE A GOOD PLACE

758
00:33:36,752 --> 00:33:42,758
TO START AS WE HEARD THE 

759
00:33:42,758 --> 00:33:44,260
METABOLOMIC APPROACHES WILL 

760
00:33:44,260 --> 00:33:46,963
OVERCOME THE EARLIER TARGETED 

761
00:33:46,963 --> 00:33:47,596
STUDIES.

762
00:33:47,596 --> 00:33:49,365
AND STARTING WITH SINGLE LIPIDS 

763
00:33:49,365 --> 00:33:50,800
THESE ARE SOME OF THE BEST 

764
00:33:50,800 --> 00:33:58,007
STUDIED METABOLITES AND THIS IS 

765
00:33:58,007 --> 00:34:08,551
JUST WHAT HAPPENS IN A DOSE WAY 

766
00:34:16,225 --> 00:34:17,827
RESPONSE AND THE AIRWAY GOES UP 

767
00:34:17,827 --> 00:34:21,697
AND WHEN YOU EXPOSE THE CELLS TO

768
00:34:21,697 --> 00:34:24,133
CHOLINE YOU SEE A MORE 

769
00:34:24,133 --> 00:34:25,434
HYPERRESPONSIVENESS AS MEASURED 

770
00:34:25,434 --> 00:34:30,940
BY FORCE IN THE D PANEL THERE.

771
00:34:30,940 --> 00:34:38,280
SO THAT'S IN ASTHMA.

772
00:34:38,280 --> 00:34:44,320
ON THE RIGHT IS EMPHYSEMA FROM 

773
00:34:44,320 --> 00:34:48,657
THE COPD INVESTIGATE EORS THIS  

774
00:34:48,657 --> 00:34:55,498
A COHORT STUDY AND THIS GROUP IN

775
00:34:55,498 --> 00:35:02,938
CROSS SECTION ASSESSED 

776
00:35:02,938 --> 00:35:04,707
RELATIONSHIP WITH SEVERITY OF 

777
00:35:04,707 --> 00:35:04,907
COPD.

778
00:35:04,907 --> 00:35:06,175
THIS COULD RUN INTO POTENTIAL 

779
00:35:06,175 --> 00:35:08,244
ISSUES I'LL DISCUSS LATER BUT AT

780
00:35:08,244 --> 00:35:10,346
LEAST IN CROSS-SECTION WE DO SEE

781
00:35:10,346 --> 00:35:12,148
THERE APPEARS TO BE SOME DEGREE 

782
00:35:12,148 --> 00:35:13,315
OF DOSE RESPONSE BETWEEN SEVERAL

783
00:35:13,315 --> 00:35:16,085
OF THE METABOLITES AND THE 

784
00:35:16,085 --> 00:35:26,462
SEVERITY OF EMPHYSEMA.

785
00:35:27,163 --> 00:35:30,499
FOR FATTY ACID METABOLITES WE 

786
00:35:30,499 --> 00:35:33,469
KNOW CIGARETTE SPOKE CAN AFFECT 

787
00:35:33,469 --> 00:35:36,639
METABOLISM AND WHEN THAT OCCURS 

788
00:35:36,639 --> 00:35:39,608
WE SEE THERE'S PROBABLY 

789
00:35:39,608 --> 00:35:43,612
INCREASED IN APOPTOSIS.

790
00:35:43,612 --> 00:35:47,616
THERE'S INTERACTION BETWEEN 

791
00:35:47,616 --> 00:35:49,852
CIGARETTE SPOKE AND APOPTOSIS SO

792
00:35:49,852 --> 00:35:52,321
INDIVIDUALS WITH COPD MAY HAVE 

793
00:35:52,321 --> 00:35:56,292
CELL TURNOVER AS A BIPARTISAN OF

794
00:35:56,292 --> 00:35:59,595
THIS IMPACT ON THE FATTY ACID 

795
00:35:59,595 --> 00:36:02,131
METABOLISM ON THE RIGHT IS 

796
00:36:02,131 --> 00:36:05,334
SOMETHING MORE IN MY WHEELHOUSE 

797
00:36:05,334 --> 00:36:08,671
PART OF OUR PRECISIONS TRIAL 

798
00:36:08,671 --> 00:36:12,174
ASSESSING A HANDFUL OF DIFFERENT

799
00:36:12,174 --> 00:36:14,410
OMEGA 3 FATTY ACIDS FROM 

800
00:36:14,410 --> 00:36:19,615
PATIENTS FROM THE PULMONARY 

801
00:36:19,615 --> 00:36:21,817
FIBROSIS STUDY AND FOUND A 

802
00:36:21,817 --> 00:36:23,819
HANDFUL OF THE DIFFERENT OMEGA 3

803
00:36:23,819 --> 00:36:26,388
FATTY ACIDS WERE FOUND TO CHANGE

804
00:36:26,388 --> 00:36:30,626
LING FUNCTION.

805
00:36:30,626 --> 00:36:31,594
-- LUNG FUNCTION.

806
00:36:31,594 --> 00:36:33,329
THIS CHANGES THE GAS TRANSFER 

807
00:36:33,329 --> 00:36:39,001
WHICH IS HOW IT CROSSES IN THE 

808
00:36:39,001 --> 00:36:49,111
BLOOD.

809
00:37:06,095 --> 00:37:08,364
AND THIS FIGURE IS ONE OF SELF I

810
00:37:08,364 --> 00:37:10,900
CHOSE BECAUSE IT SHOWS A NICE 

811
00:37:10,900 --> 00:37:16,071
DISK RESPONSE BUT IT'S A 

812
00:37:16,071 --> 00:37:26,582
COMPOSITE MEASURE YOU SEE THE 

813
00:37:32,288 --> 00:37:34,890
STEP WISE IN THE COMPOSITION 

814
00:37:34,890 --> 00:37:37,393
RELATED TO THE COMPOSITION.

815
00:37:37,393 --> 00:37:39,028
THE SMOKERS INTERESTINGLY HAD A 

816
00:37:39,028 --> 00:37:41,230
DIFFERENT PATTERN THERE AND THE 

817
00:37:41,230 --> 00:37:47,937
LAST TWO PANELS ARE LONGITUDINAL

818
00:37:47,937 --> 00:37:50,139
MEASURES.

819
00:37:50,139 --> 00:37:53,008
I DIDN'T WANT TO GET INTO 

820
00:37:53,008 --> 00:37:53,876
INTERVENTIONAL TRIALS BECAUSE WE

821
00:37:53,876 --> 00:37:57,112
HAVE AN AFTERNOON OF THAT BUT 

822
00:37:57,112 --> 00:38:02,785
WANTED TO HIGHLIGHT THE L 

823
00:38:02,785 --> 00:38:04,119
CARNTINE GIVEN TO PREMATURE 

824
00:38:04,119 --> 00:38:05,621
INFANTS AND I'LL HIGHLIGHT THE 

825
00:38:05,621 --> 00:38:16,165
SECOND AND THIRD ROWS THAT THEY 

826
00:38:26,875 --> 00:38:28,444
HAD LESS DAYS ON THE VENTILATOR 

827
00:38:28,444 --> 00:38:29,378
WHICH IS A CRITICAL OUTCOME IN 

828
00:38:29,378 --> 00:38:34,183
THE RESEARCH.

829
00:38:34,183 --> 00:38:39,021
SO RESEARCH GAPS.

830
00:38:39,021 --> 00:38:40,189
I MENTIONED RECALL BIAS EARLIER 

831
00:38:40,189 --> 00:38:42,491
AND THERE'S ANOTHER BIAS 

832
00:38:42,491 --> 00:38:46,195
INHERENT TO CROSS SECTIONAL 

833
00:38:46,195 --> 00:38:50,466
STUDIES WHEREBY YOU GET REVERSE 

834
00:38:50,466 --> 00:38:53,902
CAUSATION AND THERE CAN BE 

835
00:38:53,902 --> 00:38:55,070
IMPACTS ON THE MEASUREMENT ERROR

836
00:38:55,070 --> 00:38:57,906
WITH YOUR METABOLITES IN 

837
00:38:57,906 --> 00:38:59,608
FIBROTIC LUNG DISEASE, DISEASE 

838
00:38:59,608 --> 00:39:02,378
SEVERITY IS ACTUALLY A STRONG 

839
00:39:02,378 --> 00:39:06,915
CONFOUNDER BETWEEN BIOMARKER 

840
00:39:06,915 --> 00:39:07,850
LEVEL AND OUTCOME.

841
00:39:07,850 --> 00:39:09,985
WE NEED TO KEEP THIS IN MIND 

842
00:39:09,985 --> 00:39:10,586
ESPECIALLY IN CROSS SECTIONAL 

843
00:39:10,586 --> 00:39:15,658
STUDIES.

844
00:39:15,658 --> 00:39:19,595
THE OTHER ISSUE IS CONFOUNDING.

845
00:39:19,595 --> 00:39:22,197
HYPOXEMIA CAUSES EVENTS 

846
00:39:22,197 --> 00:39:25,200
THROUGHOUT THE BODY, PULMONARY 

847
00:39:25,200 --> 00:39:27,603
AND NEUROLOGIC THAT WILL AFFECT 

848
00:39:27,603 --> 00:39:30,906
YOUR DIETARY METABOLITE LEVELS.

849
00:39:30,906 --> 00:39:35,344
AND LOOK AT HOW CAUSAL DIAGRAMS 

850
00:39:35,344 --> 00:39:39,615
ASSESS HOW WELL THE METABOLITES 

851
00:39:39,615 --> 00:39:44,086
PREDICT OUTCOMES.

852
00:39:44,086 --> 00:39:47,589
NEXT IS A LOT OF WHAT I'VE SHOWN

853
00:39:47,589 --> 00:39:49,358
HAVE BEEN INDIVIDUAL 

854
00:39:49,358 --> 00:39:49,658
METABOLITES.

855
00:39:49,658 --> 00:39:51,327
IT'S IMPORTANT TO KEEP IN MIND 

856
00:39:51,327 --> 00:39:55,597
NONE OF THIS HAPPENS IN A 

857
00:39:55,597 --> 00:39:57,599
VACUUM.

858
00:39:57,599 --> 00:40:01,570
THIS IS AN EDITORIAL SHOWING 

859
00:40:01,570 --> 00:40:03,639
INFORMATION THAT SOME OF THEIR 

860
00:40:03,639 --> 00:40:05,741
METABOLITES YOU GET HIGHER 

861
00:40:05,741 --> 00:40:10,346
RESPONSIVENESS AND GET 

862
00:40:10,346 --> 00:40:11,580
REMODELLING AN KEEPING UNMIND 

863
00:40:11,580 --> 00:40:12,781
INDIVIDUAL METABOLITES MAY NOT 

864
00:40:12,781 --> 00:40:15,017
BE THE ANSWER BUT HOW THEY 

865
00:40:15,017 --> 00:40:25,561
INTERACT WITH OTHER METABOLITES.

866
00:40:33,936 --> 00:40:36,605
A FOCUS ON ONE METABOLITE WILL 

867
00:40:36,605 --> 00:40:38,040
PROBABLY PAINT A MISLEADING 

868
00:40:38,040 --> 00:40:38,874
PICTURE AND WE NEED TO 

869
00:40:38,874 --> 00:40:40,242
UNDERSTAND HOW THEY FIT NEXT IT 

870
00:40:40,242 --> 00:40:42,144
ONE ANOTHER AND WHAT THEIR 

871
00:40:42,144 --> 00:40:43,612
IMPACT IS RELATIVE TO ONE 

872
00:40:43,612 --> 00:40:49,551
ANOTHER.

873
00:40:49,551 --> 00:40:57,860
FINALLY FROM THE STUDY I SHOWED 

874
00:40:57,860 --> 00:41:00,329
ASSESSING THESE IN CROSS SECTION

875
00:41:00,329 --> 00:41:01,497
PROBABLY IGNORES THE TEMPORAL 

876
00:41:01,497 --> 00:41:07,236
IMPORTANCE OF UPSTREAM AND DOWN 

877
00:41:07,236 --> 00:41:09,872
STREAM EFFECTS OF ANY ONE 

878
00:41:09,872 --> 00:41:10,172
METABOLITE.

879
00:41:10,172 --> 00:41:11,273
OUR KEY OPPORTUNITIES AND 

880
00:41:11,273 --> 00:41:14,843
RESEARCH QUESTIONS FROM THE 

881
00:41:14,843 --> 00:41:18,547
CHICKEN OR THE EGG QUESTION IS 

882
00:41:18,547 --> 00:41:23,519
WE HAVE THESE NICE LUNG FOCUSSED

883
00:41:23,519 --> 00:41:27,456
COHORTS, COPD AND MESA AND A NEW

884
00:41:27,456 --> 00:41:31,093
INDUSTRY STUDY I'M LEADING 

885
00:41:31,093 --> 00:41:33,529
CALLED PRIME PROGRESSIVE 

886
00:41:33,529 --> 00:41:35,664
PULMONARY FIBROSIS WHICH WILL 

887
00:41:35,664 --> 00:41:37,866
HOPEFULLY HAVE NHLBI INVOLVEMENT

888
00:41:37,866 --> 00:41:40,369
AT SOME POINT AND THESE ARE 

889
00:41:40,369 --> 00:41:44,106
PROSPECTIVE COHORT STUDIES WITH 

890
00:41:44,106 --> 00:41:45,874
CLINICAL DATA AND BIO SPECIMENS.

891
00:41:45,874 --> 00:41:48,243
WE HAVE A GOOD OPPORTUNITY USING

892
00:41:48,243 --> 00:41:50,012
THE BIO SPECIMENS WITH THE 

893
00:41:50,012 --> 00:41:52,147
ADVANCE IN METABOLOMICS TO GET 

894
00:41:52,147 --> 00:41:54,183
AROUND THE CROSS-SECTIONAL 

895
00:41:54,183 --> 00:41:56,485
STUDIES AND GETTING A STRONGER 

896
00:41:56,485 --> 00:41:58,287
SENSE AS TO POTENTIAL CAUSATION 

897
00:41:58,287 --> 00:42:00,756
JUST BECAUSE WE KNOW THE BLOOD 

898
00:42:00,756 --> 00:42:03,392
DRAW IS OCCURRING BEFORE THE 

899
00:42:03,392 --> 00:42:05,194
OUTCOMES AND WE HAVE MORE 

900
00:42:05,194 --> 00:42:07,196
GRANULAR CLINICAL DATA THAT'S 

901
00:42:07,196 --> 00:42:09,698
GOING TO INCREASE CONFIDENCE THE

902
00:42:09,698 --> 00:42:10,332
BIOMARKERS ARE MEASURING A TRUE 

903
00:42:10,332 --> 00:42:13,168
OUTCOME.

904
00:42:13,168 --> 00:42:15,571
>> TWO MINUTES REMAINING.

905
00:42:15,571 --> 00:42:22,311
>> AND FINALLY WITH THESE
WELL 

906
00:42:22,311 --> 00:42:26,515
DESIGN COHORT STUDIES LEADS TO 

907
00:42:26,515 --> 00:42:27,783
CLINICAL TRIALS WE'LL HEAR ABOUT

908
00:42:27,783 --> 00:42:29,852
LATER BUT IF WE'RE LOOKING TO 

909
00:42:29,852 --> 00:42:33,255
BLOCK A CERTAIN METABOLITE OR 

910
00:42:33,255 --> 00:42:35,624
AUGMENT A CERTAIN METABOLITE 

911
00:42:35,624 --> 00:42:37,226
IT'S THE NATURE NEXT STEP FROM 

912
00:42:37,226 --> 00:42:47,703
WELL DESIGN COHORT STUDIES.

913
00:42:53,475 --> 00:42:55,511
AND I THINK IT REMAINS UNCLEAR 

914
00:42:55,511 --> 00:42:58,313
AT THIS POINT BASED ON THE 

915
00:42:58,313 --> 00:43:00,482
AVAILABLE DATA WHETHER A 

916
00:43:00,482 --> 00:43:02,885
DEFICIENCY OR OVER ABUNDANCE OF 

917
00:43:02,885 --> 00:43:04,019
THESE REPRESENTS A CAUSAL 

918
00:43:04,019 --> 00:43:06,622
RELATIONSHIP ONE THE OUTCOMES.

919
00:43:06,622 --> 00:43:08,156
BUT AS WE HEARD PREVIOUSLY I 

920
00:43:08,156 --> 00:43:12,895
THINK IN A MORE ELEGANT FASHION 

921
00:43:12,895 --> 00:43:14,997
THERE'S RAPID ADVANCES IN 

922
00:43:14,997 --> 00:43:15,631
METABOLOMIC INVESTIGATION AND 

923
00:43:15,631 --> 00:43:20,235
THE PLATFORMS AND THE ABILITY TO

924
00:43:20,235 --> 00:43:22,137
GENERATE HIGH THROUGHPUT DATA 

925
00:43:22,137 --> 00:43:26,375
FROM THE GENOMIC AN PROTEOMIC 

926
00:43:26,375 --> 00:43:28,310
AND TRANSCRIPTOMICS TOO 

927
00:43:28,310 --> 00:43:30,512
STANDPOINT WILL MEASURE 

928
00:43:30,512 --> 00:43:31,313
NUTRITIONAL EXPOSURES AND START 

929
00:43:31,313 --> 00:43:33,248
TO PICK APART WHICH ONES ARE 

930
00:43:33,248 --> 00:43:36,118
MOST IMPORTANT, HOW THEY 

931
00:43:36,118 --> 00:43:37,519
INTERACT WITH OTHERS.

932
00:43:37,519 --> 00:43:42,758
CERTAINLY PROVIDES AN OBJECTIVE 

933
00:43:42,758 --> 00:43:46,562
MEASURE ABLE TO AFFECT THE 

934
00:43:46,562 --> 00:43:49,698
RECALL BIAS AND NEED TO LEVERAGE

935
00:43:49,698 --> 00:43:50,666
COHORT STUDIES IN EXISTENCE AND 

936
00:43:50,666 --> 00:43:53,669
THIS WILL SET THE STAGE FOR 

937
00:43:53,669 --> 00:43:54,736
HOPEFULLY INTERVENTIONAL TRIALS 

938
00:43:54,736 --> 00:44:03,111
TARGETING THE METABOLITES.

939
00:44:03,111 --> 00:44:03,779
I'LL FINISH THERE AND THANKS FOR

940
00:44:03,779 --> 00:44:08,784
YOUR ATTENTION.

941
00:44:08,784 --> 00:44:09,651
>> THANK YOU SO MUCH.

942
00:44:09,651 --> 00:44:12,621
NEXT I WANT TO WELCOME 

943
00:44:12,621 --> 00:44:14,890
DR. MACHADO BACK TO THE STAGE TO

944
00:44:14,890 --> 00:44:25,434
SPEAK TO GIVE A TALK ON BOD MASS

945
00:44:27,035 --> 00:44:28,604
RELATE -- BODY MASS RELATED 

946
00:44:28,604 --> 00:44:31,506
MARKERS PREDICTING OUTCOMES OF 

947
00:44:31,506 --> 00:44:37,012
RESPIRATORY DISEASES.

948
00:44:37,012 --> 00:44:40,349
>> DURING MY Ph.D. I
CONDUCTED 

949
00:44:40,349 --> 00:44:44,720
STUDIES ON BODY MASS RELATED 

950
00:44:44,720 --> 00:44:46,355
MARKERS ON RESPIRATORY DISEASE.

951
00:44:46,355 --> 00:44:48,490
THAT'S GOING TO BE MY TOPIC AND 

952
00:44:48,490 --> 00:44:49,791
THANK YOU FOR THE OPPORTUNITY TO

953
00:44:49,791 --> 00:44:52,427
BE HERE AND TALK A LITTLE BIT 

954
00:44:52,427 --> 00:44:57,833
ABOUT THIS INTERESTING TOPIC.

955
00:44:57,833 --> 00:45:01,036
SO I'D LIKE TO BEGIN BY 

956
00:45:01,036 --> 00:45:02,738
DISCUSSING A SINGLE BIOMARKER OF

957
00:45:02,738 --> 00:45:05,841
THE BODY MASS INDEX AND OVER 20 

958
00:45:05,841 --> 00:45:09,778
YEARS AGO A RESEARCH GROUP FROM 

959
00:45:09,778 --> 00:45:19,621
DENMARK SHOWED BMI AFFECTS BOTH 

960
00:45:19,621 --> 00:45:30,165
COPD IN MEN AND WOMEN AND WE CAN

961
00:45:35,337 --> 00:45:39,107
ALSO SEE THERE WAS THIS LINK 

962
00:45:39,107 --> 00:45:41,576
BETWEEN BMI AND SURVIVOR WAS 

963
00:45:41,576 --> 00:45:43,578
DIFFERENT DEPENDING ON THE STAGE

964
00:45:43,578 --> 00:45:44,246
OF THE DISEASE.

965
00:45:44,246 --> 00:45:51,586
THE PATIENTS WITH COPD WAS MORE 

966
00:45:51,586 --> 00:45:55,657
SEVERE WE SEE HIGHER IMPACT OF 

967
00:45:55,657 --> 00:45:56,091
BEING UNDER WEIGHT.

968
00:45:56,091 --> 00:45:58,460
IN COMPARISON WITH THOSE WITH 

969
00:45:58,460 --> 00:46:07,536
MODERATE OR MILD COPD.

970
00:46:07,536 --> 00:46:15,577
AND A FEW YEARS LATER IN 

971
00:46:15,577 --> 00:46:16,511
2004BM200

972
00:46:16,511 --> 00:46:17,446
2004BM200

973
00:46:17,446 --> 00:46:18,380
2004BM200

974
00:46:18,380 --> 00:46:19,314
2004BM200

975
00:46:19,314 --> 00:46:22,417
2004BMIVE -- 2004, BMI WAS USED 

976
00:46:22,417 --> 00:46:25,387
TO PREDICT THE RISK OF DEATH 

977
00:46:25,387 --> 00:46:28,190
WITH THOSE IN COPD AND THIS IS 

978
00:46:28,190 --> 00:46:31,526
MORE CLOSELY RELATED OR 

979
00:46:31,526 --> 00:46:33,795
ASSOCIATED WITH MORTALITY THAN 

980
00:46:33,795 --> 00:46:40,268
THE STAGE OF THE DISEASE.

981
00:46:40,268 --> 00:46:43,038
WE CAN ALSO SEE AND THE 

982
00:46:43,038 --> 00:46:48,910
CONTRIBUTION TO THE BMI INDEX IS

983
00:46:48,910 --> 00:46:49,444
RATHER LOW.

984
00:46:49,444 --> 00:46:58,420
IT CAN BE ATTRIBUTED TO BMI OR 

985
00:46:58,420 --> 00:46:58,954
LUNG FUNCTION OR EXERCISE 

986
00:46:58,954 --> 00:47:09,131
CAPACITY.

987
00:47:13,301 --> 00:47:15,237
IT'S RAISED THE IMPORTANCE OF 

988
00:47:15,237 --> 00:47:21,143
LOOKING AT PATIENTS AND WE HAVE 

989
00:47:21,143 --> 00:47:25,714
A CLEAR UNDERSTANDING ABOUT THE 

990
00:47:25,714 --> 00:47:28,383
MUTATIONS OF BMI AND WE CAN SEE 

991
00:47:28,383 --> 00:47:32,788
IF WE APPLY BMI IN THE GROUP OF 

992
00:47:32,788 --> 00:47:35,590
PATIENTS WITH COPD AND LOOK AT 

993
00:47:35,590 --> 00:47:38,760
DATA FROM MORE THAN 50,000 

994
00:47:38,760 --> 00:47:39,761
PATIENTS WITH COPD FROM THE U.K.

995
00:47:39,761 --> 00:47:46,501
BIO BANK.

996
00:47:46,501 --> 00:47:52,808
WE'LL IDENTIFY LESS THAN 1% WITH

997
00:47:52,808 --> 00:47:55,544
A FEEPT.

998
00:47:55,544 --> 00:47:55,911
WHEN WE LOOK AT THE 

999
00:48:02,117 --> 00:48:07,422
-- WITH THE PHENOTYPE AND 

1000
00:48:07,422 --> 00:48:10,325
PATIENTS CAN BE CLASSIFIED AND 

1001
00:48:10,325 --> 00:48:20,702
IN PANEL C AND B WE OBSERVE D 

1002
00:48:20,702 --> 00:48:26,208
CLASSIFIED THE PATIENTS AND WAS 

1003
00:48:26,208 --> 00:48:31,313
ASSOCIATED WITH COPD RELATED 

1004
00:48:31,313 --> 00:48:41,423
DEATH.

1005
00:48:42,891 --> 00:48:44,960
AND IT'S IMPORTANT TO LOOK AT 

1006
00:48:44,960 --> 00:48:50,899
BODY MASS MARKERS TO BETTER 

1007
00:48:50,899 --> 00:48:53,969
UNDERSTAND THE RACE MARKERS ON 

1008
00:48:53,969 --> 00:48:54,569
DIFFERENT OUTCOMES IN THE 

1009
00:48:54,569 --> 00:48:56,471
RESPIRATORY DISEASE.

1010
00:48:56,471 --> 00:48:57,839
THIS APPROACH OF INTEGRATING 

1011
00:48:57,839 --> 00:49:03,545
DIFFERENT MARKERS IS ILLUSTRATED

1012
00:49:03,545 --> 00:49:08,450
IN THE FIGURE THAT IS FROM THE 

1013
00:49:08,450 --> 00:49:11,586
NUTRITIONAL RISK FROM THE 

1014
00:49:11,586 --> 00:49:12,754
STATEMENT ON NUTRITIONAL 

1015
00:49:12,754 --> 00:49:18,627
ASSESSMENT AND THERAPY IN COPD.

1016
00:49:18,627 --> 00:49:27,903
THE THERE'S THREE MAIN PARKERS 

1017
00:49:27,903 --> 00:49:35,310
AND THIS THOSE THE MARKERS UNTO 

1018
00:49:35,310 --> 00:49:39,180
ACT AND ARE ASSOCIATED WOMEN 

1019
00:49:39,180 --> 00:49:41,750
OUTCOMES WITH INCREASED 

1020
00:49:41,750 --> 00:49:44,586
CARDIOVASCULAR RATES OR 

1021
00:49:44,586 --> 00:49:46,855
DECREASED PHYSICAL PERFORMANCE 

1022
00:49:46,855 --> 00:49:51,826
AND THIS ALSO HIGHLIGHTS THE 

1023
00:49:51,826 --> 00:50:00,535
PRESENCE OF LOW MUSCLE MASS WAS 

1024
00:50:00,535 --> 00:50:03,138
FOUND IN PATIENTS AS SHOWN BY 

1025
00:50:03,138 --> 00:50:13,682
THE RECENT RELEASE OF THE FIRST 

1026
00:50:16,618 --> 00:50:27,028
LOOKING AT OBESITY AND ONE 

1027
00:50:28,330 --> 00:50:30,131
ASPECT IS LOW MUSCLE MASS IN 

1028
00:50:30,131 --> 00:50:30,532
OBESITY.

1029
00:50:30,532 --> 00:50:33,034
THIS CAN BE CHALLENGING.

1030
00:50:33,034 --> 00:50:36,972
IN THIS STUDY WE FOUND THAT WE 

1031
00:50:36,972 --> 00:50:41,576
CANNOT USE THE SAME FOR MUSCLE 

1032
00:50:41,576 --> 00:50:47,015
MASS AS FOR PATIENTS WITH COPD 

1033
00:50:47,015 --> 00:50:57,559
WHICH WE NEED TO APPLY BMI AND 

1034
00:51:00,228 --> 00:51:03,698
LOW MUSCLE MASS IN THE BMI 

1035
00:51:03,698 --> 00:51:05,367
GROUPS.

1036
00:51:05,367 --> 00:51:06,835
THIS FIGURE SHOWS THE MAIN 

1037
00:51:06,835 --> 00:51:13,041
RESULTS OF OUR STUDY AND WE CAN 

1038
00:51:13,041 --> 00:51:15,744
REVIEW IT WHEN WE AND IF WE 

1039
00:51:15,744 --> 00:51:17,545
FOUND BLACK AND GRAY BARS WE CAN

1040
00:51:17,545 --> 00:51:20,081
SEE THEY DECREASED FROM LEFT TO 

1041
00:51:20,081 --> 00:51:23,985
RIGHT AND THAT BASICALLY MEANS 

1042
00:51:23,985 --> 00:51:29,257
AS THE BMI INCREASES THE 

1043
00:51:29,257 --> 00:51:35,397
PRESENCE OF LOW MUSCLE PASS 

1044
00:51:35,397 --> 00:51:40,802
DECREASES OR IS NOT POSSIBLE TO 

1045
00:51:40,802 --> 00:51:46,408
IDENTIFY WHEN WE USE BMI 

1046
00:51:46,408 --> 00:51:51,012
SPECIFIC GROUPS AND WE FOUND 

1047
00:51:51,012 --> 00:51:54,816
BLACK BARS THE BMI SPECIFIC WE 

1048
00:51:54,816 --> 00:51:58,586
SEE THE PREVALENCE OF MUSCLE 

1049
00:51:58,586 --> 00:52:00,355
MASS IS SIMILAR AMONG THE 

1050
00:52:00,355 --> 00:52:09,597
DIFFERENT BMI.

1051
00:52:09,597 --> 00:52:10,799
FOLLOWING THE STUDY WE HAVE A 

1052
00:52:10,799 --> 00:52:16,337
COHORT OF PATIENTS WITH COPD.

1053
00:52:16,337 --> 00:52:19,140
THEY'RE COMING FROM A STUDY IN 

1054
00:52:19,140 --> 00:52:25,346
GERMANY AND WE AGAIN CONFIRMED 

1055
00:52:25,346 --> 00:52:30,251
USING BMI HELPS TO IDENTIFY 

1056
00:52:30,251 --> 00:52:33,088
THOSE OVERWEIGHT AND OBESE 

1057
00:52:33,088 --> 00:52:40,628
PATIENTS WITH LOW MUSCLE MASS.

1058
00:52:40,628 --> 00:52:45,066
THE PATIENTS WITH LOW FAT INDEX 

1059
00:52:45,066 --> 00:52:48,670
IRRESPECTIVELY OF THEIR BMI 

1060
00:52:48,670 --> 00:52:49,604
GROUPS REFLECT A REDUCED 

1061
00:52:49,604 --> 00:52:53,341
EXERCISE CAPACITY AS 

1062
00:52:53,341 --> 00:52:58,546
DEMONSTRATED BY LOWER WALKING 

1063
00:52:58,546 --> 00:53:01,783
DISTANCE AND HIGHER SCORE 

1064
00:53:01,783 --> 00:53:02,417
REPRESENTING A WORSE QUALITY OF 

1065
00:53:02,417 --> 00:53:12,827
LIFE IN THOSE PATIENTS.

1066
00:53:13,294 --> 00:53:15,063
WE ALSO HAVE DATA SHOWING THE 

1067
00:53:15,063 --> 00:53:20,201
INTENTIONAL WEIGHT LOSS WHICH IS

1068
00:53:20,201 --> 00:53:24,038
A KEY COMPONENT IN THE FINAL 

1069
00:53:24,038 --> 00:53:32,747
PANEL B AND DID ON THE LEFT THE 

1070
00:53:32,747 --> 00:53:37,652
PREVALENCE IS DISTRIBUTED ACROSS

1071
00:53:37,652 --> 00:53:40,722
THE DIFFERENT STAGES OF THE 

1072
00:53:40,722 --> 00:53:44,926
DISEASE AND PATIENTS WITH 

1073
00:53:44,926 --> 00:53:50,565
OVERWEIGHT AND OBESITY AND THE 

1074
00:53:50,565 --> 00:53:55,270
FIGURE ON THE RIGHT IF WE FOCUS 

1075
00:53:55,270 --> 00:53:59,340
ON PANEL B YOU CAN SEE RATES ARE

1076
00:53:59,340 --> 00:54:01,609
HIGHER IN PATIENTS WITH WEIGHT 

1077
00:54:01,609 --> 00:54:03,545
LOSS HAVE A HIGHER RISK OF 

1078
00:54:03,545 --> 00:54:09,350
MORTALITY COMPARED TO THOSE WITH

1079
00:54:09,350 --> 00:54:12,420
COPD WITH STABLE BODY WEIGHT AND

1080
00:54:12,420 --> 00:54:17,592
COMPARING PANELS A, B AND C WE 

1081
00:54:17,592 --> 00:54:19,460
CAN CONCLUDE WEIGHT LOSS WHETHER

1082
00:54:19,460 --> 00:54:22,664
CONSIDERED ALONE OR INCORPORATED

1083
00:54:22,664 --> 00:54:26,968
IN THE DIAGNOSIS OF PROTECTION 

1084
00:54:26,968 --> 00:54:30,638
IS ASSOCIATED WITH OUTCOME IN 

1085
00:54:30,638 --> 00:54:40,648
PATIENTS WITH COPD.

1086
00:54:40,648 --> 00:54:46,554
WE CAN ALSO CONSIDER TRACKING 

1087
00:54:46,554 --> 00:54:52,660
BODY COMPOSITION OVER TIME WE 

1088
00:54:52,660 --> 00:54:56,664
FOLLOWED PATIENTS SMOKING AND 

1089
00:54:56,664 --> 00:55:01,803
NON-SMOKING AND USED THE DEXI 

1090
00:55:01,803 --> 00:55:07,442
SCAN AND AFTER TWO YEARS YOU CAB

1091
00:55:07,442 --> 00:55:09,444
SEE THE PATIENTS WITH COPD AND 

1092
00:55:09,444 --> 00:55:12,814
THOSE PARTICIPANTS FROM THE 

1093
00:55:12,814 --> 00:55:14,082
SMOKING CONTROLLED GROUP SHOWED 

1094
00:55:14,082 --> 00:55:19,754
SIGNIFICANT DECLINE OVER TWO 

1095
00:55:19,754 --> 00:55:27,595
YEARS ESPECIALLY COMPARED WITH 

1096
00:55:27,595 --> 00:55:30,298
NON SMOKING ATROPHY AND 

1097
00:55:30,298 --> 00:55:35,403
IDENTIFIED A SUB GROUP WITH 

1098
00:55:35,403 --> 00:55:42,343
THOSE AT BASELINE AND AND A 

1099
00:55:42,343 --> 00:55:42,977
DECLINE ON FAT MASS DURING THE 

1100
00:55:42,977 --> 00:55:53,154
TWO YEARS.

1101
00:55:55,657 --> 00:55:59,594
AND DON'T UNDERSTAND WHETHER THE

1102
00:55:59,594 --> 00:56:02,297
GROUP ALSO HAS A WORSE 

1103
00:56:02,297 --> 00:56:03,031
PROGNOSIS.

1104
00:56:03,031 --> 00:56:08,670
THIS IS THE FIRST RESEARCH GAP 

1105
00:56:08,670 --> 00:56:18,813
THAT I'VE IDENTIFIED.

1106
00:56:18,813 --> 00:56:22,183
THERE'S OTHER CURRENT GAPS AND 

1107
00:56:22,183 --> 00:56:22,817
OPPORTUNITIES ASSOCIATED WITH 

1108
00:56:22,817 --> 00:56:24,185
THE CURRENT GAP.

1109
00:56:24,185 --> 00:56:26,554
I THINK CURRENTLY THERE'S 

1110
00:56:26,554 --> 00:56:27,722
INEFFICIENT EVIDENCE ON THIS 

1111
00:56:27,722 --> 00:56:34,329
INTERPLAY BETWEEN BODY RELATED 

1112
00:56:34,329 --> 00:56:36,631
MARKERS UNPREDICTING ADVERSE 

1113
00:56:36,631 --> 00:56:38,132
OUTCOME AND WE HAVE THE 

1114
00:56:38,132 --> 00:56:43,504
OPPORTUNITY TO CONDUCT 

1115
00:56:43,504 --> 00:56:44,972
LONGITUDINAL STUDIES WITH 

1116
00:56:44,972 --> 00:56:46,441
LONG-TERM FOLLOW-UP AND THE 

1117
00:56:46,441 --> 00:56:48,676
RESEARCH IS ON HOW TO ADAPT 

1118
00:56:48,676 --> 00:56:55,016
METHODOLOGIES AND LOOK AT THE 

1119
00:56:55,016 --> 00:56:57,118
SELECTION OF MUSCLE MASS 

1120
00:56:57,118 --> 00:57:00,488
VARIABLES AND SHOULD WE IDENTIFY

1121
00:57:00,488 --> 00:57:05,059
LOW MUSCLE MASS IN INDIVIDUALS 

1122
00:57:05,059 --> 00:57:06,361
WITH OBESITY.

1123
00:57:06,361 --> 00:57:10,765
I THINK THE ALGORITHM COULD BE 

1124
00:57:10,765 --> 00:57:14,902
AN OPPORTUNITY SINCE WE CAN TEST

1125
00:57:14,902 --> 00:57:15,570
THE DIAGNOSTIC PERFORMANCE OF 

1126
00:57:15,570 --> 00:57:25,380
THIS APPROACH.

1127
00:57:25,380 --> 00:57:27,582
FINAL HI THERE'S RESEARCH ON HOW

1128
00:57:27,582 --> 00:57:32,153
TO TAILOR REHABILITATION TO LOOK

1129
00:57:32,153 --> 00:57:39,060
AT PATIENTS IN TERMS OF DIET AND

1130
00:57:39,060 --> 00:57:44,198
SKERS AND THERE'S AN OPPORTUNITY

1131
00:57:44,198 --> 00:57:48,503
FOR RANDOMIZED TRIALS FOR 

1132
00:57:48,503 --> 00:57:48,836
INTERVENTIONS.

1133
00:57:48,836 --> 00:57:56,711
AND FINALLY THERE REMAINS 

1134
00:57:56,711 --> 00:57:58,813
UNCERTAINTY WHETHER IDENTIFYING 

1135
00:57:58,813 --> 00:58:00,948
THE BODY MASS RELATED MARKERS 

1136
00:58:00,948 --> 00:58:03,117
WILL LEAD TO MEANINGFUL CHANGE 

1137
00:58:03,117 --> 00:58:08,423
IN THE COURSE OF THE DISEASE.

1138
00:58:08,423 --> 00:58:14,662
SO WE ALSO NEED TO FOCUS ON 

1139
00:58:14,662 --> 00:58:16,097
INTERVENTION STUDIES WITH 

1140
00:58:16,097 --> 00:58:17,532
LONG-TERM FOLLOW-UP TO ANSWER 

1141
00:58:17,532 --> 00:58:18,199
THE QUESTION.

1142
00:58:18,199 --> 00:58:19,267
THAT'S THE END OF MY 

1143
00:58:19,267 --> 00:58:24,105
PRESENTATION AND THANK YOU FOR 

1144
00:58:24,105 --> 00:58:26,240
YOUR ATTENTION.

1145
00:58:26,240 --> 00:58:31,012
I CAN INTRODUCE THE NEXT SPEAKER

1146
00:58:31,012 --> 00:58:33,414
MELODY DUVALL ASSISTANT 

1147
00:58:33,414 --> 00:58:34,015
PROFESSOR AT HARVARD MEDICAL 

1148
00:58:34,015 --> 00:58:42,723
SCHOOL.

1149
00:58:42,723 --> 00:58:44,425
>> WONDERFUL.

1150
00:58:44,425 --> 00:58:46,527
MANY THANKS TO THE NHLBI FOR 

1151
00:58:46,527 --> 00:58:47,595
ORGANIZING THE WORKSHOP AND 

1152
00:58:47,595 --> 00:58:51,666
THANK YOU FOR THE OPPORTUNITY TO

1153
00:58:51,666 --> 00:58:52,099
SPEAK TO YOU TODAY.

1154
00:58:52,099 --> 00:58:58,940
I'LL SPECIAL ON SPECIALIZED PRO 

1155
00:58:58,940 --> 00:59:00,441
RESOLVING MEDIATORS ON 

1156
00:59:00,441 --> 00:59:01,075
PREDICTING RESPIRATORY DISEASE 

1157
00:59:01,075 --> 00:59:03,578
AND HAVE NO CONFLICTS TO 

1158
00:59:03,578 --> 00:59:07,582
DISCLOSE.

1159
00:59:07,582 --> 00:59:09,750
IN REVIEWING EVERYDAY FOR 

1160
00:59:09,750 --> 00:59:13,154
PREVENTION OF RESPIRATORY 

1161
00:59:13,154 --> 00:59:15,590
DISEASE THROUGH DIETARY 

1162
00:59:15,590 --> 00:59:16,958
SUPPLEMENTATION AND HIGHLIGHT 

1163
00:59:16,958 --> 00:59:18,326
THIS STUDY IN THE NEW ENGLAND 

1164
00:59:18,326 --> 00:59:21,596
JOURNAL FROM 2016 IN THIS DOUBLE

1165
00:59:21,596 --> 00:59:27,735
RANDOMIZED CONTROL TRIAL WOMEN 

1166
00:59:27,735 --> 00:59:30,204
RECEIVED A PLACEBO IN THIRD 

1167
00:59:30,204 --> 00:59:31,806
TRIMESTER AND CHILDREN FOLLOWED 

1168
00:59:31,806 --> 00:59:35,576
TO ABLE 5 YEARS.

1169
00:59:35,576 --> 00:59:38,679
MATERNAL SUPPLEMENTATION REDUCED

1170
00:59:38,679 --> 00:59:41,916
THE RISK OF WHEEZE OR ASTHMA IN 

1171
00:59:41,916 --> 00:59:44,652
THEIR CHILDREN WITH OMEGA 3 AND 

1172
00:59:44,652 --> 00:59:45,953
DRIVEN ALMOST EXCLUSIVELY WITH 

1173
00:59:45,953 --> 00:59:50,491
CHILDREN OF MOTHERS WHO HAD THE 

1174
00:59:50,491 --> 00:59:52,660
LOWEST BLOOD LEVELS OF THESE 

1175
00:59:52,660 --> 00:59:54,896
RANDOMIZATION IN THE LEFT GRAPH.

1176
00:59:54,896 --> 00:59:57,231
IN THIS SUBGROUP ANALYSIS, THE 

1177
00:59:57,231 --> 00:59:58,933
RISK OF PERSISTENT WHEEZE IN 

1178
00:59:58,933 --> 01:00:00,535
THIS GROUP OF CHILDREN WAS 

1179
01:00:00,535 --> 01:00:03,137
REDUCED BY HALF.

1180
01:00:03,137 --> 01:00:05,039
FURTHER, MATERNAL PROOF OF 

1181
01:00:05,039 --> 01:00:11,045
SUPPLEMENTATION REDUCED THE RISK

1182
01:00:11,045 --> 01:00:13,314
OF RESPIRATORY TRACK INFECTIONS 

1183
01:00:13,314 --> 01:00:15,216
IN FOLLOW-UP OF 5 YEARS OF THE 

1184
01:00:15,216 --> 01:00:16,984
CHILDREN AND LOOKED AT 

1185
01:00:16,984 --> 01:00:22,123
MECHANISTIC UNDER PINNINGS.

1186
01:00:22,123 --> 01:00:27,128
THE ACIDS MEDIATED BRONCO 

1187
01:00:27,128 --> 01:00:29,530
CONSTRICTION AND FISH OILS 

1188
01:00:29,530 --> 01:00:33,067
DISPLAY THE ACID IN PHOSPHO 

1189
01:00:33,067 --> 01:00:38,439
LIPIDS AND CONVERTED TO PRO 

1190
01:00:38,439 --> 01:00:40,141
RESOLVING MEDIATORS DAMPENING 

1191
01:00:40,141 --> 01:00:41,042
RESPONSIVE.

1192
01:00:41,042 --> 01:00:47,048
AND PROMOTE THE RESOLUTION OF 

1193
01:00:47,048 --> 01:00:48,215
INFLAMMATION.

1194
01:00:48,215 --> 01:00:54,789
ACUTE INFLAMMATION IS VITAL TO 

1195
01:00:54,789 --> 01:00:58,259
HUMAN HEALTH AND IT PROCEEDS 

1196
01:00:58,259 --> 01:01:00,695
UNAN ACTIVELY REGULATED SERIES 

1197
01:01:00,695 --> 01:01:04,231
OF BIOLOGICAL PROCESSES MEDIATED

1198
01:01:04,231 --> 01:01:05,066
BY CLASS SWITCHING.

1199
01:01:05,066 --> 01:01:08,402
IN HEALTH A RAPID HOST RESPONSE 

1200
01:01:08,402 --> 01:01:10,137
RESULTS IN EDEMA WITHIN SECONDS 

1201
01:01:10,137 --> 01:01:13,007
AT THE SITE.

1202
01:01:13,007 --> 01:01:16,677
INFLAMMATORY MEDIATORS 

1203
01:01:16,677 --> 01:01:19,580
PHYSIOLOGICALLY MEDIATE THE 

1204
01:01:19,580 --> 01:01:23,084
REDNESS, SWELLING, WARMTH AND 

1205
01:01:23,084 --> 01:01:26,053
CHEMO TRACTANTS OF NEUTROPHILS 

1206
01:01:26,053 --> 01:01:31,592
THAT SWARM TO THE INFLAMMATION 

1207
01:01:31,592 --> 01:01:42,103
THROUGH PHAGOCYTOSIS AND BIO 

1208
01:01:44,238 --> 01:01:46,674
SYNTHESIS WITH PRO RESOLVING 

1209
01:01:46,674 --> 01:01:51,579
ACTIVITY WITH K CELLS AND 

1210
01:01:51,579 --> 01:01:54,015
MACROPHAGES TO RESTORE 

1211
01:01:54,015 --> 01:01:55,549
HOMEOSTASIS.

1212
01:01:55,549 --> 01:01:59,053
THIS SUPER FAMILY OF PROTECTANTS

1213
01:01:59,053 --> 01:02:00,821
COMPRISES MORE THAN 30 DISTINCT 

1214
01:02:00,821 --> 01:02:03,591
MEDIATORS THAT HAVE 

1215
01:02:03,591 --> 01:02:05,092
ANTI-INFLAMMATORY PROPERTIES TO 

1216
01:02:05,092 --> 01:02:07,528
BLOCK LEUKO TRIIN PRODUCTION AND

1217
01:02:07,528 --> 01:02:10,598
HALT NEUTROPHIL RECRUITMENT AS 

1218
01:02:10,598 --> 01:02:13,000
WELL AS PRO RESOLVING FUNCTION 

1219
01:02:13,000 --> 01:02:16,570
TO RECRUIT MONOCYTE AND 

1220
01:02:16,570 --> 01:02:25,546
STIMULATE PHAGOCYTOSIS.

1221
01:02:25,546 --> 01:02:27,581
THE SIGN OF INFLAMMATION WAS 

1222
01:02:27,581 --> 01:02:32,353
CITED IN THE FIRST CENTURY, 

1223
01:02:32,353 --> 01:02:33,654
FEVER, EDEMA AND SENSE OF 

1224
01:02:33,654 --> 01:02:33,921
FUNCTION.

1225
01:02:33,921 --> 01:02:35,856
AND WE BEGAN TO APPRECIATE THE 

1226
01:02:35,856 --> 01:02:38,125
RESOLUTION OF RESOLUTION IS 

1227
01:02:38,125 --> 01:02:41,162
CHARACTERIZED BY SPECIFIC CA

1228
01:02:41,162 --> 01:02:43,597
CARDINAL PROCESSES AND REMOVAL 

1229
01:02:43,597 --> 01:02:48,903
OF DEAD CELLS AND DEBRIS AND 

1230
01:02:48,903 --> 01:02:50,204
TISSUE PROFUSION AND 

1231
01:02:50,204 --> 01:02:51,305
REGENERATION OF TISSUE, 

1232
01:02:51,305 --> 01:02:54,308
REMISSION OF FEVER AND RELIEF OF

1233
01:02:54,308 --> 01:02:55,576
PAIN.

1234
01:02:55,576 --> 01:02:59,113
AND IN HEALTH SPMs FROM DIETARY 

1235
01:02:59,113 --> 01:03:02,817
FATTY ACIDS ORCHESTRATE THE 

1236
01:03:02,817 --> 01:03:04,418
PROCESS OF INFLAMMATION 

1237
01:03:04,418 --> 01:03:07,722
RESOLUTION TO MAINTAIN AND 

1238
01:03:07,722 --> 01:03:13,561
RESTORE TISSUE HOMEOSTASIS.

1239
01:03:13,561 --> 01:03:17,231
THERE ARE A NUMBER OF CHRONIC 

1240
01:03:17,231 --> 01:03:23,170
RESPIRATORY DISEASES WITH 

1241
01:03:23,170 --> 01:03:33,147
MEDIATORS.

1242
01:03:33,147 --> 01:03:34,982
RINE YOU SIGHT IS AND ALL THESE 

1243
01:03:34,982 --> 01:03:36,984
DISEASES HAVE BEEN ASSOCIATED 

1244
01:03:36,984 --> 01:03:40,721
WITH RELATIVE DEFICIENCIES IN 

1245
01:03:40,721 --> 01:03:43,491
PRO RESOLVING SPMs IMBALANCED 

1246
01:03:43,491 --> 01:03:47,161
WITH PRO-INFLAMMATORY MEDIATORS.

1247
01:03:47,161 --> 01:03:49,330
I'LL HIGHLIGHT SOME WORK IN 

1248
01:03:49,330 --> 01:03:53,234
ASTHMA WHERE DYSREGULATED BIO 

1249
01:03:53,234 --> 01:03:57,471
SYNTHESIS IS LINKED TO 

1250
01:03:57,471 --> 01:04:02,042
HYPERACTIVITY AND INFLAMMATION.

1251
01:04:02,042 --> 01:04:07,581
WE HAVE A STUDY OF PARTICIPANTS 

1252
01:04:07,581 --> 01:04:10,184
FUNDED BY NHLBI FOR NEARLY 20 

1253
01:04:10,184 --> 01:04:10,417
YEARS.

1254
01:04:10,417 --> 01:04:12,853
AT THE PEAK IT INCLUDED 700 

1255
01:04:12,853 --> 01:04:14,288
PARTICIPANTS FROM 7 LEADING 

1256
01:04:14,288 --> 01:04:15,723
ASTHMA CLINICAL RESEARCH CENTERS

1257
01:04:15,723 --> 01:04:26,167
ACROSS THE UNITED STATES.

1258
01:04:27,635 --> 01:04:30,437
SPMs HAVE BEEN THE FOCUS OF MANY

1259
01:04:30,437 --> 01:04:32,873
STUDIES AND HIGHLIGHT THREE.

1260
01:04:32,873 --> 01:04:36,877
FIRST MEASURING AIR WAY 

1261
01:04:36,877 --> 01:04:39,346
CONCENTRATIONS REL RELATIVE TO 

1262
01:04:39,346 --> 01:04:41,816
THE PROINFLAMMATORY MEDIATOR 

1263
01:04:41,816 --> 01:04:43,584
SERUM AMYLOID A.

1264
01:04:43,584 --> 01:04:48,222
AND LEUKOCYTES IN ASTHMA WITH 

1265
01:04:48,222 --> 01:04:50,758
INTENTION TO NATURAL KILLER 

1266
01:04:50,758 --> 01:04:53,894
CELLS AND AFFECT OF STEROIDS ON 

1267
01:04:53,894 --> 01:05:04,438
M CELL FUNCTION AND RECEPTOR ON 

1268
01:05:11,378 --> 01:05:11,612
P

1269
01:05:11,612 --> 01:05:17,351
PROINFLAMMATORY LEUKOCYTES.

1270
01:05:17,351 --> 01:05:24,124
ABOUT A THIRD OF OUR COHORT HAD 

1271
01:05:24,124 --> 01:05:31,432
LOW LEVELS AND THEY HAD LOW SAA 

1272
01:05:31,432 --> 01:05:31,665
LEVELS.

1273
01:05:31,665 --> 01:05:35,369
AND WHEN WE COMPARED THE TWO 

1274
01:05:35,369 --> 01:05:36,570
OPPOSITE POPULATIONS OF SUBJECTS

1275
01:05:36,570 --> 01:05:39,573
WE REPORTED DIFFERENCES IN 

1276
01:05:39,573 --> 01:05:42,743
ASTHMA CLINICAL MEASURES.

1277
01:05:42,743 --> 01:05:49,216
IN THE PATIENTS WITH LOW LXA4 

1278
01:05:49,216 --> 01:05:53,621
REPORTED MORE ASTHMA SYMPTOMS 

1279
01:05:53,621 --> 01:05:54,822
AND LOWER FUNCTION.

1280
01:05:54,822 --> 01:05:58,425
THE STUDY IDENTIFIED AN ENDOTYPE

1281
01:05:58,425 --> 01:06:03,530
OF SEVERE ASTHMA CHARACTERIZED 

1282
01:06:03,530 --> 01:06:09,069
BY DEFICIENCIES AND MEASURES OF 

1283
01:06:09,069 --> 01:06:17,378
RESPIRATORY DISEASE PATHOLOGY.

1284
01:06:17,378 --> 01:06:25,719
AND A NUMBER OF PROTEIN COUPLED 

1285
01:06:25,719 --> 01:06:27,488
RECEPTORS HAVE BEEN IDENTIFIED 

1286
01:06:27,488 --> 01:06:31,625
AS COGNATE RECEPTORS FOR 

1287
01:06:31,625 --> 01:06:34,295
SPECIFIC GPR18 IDENTIFIED AS THE

1288
01:06:34,295 --> 01:06:38,899
RECEPTOR FOR THE DHA DERIVED 

1289
01:06:38,899 --> 01:06:39,566
RESOLVENT D2.

1290
01:06:39,566 --> 01:06:43,003
OF INTEREST GPR18 NOW TERMED 

1291
01:06:43,003 --> 01:06:44,571
DRV2 WAS RECENTLY IDENTIFIED AS 

1292
01:06:44,571 --> 01:06:47,041
A CANDIDATE CAUSAL GENE FOR 

1293
01:06:47,041 --> 01:06:47,908
ASTHMA SUSCEPTIBILITY IN THE 

1294
01:06:47,908 --> 01:06:51,211
STUDY FROM THE U.K. BIO BANK.

1295
01:06:51,211 --> 01:06:53,113
IN ADDITION TO EVALUATING 

1296
01:06:53,113 --> 01:06:58,352
CONCENTRATIONS OF SPMs INTH 

1297
01:06:58,352 --> 01:06:59,520
ASTHMA WE'VE BEEN INTERESTED IN 

1298
01:06:59,520 --> 01:07:04,425
AIRWAY LEUKOCYTES AND EXAMINED 

1299
01:07:04,425 --> 01:07:07,594
DRD2 EXPRESSION ON BLOOD 

1300
01:07:07,594 --> 01:07:09,296
EOSINOPHILS IN SARP 4 AND FOUND 

1301
01:07:09,296 --> 01:07:13,667
THE EXPRESSION IN ASTHMA ON THE 

1302
01:07:13,667 --> 01:07:15,569
RIGHT SIDE GRAPH WAS HIGHER WITH

1303
01:07:15,569 --> 01:07:16,170
MORE THAN THREE FOLD HIGHER 

1304
01:07:16,170 --> 01:07:20,841
EXPRESSION OF D 

1305
01:07:20,841 --> 01:07:25,646
-- DRB2 AND OUT WAS EFFECTIVE AT

1306
01:07:25,646 --> 01:07:28,315
REDUCING INFLAMMATORY RESPONSES 

1307
01:07:28,315 --> 01:07:29,116
AND PROMOTING INFLAMMATION 

1308
01:07:29,116 --> 01:07:31,051
RESOLUTION IN PARTICULAR BY 

1309
01:07:31,051 --> 01:07:36,690
REGULATING EO SIN OFFICIAL 

1310
01:07:36,690 --> 01:07:37,024
TYPES.

1311
01:07:37,024 --> 01:07:39,026
AND THE STUDIES I'LL HIGHLIGHT 

1312
01:07:39,026 --> 01:07:42,696
FORCE ON NATURAL KILLER CELLS 

1313
01:07:42,696 --> 01:07:45,699
AND INNATE CELLS CRITICAL FOR 

1314
01:07:45,699 --> 01:07:46,333
HOST DEFENSE.

1315
01:07:46,333 --> 01:07:50,037
THE TRIAL DEMONSTRATED THE 

1316
01:07:50,037 --> 01:07:52,406
BENEFIT OF PROOF OF 

1317
01:07:52,406 --> 01:07:54,208
SUPPLEMENTATION ON INFECTION IN 

1318
01:07:54,208 --> 01:07:55,576
CHILDREN.

1319
01:07:55,576 --> 01:07:57,511
IN ADDITION TO VIRAL HOST 

1320
01:07:57,511 --> 01:07:58,946
DEFENSE IN THE CASE OF 

1321
01:07:58,946 --> 01:08:00,881
INFLAMMATION, MK CELLS ARE 

1322
01:08:00,881 --> 01:08:02,316
IMPORTED IN INDUCING APOPTOSIS 

1323
01:08:02,316 --> 01:08:06,487
OF RECRUITIVE LEUKOCYTES FOR 

1324
01:08:06,487 --> 01:08:08,188
DOWN STREAM MACROPHAGE 

1325
01:08:08,188 --> 01:08:10,758
ENGULFMENT TO RETURN TO A RETURN

1326
01:08:10,758 --> 01:08:12,893
TO TISSUE HOMEOSTASIS IN THE 

1327
01:08:12,893 --> 01:08:15,562
CARTOON ON THE LEFT.

1328
01:08:15,562 --> 01:08:25,305
IN SARK 3 THE RATIO TO NK CELLS 

1329
01:08:25,305 --> 01:08:27,574
IN THE AIRWAY WAS DRAMATICALLY 

1330
01:08:27,574 --> 01:08:30,377
INCREASED IN SEVERE ASTHMA 

1331
01:08:30,377 --> 01:08:30,677
POPULATION.

1332
01:08:30,677 --> 01:08:34,915
THE FREQUENCY OF CYTOTOXIC CELLS

1333
01:08:34,915 --> 01:08:36,717
WAS CORRELATED WITH LOWER LUNG 

1334
01:08:36,717 --> 01:08:41,422
FUNCTION IN ASTHMA AND ALOOKING 

1335
01:08:41,422 --> 01:08:42,823
EX VIVO THERE'S FUNCTIONALLY 

1336
01:08:42,823 --> 01:08:45,492
IMPAIRED IN ASTHMA WITH REDUCED 

1337
01:08:45,492 --> 01:08:51,565
ABILITY OF APOPTOSIS.

1338
01:08:51,565 --> 01:08:54,201
WE HYPOTHESIZED STEROID EXPOSURE

1339
01:08:54,201 --> 01:08:57,337
MAY BE IMPACTED K CELL RECEPTOR 

1340
01:08:57,337 --> 01:09:00,641
FUNCTION AND SHOWED IN VITRO THE

1341
01:09:00,641 --> 01:09:05,479
STEROID SUPPRESSED NK CELL 

1342
01:09:05,479 --> 01:09:13,854
APOPTOSIS AND COMPARED TO THE 

1343
01:09:13,854 --> 01:09:14,488
CYTOTOXICITY.

1344
01:09:14,488 --> 01:09:17,524
WE IDENTIFIED THE LIN KINASES 

1345
01:09:17,524 --> 01:09:23,530
IMPACTED BY THESE.

1346
01:09:23,530 --> 01:09:28,268
SO OF ALL THOSE STUDIES PREVIOUS

1347
01:09:28,268 --> 01:09:30,370
STUDY I MENTIONED LOOKED AT 

1348
01:09:30,370 --> 01:09:32,106
HUMAN PATHWAYS.

1349
01:09:32,106 --> 01:09:35,175
THERE'S BEEN STUDIES IN 

1350
01:09:35,175 --> 01:09:36,143
PRECLINICAL RESPIRATORY DISEASE 

1351
01:09:36,143 --> 01:09:38,979
MODEL DEMONSTRATING THE 

1352
01:09:38,979 --> 01:09:40,881
BENEFICIAL EFFECTS OF SPMs ON 

1353
01:09:40,881 --> 01:09:42,883
DAMPENING PRO-INFLAMMATORY HOST 

1354
01:09:42,883 --> 01:09:45,018
RESPONSES IN PATHOBIOLOGY AND 

1355
01:09:45,018 --> 01:09:46,820
STIMULATING RESOLUTION.

1356
01:09:46,820 --> 01:09:48,122
I'VE HIGHLIGHTED A FEW ALREADY 

1357
01:09:48,122 --> 01:09:51,225
IN THE CATEGORY OF ALLERGIC LUNG

1358
01:09:51,225 --> 01:09:51,592
INFLAMMATION.

1359
01:09:51,592 --> 01:09:54,394
A NUMBER OF STUDIES IN 

1360
01:09:54,394 --> 01:09:56,797
SMOKE-INDUCED LUNG JOURNAL 

1361
01:09:56,797 --> 01:09:58,165
INJURY AND COPD.

1362
01:09:58,165 --> 01:10:01,135
VIRAL LUNG IN INFECTIONS, RSV 

1363
01:10:01,135 --> 01:10:02,970
AND INFLUENZA, BACTERIAL 

1364
01:10:02,970 --> 01:10:04,805
PNEUMONIA AND SEPSIS INDUCED 

1365
01:10:04,805 --> 01:10:07,341
LUNG DISEASE AND THESE STUDIES 

1366
01:10:07,341 --> 01:10:09,076
HIGHLIGHT A NUMBER OF DISTINCT 

1367
01:10:09,076 --> 01:10:14,848
MOLECULES MEDIATING BENEFICIAL 

1368
01:10:14,848 --> 01:10:15,182
AN

1369
01:10:15,182 --> 01:10:15,516
AN

1370
01:10:15,516 --> 01:10:16,683
ANTI-INFLAMMATORY EFFECTS TO 

1371
01:10:16,683 --> 01:10:21,221
REDUCE LUNG INFLAMMATION AND 

1372
01:10:21,221 --> 01:10:22,156
INJURY.

1373
01:10:22,156 --> 01:10:23,590
SO HERE I'LL HIGHLIGHT KEY 

1374
01:10:23,590 --> 01:10:27,594
POINTS IN THE STATE OF SCIENCE 

1375
01:10:27,594 --> 01:10:29,029
IN RESPIRATORY HEALTH AND 

1376
01:10:29,029 --> 01:10:29,596
DISEASE.

1377
01:10:29,596 --> 01:10:30,531
INFLAMMATION RESOLUTION IS AN 

1378
01:10:30,531 --> 01:10:32,466
ACTIVE PROCESS ORCHESTRATED IN 

1379
01:10:32,466 --> 01:10:35,569
PART BY ESSENTIAL DIETARY FATTY 

1380
01:10:35,569 --> 01:10:40,574
ACID DERIVED SPMs WITH POTENT 

1381
01:10:40,574 --> 01:10:41,608
PRO-RESOLVING AND 

1382
01:10:41,608 --> 01:10:43,577
ANTI-INFLAMMATORY ACTIONS TO 

1383
01:10:43,577 --> 01:10:46,480
RESTORE HOMEOSTASIS IN HEALTH.

1384
01:10:46,480 --> 01:10:51,185
THE REGULATION OF SPMs RELATIVE 

1385
01:10:51,185 --> 01:10:53,587
TO MEDIATORS IS IN SEVERE ASTHMA

1386
01:10:53,587 --> 01:10:55,589
AND AASSOCIATED WITH IMPAIRED 

1387
01:10:55,589 --> 01:10:58,125
LUNG FUNCTION INCREASED SYMPTOMS

1388
01:10:58,125 --> 01:11:03,564
AND CHRONIC AIRWAY INFLAMMATION.

1389
01:11:03,564 --> 01:11:05,599
LEUKOCYTE RECEPTORS INCLUDING NK

1390
01:11:05,599 --> 01:11:09,169
CELLS HAVE REGULATION BY SPMs 

1391
01:11:09,169 --> 01:11:11,038
DISTINCT FROM THE 

1392
01:11:11,038 --> 01:11:15,776
IMMUNOSUPPRESSIVE EFFECTS AND 

1393
01:11:15,776 --> 01:11:17,511
EXOGENOUS SPMs CAN LOOK AT HOST 

1394
01:11:17,511 --> 01:11:19,846
RESPONSES AND IMPACT BIOLOGY AND

1395
01:11:19,846 --> 01:11:20,347
STIMULATE INFLAMMATION 

1396
01:11:20,347 --> 01:11:22,816
RESOLUTION IN PRE-CLINICAL AND 

1397
01:11:22,816 --> 01:11:26,587
RESPIRATORY DISEASE MODELS.

1398
01:11:26,587 --> 01:11:27,588
FINALLY I'LL HIGHLIGHT THREE 

1399
01:11:27,588 --> 01:11:29,690
CURRENT GAPS AND POTENTIAL KEY 

1400
01:11:29,690 --> 01:11:37,631
RESEARCH QUESTIONS.

1401
01:11:37,631 --> 01:11:39,566
ONE, COULD DIETARY 

1402
01:11:39,566 --> 01:11:42,135
SUPPLEMENTATION PROMOTE NATURAL 

1403
01:11:42,135 --> 01:11:44,171
GAS RESOLUTION IN RESPIRATORY 

1404
01:11:44,171 --> 01:11:47,574
DISEASES IN HUMANS.

1405
01:11:47,574 --> 01:11:50,043
EVERYDAY SUGGESTED RICH MARINE 

1406
01:11:50,043 --> 01:11:51,578
OILS CAN INCREASE CIRCULATING 

1407
01:11:51,578 --> 01:11:56,149
OILS OF SPMs IN PERIPHERAL BLOOD

1408
01:11:56,149 --> 01:11:57,384
BUT WHAT ABOUT THE AIRWAY.

1409
01:11:57,384 --> 01:11:59,686
CAN WE FEED THE LUNG THROUGH THE

1410
01:11:59,686 --> 01:12:01,455
GUT?

1411
01:12:01,455 --> 01:12:03,290
SECOND, WHAT UNDERLYING IMMUNE 

1412
01:12:03,290 --> 01:12:04,591
PATHWAY ARE LINKED WITH 

1413
01:12:04,591 --> 01:12:06,760
RESPIRATORY DISEASE ACTIVITY 

1414
01:12:06,760 --> 01:12:08,729
PRIMED FOR REGULATION BY SPMs 

1415
01:12:08,729 --> 01:12:10,931
AND COULD WE STUDY IN VITRO?

1416
01:12:10,931 --> 01:12:12,733
I'VE HIGHLIGHTED IN K CELLS A 

1417
01:12:12,733 --> 01:12:16,770
SUB CLASS AND THERE'S INMATE 

1418
01:12:16,770 --> 01:12:18,905
LYMPHOID CELLS, ADAPTIVE IMMUNE 

1419
01:12:18,905 --> 01:12:22,542
CELLS AND CD4 AND CD 8 CELLS AND

1420
01:12:22,542 --> 01:12:24,711
ASTHMA BIOLOGY AND MACROPHAGES 

1421
01:12:24,711 --> 01:12:26,647
AND IN PARTICULAR THIS 

1422
01:12:26,647 --> 01:12:29,483
EPITHELIAL CELL CROSS TALK.

1423
01:12:29,483 --> 01:12:32,719
THIRD, ARE THERE RELATIONSHIPS 

1424
01:12:32,719 --> 01:12:33,387
BETWEEN DYSREGULATED CIRCUITS 

1425
01:12:33,387 --> 01:12:35,589
AND DISEASE ACTIVITY THAT COULD 

1426
01:12:35,589 --> 01:12:38,892
BE INTERROGATED USING BIO BANK 

1427
01:12:38,892 --> 01:12:41,228
SAMPLES FROM EXIST BEING 

1428
01:12:41,228 --> 01:12:42,996
PATIENTS FROM INFLAMMATORY, 

1429
01:12:42,996 --> 01:12:47,567
PRORESPIRATORY DISEASE AND I 

1430
01:12:47,567 --> 01:12:49,603
MENTION THE SARP AND OTHERS 

1431
01:12:49,603 --> 01:12:52,939
MENTIONED PREVIOUSLY IN THE COPD

1432
01:12:52,939 --> 01:12:58,345
ARENA AND RECOVER COHORT 

1433
01:12:58,345 --> 01:12:59,012
FOCUSSED ON COVID AND OTHERS OF 

1434
01:12:59,012 --> 01:13:01,181
RELEVANCE.

1435
01:13:01,181 --> 01:13:04,651
I'LL END WITH ACKNOWLEDGEMENTS 

1436
01:13:04,651 --> 01:13:06,553
OF ALL OF OUR MEMBERS OF OUR A 

1437
01:13:06,553 --> 01:13:08,955
WAY AND RESOLUTION LAB AT 

1438
01:13:08,955 --> 01:13:11,258
HARVARD AND WOMEN AND BRIGHAM'S 

1439
01:13:11,258 --> 01:13:13,994
HOSPITAL AND THOSE IN THE SARP 

1440
01:13:13,994 --> 01:13:15,696
NETWORK AND NHLBI AND OTHERS FOR

1441
01:13:15,696 --> 01:13:16,330
FUNDING AND APPRECIATE YOU FOR 

1442
01:13:16,330 --> 01:13:26,606
YOUR ATTENTION.

1443
01:13:30,510 --> 01:13:33,280
>> THANK YOU SO MUCH DR.
DUVALL 

1444
01:13:33,280 --> 01:13:35,048
FOR THE GREAT PRESENTATION 

1445
01:13:35,048 --> 01:13:39,886
EXTENDING SOME OF THE MESSAGES 

1446
01:13:39,886 --> 01:13:41,555
WE HEARD FROM A FEW SPEAKERS 

1447
01:13:41,555 --> 01:13:43,590
FROM YESTERDAY ON THE TOPIC OF 

1448
01:13:43,590 --> 01:13:46,159
FATTY ACIDS AND POTENTIAL 

1449
01:13:46,159 --> 01:13:46,660
UNDERLYING MECHANISMS.

1450
01:13:46,660 --> 01:13:51,732
NOW DR. MACHADO, WOULD YOU LIKE 

1451
01:13:51,732 --> 01:13:53,500
TO DO A BRIEF SUMMARY OF THE 

1452
01:13:53,500 --> 01:13:54,234
PRESENTATIONS BEFORE WE OPEN IT 

1453
01:13:54,234 --> 01:14:00,073
UP FOR PANEL DISCUSSION?

1454
01:14:00,073 --> 01:14:01,675
>> YES.

1455
01:14:01,675 --> 01:14:05,912
THE IDEA IS WE HIGHLIGHT KEY 

1456
01:14:05,912 --> 01:14:11,585
POINTS BEFORE WE OPEN FOR 

1457
01:14:11,585 --> 01:14:21,795
DISCUSSION.

1458
01:14:27,200 --> 01:14:27,834
WE DECIDED TO HIGHLIGHT A FEW 

1459
01:14:27,834 --> 01:14:38,044
KEY POINTS.

1460
01:14:39,246 --> 01:14:45,285
FOR THE FIRST LECTURE WE NOTICED

1461
01:14:45,285 --> 01:14:46,219
BIOMARKERS FROM OBSERVATIONAL 

1462
01:14:46,219 --> 01:14:49,856
STUDIES NEED TO BE VALIDATED IN 

1463
01:14:49,856 --> 01:14:53,860
MEDIUM AND LONG-TERM 

1464
01:14:53,860 --> 01:14:55,195
INTERVENTION STUDIES AND ALSO 

1465
01:14:55,195 --> 01:14:57,230
SERUM SAMPLE CANNOT CAPTURE THE 

1466
01:14:57,230 --> 01:14:59,599
TRUE VARIATION INDICT AND 

1467
01:14:59,599 --> 01:15:04,538
LONG-TERM DIETARY PATTERNS.

1468
01:15:04,538 --> 01:15:10,544
AS WELL AS CONCENTRATIONS OF 

1469
01:15:10,544 --> 01:15:15,449
NOTABLE FACTORS OTHER THAN DIET 

1470
01:15:15,449 --> 01:15:17,684
SUCH

1471
01:15:17,684 --> 01:15:18,185
SUCH

1472
01:15:18,185 --> 01:15:22,222
SUCH AS POLLUTION WE RESERVED 

1473
01:15:22,222 --> 01:15:25,725
SEVERAL DIETARY METABOLITES 

1474
01:15:25,725 --> 01:15:29,596
RELATED TO DISEASE SEVERITY AND 

1475
01:15:29,596 --> 01:15:34,568
OUTCOMES AND CAUSAL 

1476
01:15:34,568 --> 01:15:37,437
RELATIONSHIPS AND ALSO TOOLS 

1477
01:15:37,437 --> 01:15:40,941
HAVE OPPORTUNITIES TO MEASURE 

1478
01:15:40,941 --> 01:15:45,212
NUTRITIONAL EXPOSURES AND 

1479
01:15:45,212 --> 01:15:51,585
CONSERVE BIASES AND MEASUREMENTS

1480
01:15:51,585 --> 01:16:01,294
OF INTERVENTION DRIVERS.

1481
01:16:01,294 --> 01:16:04,731
AND I'LL END BY EVIDENCE OF THE 

1482
01:16:04,731 --> 01:16:07,100
INTERPLAY BETWEEN BODY MASS 

1483
01:16:07,100 --> 01:16:09,169
RELATED MARKERS IN PREDICTING 

1484
01:16:09,169 --> 01:16:12,672
ADVERSE OUTCOMES AND PROGNOSIS 

1485
01:16:12,672 --> 01:16:15,575
AND RESERVE IS LIMITED ON HOW WE

1486
01:16:15,575 --> 01:16:17,611
ADAPT METHODOLOGIES TO IDENTIFY 

1487
01:16:17,611 --> 01:16:23,550
LOW MUSCLE MASS IN INDIVIDUALS 

1488
01:16:23,550 --> 01:16:27,587
WITH OBESITY.

1489
01:16:27,587 --> 01:16:32,092
AND DIFFERENT APPROACHES 

1490
01:16:32,092 --> 01:16:34,394
INCLUDING THE NEW ALGORITHM IS 

1491
01:16:34,394 --> 01:16:39,199
AN OPPORTUNITY.

1492
01:16:39,199 --> 01:16:47,574
AND NOW WE JUST SAW AND IT'S 

1493
01:16:47,574 --> 01:16:58,018
ORCHESTRATED BY SPMs WITH 

1494
01:16:59,185 --> 01:17:05,592
INFLAMMATORY ACTIONS AND THE 

1495
01:17:05,592 --> 01:17:06,826
MEDIATORS ARE ACTIVE IN LUNG 

1496
01:17:06,826 --> 01:17:11,064
DISEASE AND SOME EXAMPLES ARE 

1497
01:17:11,064 --> 01:17:12,032
ASTHMA AND THERE'S MANY OTHERS 

1498
01:17:12,032 --> 01:17:15,335
AND THIS IS ASSOCIATED WITH 

1499
01:17:15,335 --> 01:17:16,536
LOWER LUNG FUNCTION AND AIRWAY 

1500
01:17:16,536 --> 01:17:20,674
NATURAL GAS.

1501
01:17:20,674 --> 01:17:25,779
-- INFLAMMATION AND POTENTIAL 

1502
01:17:25,779 --> 01:17:33,987
FOR THE SUPPLEMENTATION TO 

1503
01:17:33,987 --> 01:17:36,389
LEVELS AND PROMOTE INFLAMMATION 

1504
01:17:36,389 --> 01:17:39,826
IN RESPIRATORY DISEASE.

1505
01:17:39,826 --> 01:17:45,265
THOSE ARE KEY POINTS.

1506
01:17:45,265 --> 01:17:48,101
WE WILL NOW ADDRESS THE KEY 

1507
01:17:48,101 --> 01:17:50,837
QUESTIONS THE SECTION WHICH IS 

1508
01:17:50,837 --> 01:17:53,306
CAN NUTRITIONAL BIOMARKERS 

1509
01:17:53,306 --> 01:17:58,778
PREDICT LUNG HEALTH AND OUTCOMES

1510
01:17:58,778 --> 01:18:08,288
OF LUNG DISEASE?

1511
01:18:08,288 --> 01:18:11,591
>> SPEAKERS, TURN ON YOUR
VIDEO 

1512
01:18:11,591 --> 01:18:14,461
AND WELCOME DR. GARCIA-LARSEN TO

1513
01:18:14,461 --> 01:18:16,229
JOIN THE DISCUSSION AS WELL.

1514
01:18:16,229 --> 01:18:21,568
MAYBE WE CAN START WITH THE KEY 

1515
01:18:21,568 --> 01:18:30,143
QUESTION AND FOR OUTCOMES OF 

1516
01:18:30,143 --> 01:18:31,044
LUNG DISEASES.

1517
01:18:31,044 --> 01:18:32,112
I KNOW IT'S A BROAD QUESTION.

1518
01:18:32,112 --> 01:18:38,084
WE'LL START WITH THAT AND HAVE 

1519
01:18:38,084 --> 01:18:40,053
SOME MORE SPECIFIC QUESTIONS 

1520
01:18:40,053 --> 01:18:40,320
FOLLOWING.

1521
01:18:40,320 --> 01:18:45,425
WE CAN GO IN ORDER OF THE 

1522
01:18:45,425 --> 01:18:48,662
SPEAKER AND 

1523
01:18:48,662 --> 01:18:53,033
>> I THINK NUTRITIONAL 

1524
01:18:53,033 --> 01:18:55,468
BIOMARKERS INHERENTLY ARE MORE 

1525
01:18:55,468 --> 01:18:58,571
POWERFUL BECAUSE THEY CAN 

1526
01:18:58,571 --> 01:19:01,207
CAPTURE THE VARIATION DIETARY 

1527
01:19:01,207 --> 01:19:03,576
INSTRUMENTS CANNOT IN 

1528
01:19:03,576 --> 01:19:05,045
METABOLISM.

1529
01:19:05,045 --> 01:19:06,980
FROM A STATISTICAL STANDPOINT IF

1530
01:19:06,980 --> 01:19:09,549
THERE IS AN ASSOCIATION BETWEEN 

1531
01:19:09,549 --> 01:19:13,787
A NUTRITIONAL COMPONENT AND 

1532
01:19:13,787 --> 01:19:15,555
RESPIRATORY HEALTH UTILIZING THE

1533
01:19:15,555 --> 01:19:20,126
BIOMARKER WOULD SHOW THAT 

1534
01:19:20,126 --> 01:19:22,028
ASSOCIATION BECAUSE IT DOES 

1535
01:19:22,028 --> 01:19:32,572
CAPTURE THE INTRINSIC VARIATION.

1536
01:19:34,374 --> 01:19:35,909
>> THE NICE PART IS
PREDICTION 

1537
01:19:35,909 --> 01:19:36,810
IS NOT INFERENCE.

1538
01:19:36,810 --> 01:19:39,579
EVEN IF A BIOMARKER IS NOT 

1539
01:19:39,579 --> 01:19:40,513
CAUSALLY RELATED TO A DISEASE 

1540
01:19:40,513 --> 01:19:42,182
PROCESS IT DOESN'T MEAN IT'S NOT

1541
01:19:42,182 --> 01:19:49,089
INFORM FOR OUTCOME PREDICTION.

1542
01:19:49,089 --> 01:19:51,558
I THINK MANY BIOMARKERS AND 

1543
01:19:51,558 --> 01:19:54,494
NUTRITIONAL METABOLITES HAVE 

1544
01:19:54,494 --> 01:19:55,729
HIGH POTENTIAL WHEN MEASURED IN 

1545
01:19:55,729 --> 01:19:56,062
COMPOSITE.

1546
01:19:56,062 --> 01:19:59,566
I DON'T KNOW ANY STAND ALONE 

1547
01:19:59,566 --> 01:20:03,303
BIOMARKER WILL DO THE TRICK.

1548
01:20:03,303 --> 01:20:05,638
THESE ARE THE HIGHEST POTENTIAL 

1549
01:20:05,638 --> 01:20:10,276
TO PROVIDE A BIOMARKER WITH HIGH

1550
01:20:10,276 --> 01:20:12,679
TEST PURPOSE TO WARRANT CLINICAL

1551
01:20:12,679 --> 01:20:13,179
USE.

1552
01:20:13,179 --> 01:20:18,184
>> DR. MACHADO.

1553
01:20:18,184 --> 01:20:28,795
>> I A GGEE THEY OFFER AN 

1554
01:20:30,864 --> 01:20:35,568
OPPORTUNITY TO LOOK AT SURVIVAL 

1555
01:20:35,568 --> 01:20:41,808
AND OUTCOMES AND PARTICULAR TO 

1556
01:20:41,808 --> 01:20:49,048
BIOMARKERS AND THE KNOWN PATTERN

1557
01:20:49,048 --> 01:20:59,592
OR PHYSICAL ACTIVITIES AND LOOK 

1558
01:21:09,769 --> 01:21:12,172
AT BODY RELATED MARKERS.

1559
01:21:12,172 --> 01:21:13,106
>> DR. MA.

1560
01:21:13,106 --> 01:21:16,342
>> I AGREE WITH THE
PANELISTS IN

1561
01:21:16,342 --> 01:21:17,410
PARTICULARLY AROUND THE CONCEPT 

1562
01:21:17,410 --> 01:21:22,816
SINGLE BIOMARKERS ARE UNLIKELY 

1563
01:21:22,816 --> 01:21:29,689
TO BE THE PAN SACEA OF RESPIRATY

1564
01:21:29,689 --> 01:21:33,560
DISEASES AND LOOK AT BIOMARKERS 

1565
01:21:33,560 --> 01:21:36,196
IN CONJUNCTION WITH PRO 

1566
01:21:36,196 --> 01:21:37,263
INFLAMMATORY MARKERS AND THAT 

1567
01:21:37,263 --> 01:21:40,567
ABUNDANCE OF THOSE BIOMARKERS 

1568
01:21:40,567 --> 01:21:43,570
COULD BE HELPFUL IN COMPOSITE.

1569
01:21:43,570 --> 01:21:45,972
FURTHERMORE I THINK THE CONCEPT 

1570
01:21:45,972 --> 01:21:49,008
OF LOOKING FOR BIOMARKERS IN 

1571
01:21:49,008 --> 01:21:50,476
AIRWAY SPECIFIC SAMPLES AND IT 

1572
01:21:50,476 --> 01:21:52,879
WAS MENTIONED CONDENSATE IS THAT

1573
01:21:52,879 --> 01:21:54,214
A BETTER WINDOW TO WHAT'S 

1574
01:21:54,214 --> 01:21:55,281
HAPPENING IN THE LUNG THAN 

1575
01:21:55,281 --> 01:21:59,552
CIRCULATING BIOMARKERS?

1576
01:21:59,552 --> 01:22:02,222
A FOLLOW UP WITH A QUESTION 

1577
01:22:02,222 --> 01:22:03,122
OBVIOUSLY THIS SESSION IS 

1578
01:22:03,122 --> 01:22:07,360
FOCUSSED ON PRECISION NUTRITION 

1579
01:22:07,360 --> 01:22:07,927
BIOMARKERS.

1580
01:22:07,927 --> 01:22:12,432
THE ADVANTAGE EACH OF YOU SPEAK 

1581
01:22:12,432 --> 01:22:15,401
TO THE ADVANTAGE THEY HAVE FOR 

1582
01:22:15,401 --> 01:22:17,270
TRADITIONAL MEASURES AND 

1583
01:22:17,270 --> 01:22:18,605
ASSESSMENT TOOLS WHETHER IT'S BY

1584
01:22:18,605 --> 01:22:19,906
SELF-REPORT OR INTERVIEW.

1585
01:22:19,906 --> 01:22:23,309
I WANT TO POSE TO THE PANEL DO 

1586
01:22:23,309 --> 01:22:26,479
YOU THINK THERE'S STILL A ROLE 

1587
01:22:26,479 --> 01:22:27,113
OF TRADITIONAL DIETARY 

1588
01:22:27,113 --> 01:22:32,085
ASSESSMENT TOOLS IF YOU THINK 

1589
01:22:32,085 --> 01:22:35,555
THERE IS, WHAT THAT MIGHT BE 

1590
01:22:35,555 --> 01:22:37,924
WITH THE BIOMARKER MEASURES THAT

1591
01:22:37,924 --> 01:22:42,228
YOU ALL SPOKE ELOQUENTLY ABOUT.

1592
01:22:42,228 --> 01:22:50,536
AGAIN, WE'LL DO THE ORDER OF THE

1593
01:22:50,536 --> 01:22:50,970
SPEAKERS.

1594
01:22:50,970 --> 01:22:56,843
>> ALL THESE EMERGING
BIOMARKERS

1595
01:22:56,843 --> 01:22:58,278
ARE MEANT TO BE COMPLIMENTARY 

1596
01:22:58,278 --> 01:23:04,884
RATHER THAN A REPLACEMENT OF 

1597
01:23:04,884 --> 01:23:09,289
DIETARY TOOLS.

1598
01:23:09,289 --> 01:23:11,824
IF WITH USE THEM THE WAY WE'RE 

1599
01:23:11,824 --> 01:23:13,860
SUPPOSED TO THEY PROVIDE 

1600
01:23:13,860 --> 01:23:17,864
VALUABLE SOURCES OF INFORMATION 

1601
01:23:17,864 --> 01:23:19,565
UP LARGE POPULATION STUDIES CAN 

1602
01:23:19,565 --> 01:23:23,569
GET A LONG-TERM DIET AND CAN 

1603
01:23:23,569 --> 01:23:25,138
DRIVE PEOPLE IN AN ADEQUATE 

1604
01:23:25,138 --> 01:23:26,072
QUESTION AND THAT'S WHAT THE FAQ

1605
01:23:26,072 --> 01:23:27,273
IS DESIGN TO DO.

1606
01:23:27,273 --> 01:23:28,808
IT'S NOT DESIGN TO GET A TOTAL 

1607
01:23:28,808 --> 01:23:30,276
ENERGY INTAKE.

1608
01:23:30,276 --> 01:23:33,579
THAT WAS NEVER THE OBJECTIVE.

1609
01:23:33,579 --> 01:23:39,452
I THINK TRADITIONAL DIETARY 

1610
01:23:39,452 --> 01:23:41,754
ASSESSMENT TOOLS HAVE A ROLE AND

1611
01:23:41,754 --> 01:23:43,589
THE BIOMARKERS ARE MEANT TO BE 

1612
01:23:43,589 --> 01:23:44,357
COMPLEMENTARY TO THE TRADITIONAL

1613
01:23:44,357 --> 01:23:54,801
DIETARY ASSESSMENT TOOLS.

1614
01:24:03,643 --> 01:24:06,179
>> THERE'S LIKE A GUT
CHECK WE 

1615
01:24:06,179 --> 01:24:10,683
CAN TRUST OVERSEEING.

1616
01:24:10,683 --> 01:24:16,789
>> I THINK THE INTEGRATION
OF 

1617
01:24:16,789 --> 01:24:20,727
DIFFERENT MARKERS IS THE WAY TO 

1618
01:24:20,727 --> 01:24:25,765
GO TO BETTER UNDERSTAND WHAT THE

1619
01:24:25,765 --> 01:24:34,774
INT

1620
01:24:34,774 --> 01:24:36,175
INTERSECT OF OUTCOMES.

1621
01:24:36,175 --> 01:24:38,044
>> AS WE MOVE FORWARD IN
THIS 

1622
01:24:38,044 --> 01:24:40,279
WORLD OF OMIC AND IDENTIFY 

1623
01:24:40,279 --> 01:24:42,115
POTENTIAL BIOMARKERS OF INTEREST

1624
01:24:42,115 --> 01:24:44,517
WORKING BACKWARDS TO THE DIETARY

1625
01:24:44,517 --> 01:24:45,485
HISTORY AND IDENTIFYING WHERE 

1626
01:24:45,485 --> 01:24:46,652
IT'S LIKELY SOURCED COULD BE 

1627
01:24:46,652 --> 01:24:55,561
POWERFUL.

1628
01:24:55,561 --> 01:25:03,569
>> YES, I'D LIKE TO START
BY 

1629
01:25:03,569 --> 01:25:13,780
THANKING DR. MACHADO AND 

1630
01:25:13,780 --> 01:25:15,581
GARCIA-LARSEN IN TERMS OF 

1631
01:25:15,581 --> 01:25:18,684
LEARNING NUTRITIONAL BIOMARKERS.

1632
01:25:18,684 --> 01:25:20,319
BRIEFLY YESTERDAY WE PRESENTED 

1633
01:25:20,319 --> 01:25:23,322
ATTEMPTS IN OUR RESEARCH GROUP 

1634
01:25:23,322 --> 01:25:26,292
TO UNDERSTAND WHETHER SPECIFIC 

1635
01:25:26,292 --> 01:25:29,562
METABOLITES OF FLAVONOIDS CAN 

1636
01:25:29,562 --> 01:25:32,198
HELP UNDERSTAND A BIT BETTER 

1637
01:25:32,198 --> 01:25:33,399
TWLA THE DIETARY INTAKE OF THIS 

1638
01:25:33,399 --> 01:25:40,139
GROUP OF BIO COMPOUNDS IS.

1639
01:25:40,139 --> 01:25:48,514
AND I TO PLAY DEVIL'S ADVOCATE 

1640
01:25:48,514 --> 01:25:50,383
WE DO HAVE A LOT OF OPPORTUNITY 

1641
01:25:50,383 --> 01:25:52,251
FOR ADVANCED KNOWLEDGE AND THE 

1642
01:25:52,251 --> 01:25:55,488
BIOMARKERS ADDRESS RECALL BIAS 

1643
01:25:55,488 --> 01:25:58,458
WHICH IS A MAJOR PROBLEM BUT 

1644
01:25:58,458 --> 01:26:03,396
DON'T HELP US ADDRESS 

1645
01:26:03,396 --> 01:26:05,231
MEASUREMENT BIAS.

1646
01:26:05,231 --> 01:26:07,166
NOT ENTIRELY AT LEAST AND WE 

1647
01:26:07,166 --> 01:26:09,635
NEED SEVERAL BIOMARKERS TO HAVE 

1648
01:26:09,635 --> 01:26:10,937
SPECIFIC INSIGHTS INTO WHAT 

1649
01:26:10,937 --> 01:26:15,708
THEIR USUALLY DIETARY INTAKE IS.

1650
01:26:15,708 --> 01:26:22,582
IF WE HAD THE TOWN TO DO A WELL 

1651
01:26:22,582 --> 01:26:25,184
DESIGNED COHORT STUDY WHAT WOULD

1652
01:26:25,184 --> 01:26:29,188
BE THE BEST COMBINATION OF 

1653
01:26:29,188 --> 01:26:30,923
NUTRITIONAL TOOLS TO ASCERTAIN 

1654
01:26:30,923 --> 01:26:32,959
DIETARY INTAKE?

1655
01:26:32,959 --> 01:26:38,998
SHOULD WE FOCUS ON NUTRITIONAL 

1656
01:26:38,998 --> 01:26:39,565
BIOMARKERS ONLY 

1657
01:26:39,565 --> 01:26:48,407
>> 

1658
01:26:48,407 --> 01:26:50,576
>> WE GRAPPLED WITH THAT
IN THE 

1659
01:26:50,576 --> 01:26:52,845
NURSE PROFESSIONALS HEALTH 

1660
01:26:52,845 --> 01:26:53,746
FOLLOW-UP STUDY.

1661
01:26:53,746 --> 01:26:59,318
WE HAVE A VOL DATED FFK WE USED 

1662
01:26:59,318 --> 01:27:02,655
AND HAVE ARCHIVED BIO SPECIMENS 

1663
01:27:02,655 --> 01:27:09,695
AND THE LIFESTYLE VALIDATION 

1664
01:27:09,695 --> 01:27:12,465
STUDIES MEASURING WATER AND AN 

1665
01:27:12,465 --> 01:27:14,567
OBJECTIVE MEASURE OF INTAKE AND 

1666
01:27:14,567 --> 01:27:17,603
URINARY SODIUM AND POTASSIUM BUT

1667
01:27:17,603 --> 01:27:23,075
REALLY THE GOAL IS TO LOOK FOR 

1668
01:27:23,075 --> 01:27:24,377
MEASUREMENT ERROR AND 

1669
01:27:24,377 --> 01:27:25,011
RECALIBRATE TRADITIONAL DIETARY 

1670
01:27:25,011 --> 01:27:33,953
ASSESSMENT TOOL.

1671
01:27:33,953 --> 01:27:39,559
IN TERMS OF BIOMARKERS WE SHOULD

1672
01:27:39,559 --> 01:27:46,032
BE MEASURES YOU CAN LOOK AT A 

1673
01:27:46,032 --> 01:27:48,067
WIDE RANGE OF METABOLITES TO 

1674
01:27:48,067 --> 01:27:49,669
REFLECT THE OVER ALL DIET 

1675
01:27:49,669 --> 01:27:54,273
OPPOSED TO A CERTAIN CLASS OF 

1676
01:27:54,273 --> 01:28:01,247
MASS TABL ITS FOR -- METABOLITES

1677
01:28:01,247 --> 01:28:02,648
REFLECTING A FOOD OR DIETARY 

1678
01:28:02,648 --> 01:28:02,982
PATTERN.

1679
01:28:02,982 --> 01:28:08,354
IN DETERMINES OF DESIGNING A 

1680
01:28:08,354 --> 01:28:11,123
STUDY I THINK HAVING A TOOL AND 

1681
01:28:11,123 --> 01:28:13,593
UNDERSTANDING WHAT THE RELEVANT 

1682
01:28:13,593 --> 01:28:19,498
EXPOSURE OF INTEREST IS IS IF 

1683
01:28:19,498 --> 01:28:26,772
YOU'RE LOOKING AT RECENT AND YOU

1684
01:28:26,772 --> 01:28:30,509
CAN GO WITH THE FFY AND COLLECT 

1685
01:28:30,509 --> 01:28:38,351
BLOOD SAMPLES AND RUN OMICS 

1686
01:28:38,351 --> 01:28:48,894
MEASURES ON IT OR OR SODIUM OR 

1687
01:28:49,862 --> 01:28:53,466
NITROGEN ARE EXPENSIVE TO DO.

1688
01:28:53,466 --> 01:28:55,368
HAVING THE ARCHIVED SAMPLES IN 

1689
01:28:55,368 --> 01:28:56,736
COMBINATION WITH A DIETARY 

1690
01:28:56,736 --> 01:28:59,572
ASSESSMENT TOOL WOULD BE THE WAY

1691
01:28:59,572 --> 01:29:04,910
TO GO.

1692
01:29:04,910 --> 01:29:06,112
>> AGAIN, PROBABLY
SHOULDN'T 

1693
01:29:06,112 --> 01:29:08,314
WEIGH IN ON THE NUTRITIONAL 

1694
01:29:08,314 --> 01:29:10,916
ASPECT BUT WE OFTEN TALK ABOUT 

1695
01:29:10,916 --> 01:29:20,726
THE HOLY GRAIL OF MUL

1696
01:29:20,726 --> 01:29:22,695
MULTI-BIOMARKERS AND WE SEE THE 

1697
01:29:22,695 --> 01:29:23,596
MOLECULAR ASSESSMENTS ARE 

1698
01:29:23,596 --> 01:29:24,864
GETTING TO A POINT WHERE 

1699
01:29:24,864 --> 01:29:27,566
CONCURRENT LUNG FUNCTION OR 

1700
01:29:27,566 --> 01:29:30,369
CHEST IMAGING IS NO LONGER 

1701
01:29:30,369 --> 01:29:32,972
PROVIDING A WHOLE LOT OF BANG 

1702
01:29:32,972 --> 01:29:35,308
FOR YOUR BUCKET AND CREATES 

1703
01:29:35,308 --> 01:29:36,108
COMPLEXITY IN TRYING TO MERGE 

1704
01:29:36,108 --> 01:29:38,044
THEM TO A SINGLE BIOMARKER.

1705
01:29:38,044 --> 01:29:43,416
I THINK THAT'S IMPORTANT FOR ANY

1706
01:29:43,416 --> 01:29:45,418
FIELD TO QUESTION HOW MUCH BY 

1707
01:29:45,418 --> 01:29:47,420
ADDING THE LAYER OF COMPLEX WHEN

1708
01:29:47,420 --> 01:29:48,487
IT COMES TO BIOMARKER 

1709
01:29:48,487 --> 01:29:52,992
DEVELOPMENT.

1710
01:29:52,992 --> 01:29:56,762
>> WE HAVE SOME QUESTIONS
IN THE

1711
01:29:56,762 --> 01:30:02,034
CHAT AND THERE'S ONE RELATED TO 

1712
01:30:02,034 --> 01:30:03,969
THIS DISCUSSION JUST NOW.

1713
01:30:03,969 --> 01:30:06,505
WHY DO WE NEED TO IMPROVE THE 

1714
01:30:06,505 --> 01:30:10,009
SPECIFICITY OF BIOMARKERS FOR 

1715
01:30:10,009 --> 01:30:11,243
FOOD?

1716
01:30:11,243 --> 01:30:14,246
IT SEEMS SUFFICIENT AND AN 

1717
01:30:14,246 --> 01:30:15,247
ENORMOUS ADVANTAGE TO MEASURE 

1718
01:30:15,247 --> 01:30:16,449
COMPONENT AND METABOLITES 

1719
01:30:16,449 --> 01:30:19,552
REGARDLESS OF THE SOURCE FROM A 

1720
01:30:19,552 --> 01:30:23,589
BIOLOGICAL PERSPECTIVE.

1721
01:30:23,589 --> 01:30:28,194
>> I CAN TAKE THAT.

1722
01:30:28,194 --> 01:30:33,466
I KNOW I SPOKE ABOUT 

1723
01:30:33,466 --> 01:30:34,500
SPECIFICITY.

1724
01:30:34,500 --> 01:30:37,336
THE QUESTION WITH SPECIFICITY IS

1725
01:30:37,336 --> 01:30:39,372
DOING CORRECTION WITH THE 

1726
01:30:39,372 --> 01:30:42,541
DIETARY ASSESSMENT TOOLS.

1727
01:30:42,541 --> 01:30:44,844
TALKING ABOUT WHAT DR. DUVAL 

1728
01:30:44,844 --> 01:30:47,580
SAID TRACING TO WHAT THE DIETARY

1729
01:30:47,580 --> 01:30:49,348
COMPONENT COULD BE AND IN MAKING

1730
01:30:49,348 --> 01:30:54,086
RECOMMENDATIONS AND POLICY 

1731
01:30:54,086 --> 01:31:03,596
CHANGES MAY BE IMPORTANT BUT IS 

1732
01:31:03,596 --> 01:31:08,033
THE ROLE COFFEE OR LEGUMES CAN 

1733
01:31:08,033 --> 01:31:10,403
INFLUENCE DIETARY 

1734
01:31:10,403 --> 01:31:11,837
RECOMMENDATIONS AND CALIBRATE 

1735
01:31:11,837 --> 01:31:12,405
YOUR OWN DIETARY ASSESSMENT 

1736
01:31:12,405 --> 01:31:22,515
TOOLS.

1737
01:31:23,182 --> 01:31:27,553
ANY OTHER COMMENTS?

1738
01:31:27,553 --> 01:31:33,025
>> WE ALSO HAVE A QUESTION
ABOUT

1739
01:31:33,025 --> 01:31:38,264
CAN THE PANEL COMMENT ON THE 

1740
01:31:38,264 --> 01:31:43,068
IDEAL DIETARY ASSESSMENT OR DOES

1741
01:31:43,068 --> 01:31:47,173
THE PANEL BELIEVE THE MOST 

1742
01:31:47,173 --> 01:31:49,275
WIDELY USED 24-HOUR RECALL IS 

1743
01:31:49,275 --> 01:31:59,585
THE BEST WE HAVE?

1744
01:32:00,653 --> 01:32:02,455
DIETARY QUESTIONNAIRES HAVE 

1745
01:32:02,455 --> 01:32:02,955
SPECIFIC FUNCTIONS.

1746
01:32:02,955 --> 01:32:05,558
IT ALL DEPENDS WHAT WE'RE TRYING

1747
01:32:05,558 --> 01:32:06,559
TO ADDRESS.

1748
01:32:06,559 --> 01:32:08,127
SO THE 24 HOUR RECALL QUESTION 

1749
01:32:08,127 --> 01:32:12,631
CAN BE EXTREMELY USEFUL IF WE 

1750
01:32:12,631 --> 01:32:15,568
WANT TO UNDERSTAND DIETARY 

1751
01:32:15,568 --> 01:32:18,103
INTAKE THE PAST FEW DAYS BUT IF 

1752
01:32:18,103 --> 01:32:23,576
IT'S REPEATED ENOUGH TIMES AND 

1753
01:32:23,576 --> 01:32:26,479
RESEARCHERS PROPOSE UP TO SEVEN 

1754
01:32:26,479 --> 01:32:27,046
QUESTIONNAIRES SHOULD BE 

1755
01:32:27,046 --> 01:32:29,215
SUFFICIENT TO HAVE AN IDEA OF 

1756
01:32:29,215 --> 01:32:30,983
THE USUAL DIETARY INTAKE.

1757
01:32:30,983 --> 01:32:33,486
THE OTHER STUDIES SUGGEST IF WE 

1758
01:32:33,486 --> 01:32:36,922
WANT TO UNDERSTAND THE ISSUE OF 

1759
01:32:36,922 --> 01:32:41,927
HABITS WE NEED TO CONSIDER 

1760
01:32:41,927 --> 01:32:45,865
FREQUENCY QUESTIONNAIRE AND I'M 

1761
01:32:45,865 --> 01:32:47,733
NOT SURE THERE'S UP WITH PERFECT

1762
01:32:47,733 --> 01:32:51,570
OR PREFERRED TOOL WHEN IT COMES 

1763
01:32:51,570 --> 01:32:55,574
TO QUESTIONNAIRES.

1764
01:32:55,574 --> 01:33:03,115
WE KNOW SOME ARE PERFORMING BEST

1765
01:33:03,115 --> 01:33:07,553
SO FOR SOME AND WHEN WE WANT TO 

1766
01:33:07,553 --> 01:33:12,758
DERIVE DIETARY PATTERNS BUT FOR 

1767
01:33:12,758 --> 01:33:17,162
SOME OF THE NEW ER INDEX THEY 

1768
01:33:17,162 --> 01:33:18,731
APPEAR TO PERFORM BETTER SO I 

1769
01:33:18,731 --> 01:33:21,000
THINK IT ALL DEPENDS ON WHAT 

1770
01:33:21,000 --> 01:33:21,700
WE'RE TRYING TO MEASURE.

1771
01:33:21,700 --> 01:33:32,244
I KNOW WE HAVE A FEW EXPERTS IN 

1772
01:33:33,546 --> 01:33:36,916
NUTRITIONAL EPIDEMIOLOGY IN THE 

1773
01:33:36,916 --> 01:33:38,684
ROOM SO I'D LIKE TO HEAR 

1774
01:33:38,684 --> 01:33:39,552
PEOPLE'S THOUGHTS.

1775
01:33:39,552 --> 01:33:42,354
>> I AGREE WITH 

1776
01:33:42,354 --> 01:33:44,890
DR. GARCIA-LARSEN JUST SAID.

1777
01:33:44,890 --> 01:33:47,560
IT COMES DOWN TO YOUR RESEARCH 

1778
01:33:47,560 --> 01:33:51,463
QUESTION.

1779
01:33:51,463 --> 01:33:52,364
24-HOUR RECALL CAN APPROXIMATE 

1780
01:33:52,364 --> 01:33:54,667
USUAL INTAKE IF YOU REPEAT YOUR 

1781
01:33:54,667 --> 01:33:57,036
ASSESSMENT OVER TIME AND OVER 

1782
01:33:57,036 --> 01:33:59,572
DIFFERENT SEASONS.

1783
01:33:59,572 --> 01:34:10,049
HAVING SAID THAT, I KNOW IT 

1784
01:34:10,683 --> 01:34:12,184
TAKES UNDERSTANDING TO 

1785
01:34:12,184 --> 01:34:15,454
UNDERSTAND WHAT FOOD ITEMS GET 

1786
01:34:15,454 --> 01:34:15,988
IN THE QUESTIONNAIRE IS 

1787
01:34:15,988 --> 01:34:17,957
IMPORTANT IN ITSELF AND THE 

1788
01:34:17,957 --> 01:34:20,659
EXAMPLE I GIVE AS YOU WANT TO 

1789
01:34:20,659 --> 01:34:27,566
INCLUDE FOODS WHERE THERE IS 

1790
01:34:27,566 --> 01:34:31,136
ENOUGH PARTICIPATE POPULATION 

1791
01:34:31,136 --> 01:34:33,806
AND IF THE POPULATION CONSUMES 

1792
01:34:33,806 --> 01:34:39,545
THREE TOMATOES A DAY WILL NOT 

1793
01:34:39,545 --> 01:34:41,747
ADEQUATELY CAPTURE.

1794
01:34:41,747 --> 01:34:43,582
OFTEN WE USE FOOD FREQUENCIES 

1795
01:34:43,582 --> 01:34:45,784
VALIDATED FOR ONE POPULATION AND

1796
01:34:45,784 --> 01:34:46,752
ANOTHER POPULATION WITHOUT 

1797
01:34:46,752 --> 01:34:49,555
REALLY VALIDATING THE EFFORTS.

1798
01:34:49,555 --> 01:34:56,662
I THINK THAT'S WHY OF THE OFTEN 

1799
01:34:56,662 --> 01:34:58,397
FAQ'S GET A BAD WRAP AND MAB 

1800
01:34:58,397 --> 01:34:59,565
THEY WEREN'T VALIDATED IN THE 

1801
01:34:59,565 --> 01:35:06,939
FIRST PLACE.

1802
01:35:06,939 --> 01:35:10,042
>> WE HAVE A COUPLE
QUESTIONS 

1803
01:35:10,042 --> 01:35:12,111
FROM TERESA.

1804
01:35:12,111 --> 01:35:14,413
SHE ASKED DO YOU INCLUDE THE 

1805
01:35:14,413 --> 01:35:16,382
DIETARY INTAKE RECORDING GIVEN 

1806
01:35:16,382 --> 01:35:19,551
LIMITATIONS OF RECALL FOR SOME 

1807
01:35:19,551 --> 01:35:21,286
PATIENTS AND ARE YOU ASKING 

1808
01:35:21,286 --> 01:35:27,493
PATIENTS FOR PHOTOS OF MEALS OR 

1809
01:35:27,493 --> 01:35:30,129
INTAKE WHICH COULD BE EASIER FOR

1810
01:35:30,129 --> 01:35:35,601
SOME AND THE TECHNOLOGY IS NOW 

1811
01:35:35,601 --> 01:35:45,944
AVAILABLE FOR DOING SO.

1812
01:35:45,944 --> 01:35:48,213
>> THIS IS A CURIOUS
QUESTION 

1813
01:35:48,213 --> 01:35:51,483
SINCE THE RECALL BIAS IS APPLIED

1814
01:35:51,483 --> 01:35:55,921
PHYSICAL ACTIVITY QUESTIONNAIRES

1815
01:35:55,921 --> 01:35:58,490
AND AS HIGHLIGHTED.

1816
01:35:58,490 --> 01:36:01,960
THERE'S HYPOXIA AND OTHER 

1817
01:36:01,960 --> 01:36:03,562
CORRECTORS AND LUNG DISEASE ARE 

1818
01:36:03,562 --> 01:36:06,465
ASSOCIATED WITH THE DECLINE IN 

1819
01:36:06,465 --> 01:36:07,499
REGULATORY FUNCTIONS.

1820
01:36:07,499 --> 01:36:09,802
IT COULD BE QUITE CHALLENGING TO

1821
01:36:09,802 --> 01:36:12,004
USE THIS APPROACH.

1822
01:36:12,004 --> 01:36:15,841
I'D BE CURIOUS TO KNOW WHAT CAN 

1823
01:36:15,841 --> 01:36:18,777
BE DONE TO LOOK THE LIMITATIONS 

1824
01:36:18,777 --> 01:36:23,749
OF THE TRADITIONAL DIETARY 

1825
01:36:23,749 --> 01:36:33,792
ASSESSME

1826
01:36:33,792 --> 01:36:35,427
ASSESSMENTS 

1827
01:36:35,427 --> 01:36:36,829
>> IS THERE ANYTHING YOU'D
LIKE 

1828
01:36:36,829 --> 01:36:38,197
TO COMMENT ON?

1829
01:36:38,197 --> 01:36:40,966
>> I'M LOOKING AT DR.
PANDA'S 

1830
01:36:40,966 --> 01:36:41,500
NEXT QUESTION.

1831
01:36:41,500 --> 01:36:44,737
IT'S A REALLY GOOD ONE.

1832
01:36:44,737 --> 01:36:47,673
HE SAYS NHANES USES ONLY ONE OF 

1833
01:36:47,673 --> 01:36:49,575
TWO 24-HOUR RECALL 

1834
01:36:49,575 --> 01:36:50,275
QUESTIONNAIRES AN THERE'S 

1835
01:36:50,275 --> 01:36:54,513
THOUSANDS OF PAPERS PUBLISHED 

1836
01:36:54,513 --> 01:36:56,248
FOR THE TWO DAYS OF RECALL WITH 

1837
01:36:56,248 --> 01:36:57,015
HEALTH OUTCOMES.

1838
01:36:57,015 --> 01:37:07,392
IS THAT THE RIGHT USE?

1839
01:37:09,261 --> 01:37:10,796
I MYSELF HAVE USED NHANES DATA 

1840
01:37:10,796 --> 01:37:13,565
TO LINK DIETARY INTAKE AT 

1841
01:37:13,565 --> 01:37:16,101
VARIOUS DIETARY COMPONENTS IN 

1842
01:37:16,101 --> 01:37:16,869
RESPIRATORY HEALTH.

1843
01:37:16,869 --> 01:37:18,771
QUITE OFTEN IN THE MANUSCRIPTS 

1844
01:37:18,771 --> 01:37:21,740
WE ACKNOWLEDGE THE LIMITATION OF

1845
01:37:21,740 --> 01:37:24,743
COLLECTING DATA OR HAVING DATA 

1846
01:37:24,743 --> 01:37:28,914
AVAILABLE FOR ONE OR TWO DAYS 

1847
01:37:28,914 --> 01:37:31,316
AND SOMETIMES SOME OF THE DATA 

1848
01:37:31,316 --> 01:37:32,985
IN NHANES IS FROM ONE DAY AND 

1849
01:37:32,985 --> 01:37:35,554
NOT ALL PATIENTS HAVE DATA ON 

1850
01:37:35,554 --> 01:37:38,290
TWO DAYS.

1851
01:37:38,290 --> 01:37:40,392
STILL IF THE METHODS HAVE BEEN 

1852
01:37:40,392 --> 01:37:44,396
VALIDATED AND WE HAVE 

1853
01:37:44,396 --> 01:37:51,403
INFORMATION ON A WIDE RANGE OF 

1854
01:37:51,403 --> 01:37:52,437
VARIETIES CAN BE IMPORTANT TO 

1855
01:37:52,437 --> 01:37:53,138
INVESTIGATE THE RELATIONSHIP 

1856
01:37:53,138 --> 01:37:55,741
BETWEEN DIET AND HEALTH 

1857
01:37:55,741 --> 01:37:56,008
OUTCOMES.

1858
01:37:56,008 --> 01:37:56,875
IT'S NOT PERFECT.

1859
01:37:56,875 --> 01:37:59,578
NONE OF THE INSTRUMENTS ARE.

1860
01:37:59,578 --> 01:38:00,979
I THINK EVEN FOR SURVEYS THAT 

1861
01:38:00,979 --> 01:38:04,283
HAVE USED THREE, FIVE, 24-HOUR 

1862
01:38:04,283 --> 01:38:06,485
RECALL QUESTIONNAIRES WE MATE 

1863
01:38:06,485 --> 01:38:09,454
SEE THE SAME ISSUE WHEREBY WE'RE

1864
01:38:09,454 --> 01:38:14,593
NOT CAPTURING ALL THE INITIAL 

1865
01:38:14,593 --> 01:38:15,227
DATA, DIETARY DATA.

1866
01:38:15,227 --> 01:38:18,497
SO THERE'S NOT -- I DON'T THINK 

1867
01:38:18,497 --> 01:38:21,099
THERE'S A BINARY ANSWER TO THAT 

1868
01:38:21,099 --> 01:38:21,667
QUESTION.

1869
01:38:21,667 --> 01:38:23,135
OFTEN THE MANUSCRIPTS 

1870
01:38:23,135 --> 01:38:24,770
ACKNOWLEDGE THE LIMITATION OF UP

1871
01:38:24,770 --> 01:38:27,472
WITH OR TWO QUESTIONNAIRES BUT 

1872
01:38:27,472 --> 01:38:29,975
STILL INFORMATIVE.

1873
01:38:29,975 --> 01:38:31,243
NHANES HAS AN EXCELLENT STUDY 

1874
01:38:31,243 --> 01:38:34,079
FOR THE FRAMEWORK AND THE 

1875
01:38:34,079 --> 01:38:36,114
COLLECTION OF DATA ON NUMEROUS 

1876
01:38:36,114 --> 01:38:38,016
OTHER FACTORS MAKING IT A ROBUST

1877
01:38:38,016 --> 01:38:45,891
DATA SET TO USE.

1878
01:38:45,891 --> 01:38:47,559
>> DR. BHUPATHIRAJU I SEE
YOUR 

1879
01:38:47,559 --> 01:38:48,861
HAND UP.

1880
01:38:48,861 --> 01:38:50,829
>> YES, TO RESPOND TO 

1881
01:38:50,829 --> 01:38:54,600
DR. PANDA'S QUESTION AND TO 

1882
01:38:54,600 --> 01:38:56,702
FOLLOW-UP AND TO WHAT 

1883
01:38:56,702 --> 01:38:59,471
DR. GARCIA-LARSEN SO ELEGANTLY 

1884
01:38:59,471 --> 01:39:01,673
PUT, SO THE NCI HAS A MACRO YOU 

1885
01:39:01,673 --> 01:39:06,111
CAN RUN ON YOUR NUTRIENT DATA TO

1886
01:39:06,111 --> 01:39:10,782
APPROXIMATE USUAL INTAKE.

1887
01:39:10,782 --> 01:39:12,985
YOU CAN TAKE THE AVAILABLE 

1888
01:39:12,985 --> 01:39:14,453
ESTABLISHED METHODS THE NCI TEAM

1889
01:39:14,453 --> 01:39:17,089
HAS DONE WHERE YOU CAN USE THAT 

1890
01:39:17,089 --> 01:39:19,191
TO APPROVXIMATE USUAL INTAKE.

1891
01:39:19,191 --> 01:39:24,029
WE USE THAT IN ALL OF OUR 

1892
01:39:24,029 --> 01:39:24,263
STUDIES.

1893
01:39:24,263 --> 01:39:27,232
AND AGAIN ACKNOWLEDGING THIS 

1894
01:39:27,232 --> 01:39:28,834
ISN'T PERFECT BUT THE METHOD 

1895
01:39:28,834 --> 01:39:31,970
DOES A GOOD JOB OF APPROXIMATING

1896
01:39:31,970 --> 01:39:39,077
TAKING THE DATA FROM THE 24-HOUR

1897
01:39:39,077 --> 01:39:40,479
RECALL AND THE PROXIMAL INTAKE 

1898
01:39:40,479 --> 01:39:42,414
AND THERE'S A FOOD PROPENSITY 

1899
01:39:42,414 --> 01:39:42,848
QUESTIONNAIRE.

1900
01:39:42,848 --> 01:39:46,051
OFTEN WE USE IT IN CONJUNCTION 

1901
01:39:46,051 --> 01:39:48,053
WITH THE 24-HOUR RECALL TO GET 

1902
01:39:48,053 --> 01:39:49,855
AT USUAL INTAKE.

1903
01:39:49,855 --> 01:39:56,495
SO THERE ARE WAYS AROUND THAT.

1904
01:39:56,495 --> 01:39:59,097
AGAIN, IT'S SUCH A RICH DATA SET

1905
01:39:59,097 --> 01:40:00,432
HAVING THE INFORMATION AT THE 

1906
01:40:00,432 --> 01:40:01,133
POPULATION LEVEL IS INCREDIBLY 

1907
01:40:01,133 --> 01:40:11,276
HELPFUL.

1908
01:40:27,025 --> 01:40:29,861
>> THERE'S COPD AND
PULMONARY 

1909
01:40:29,861 --> 01:40:30,963
DISEASE AREAS AND OTHER AREAS IN

1910
01:40:30,963 --> 01:40:33,765
THE BIO SAMPLES WE HAVE TO 

1911
01:40:33,765 --> 01:40:34,132
DIFFERENT MEANS.

1912
01:40:34,132 --> 01:40:38,270
I WAS WONDERING IF YOU COULD 

1913
01:40:38,270 --> 01:40:43,008
SPEAK TO THE CHALLENGES OF 

1914
01:40:43,008 --> 01:40:44,209
HARMONIZING ACROSS STUDIES AND 

1915
01:40:44,209 --> 01:40:45,944
BOTH IN TERMS OF DATA COLLECTION

1916
01:40:45,944 --> 01:40:48,480
AND DATA ANALYSIS.

1917
01:40:48,480 --> 01:40:51,183
HOW DO WE REALLY GET TO 

1918
01:40:51,183 --> 01:40:54,486
HARMONIZE CROSS STUDIES SO WE 

1919
01:40:54,486 --> 01:40:58,757
KNOW IN WORKING WITH DATA AND 

1920
01:40:58,757 --> 01:40:59,725
CERTAIN QUALITY ACCORDING TO A 

1921
01:40:59,725 --> 01:41:03,595
SET OF STANDARDS.

1922
01:41:03,595 --> 01:41:05,364
I THINK IT'S AN IMPORTANT 

1923
01:41:05,364 --> 01:41:07,766
QUESTION AND ONE WE GRAPPLE WITH

1924
01:41:07,766 --> 01:41:08,266
A LOT.

1925
01:41:08,266 --> 01:41:11,069
I POSE THE QUESTION BECAUSE I 

1926
01:41:11,069 --> 01:41:14,806
FEEL SO MANY OF US HAVE 

1927
01:41:14,806 --> 01:41:16,041
CONTRIBUTED TO ENROLLING 

1928
01:41:16,041 --> 01:41:17,743
HUNDREDS AND THOUSANDS OF 

1929
01:41:17,743 --> 01:41:22,414
PATIENTS WITH RESPIRATORY 

1930
01:41:22,414 --> 01:41:24,716
DISEASES AND BIO BANKING 

1931
01:41:24,716 --> 01:41:27,119
FREEZERS ACROSS THE WORLD.

1932
01:41:27,119 --> 01:41:29,087
RATHER THAN MOVING PROSPECTIVELY

1933
01:41:29,087 --> 01:41:30,522
TO ADDITIONAL COHORTS WHAT CAN 

1934
01:41:30,522 --> 01:41:32,357
WE LEARN FROM THE DATA WE 

1935
01:41:32,357 --> 01:41:33,425
ALREADY HAVE.

1936
01:41:33,425 --> 01:41:35,627
THE BENEFIT FROM COHORTS IS 

1937
01:41:35,627 --> 01:41:39,598
THEY'RE RICHLY STUDIED IN TERMS 

1938
01:41:39,598 --> 01:41:44,269
OF PARAMETERS, SPIROMETRY AND CT

1939
01:41:44,269 --> 01:41:47,272
SCANS AND DIETARY HISTORIES, 

1940
01:41:47,272 --> 01:41:51,743
MARKERS OF OBESITY, ALL THESE 

1941
01:41:51,743 --> 01:41:53,011
THINGS EXIST.

1942
01:41:53,011 --> 01:41:55,013
IN THE ASTHMA WORLD WE'RE 

1943
01:41:55,013 --> 01:41:57,983
DEALING WITH THE EUROPEAN COHORT

1944
01:41:57,983 --> 01:42:00,852
AND WE GOT RELATIONSHIPS WITH 

1945
01:42:00,852 --> 01:42:04,823
THAT GROUP SO HOW CAN WE GO TO 

1946
01:42:04,823 --> 01:42:10,462
THE FREEZERS AND EVALUATE WITH A

1947
01:42:10,462 --> 01:42:12,330
TARGETED APPROACH MARKERS OF 

1948
01:42:12,330 --> 01:42:12,664
INTEREST.

1949
01:42:12,664 --> 01:42:16,835
A COUPLE THINGS ACROSS THE WAY.

1950
01:42:16,835 --> 01:42:18,570
ONE IS BIO SAMPLE COLLECTION 

1951
01:42:18,570 --> 01:42:20,138
STRATEGY SHOULD BE SIMILAR.

1952
01:42:20,138 --> 01:42:23,175
A LOT OF THESE THINGS ARE PRETTY

1953
01:42:23,175 --> 01:42:27,546
ROUTINE IN TERMS OF PLASMA.

1954
01:42:27,546 --> 01:42:31,583
THERE'S NOT SO MANY WAYS TO 

1955
01:42:31,583 --> 01:42:34,586
ISOL

1956
01:42:34,586 --> 01:42:35,587
ISOL

1957
01:42:35,587 --> 01:42:39,124
ISOLATE PLASMA.

1958
01:42:39,124 --> 01:42:43,061
NOT EVERYBODY UNDER GOES A 

1959
01:42:43,061 --> 01:42:45,430
LEAVLEAVE

1960
01:42:45,430 --> 01:42:48,834
AGE  -- LEVAGE AND THERE'S NOT A

1961
01:42:48,834 --> 01:42:55,040
LOT OF DIFFERENT WAYS TO DO IT 

1962
01:42:55,040 --> 01:43:01,913
SO HARMONIZED PLASMA SHOULD BE 

1963
01:43:01,913 --> 01:43:03,582
RELATIVELY STRAIGHTFORWARD 

1964
01:43:03,582 --> 01:43:13,892
ACROSS THE BOARD.

1965
01:43:25,103 --> 01:43:27,072
BUT WE SHOULD BE ABLE TO 

1966
01:43:27,072 --> 01:43:28,807
LEVERAGE BIO SPECIMENS ALREADY.

1967
01:43:28,807 --> 01:43:30,809
>> THERE'S A QUESTION FOR
YOU 

1968
01:43:30,809 --> 01:43:37,048
AND DR. DUVAL AND ASKED WHAT'S 

1969
01:43:37,048 --> 01:43:41,319
IN THE DATA OVER TIME ASSUMING 

1970
01:43:41,319 --> 01:43:43,755
IT'S FROM CROSS SECTIONING AND 

1971
01:43:43,755 --> 01:43:47,092
HOW MUCH INTERVARIABILITY IS 

1972
01:43:47,092 --> 01:43:49,961
THERE AND WE REFLECT DIET OVER 

1973
01:43:49,961 --> 01:43:51,596
LONGER TERM.

1974
01:43:51,596 --> 01:43:57,435
>> THIS IS APE IMPORTANT 

1975
01:43:57,435 --> 01:43:59,571
QUESTION BECAUSE I THINK LUNG 

1976
01:43:59,571 --> 01:44:01,039
FUNCTION FLUCTUATES OVER TIME AS

1977
01:44:01,039 --> 01:44:01,706
DO METABOLITES.

1978
01:44:01,706 --> 01:44:05,043
PART OF WHAT WE'RE DOING IN THE 

1979
01:44:05,043 --> 01:44:05,644
SARP COHORT IN PARTICULAR IS 

1980
01:44:05,644 --> 01:44:08,547
LOOKING AT SOME OF THE MARKERS 

1981
01:44:08,547 --> 01:44:09,114
LONGITUDINALLY.

1982
01:44:09,114 --> 01:44:11,583
ALL THE DATA WAS A SNAPSHOT IN 

1983
01:44:11,583 --> 01:44:19,090
TIME.

1984
01:44:19,090 --> 01:44:21,526
LOOKING AT CHANGES OVER TIME IN 

1985
01:44:21,526 --> 01:44:25,096
CLINICAL POSITION ARE IMPORTANT.

1986
01:44:25,096 --> 01:44:28,466
I'LL SPEAK TO IN SARP WE FELLOW 

1987
01:44:28,466 --> 01:44:30,835
PATIENTS WHEN THEY'RE STABLE AND

1988
01:44:30,835 --> 01:44:32,204
I'M INTERESTED IN WHAT HAPPENS 

1989
01:44:32,204 --> 01:44:33,238
DURING EXACERBATION.

1990
01:44:33,238 --> 01:44:36,107
WHEN THEY GET A VIRAL INFECTION 

1991
01:44:36,107 --> 01:44:37,108
FOR INSTANCE WHAT HAPPENS TO THE

1992
01:44:37,108 --> 01:44:43,114
MEDIATORS OF INTEREST.

1993
01:44:43,114 --> 01:44:43,782
FOLLOWING LONGITUDINALLY AND 

1994
01:44:43,782 --> 01:44:53,325
DURING SASEXACERBATION THAT 

1995
01:44:53,325 --> 01:44:55,093
FLUCTUATION OVER TIME BASED ON 

1996
01:44:55,093 --> 01:44:58,597
DIETARY INTAKE BUT HOW IT 

1997
01:44:58,597 --> 01:45:00,332
RELATES TO DIETARY CHANGES WE'RE

1998
01:45:00,332 --> 01:45:02,133
IN THE INFANCY OF UNDERSTANDING 

1999
01:45:02,133 --> 01:45:04,669
AND WE HAVE COHORTS WHERE WE 

2000
01:45:04,669 --> 01:45:05,670
HAVE BIO BANK SAMPLES NOT JUST 

2001
01:45:05,670 --> 01:45:07,138
FROM A SNAPSHOT IN TIME BUT 

2002
01:45:07,138 --> 01:45:17,415
LONGITUDINALLY.

2003
01:45:27,459 --> 01:45:28,727
>> THERE'S A QUESTION
WHETHER WE

2004
01:45:28,727 --> 01:45:31,563
INCLUDE THE DIETARY INTAKE AND 

2005
01:45:31,563 --> 01:45:37,369
GIVEN THE LIMITATIONS OF RECALL 

2006
01:45:37,369 --> 01:45:41,940
FOR SOME PATIENTS AND LOOK AT 

2007
01:45:41,940 --> 01:45:47,579
MEAL INTAKE AND FOR THE PATIENTS

2008
01:45:47,579 --> 01:45:57,789
IN GENERAL.

2009
01:45:59,057 --> 01:46:01,226
I'VE BEEN INVOLVED IN SMALL 

2010
01:46:01,226 --> 01:46:02,661
CLINICAL STUDIES WITH ASTHMA 

2011
01:46:02,661 --> 01:46:06,231
PATIENTS AND WHAT WE DO IS WE 

2012
01:46:06,231 --> 01:46:09,334
TRY TO CARRY OUT THE 

2013
01:46:09,334 --> 01:46:11,970
QUESTIONNAIRE WITH THEM BUT WE 

2014
01:46:11,970 --> 01:46:15,607
ALSO INVITE WHOEVER SPENDS MORE 

2015
01:46:15,607 --> 01:46:17,242
TIME WITH THEM.

2016
01:46:17,242 --> 01:46:19,177
FOR EXAMPLE THERE'S A HOSPITAL 

2017
01:46:19,177 --> 01:46:22,914
IN LONDON WE WOULD HAVE 

2018
01:46:22,914 --> 01:46:24,816
ASTHMATIC CHILDREN SOME WITH 

2019
01:46:24,816 --> 01:46:29,187
SEVERE ASTHMA AND WOULD TRY TO 

2020
01:46:29,187 --> 01:46:31,356
ASK THE CHILD OR ADOLESCENT 

2021
01:46:31,356 --> 01:46:34,526
DEPENDING ON THE AGE ABOUT THE 

2022
01:46:34,526 --> 01:46:36,594
USUAL DIET AND WHAT THEY EIGHT 

2023
01:46:36,594 --> 01:46:39,597
THE DAY BEFORE AND THE 

2024
01:46:39,597 --> 01:46:40,999
DESIGNATED CAREGIVER WHO WASN'T 

2025
01:46:40,999 --> 01:46:45,470
ALWAYS THE PARENT WOULD BE THERE

2026
01:46:45,470 --> 01:46:46,838
TO CORROBORATE SOME OF THE 

2027
01:46:46,838 --> 01:46:47,138
INFORMATION.

2028
01:46:47,138 --> 01:46:48,373
IF THE CHILD WAS YOUNG WE WOULD 

2029
01:46:48,373 --> 01:46:54,279
ASK THE CAREGIVER OR THE PARENT 

2030
01:46:54,279 --> 01:46:58,616
SIMILAR TO THE NATIONAL 

2031
01:46:58,616 --> 01:46:59,784
GUIDELINES FOR ADMINISTRATION OF

2032
01:46:59,784 --> 01:47:02,520
THE QUESTIONNAIRES TO CHILDREN.

2033
01:47:02,520 --> 01:47:09,861
AND FOR ADULTS I WOULD IMAGINE 

2034
01:47:09,861 --> 01:47:16,935
IF ADULTS ARE BE PATIENTS WHO 

2035
01:47:16,935 --> 01:47:27,445
HAVE A CAREGIVER IT MAY BE U

2036
01:47:29,547 --> 01:47:39,958
USEFUL TO HAVE IN THE ROOM 

2037
01:47:42,060 --> 01:47:44,796
>> THERE'S A QUESTION OF 

2038
01:47:44,796 --> 01:47:47,232
MEASUREMENT OF BODY COMPOSITION 

2039
01:47:47,232 --> 01:47:49,200
AND ASKING RECOMMENDATIONS FOR 

2040
01:47:49,200 --> 01:47:50,602
MEASURING BODY COMPOSITION THAT 

2041
01:47:50,602 --> 01:47:55,173
MAY BE SUITABLE FOR PATIENTS 

2042
01:47:55,173 --> 01:48:04,916
WITH LUNG DISEASE.

2043
01:48:04,916 --> 01:48:13,158
>> YES, CT SCANS ARE
SOMETIMES 

2044
01:48:13,158 --> 01:48:18,463
USED BECAUSE THE PATIENTS HAVE 

2045
01:48:18,463 --> 01:48:24,269
TO UNDER GO CT SCANS AND THERE'S

2046
01:48:24,269 --> 01:48:25,703
MEASUREMENTS WHERE YOU CAN 

2047
01:48:25,703 --> 01:48:29,307
MEASURE FOR MUSCLE THICKNESS OR 

2048
01:48:29,307 --> 01:48:35,346
OTHER PARAMETERS THAT CAN BE 

2049
01:48:35,346 --> 01:48:37,248
ASSESSED BY INTRACELL 

2050
01:48:37,248 --> 01:48:40,618
MEASUREMENTS SUCH AS THE ECO 

2051
01:48:40,618 --> 01:48:40,885
INTENSITY.

2052
01:48:40,885 --> 01:48:45,990
THESE ARE SOME OTHER OPTIONS IN 

2053
01:48:45,990 --> 01:48:56,167
ADDITION.

2054
01:48:59,070 --> 01:49:02,440
>> GENETICS PLAY A ROLE IN

2055
01:49:02,440 --> 01:49:04,142
OBESITY AND MAYBE ABSORPTION IN 

2056
01:49:04,142 --> 01:49:09,247
THE METABOLISM AND SHOULD MARKER

2057
01:49:09,247 --> 01:49:12,584
DATA BEING INTEGRATED?

2058
01:49:12,584 --> 01:49:15,353
YOU SPOKE TO THIS DURING YOUR 

2059
01:49:15,353 --> 01:49:17,622
PRESENTATION, DO YOU WANT TO 

2060
01:49:17,622 --> 01:49:19,090
ELABORATE ON WHAT YOU PRESENTED 

2061
01:49:19,090 --> 01:49:24,362
AND THEN OTHER S TO ADD TO YOUR 

2062
01:49:24,362 --> 01:49:26,698
COMMENTS AND PERSPECTIVE AS 

2063
01:49:26,698 --> 01:49:26,898
WELL.

2064
01:49:26,898 --> 01:49:27,765
>> SURE.

2065
01:49:27,765 --> 01:49:30,235
TYPICALLY WHEN WE'RE ONLY 

2066
01:49:30,235 --> 01:49:32,170
DEALING WITH OBSERVATIONAL DATA 

2067
01:49:32,170 --> 01:49:34,873
IT'S HARD TO HAVE INTERVENTION 

2068
01:49:34,873 --> 01:49:37,275
TRIALS BECAUSE THEY'RE DIFFICULT

2069
01:49:37,275 --> 01:49:39,811
AND EXPENSIVE TO CONDUCT.

2070
01:49:39,811 --> 01:49:45,817
WE USE THE GWAS DATA TO LOOK AT 

2071
01:49:45,817 --> 01:49:48,152
CAUSALITY AND INTEGRATING 

2072
01:49:48,152 --> 01:49:52,123
GENETICS DATA WITH METABOLOMICS 

2073
01:49:52,123 --> 01:50:02,634
DATA WILL HELP IN THAT REGARD.

2074
01:50:07,338 --> 01:50:09,474
>> ANY OTHER COMMENTS?

2075
01:50:09,474 --> 01:50:11,109
I HAVE A QUESTION KIND OF 

2076
01:50:11,109 --> 01:50:13,778
RELATED TO YOUR RESPONSE TO THE 

2077
01:50:13,778 --> 01:50:15,980
QUESTION, DR. MA HADDO AND THIS 

2078
01:50:15,980 --> 01:50:16,414
APPLIES TO THE PANEL -- 

2079
01:50:22,754 --> 01:50:27,525
TO YOUR RESPONSE, DR. MA CLADDO 

2080
01:50:30,595 --> 01:50:35,199
AND USING PRECISION NUTRITIONAL 

2081
01:50:35,199 --> 01:50:38,236
BIOMARKERS AT THE SAME TIME IT 

2082
01:50:38,236 --> 01:50:40,905
REQUIRES BIO SPECIMEN COLLECTION

2083
01:50:40,905 --> 01:50:44,242
WHICH COULD BE CHALLENGES 

2084
01:50:44,242 --> 01:50:48,012
ESPECIALLY FOR SOME OF OUR UNDER

2085
01:50:48,012 --> 01:50:50,915
SERVED POPULATIONS CAN BE A 

2086
01:50:50,915 --> 01:50:53,184
PROBLEM TO COME TO A MEDICAL 

2087
01:50:53,184 --> 01:50:55,587
CENTER OR RESEARCH CLINIC WHERE 

2088
01:50:55,587 --> 01:51:00,158
BARRIERS CAN MAKE IT DIFFICULT 

2089
01:51:00,158 --> 01:51:03,595
IF NOT IMPOSSIBLE POSSIBLE TO 

2090
01:51:03,595 --> 01:51:07,599
HAVE THE BIO SPECIMENS ACCORDING

2091
01:51:07,599 --> 01:51:12,370
TO RIGOROUS RESEARCH PROTOCOL 

2092
01:51:12,370 --> 01:51:15,573
AND DR. MACHADO YOU SPOKE TO THE

2093
01:51:15,573 --> 01:51:18,009
CHALLENGES OF DOING IMAGING AND 

2094
01:51:18,009 --> 01:51:19,177
DEXA IN SOME OF THE MEASUREMENT 

2095
01:51:19,177 --> 01:51:27,285
METHODS THAT WOULD ALLOW US TO 

2096
01:51:27,285 --> 01:51:30,521
ADVANCE IN NUTRITIONAL 

2097
01:51:30,521 --> 01:51:32,523
ASSESSMENT AT THE SAME TIME MAY 

2098
01:51:32,523 --> 01:51:34,325
POSE BARRIERS TO PARTICIPANTS.

2099
01:51:34,325 --> 01:51:36,394
I WONDER IF EACH OF YOU COULD 

2100
01:51:36,394 --> 01:51:39,964
SPEAK TO THAT AND THEN RELATED 

2101
01:51:39,964 --> 01:51:41,966
TO IT IS THERE POINT OF CARE 

2102
01:51:41,966 --> 01:51:45,370
TESTING METHODS THAT MIGHT BE 

2103
01:51:45,370 --> 01:51:48,039
EVOLVED TO HELP US COLLECT THE 

2104
01:51:48,039 --> 01:51:55,313
SAMPLES WE NEED FOR METABOLITE 

2105
01:51:55,313 --> 01:51:58,449
ASSESSMENT WITHOUT LIMITATIONS 

2106
01:51:58,449 --> 01:51:59,584
FROM PARTICIPANT CENTERED 

2107
01:51:59,584 --> 01:52:02,720
RESEARCH PERSPECTIVE.

2108
01:52:02,720 --> 01:52:03,321
WE CAN GO IN ORDER OF THE 

2109
01:52:03,321 --> 01:52:10,228
SPEAKERS.

2110
01:52:10,228 --> 01:52:12,497
>> FOR THE STRATEGIC PLAN
FOR 

2111
01:52:12,497 --> 01:52:13,131
NUTRITION RESEARCH.

2112
01:52:13,131 --> 01:52:15,466
ONE OF THE GOALS WAS TO REDUCE 

2113
01:52:15,466 --> 01:52:17,335
HEALTH DISPARITIES.

2114
01:52:17,335 --> 01:52:18,603
I DO WORRY THAT WHEN WE'RE 

2115
01:52:18,603 --> 01:52:20,838
LOOKING AT OMICS AND THE 

2116
01:52:20,838 --> 01:52:27,945
PRECISION MEASURES WE 

2117
01:52:27,945 --> 01:52:31,349
INADVERTENTLY EXACERBATE 

2118
01:52:31,349 --> 01:52:32,450
EXISTING DESPAIRS BECAUSE OF THE

2119
01:52:32,450 --> 01:52:34,352
ISSUES AND COMING TO A CLINIC OR

2120
01:52:34,352 --> 01:52:37,488
IF YOU THINK ABOUT THOSE WHO ARE

2121
01:52:37,488 --> 01:52:40,058
PARTICIPATING UP RESEARCH 

2122
01:52:40,058 --> 01:52:41,392
STUDIES IT'S NOT THE MINORITY.

2123
01:52:41,392 --> 01:52:44,529
I THINK THERE HAS TO BE A 

2124
01:52:44,529 --> 01:52:50,568
CONSCIOUS EFFORT TO DO THESE 

2125
01:52:50,568 --> 01:52:53,805
STUDIES AND POPULATIONS WITH 

2126
01:52:53,805 --> 01:52:55,073
PUBLISHED DISPARITIES AND THOSE 

2127
01:52:55,073 --> 01:52:57,709
UNDER REPRESENTED IN NUTRITION 

2128
01:52:57,709 --> 01:52:59,577
RESEARCH AND CLINICAL RESEARCH 

2129
01:52:59,577 --> 01:53:01,813
AND EVEN LOOKING AT SOME GROUPS 

2130
01:53:01,813 --> 01:53:03,247
YESTERDAY ONE OF THE SPEAKERS 

2131
01:53:03,247 --> 01:53:05,783
TALKED ABOUT LOOKING AT 

2132
01:53:05,783 --> 01:53:08,086
HISPANICS AS A MONOLITH BUT WHEN

2133
01:53:08,086 --> 01:53:10,154
YOU LOOK AT THE SUB TYPES, 

2134
01:53:10,154 --> 01:53:15,727
PUERTO RICANS HAVE A MUCH HIGHER

2135
01:53:15,727 --> 01:53:17,228
RISK OF RESPIRATORY DISEASES AND

2136
01:53:17,228 --> 01:53:23,067
SOME OF OUR WORK HAS SHOWN 

2137
01:53:23,067 --> 01:53:31,375
PUERTO RICANS HAVE ESTABLISHED 

2138
01:53:31,375 --> 01:53:35,913
HEALTH DEFICIENCIES AND WE NEED 

2139
01:53:35,913 --> 01:53:39,851
TO LOOK AT POPULATIONS.

2140
01:53:39,851 --> 01:53:43,387
>> I AGREE.

2141
01:53:43,387 --> 01:53:47,291
I THINK THAT AS MUCH EMPHASIS ON

2142
01:53:47,291 --> 01:53:48,893
OBTAINING BIO SPECIMENS IN 

2143
01:53:48,893 --> 01:53:54,365
CLINICAL DATA FROM UNDER SERVED 

2144
01:53:54,365 --> 01:53:56,167
POPULATIONS EMPHASIS SHOULD BE 

2145
01:53:56,167 --> 01:53:59,370
PUT ON IDENTIFYING WAYS TO 

2146
01:53:59,370 --> 01:54:00,004
IDENTIFY THOSE.

2147
01:54:00,004 --> 01:54:01,439
BECAUSE A COLLEAGUE LAST WEEK 

2148
01:54:01,439 --> 01:54:10,281
TOLL ME  -- TOLD ME THEY OPENED 

2149
01:54:10,281 --> 01:54:17,555
UP AN AFTER HOURS CLINIC AND 

2150
01:54:17,555 --> 01:54:24,095
IT'S COMPANY A LONG WAY AND 

2151
01:54:24,095 --> 01:54:28,232
THESE DECISION POINTS WOULD BE 

2152
01:54:28,232 --> 01:54:29,901
HELPFUL TO OPTIMIZE RESEARCH IN 

2153
01:54:29,901 --> 01:54:39,544
THESE UNDER SERVED POPULATIONS.

2154
01:54:39,544 --> 01:54:41,646
>> RELATED TO THE BODY 

2155
01:54:41,646 --> 01:54:45,082
COMPOSITION MEASUREMENTS AND 

2156
01:54:45,082 --> 01:54:47,585
MARKERS WITH ACCESS TO AN ACCESS

2157
01:54:47,585 --> 01:54:52,857
SCAN AND BIO IMAGING AND 

2158
01:54:52,857 --> 01:54:55,193
TECHNIQUES SOMETIMES IT'S 

2159
01:54:55,193 --> 01:54:56,894
EXPENSIVE AND NOT EASY TO HAVE 

2160
01:54:56,894 --> 01:54:59,363
ACCESS TO THOSE ASSESSMENTS.

2161
01:54:59,363 --> 01:55:05,970
WE ALSO NEED TO LEARN HOW TO 

2162
01:55:05,970 --> 01:55:09,140
UTILIZE THIS ASSESSMENT TO THOSE

2163
01:55:09,140 --> 01:55:15,847
PEOPLE WHO DONT HAVE ACCESS OR 

2164
01:55:15,847 --> 01:55:25,523
TRYING TO DEVELOP MORE EASY WAY 

2165
01:55:25,523 --> 01:55:30,394
TO CONDUCT ASSESSMENTS.

2166
01:55:30,394 --> 01:55:36,868
IN ORDER TO INCREASE ACCESS.

2167
01:55:36,868 --> 01:55:42,640
>> I'LL ADD THAT THERE ARE

2168
01:55:42,640 --> 01:55:48,479
TECHNIQUES THAT CAN BE DONE AT 

2169
01:55:48,479 --> 01:55:48,980
HOME.

2170
01:55:48,980 --> 01:55:51,249
SO FOR INSTANCE RESPIRATORY 

2171
01:55:51,249 --> 01:55:57,288
COLLECTION IS OFTEN DONE AT HOME

2172
01:55:57,288 --> 01:55:59,357
AND THOSE ARE THINGS THAT 

2173
01:55:59,357 --> 01:56:01,259
ALREADY EXIST AND DRY BLOOD 

2174
01:56:01,259 --> 01:56:05,863
SPOTS CAN BE CONDUCTED AT THE 

2175
01:56:05,863 --> 01:56:07,565
HOME AND DONE IN THE COVID-19 

2176
01:56:07,565 --> 01:56:10,001
GROUP.

2177
01:56:10,001 --> 01:56:12,470
MAYBE ONE OPPORTUNITY HERE IS TO

2178
01:56:12,470 --> 01:56:14,138
STRATEGIZE TO REDUCE DISPARITIES

2179
01:56:14,138 --> 01:56:17,508
IN ACCESS AS DISCUSSED TO FIGURE

2180
01:56:17,508 --> 01:56:20,645
OUT HOW WE COULD COLLECT BIO 

2181
01:56:20,645 --> 01:56:29,954
SPECIMENS MORE EASILY AT HOME.

2182
01:56:29,954 --> 01:56:30,554
>> THANK YOU.

2183
01:56:30,554 --> 01:56:34,091
I WANT IT GIVE THE PANELISTS AN 

2184
01:56:34,091 --> 01:56:38,462
OPPORTUNITY IF YOU HAVE 

2185
01:56:38,462 --> 01:56:45,736
QUESTIONS OF EACH OTHER HOW  -- 

2186
01:56:45,736 --> 01:56:46,971
NOW IS AN OPPORTUNITY TO RAISE 

2187
01:56:46,971 --> 01:56:51,442
THOSE.

2188
01:56:51,442 --> 01:56:53,210
THERE'S A COMMENT IN THE CHAT DO

2189
01:56:53,210 --> 01:56:55,613
YOU WANT THEM TO SAY IT OR WANT 

2190
01:56:55,613 --> 01:57:01,419
ME TO READ IT?

2191
01:57:01,419 --> 01:57:04,288
>> YOU CAN READ IT IF
THAT'S 

2192
01:57:04,288 --> 01:57:04,522
OKAY.

2193
01:57:04,522 --> 01:57:06,324
>> AND ANOTHER POTENTIAL
BENEFIT

2194
01:57:06,324 --> 01:57:09,126
OF LOOKING AT THE COMPONENT OF 

2195
01:57:09,126 --> 01:57:16,067
METABOLICS OF VIDEO INSTEAD OF 

2196
01:57:16,067 --> 01:57:21,405
FOOD RECALL DATA IS DIFFERENT 

2197
01:57:21,405 --> 01:57:22,740
NUTRITION MICROBIOME DEPENDING 

2198
01:57:22,740 --> 01:57:25,609
ON THE SOIL WHERE IT'S GROWN.

2199
01:57:25,609 --> 01:57:31,582
HOW IS THE SOIL WITH THE FUNGI 

2200
01:57:31,582 --> 01:57:37,655
AND NEMATODES LIKELY TO IMPACT 

2201
01:57:37,655 --> 01:57:40,524
HUMAN MICROBIOME DIFFERENTLY 

2202
01:57:40,524 --> 01:57:45,429
THAN A TOMATO TREAT WITH 

2203
01:57:45,429 --> 01:57:47,565
FUNGICIDE OR OTHER METHODS.

2204
01:57:47,565 --> 01:57:51,569
>> THAT'S A GOOD POINT
ACTUALLY.

2205
01:57:51,569 --> 01:57:54,672
IT'S OFTEN A BIG QUESTION WE ASK

2206
01:57:54,672 --> 01:57:55,673
OURSELVES AND I KNOW THE 

2207
01:57:55,673 --> 01:57:59,343
COLLEAGUES WHO WORK IN THE 

2208
01:57:59,343 --> 01:58:01,579
DEVELOPMENT OF SPECIFIC FOOD 

2209
01:58:01,579 --> 01:58:02,213
POSITION TABLES HAVE THIS 

2210
01:58:02,213 --> 01:58:08,753
QUESTION ALSO, WHICH TYPE OF 

2211
01:58:08,753 --> 01:58:11,589
TOMATOES ETCETERA TO HAVE FOR 

2212
01:58:11,589 --> 01:58:15,426
THE LAB ANALYSIS.

2213
01:58:15,426 --> 01:58:17,695
THERE ARE BENEFITS AND 

2214
01:58:17,695 --> 01:58:21,499
ADVANTAGES WHEN TRYING TO 

2215
01:58:21,499 --> 01:58:22,500
IDENTIFY THE EXACT NUTRIENT 

2216
01:58:22,500 --> 01:58:24,735
COMPOSITION AND DON'T HAVE A 

2217
01:58:24,735 --> 01:58:25,436
FULL PICTURE YET OF WHICH 

2218
01:58:25,436 --> 01:58:28,072
SPECIFIC METABOLITES OF FOOD 

2219
01:58:28,072 --> 01:58:32,209
HAVE A STRONGER IMPACT ON THE 

2220
01:58:32,209 --> 01:58:32,777
MICROBIOME BUT IT'S A GOOD 

2221
01:58:32,777 --> 01:58:35,579
POINT.

2222
01:58:35,579 --> 01:58:37,715
THIS YOU FOR THAT.

2223
01:58:37,715 --> 01:58:38,482
-- THANK YOU FOR THAT.

2224
01:58:38,482 --> 01:58:45,389
I HAVE A QUESTION FOR DR. DUVALL

2225
01:58:45,389 --> 01:58:46,223
ACTUALLY.

2226
01:58:46,223 --> 01:58:49,760
I FIND THE EVIDENCE ON THE 

2227
01:58:49,760 --> 01:58:54,265
SUPPLEMENTATION WITH SPM AND 

2228
01:58:54,265 --> 01:58:59,570
MARINE OILS PROMISING AND 

2229
01:58:59,570 --> 01:59:02,239
WONDERING IF YOU CAN COMMENT HOW

2230
01:59:02,239 --> 01:59:04,809
CLOSE WE ARE TO THAT BEING 

2231
01:59:04,809 --> 01:59:06,977
REPLICATED BECAUSE IT'S A 

2232
01:59:06,977 --> 01:59:07,645
NUTRITIONAL SUPPLEMENT.

2233
01:59:07,645 --> 01:59:13,184
I WANT TO BE CAREFUL HOW I USE 

2234
01:59:13,184 --> 01:59:14,919
MY WORDS HERE BUT IT DIDN'T 

2235
01:59:14,919 --> 01:59:16,954
REQUIRE MEDICAL PRESCRIPTION BUT

2236
01:59:16,954 --> 01:59:19,957
I'M SURE THERE'S CLINICAL 

2237
01:59:19,957 --> 01:59:23,894
CONSIDERATIONS BUT CLEARLY IF IT

2238
01:59:23,894 --> 01:59:25,796
ALLEVIATES INFLAMMATION AND 

2239
01:59:25,796 --> 01:59:27,431
CONSISTENTLY DEMONSTRATING SO 

2240
01:59:27,431 --> 01:59:29,500
WHAT DO YOU THINK ARE NEXT STEPS

2241
01:59:29,500 --> 01:59:32,937
TO MOVE FORWARD WITH THE 

2242
01:59:32,937 --> 01:59:38,609
EVIDENCE ON THIS TYPE OF 

2243
01:59:38,609 --> 01:59:38,976
SUPPLEMENTATION?

2244
01:59:38,976 --> 01:59:39,143
>> 

2245
01:59:39,143 --> 01:59:41,612
>> THERE'S A HANDFUL OF
CLINICAL

2246
01:59:41,612 --> 01:59:41,846
TRIALS.

2247
01:59:41,846 --> 01:59:46,016
SOME MIXED RESULTS AND SOME AT 

2248
01:59:46,016 --> 01:59:48,552
THE END THAT DEMONSTRATE MARINE 

2249
01:59:48,552 --> 01:59:50,421
OIL ENRICHED SUPPLEMENTATION CAN

2250
01:59:50,421 --> 01:59:53,023
INCREASE NOT JUST THE LEVELS OF 

2251
01:59:53,023 --> 01:59:58,596
DHA AND EPA IN THE CIRCULATION 

2252
01:59:58,596 --> 02:00:01,832
BUT DOWNSTREAM BIO CONVERTED 

2253
02:00:01,832 --> 02:00:02,533
SPMs.

2254
02:00:02,533 --> 02:00:04,869
MOSTLY THE DATA ARE IN HEALTHY 

2255
02:00:04,869 --> 02:00:05,169
INDIVIDUALS.

2256
02:00:05,169 --> 02:00:09,840
ONE STUDY IN ATHEROCLEROSIS 

2257
02:00:09,840 --> 02:00:12,176
PATIENTS BUT THAT'S THE NEXT 

2258
02:00:12,176 --> 02:00:13,811
STEP.

2259
02:00:13,811 --> 02:00:23,888
CAN WE AND SHOULD WE EMPLOY 

2260
02:00:23,888 --> 02:00:24,388
TRIALS.

2261
02:00:24,388 --> 02:00:25,823
THERE'S COMMERCIALLY AVAILABLE 

2262
02:00:25,823 --> 02:00:30,794
PRODUCTS AND ONE IS CALLED SPM 

2263
02:00:30,794 --> 02:00:31,929
ACTIVE THAT HAVE NOT JUST THE 

2264
02:00:31,929 --> 02:00:35,499
PARENT FATTY ACID BUT THE 

2265
02:00:35,499 --> 02:00:39,570
PATHWAY AND THOSE ARE IN 

2266
02:00:39,570 --> 02:00:41,405
CLINICAL TRIALS.

2267
02:00:41,405 --> 02:00:42,907
THERE ARE INDIVIDUAL SPMs 

2268
02:00:42,907 --> 02:00:45,576
STUDIED IN CLINICAL TRIALS AND 

2269
02:00:45,576 --> 02:00:47,578
SEVERAL IN PERIODONTAL DISEASE, 

2270
02:00:47,578 --> 02:00:52,983
DRY EYE, A TOPIC DERMATITIS IN 

2271
02:00:52,983 --> 02:00:53,350
CHILDREN.

2272
02:00:53,350 --> 02:00:56,487
IT'S A PARTICULAR AREA OF 

2273
02:00:56,487 --> 02:00:56,754
INTEREST.

2274
02:00:56,754 --> 02:01:00,357
AND SAFETY PROFILE WISE IS 

2275
02:01:00,357 --> 02:01:01,659
FAVORABLE TO DO ADDITIONAL 

2276
02:01:01,659 --> 02:01:02,826
CLINICAL TRIALS.

2277
02:01:02,826 --> 02:01:05,963
I'D BE SUPPORTIVE.

2278
02:01:05,963 --> 02:01:07,264
>> THANK YOU.

2279
02:01:07,264 --> 02:01:09,433
I THINK TAWNYA ROBINSON HAS 

2280
02:01:09,433 --> 02:01:11,268
PRETTY MUCH THE SAME QUESTION.

2281
02:01:11,268 --> 02:01:16,640
IT'S QUITE STRIKING TO ME TO SEE

2282
02:01:16,640 --> 02:01:19,009
THAT CONSISTENT.

2283
02:01:19,009 --> 02:01:22,313
WE'VE SEEN WELL DESIGNED 

2284
02:01:22,313 --> 02:01:23,614
INTERVENTION TRIALS AND YOU'VE 

2285
02:01:23,614 --> 02:01:25,983
SEEN VITAMIN SUPPLEMENTS OF A, B

2286
02:01:25,983 --> 02:01:28,953
AND SELENIUM THAT DON'T CON FURM

2287
02:01:28,953 --> 02:01:33,591
THE FINDINGS FROM OBSERVATIONAL 

2288
02:01:33,591 --> 02:01:35,593
STUDIES.

2289
02:01:35,593 --> 02:01:37,995
THEREFORE THE USUAL ASSUMPTION 

2290
02:01:37,995 --> 02:01:41,031
IS THE NATURE SOURCES OF DIETARY

2291
02:01:41,031 --> 02:01:43,500
INTAKE ARE NOT OBSERVED IN 

2292
02:01:43,500 --> 02:01:44,435
NUTRITIONAL SUPPLEMENTS BECAUSE 

2293
02:01:44,435 --> 02:01:46,303
IT'S NOT THERE.

2294
02:01:46,303 --> 02:01:47,538
THERE MUST BE SOMETHING ELSE 

2295
02:01:47,538 --> 02:01:51,075
INDICT BUT HERE LOOKING AT THE 

2296
02:01:51,075 --> 02:01:53,911
MECHANISMS THE PANEL WAYS THAT 

2297
02:01:53,911 --> 02:01:54,245
HAVE.

2298
02:01:54,245 --> 02:01:57,448
DESCRIBED -- PATHWAYS DESCRIBED 

2299
02:01:57,448 --> 02:02:00,618
UNRICH MARINE OILS IT WOULD SEEM

2300
02:02:00,618 --> 02:02:01,785
IT'S QUITE PROMISING.

2301
02:02:01,785 --> 02:02:06,790
I LOOK FOR WARD TO READING THE 

2302
02:02:06,790 --> 02:02:07,591
SCIENTIFIC LITERATURE IN THE 

2303
02:02:07,591 --> 02:02:08,158
COMING MONTHS.

2304
02:02:08,158 --> 02:02:13,497
THERE MAY BE SOME FUTURE THERE.

2305
02:02:13,497 --> 02:02:15,432
>> I AGREE THE TRIAL I
PRESENTED

2306
02:02:15,432 --> 02:02:17,635
AT THE BEGINNING OF MY TALK THE 

2307
02:02:17,635 --> 02:02:25,776
INTERVENTION WAS VERY HIGH DOSE.

2308
02:02:25,776 --> 02:02:28,345
THE OUTCOME WAS CLEAR IN THE 

2309
02:02:28,345 --> 02:02:30,714
WOMEN IN DEFICIENT IN THE LOWER 

2310
02:02:30,714 --> 02:02:33,917
TERTILE PUT WHAT WE DON'T KNOW 

2311
02:02:33,917 --> 02:02:35,586
FROM TRIALS LIKE THAT IS HOW DID

2312
02:02:35,586 --> 02:02:39,189
THAT IMPACT THE SPMs IN TERMS OF

2313
02:02:39,189 --> 02:02:41,692
MORE DOWN STREAM MECHANISTICALLY

2314
02:02:41,692 --> 02:02:43,594
RELEVANT MOLECULES TO BE 

2315
02:02:43,594 --> 02:02:46,830
DETERMINED.

2316
02:02:46,830 --> 02:02:47,564
>> THANK YOU.

2317
02:02:47,564 --> 02:02:48,832
JUST TO BE COGNIZANT OF THE TIME

2318
02:02:48,832 --> 02:02:51,135
AS WE ARE APPROACHING THE END OF

2319
02:02:51,135 --> 02:02:52,836
THIS SESSION, I WANT TO GIVE ALL

2320
02:02:52,836 --> 02:02:56,907
THE SPEAKERS A CHANCE TO LEAVE 

2321
02:02:56,907 --> 02:02:59,209
YOUR FINAL THOUGHTS WITH REGARD 

2322
02:02:59,209 --> 02:03:01,612
TO THE MOST CRITICAL RESEARCH 

2323
02:03:01,612 --> 02:03:04,481
GAP AND MOST PROMISING NEXT STEP

2324
02:03:04,481 --> 02:03:05,549
FROM YOUR PERSPECTIVE IN TERMS 

2325
02:03:05,549 --> 02:03:16,093
OF PRECISION NUTRITION MEASURES.

2326
02:03:21,165 --> 02:03:22,266
>> IDENTIFYING BIOMARKERS
FOR 

2327
02:03:22,266 --> 02:03:26,704
FOODS AND DIETARY PATTERNS.

2328
02:03:26,704 --> 02:03:28,005
THE BIOMARKER CONSORTIUM IS 

2329
02:03:28,005 --> 02:03:29,273
DOING THAT BUT WE'RE ONLY 

2330
02:03:29,273 --> 02:03:31,542
TESTING SIX FOODS AT HARVARD AND

2331
02:03:31,542 --> 02:03:33,110
OTHER SITES ARE TESTING 

2332
02:03:33,110 --> 02:03:34,378
ADDITIONAL FOODS.

2333
02:03:34,378 --> 02:03:35,346
WE CONSUME A LOT MORE.

2334
02:03:35,346 --> 02:03:36,947
PUTTING THE MONEY THERE AND 

2335
02:03:36,947 --> 02:03:38,549
LOOKING AT OTHER OMIC 

2336
02:03:38,549 --> 02:03:40,384
TECHNOLOGIES LIKE PROTEOMICS 

2337
02:03:40,384 --> 02:03:43,754
WHICH IS A BIT MORE STABLE THAN 

2338
02:03:43,754 --> 02:03:44,321
METABOLOMICS WOULD ALSO BE 

2339
02:03:44,321 --> 02:03:54,465
USEFUL.

2340
02:03:57,735 --> 02:04:01,739
>> IT WOULD BE IMPORTANT
TO GET 

2341
02:04:01,739 --> 02:04:06,377
DOWN TO THE TEST PERFORMANCE 

2342
02:04:06,377 --> 02:04:08,645
CHARACTERISTICS AND SEE IF THE 

2343
02:04:08,645 --> 02:04:09,279
BIOMARKERS ARE SUFFICIENT TO 

2344
02:04:09,279 --> 02:04:10,948
CHANGE DECISION MAKING.

2345
02:04:10,948 --> 02:04:14,051
THAT'S ONE PLACE WE HAVE FALLEN 

2346
02:04:14,051 --> 02:04:15,252
SHORT IN BIOMARKER WORK.

2347
02:04:15,252 --> 02:04:17,654
WE DON'T HAVE A GREAT IDEA OF 

2348
02:04:17,654 --> 02:04:19,390
THE DISCREET MEASURES OF TEST 

2349
02:04:19,390 --> 02:04:21,592
PERFORMANCE AND ONCE WE EXPLORE 

2350
02:04:21,592 --> 02:04:25,729
THOSE WE SEE WE'RE OFTEN 

2351
02:04:25,729 --> 02:04:26,964
MODESTLY BETTER THAN A COIN FLIP

2352
02:04:26,964 --> 02:04:28,365
AND NOT IN THE REALM WHERE IT'S 

2353
02:04:28,365 --> 02:04:31,568
GOING TO CHANGE WHAT WE DO IN 

2354
02:04:31,568 --> 02:04:31,869
THE CLINIC.

2355
02:04:31,869 --> 02:04:35,572
NOT ONLY DISCOVERING NEW 

2356
02:04:35,572 --> 02:04:37,574
BIOMARKERS BUT FORMATTING THEM 

2357
02:04:37,574 --> 02:04:40,711
IN THE WAY THEY HAVE TEST 

2358
02:04:40,711 --> 02:04:41,345
PERFORMANCE CHARACTERISTICS TO 

2359
02:04:41,345 --> 02:04:46,116
CHANGE PRACTICE.

2360
02:04:46,116 --> 02:04:51,588
>> I'D LIKE TO HIGHLIGHT
THE 

2361
02:04:51,588 --> 02:04:55,592
RESEARCH GAP IDENTIFIED SO 

2362
02:04:55,592 --> 02:05:00,397
CHANGING BODY MASS MARKERS I CAN

2363
02:05:00,397 --> 02:05:03,233
ALSO CHANGE OUTCOMES IN THE 

2364
02:05:03,233 --> 02:05:05,302
FUTURE IS IN MY POINT OF VIEW 

2365
02:05:05,302 --> 02:05:08,071
THE MOST IMPORTANT ONE.

2366
02:05:08,071 --> 02:05:12,576
I THINK WE SHOULD END OR TRY TO 

2367
02:05:12,576 --> 02:05:20,083
CHANGE AND IMPROVE BODY RELATED 

2368
02:05:20,083 --> 02:05:23,220
MARKERS.

2369
02:05:23,220 --> 02:05:24,221
FOR EXAMPLE INTERVENTIONS AS 

2370
02:05:24,221 --> 02:05:28,258
PART OF MORE REHABILITATION 

2371
02:05:28,258 --> 02:05:33,363
PROGRAM AND WHETHER THEY'RE 

2372
02:05:33,363 --> 02:05:42,206
ASSOCIATED WITH BETTER OUTCOMES.

2373
02:05:42,206 --> 02:05:43,874
>> FROM MY PERSPECTIVE I
WOULD 

2374
02:05:43,874 --> 02:05:47,578
SAY THE KEY RESEARCH QUESTION IS

2375
02:05:47,578 --> 02:05:52,249
COULD DIETARY SUPPLEMENTATION 

2376
02:05:52,249 --> 02:05:55,486
WITH MARINE OILS PROMOTE 

2377
02:05:55,486 --> 02:05:56,687
INFLAMMATION IN INFLAMMATORY 

2378
02:05:56,687 --> 02:05:58,422
DISEASES AND CAN WE FEED THE 

2379
02:05:58,422 --> 02:06:00,290
LUNG THROUGH THE GUT AND CAN WE 

2380
02:06:00,290 --> 02:06:10,367
GET A WINDOW INTO WHETHER 

2381
02:06:10,367 --> 02:06:11,735
DYSREGULATED CIRCUITS ARE 

2382
02:06:11,735 --> 02:06:14,137
INTERROGATED FROM COHORTS WE 

2383
02:06:14,137 --> 02:06:18,509
FOLLOW LONGITUDINALLY.

2384
02:06:18,509 --> 02:06:21,178
THANK YOU ALL SO VERY MUCH FOR 

2385
02:06:21,178 --> 02:06:24,748
YOUR INSIGHTS AND STIMULATING 

2386
02:06:24,748 --> 02:06:25,048
DISCUSSION.

2387
02:06:25,048 --> 02:06:27,184
I THINK WE CAN BRING THIS 

2388
02:06:27,184 --> 02:06:29,620
SESSION TO A CLOSE.

2389
02:06:29,620 --> 02:06:34,658
ALL THE SPEAKERS AND THE 

2390
02:06:34,658 --> 02:06:36,093
MODERATORS INCLUDING THOSE FROM 

2391
02:06:36,093 --> 02:06:38,095
YESTERDAY PLEASE DO PLAN TO JOIN

2392
02:06:38,095 --> 02:06:41,198
US THIS AFTERNOON IN THE OVER 

2393
02:06:41,198 --> 02:06:45,269
ALL PANEL DISCUSSION WHERE WE'LL

2394
02:06:45,269 --> 02:06:46,603
HAVE SOME HIGH LEVEL STRATEGIC 

2395
02:06:46,603 --> 02:06:49,206
QUESTIONS THAT HOPEFULLY WILL 

2396
02:06:49,206 --> 02:06:50,874
GENERATE GREAT DISCUSSIONS.

2397
02:06:50,874 --> 02:06:52,342
THANK YOU ALL.

2398
02:06:52,342 --> 02:06:55,612
YOU I THINK NOW WE'LL GO INTO A 

2399
02:06:55,612 --> 02:06:56,389
30-MINUTE BREAK.

2400
02:06:56,389 --> 02:07:00,092
SO WE'RE GOING TO KICK OFF 

2401
02:07:00,092 --> 02:07:03,696
THE FINAL SESSION, SESSION 5 FOR

2402
02:07:03,696 --> 02:07:07,300
THIS WORKSHOP AND IT'S MY GREAT 

2403
02:07:07,300 --> 02:07:14,640
PLEASURE TO INTRODUCE MY 

2404
02:07:14,640 --> 02:07:15,508
CO-MODERATOR LISA WOOD IN THE 

2405
02:07:15,508 --> 02:07:19,479
UNIVERSITY OF NEWCASTLE AND A 

2406
02:07:19,479 --> 02:07:23,182
KEEN LEADER FOR NUTRITION AND 

2407
02:07:23,182 --> 02:07:24,350
METABOLISM IN THE IMMUNE HALT 

2408
02:07:24,350 --> 02:07:24,984
PROGRAM AT HUNTER MEDICAL 

2409
02:07:24,984 --> 02:07:26,886
RESEARCH INSTITUTE.

2410
02:07:26,886 --> 02:07:32,124
SHE IS A REGISTERED NUTRITIONIST

2411
02:07:32,124 --> 02:07:34,026
AND CLINICAL RESEARCH SCIENTIST 

2412
02:07:34,026 --> 02:07:38,965
WHOSE RESEARCH EXPLORE NON-F

2413
02:07:38,965 --> 02:07:41,400
NON-PHARMACOLOGIC STRATEGIES FOR

2414
02:07:41,400 --> 02:07:42,134
DISEASE CONDITIONS WITH A 

2415
02:07:42,134 --> 02:07:45,171
PARTICULAR FOCUS ON ASTHMA.

2416
02:07:45,171 --> 02:07:48,808
DR. WOOD AND HER TEAM HAVE 

2417
02:07:48,808 --> 02:07:50,610
PUBLISHED EXTENSIVELY WITH OVER 

2418
02:07:50,610 --> 02:07:53,379
200 PEER-REVIEWED JOURNAL 

2419
02:07:53,379 --> 02:07:56,482
ARTICLES AND THEIR RESEARCH HAS 

2420
02:07:56,482 --> 02:07:57,884
CONTRIBUTED TO THE DEVELOPMENT 

2421
02:07:57,884 --> 02:08:03,689
OF DISEASE MANAGEMENT GUIDELINES

2422
02:08:03,689 --> 02:08:08,828
SUCH AS THOSE PRODUCED BY THE 

2423
02:08:08,828 --> 02:08:12,532
BRITISH THORACIC SOCIETY AND 

2424
02:08:12,532 --> 02:08:13,866
ASTHMA CONSULT AND HAS BEEN 

2425
02:08:13,866 --> 02:08:18,604
RECOGNIZED BY AWARD THE 

2426
02:08:18,604 --> 02:08:20,706
NUTRITION SOCIETY OF AUSTRALIA 

2427
02:08:20,706 --> 02:08:22,675
IN 2022 AND IS THE PAST 

2428
02:08:22,675 --> 02:08:23,976
PRESIDENT OF THE NUTRITION 

2429
02:08:23,976 --> 02:08:26,245
SOCIETY OF AUSTRALIA AND 

2430
02:08:26,245 --> 02:08:29,916
DIRECTOR OF THE AUSTRALIAN 

2431
02:08:29,916 --> 02:08:30,917
NUTRITION TRUST AND CURRENTLY ON

2432
02:08:30,917 --> 02:08:35,054
THE ASTHMA AUSTRALIA RESEARCH 

2433
02:08:35,054 --> 02:08:35,788
ADVISORY COMMITTEE.

2434
02:08:35,788 --> 02:08:36,455
OVER TO DR. WOOD TO INTRODUCE 

2435
02:08:36,455 --> 02:08:39,392
THE SESSION.

2436
02:08:39,392 --> 02:08:40,826
>> THANKS VERY MUCH, DR.
MA.

2437
02:08:40,826 --> 02:08:44,163
IT'S GREAT TO BE HERE.

2438
02:08:44,163 --> 02:08:45,364
I DID WANT TO COMPLIMENT 

2439
02:08:45,364 --> 02:08:48,901
YOURSELF AND THE COCHAIRS AND 

2440
02:08:48,901 --> 02:08:51,170
NIH FOR PUTTING ON SUCH A 

2441
02:08:51,170 --> 02:08:52,805
FABULOUS MEETING.

2442
02:08:52,805 --> 02:08:56,809
SO SESSION 5 IS TITLED DIETARY 

2443
02:08:56,809 --> 02:08:59,312
AND NUTRITIONAL INTERVENTION IN 

2444
02:08:59,312 --> 02:09:00,813
THE PREVENTION AND MANAGEMENT OF

2445
02:09:00,813 --> 02:09:02,782
RESPIRATORY DISEASES.

2446
02:09:02,782 --> 02:09:03,816
THE OBJECTIVES ARE TO PROVIDE 

2447
02:09:03,816 --> 02:09:07,286
EVIDENCE ON THE EFFICACY, 

2448
02:09:07,286 --> 02:09:08,387
DISSEMINATION AND IMPLEMENTATION

2449
02:09:08,387 --> 02:09:10,389
OF DIETARY AND NUTRITIONAL 

2450
02:09:10,389 --> 02:09:11,023
INTERVENTIONS FOR RESPIRATORY 

2451
02:09:11,023 --> 02:09:14,860
DISEASE PREVENTION AND CONTROL.

2452
02:09:14,860 --> 02:09:15,995
THIS KNOWLEDGE CAN GUIDE 

2453
02:09:15,995 --> 02:09:17,697
DEVELOPMENT OF COMPREHENSIVE 

2454
02:09:17,697 --> 02:09:19,665
DIETARY GUIDE LIPS.

2455
02:09:19,665 --> 02:09:23,369
SO WE'RE LOOKING FORWARD TO 

2456
02:09:23,369 --> 02:09:24,370
ANOTHER GREAT SESSION AND I 

2457
02:09:24,370 --> 02:09:25,871
WOULD PASS BACK TO DR. MA TO 

2458
02:09:25,871 --> 02:09:32,778
INTRODUCE THE FIRST SPEAKER.

2459
02:09:32,778 --> 02:09:33,479
>> THANK YOU.

2460
02:09:33,479 --> 02:09:36,382
IT'S MY PLEASURE TO INTRODUCE 

2461
02:09:36,382 --> 02:09:39,018
DR. NADIA HANSEL.

2462
02:09:39,018 --> 02:09:41,520
SHE'S A WILLIAM OSLER PROFESSOR 

2463
02:09:41,520 --> 02:09:43,122
OF MEDICINE IN THE DEPARTMENT OF

2464
02:09:43,122 --> 02:09:46,058
MEDICINE AT JOHNS HOPKINS.

2465
02:09:46,058 --> 02:09:48,394
SHE ALSO SERVED AS THE PHYSICIAN

2466
02:09:48,394 --> 02:09:48,928
IN CHIEF AT JOHNS HOPKINS 

2467
02:09:48,928 --> 02:09:51,797
HOSPITAL.

2468
02:09:51,797 --> 02:09:53,566
HER TALK WILL FOCUS ON EFFICACY 

2469
02:09:53,566 --> 02:09:57,136
OF TARGETED NUTRITION 

2470
02:09:57,136 --> 02:10:00,072
SUPPLEMENTATION IN THE 

2471
02:10:00,072 --> 02:10:05,478
MANAGEMENT OF RESPIRATORY 

2472
02:10:05,478 --> 02:10:10,616
DISEASES IN UNDER SERVED 

2473
02:10:10,616 --> 02:10:11,317
POPULATIONS.

2474
02:10:11,317 --> 02:10:13,653
>> THANK YOU SO MUCH, DR.
WOOD 

2475
02:10:13,653 --> 02:10:17,156
AND DR. MA.

2476
02:10:17,156 --> 02:10:18,724
THE SESSION IS EXCITING AS WELL 

2477
02:10:18,724 --> 02:10:19,892
AS INVITING ME TO SPEAK TODAY.

2478
02:10:19,892 --> 02:10:21,861
I WANT TO CONGRATULATION THE 

2479
02:10:21,861 --> 02:10:23,663
SPEAKERS OF THE LAST SESSION FOR

2480
02:10:23,663 --> 02:10:27,033
SOMETHING THAT WAS PROVOCATIVE 

2481
02:10:27,033 --> 02:10:28,200
AND HOPEFULLY THE SESSION WILL 

2482
02:10:28,200 --> 02:10:28,934
ADD TO THE DISCUSSIONS THAT HAVE

2483
02:10:28,934 --> 02:10:34,006
ALREADY BEEN HAD.

2484
02:10:34,006 --> 02:10:36,809
I'M GOING TO START BY TALKING 

2485
02:10:36,809 --> 02:10:39,078
THROUGH REALLY FIRST THE 

2486
02:10:39,078 --> 02:10:41,981
IMPORTANCE OF FOCUSSING ON UNDER

2487
02:10:41,981 --> 02:10:43,683
SERVED POPULATIONS TO ADDRESS 

2488
02:10:43,683 --> 02:10:44,150
HEALTH DISPARITIES.

2489
02:10:44,150 --> 02:10:46,652
AS THE UNDER SERVED POPULATION 

2490
02:10:46,652 --> 02:10:49,188
THOSE THAT HAVE LOW INCOME OR 

2491
02:10:49,188 --> 02:10:51,090
LOW FOOD ACCESS I THINK ARE 

2492
02:10:51,090 --> 02:10:53,492
PARTICULARLY VULNERABLE TO 

2493
02:10:53,492 --> 02:11:00,332
NUTRITIONAL DEFICIENCIES.

2494
02:11:00,332 --> 02:11:01,400
IN PARTICULAR THIS SLIDE REALLY 

2495
02:11:01,400 --> 02:11:03,402
HIGHLIGHTS I THINK THE MULTIPLE 

2496
02:11:03,402 --> 02:11:05,738
FACTORS IN WHICH CASE LOW INCOME

2497
02:11:05,738 --> 02:11:08,574
AND FOOD INSECURE PEOPLE CAN BE 

2498
02:11:08,574 --> 02:11:10,743
SUSCEPTIBLE IN TERMS OF 

2499
02:11:10,743 --> 02:11:11,811
RESPIRATORY DISEASE.

2500
02:11:11,811 --> 02:11:13,713
FIRST OF ALL WITH THE LIMITED 

2501
02:11:13,713 --> 02:11:16,282
RESOURCES ARE CHALLENGED FOR THE

2502
02:11:16,282 --> 02:11:20,453
PURCHASING OF QUALITY FOODS, 

2503
02:11:20,453 --> 02:11:21,153
LACK OF HEALTHY AND AFFORDABLE 

2504
02:11:21,153 --> 02:11:23,756
FOOD ACCESS PROMINENT IN UNDER 

2505
02:11:23,756 --> 02:11:24,557
SERVED COMMUNITY AND 

2506
02:11:24,557 --> 02:11:26,325
NEIGHBORHOODS WHICH CAN LEAD TO 

2507
02:11:26,325 --> 02:11:28,861
CHALLENGES IN BEHAVIORAL 

2508
02:11:28,861 --> 02:11:30,763
ADAPTATIONS AND FOOD INTAKE.

2509
02:11:30,763 --> 02:11:32,364
IT CAN BE ASSOCIATED THEN ALSO 

2510
02:11:32,364 --> 02:11:35,334
WITH THE HIGH LEVELS OF STRESS, 

2511
02:11:35,334 --> 02:11:37,903
ANXIETY AND DEPRESSION THAT CAN 

2512
02:11:37,903 --> 02:11:41,974
BE RELATED TO FOOD AND DIET.

2513
02:11:41,974 --> 02:11:44,243
ALL THESE FACTORS CAN ALSO BE 

2514
02:11:44,243 --> 02:11:46,145
CONFOUNDED BY LIMITED ACCESS TO 

2515
02:11:46,145 --> 02:11:48,647
HEALTH CARE OR PHYSICAL ACTIVITY

2516
02:11:48,647 --> 02:11:50,382
WHICH I THINK CAN COMBINE WITH 

2517
02:11:50,382 --> 02:11:52,118
CHALLENGES ON HEALTHY FOOD 

2518
02:11:52,118 --> 02:11:55,354
INTAKE TO LEAD TO CHALLENGES 

2519
02:11:55,354 --> 02:11:55,888
WITH RESPIRATORY DISEASE.

2520
02:11:55,888 --> 02:11:58,257
AND OF COURSE WE ALL KNOW 

2521
02:11:58,257 --> 02:12:00,259
THERE'S GREATER EXPOSURE TO FOOD

2522
02:12:00,259 --> 02:12:01,994
MARKETING AND FOOD AVAILABILITY 

2523
02:12:01,994 --> 02:12:03,963
TO UNHEALTHY FOOD WHICH MAKES 

2524
02:12:03,963 --> 02:12:07,133
ALL THESE CHALLENGES 

2525
02:12:07,133 --> 02:12:08,267
PARTICULARLY NOTABLE IN LOW 

2526
02:12:08,267 --> 02:12:08,834
INCOME AND UNDER SERVED 

2527
02:12:08,834 --> 02:12:14,540
POPULATIONS.

2528
02:12:14,540 --> 02:12:16,742
COPD IS WHAT I'M GOING TO FOCUS 

2529
02:12:16,742 --> 02:12:18,778
ON TRYING TO THINK HOW WE CAN IN

2530
02:12:18,778 --> 02:12:22,148
THE SPAN OF 12 TO 13 MINUTES 

2531
02:12:22,148 --> 02:12:24,517
REALLY ADDRESS FOOD 

2532
02:12:24,517 --> 02:12:26,352
SUPPLEMENTATION AND RESPIRATORY 

2533
02:12:26,352 --> 02:12:28,387
DISEASE FOCUSSING MOST THE 

2534
02:12:28,387 --> 02:12:30,923
PRESENTATION ON COPD WHICH IS A 

2535
02:12:30,923 --> 02:12:31,690
CHRONIC RESPIRATORY DISEASE I'VE

2536
02:12:31,690 --> 02:12:34,460
FOCUSSED ON IN PARTICULAR.

2537
02:12:34,460 --> 02:12:36,762
IT'S APPLICABLE BEYOND COPD IF 

2538
02:12:36,762 --> 02:12:38,364
YOU THINK OF CHRONIC LUNG 

2539
02:12:38,364 --> 02:12:40,199
DISEASE IT MAKES ALL THE 

2540
02:12:40,199 --> 02:12:43,002
CHALLENGES WE THINK IN TERMS OF 

2541
02:12:43,002 --> 02:12:44,670
WHAT UNDER SERVED POPULATIONS 

2542
02:12:44,670 --> 02:12:46,205
FACE MORE CHALLENGING WHEN YOU 

2543
02:12:46,205 --> 02:12:48,707
THINK OF A CHRONIC LUNG DISEASE 

2544
02:12:48,707 --> 02:12:50,209
WHERE PATIENTS HAVE PERHAPS 

2545
02:12:50,209 --> 02:12:51,243
HIGHER NUTRITIONAL NEEDS OR MORE

2546
02:12:51,243 --> 02:12:53,846
CHALLENGES IN TERMS OF HAVING 

2547
02:12:53,846 --> 02:12:56,816
ACCESS TO HEALTHY FOODS OR 

2548
02:12:56,816 --> 02:12:57,783
MOBILITY.

2549
02:12:57,783 --> 02:13:01,520
MALNUTRITION IS VERY COMMON IN 

2550
02:13:01,520 --> 02:13:03,656
PATIENTS WITH COPD WITH A HIGH 

2551
02:13:03,656 --> 02:13:05,958
PREVALENCE AND THE MICRONUTRIENT

2552
02:13:05,958 --> 02:13:08,294
INTAKE IN STUDIES HAVE SHOWN 

2553
02:13:08,294 --> 02:13:12,832
INADEQUATE AND MORE IMPORTANT TO

2554
02:13:12,832 --> 02:13:19,305
ADDRESS THE ANTI-INFLAMMATORY, 

2555
02:13:19,305 --> 02:13:22,775
ANTIOXIDANT NEEDS TO CONTROL AND

2556
02:13:22,775 --> 02:13:23,976
COMBAT THE DISEASE.

2557
02:13:23,976 --> 02:13:26,545
IN PARTICULAR BEFORE I DIVE INTO

2558
02:13:26,545 --> 02:13:28,747
THE SUPPLEMENTATION, I THOUGHT 

2559
02:13:28,747 --> 02:13:29,915
IT WAS WORTH PAUSING FOR TO 

2560
02:13:29,915 --> 02:13:35,054
THINK OF ALL THE WAYS IN WHICH 

2561
02:13:35,054 --> 02:13:36,789
THE CHALLENGES BECOME 

2562
02:13:36,789 --> 02:13:38,624
POTENTIATED IN UNDER SERVED 

2563
02:13:38,624 --> 02:13:38,924
COMMUNITIES.

2564
02:13:38,924 --> 02:13:41,961
I WORK WITH A FACULTY MEMBER TO 

2565
02:13:41,961 --> 02:13:46,632
LOOK AT FOOD INSECURITY BY 

2566
02:13:46,632 --> 02:13:47,933
QUESTIONNAIRE TO FOOD INSECURITY

2567
02:13:47,933 --> 02:13:52,471
HAS SUBDOMAINS OF INSUFFICIENT 

2568
02:13:52,471 --> 02:13:54,073
FOOD INTAKE OR QUALITY OR 

2569
02:13:54,073 --> 02:13:56,976
CHALLENGES ABOUT FOOD.

2570
02:13:56,976 --> 02:13:58,978
IT WASN'T CLEAR WHICH ONE OF 

2571
02:13:58,978 --> 02:14:02,147
THESE WERE PRIMARILY DRIVING THE

2572
02:14:02,147 --> 02:14:03,716
CHALLENGES OR ASSOCIATE BETWEEN 

2573
02:14:03,716 --> 02:14:05,184
FOOD INSECURITY AND COPD 

2574
02:14:05,184 --> 02:14:05,451
OUTCOMES.

2575
02:14:05,451 --> 02:14:11,924
YOU CAN SEE WHEN WE LOOKED AT 

2576
02:14:11,924 --> 02:14:14,360
MULTIPLE OUTCOMES, EXACERBATION 

2577
02:14:14,360 --> 02:14:16,095
RISK NOT ONLY WAS IT ASSOCIATED 

2578
02:14:16,095 --> 02:14:17,429
WITH THE OUTCOMES BUT SO WERE 

2579
02:14:17,429 --> 02:14:20,032
ALL THREE DOMAINS.

2580
02:14:20,032 --> 02:14:24,169
IT MAY BE A COMPLEMENT THAT FOOD

2581
02:14:24,169 --> 02:14:25,271
QUALITY, ANXIETY AND 

2582
02:14:25,271 --> 02:14:26,872
INSUFFICIENT FOOD INTAKE 

2583
02:14:26,872 --> 02:14:30,976
COMBINED HAVE INDEPENDENT 

2584
02:14:30,976 --> 02:14:32,011
ASSOCIATIONS.

2585
02:14:32,011 --> 02:14:35,147
THOUGH THE TOPIC IS FOCUSSED ON 

2586
02:14:35,147 --> 02:14:36,382
FOOD SUPPLEMENTATION IT'S ONE 

2587
02:14:36,382 --> 02:14:38,050
NARROW LOOK AT THE OPPORTUNITY 

2588
02:14:38,050 --> 02:14:39,551
FOR SERVING UNDER SERVED 

2589
02:14:39,551 --> 02:14:40,953
POPULATIONS IN TERMS OF OUR 

2590
02:14:40,953 --> 02:14:41,453
DIETARY APPROACHES OR 

2591
02:14:41,453 --> 02:14:48,794
INTERVENTIONS.

2592
02:14:48,794 --> 02:14:50,629
OF NOTE LOW FOOD ACCESS IN 

2593
02:14:50,629 --> 02:14:54,266
PARTICULAR HAS BEEN SHOWN TO BE 

2594
02:14:54,266 --> 02:14:57,903
ASSOCIATED WITH RESPIRATORY 

2595
02:14:57,903 --> 02:15:00,773
DISEASE AND FOLKS IN LOW FOOD 

2596
02:15:00,773 --> 02:15:03,509
ACCESS AREA HAVE EMPHYSEMA AND 

2597
02:15:03,509 --> 02:15:05,344
GAS TRAPPING WHEN YOU THINK OF 

2598
02:15:05,344 --> 02:15:07,079
OBJECTIVE MEASURES NOT JUST 

2599
02:15:07,079 --> 02:15:08,814
SUBJECTIVE MEASURES ASSOCIATED 

2600
02:15:08,814 --> 02:15:12,051
WITH LOWER LUNG FUNCTION AND 

2601
02:15:12,051 --> 02:15:15,321
HIGHER EXACERBATION AND WORSE 

2602
02:15:15,321 --> 02:15:18,490
RESPIRATORY SYMPTOMS AND IT'S 

2603
02:15:18,490 --> 02:15:19,325
OCCURRING IN LINK WITH 

2604
02:15:19,325 --> 02:15:20,759
RESPIRATORY OUTCOMES IS WHETHER 

2605
02:15:20,759 --> 02:15:23,062
YOU LIVE IN HIGH POVERTY AREAS.

2606
02:15:23,062 --> 02:15:24,196
THINKING IT IS PARTICULARLY 

2607
02:15:24,196 --> 02:15:27,499
LINKED TO BEING IN A LOW-FOOD 

2608
02:15:27,499 --> 02:15:30,269
ACCESS AREA.

2609
02:15:30,269 --> 02:15:32,171
SO ONE OF THE WAYS WE THINK 

2610
02:15:32,171 --> 02:15:34,373
LIVING IN A LOW FOOD ACCESS AREA

2611
02:15:34,373 --> 02:15:35,374
IS LINKED WITH RESPIRATORY 

2612
02:15:35,374 --> 02:15:37,910
DISEASE IS BECAUSE IT MAKES IT 

2613
02:15:37,910 --> 02:15:39,278
HARDER TO EAT HEALTHY FOODS.

2614
02:15:39,278 --> 02:15:42,681
WE LOOKED SPECIFICALLY AT A 

2615
02:15:42,681 --> 02:15:44,750
BALTIMORE COMMUNITY AND SEE LOW 

2616
02:15:44,750 --> 02:15:46,852
FOOD ACCESS RESIDENTS DID HAVE 

2617
02:15:46,852 --> 02:15:49,555
LOWER EPA AND DHA INTAKE BOTH IN

2618
02:15:49,555 --> 02:15:52,658
TERMS OF FOOD FREQUENCY 

2619
02:15:52,658 --> 02:15:53,826
QUESTIONNAIRE BUT ALSO AS WE 

2620
02:15:53,826 --> 02:15:54,560
TALKED ABOUT IN THE LAST SESSION

2621
02:15:54,560 --> 02:15:58,197
THE CHALLENGES POTENTIALLY WITH 

2622
02:15:58,197 --> 02:15:59,565
FOOD FREQUENCY QUESTIONNAIRES 

2623
02:15:59,565 --> 02:16:01,900
AND OBJECTIVE MEASURES OF 

2624
02:16:01,900 --> 02:16:09,408
PLASMA, EPA, DHA.

2625
02:16:09,408 --> 02:16:11,543
SO OMEGA FREE FATTY ACIDS SOME 

2626
02:16:11,543 --> 02:16:12,778
PRESENTATIONS FOCUSSED ON THE 

2627
02:16:12,778 --> 02:16:18,217
FACT THIS MAY BE LINKED TO ACUTE

2628
02:16:18,217 --> 02:16:23,055
RESPIRATORY DISPRESS SYNDROME OR

2629
02:16:23,055 --> 02:16:25,557
PULMONARY FIBROSIS AND OUR DATA 

2630
02:16:25,557 --> 02:16:28,160
LINKS OMEGA 3 FATTY ACID TO COPD

2631
02:16:28,160 --> 02:16:28,827
AND RESPIRATORY SYMPTOMS.

2632
02:16:28,827 --> 02:16:33,165
IF YOU FOCUS ON THE FLEW YOU CAN

2633
02:16:33,165 --> 02:16:37,669
SEE INCREASING OMEGA 3 INTAKE IS

2634
02:16:37,669 --> 02:16:39,304
REPRESENTED WITH SCORES OF 

2635
02:16:39,304 --> 02:16:41,974
BETTER HEALTH AND LOWER RISK OF 

2636
02:16:41,974 --> 02:16:45,444
SEVERE EXACERBATIONS WHICH DOES 

2637
02:16:45,444 --> 02:16:51,417
SUGGEST TARGETING OMEGA 3 FATTY 

2638
02:16:51,417 --> 02:16:52,484
ACIDS IN NUTRITIONAL 

2639
02:16:52,484 --> 02:16:53,018
SUPPLEMENTATION COULD BE 

2640
02:16:53,018 --> 02:17:03,162
HELPFUL.

2641
02:17:04,897 --> 02:17:06,432
AND THE LEVELS ASSOCIATED WITH 

2642
02:17:06,432 --> 02:17:11,603
RESPIRATORY SYMPTOMS AND THE 

2643
02:17:11,603 --> 02:17:14,173
OBJECTIVE MEASURES WERE HELPFUL 

2644
02:17:14,173 --> 02:17:16,642
TO CONFIRM BUT NOT STRICTLY 

2645
02:17:16,642 --> 02:17:17,810
RECALLED OR LINKS WITH 

2646
02:17:17,810 --> 02:17:18,577
ASSOCIATION OF WHAT PEOPLE ARE 

2647
02:17:18,577 --> 02:17:21,613
SELF-REPORTING.

2648
02:17:21,613 --> 02:17:23,348
HOWEVER, THE LIMITATIONS OF THE 

2649
02:17:23,348 --> 02:17:29,988
CROSS SECTIONAL STUDIES IN 

2650
02:17:29,988 --> 02:17:33,992
DETERMINING CAUSALITY MOVE THE 

2651
02:17:33,992 --> 02:17:36,295
FIELD FORWARD WITH MORE 

2652
02:17:36,295 --> 02:17:36,862
INVENTION TRIALS.

2653
02:17:36,862 --> 02:17:39,565
IN THE INTEREST OF TIME I WAS 

2654
02:17:39,565 --> 02:17:40,833
TRYING TO NOT NECESSARILY 

2655
02:17:40,833 --> 02:17:42,901
HIGHLIGHT INDIVIDUAL STUDIES BUT

2656
02:17:42,901 --> 02:17:45,070
FOCUS ON PRESENTING THE 

2657
02:17:45,070 --> 02:17:45,604
META-ANALYSIS.

2658
02:17:45,604 --> 02:17:47,106
A LOT OF THE META-ANALYSIS TO 

2659
02:17:47,106 --> 02:17:50,275
DATE REALLY DO HIGHLIGHT IN MY 

2660
02:17:50,275 --> 02:17:51,810
OPINION THE LIMITATIONS OF THE 

2661
02:17:51,810 --> 02:17:53,679
WONDERFUL STUDIES DONE TO DATE 

2662
02:17:53,679 --> 02:17:57,616
BUT WHERE OUR FIELD NEEDS TO GO.

2663
02:17:57,616 --> 02:18:01,787
OWE OMEGA 3 SUPPLEMENTATION AND 

2664
02:18:01,787 --> 02:18:03,989
COPD HAS BEEN SHOWN TO HAVE 

2665
02:18:03,989 --> 02:18:06,492
LOWER INTERLEUKIN 6 PANELS IN 

2666
02:18:06,492 --> 02:18:07,559
THE SECOND PANEL IN THE 

2667
02:18:07,559 --> 02:18:09,294
STATISTICALLY SIGNIFICANT MANNER

2668
02:18:09,294 --> 02:18:11,130
WHEN YOU LOOK AT META-ANALYSES.

2669
02:18:11,130 --> 02:18:13,332
THERE WERE TRENDS FOR OTHER 

2670
02:18:13,332 --> 02:18:14,399
SYSTEMIC INFLAMMATORY MARKERS 

2671
02:18:14,399 --> 02:18:15,334
BUT THEY DID NOT REACH 

2672
02:18:15,334 --> 02:18:20,372
STATISTICAL SIGNIFICANCE.

2673
02:18:20,372 --> 02:18:24,810
IN ADDITION, THERE WAS NO 

2674
02:18:24,810 --> 02:18:26,845
ASSOCIATION WITH OMEGA 3 

2675
02:18:26,845 --> 02:18:27,646
SUPPLEMENTATION AND CRITICAL 

2676
02:18:27,646 --> 02:18:31,283
COPD OUTCOMES SUCH AS 6 MINUTE 

2677
02:18:31,283 --> 02:18:32,751
WALK DISTANCE AND THERE ARE SOME

2678
02:18:32,751 --> 02:18:34,820
EVIDENCE IN SOME OF OUR 

2679
02:18:34,820 --> 02:18:39,658
RANDOMIZED CONTROL TRIALS TO 

2680
02:18:39,658 --> 02:18:44,096
SUGGEST OMEGA 3 SUPPLEMENTATION 

2681
02:18:44,096 --> 02:18:47,499
CAN RELATE TO MUSCLE MASS BUT 

2682
02:18:47,499 --> 02:18:49,701
HOW IT RELATES TO COPD HEALTH IS

2683
02:18:49,701 --> 02:18:51,069
YET UNKNOWN AND A LOT OF THE 

2684
02:18:51,069 --> 02:18:53,405
INTERPRETATION OF THE DATA SO 

2685
02:18:53,405 --> 02:18:57,609
FAR IN RESPIRATORY ARE LIMITED 

2686
02:18:57,609 --> 02:19:00,879
BY SMALL AND HETEROGENEOUS 

2687
02:19:00,879 --> 02:19:04,149
STUDIES WIN SAMPLE SIZE, 

2688
02:19:04,149 --> 02:19:05,050
POPULATION S AND DIFFERENCES IN 

2689
02:19:05,050 --> 02:19:10,622
OUTCOMES MEASURED.

2690
02:19:10,622 --> 02:19:11,790
THIS WAS HIGHLIGHTED IN THE 

2691
02:19:11,790 --> 02:19:12,824
PREVIOUS SESSION.

2692
02:19:12,824 --> 02:19:15,327
THE STUDY WAS DONE ABOUT EIGHT 

2693
02:19:15,327 --> 02:19:16,995
YEARS AGO BUT THIS IS A LANDMARK

2694
02:19:16,995 --> 02:19:21,700
STUDY THAT HELPS ENCOURAGE 

2695
02:19:21,700 --> 02:19:23,802
THERE'S PROMISE IN 

2696
02:19:23,802 --> 02:19:25,370
SUPPLEMENTATION FOR LUNG 

2697
02:19:25,370 --> 02:19:25,604
DISEASE.

2698
02:19:25,604 --> 02:19:32,578
THIS WAS DONE IN PREGNANT WOMEN 

2699
02:19:32,578 --> 02:19:34,713
OFFSPRING SHOWING THAT 

2700
02:19:34,713 --> 02:19:36,315
SUPPLEMENTATION HAS THE 

2701
02:19:36,315 --> 02:19:39,985
POTENTIAL TO IMPROVE REDUCED 

2702
02:19:39,985 --> 02:19:42,254
RISK OF WHEEZE OR PERSISTENT 

2703
02:19:42,254 --> 02:19:42,955
WHEEZE.

2704
02:19:42,955 --> 02:19:45,157
IT'S CRITICAL TO REALLY THINK 

2705
02:19:45,157 --> 02:19:46,925
ABOUT THE POPULATION AT RISK AND

2706
02:19:46,925 --> 02:19:51,630
WHO WOULD BENEFIT MOST WITH THE 

2707
02:19:51,630 --> 02:19:55,634
PRODOMINANCE OF THE SIGNAL BEING

2708
02:19:55,634 --> 02:19:57,436
SEEN IN WOMEN THAT HAD LOW 

2709
02:19:57,436 --> 02:19:58,604
LEVELS TO BEGIN WITH.

2710
02:19:58,604 --> 02:20:01,840
THIS IS WHERE IN TERMS OF THE 

2711
02:20:01,840 --> 02:20:02,507
PRECISION NUTRITION BROUGHT UP 

2712
02:20:02,507 --> 02:20:04,643
ALREADY WE NEED TO BE MORE 

2713
02:20:04,643 --> 02:20:06,778
STRATEGIC IN THINKING ABOUT THE 

2714
02:20:06,778 --> 02:20:08,814
POPULATION THAT CAN BENEFIT FROM

2715
02:20:08,814 --> 02:20:15,187
SUPPLEMENTATION.

2716
02:20:15,187 --> 02:20:17,055
THERE'S BEEN SELF STUDIES THAT 

2717
02:20:17,055 --> 02:20:20,792
HAVE LOOKED AT VITAMIN D 

2718
02:20:20,792 --> 02:20:21,994
SUPPLEMENTATION FOR EXACERBATION

2719
02:20:21,994 --> 02:20:22,694
RISK.

2720
02:20:22,694 --> 02:20:27,966
THIS WAS INCLUDED IN THE GOLD 

2721
02:20:27,966 --> 02:20:32,371
GOOD LINES PREVIOUSLY A SMALL 

2722
02:20:32,371 --> 02:20:33,772
NOTATION ABOUT VITAMIN D 

2723
02:20:33,772 --> 02:20:34,740
SUPPLEMENTATION BUT 

2724
02:20:34,740 --> 02:20:35,607
META-ANALYSIS DID NOT SHOW OVER 

2725
02:20:35,607 --> 02:20:39,745
ALL BENEFIT IF YOU LOOK AT COPD 

2726
02:20:39,745 --> 02:20:43,582
COHORTS OVER ALL.

2727
02:20:43,582 --> 02:20:45,450
AGAIN, SIMILAR TO THE STUDY WE 

2728
02:20:45,450 --> 02:20:47,152
JUST SHOWED ON PROOF OF 

2729
02:20:47,152 --> 02:20:51,156
SUPPLEMENTATION IN ASTHMA, YOU 

2730
02:20:51,156 --> 02:20:53,225
CAN SEE THE BENEFIT WAS 

2731
02:20:53,225 --> 02:20:55,460
PREDOMINANTLY AMONG THE 

2732
02:20:55,460 --> 02:20:56,295
POPULATION WITH LOW VITAMIN D 

2733
02:20:56,295 --> 02:20:59,531
LEVELS AT BASELINE.

2734
02:20:59,531 --> 02:21:02,834
I THINK AS WE MOVE FORWARD WE DO

2735
02:21:02,834 --> 02:21:08,640
OURSELVES A DISSERVICE BIT NOT 

2736
02:21:08,640 --> 02:21:09,775
FULLY ADDRESSING WHAT OUR 

2737
02:21:09,775 --> 02:21:15,847
BASELINE NUTRIENT STATUS IS.

2738
02:21:15,847 --> 02:21:18,216
IF WE LOOK MORE BROADLY NOT JUST

2739
02:21:18,216 --> 02:21:20,819
AT DISEASE OUTCOMES SUCH AS 

2740
02:21:20,819 --> 02:21:23,355
EXACERBATION BUT FEB1 AS AN OVER

2741
02:21:23,355 --> 02:21:25,424
ALL MEASURE OF LUNG FUNCTION 

2742
02:21:25,424 --> 02:21:28,527
RELEVANT FOR MANY CHRONIC 

2743
02:21:28,527 --> 02:21:30,262
DISEASES, THERE'S A RECENT 

2744
02:21:30,262 --> 02:21:31,730
PUBLICATION THIS YEAR PUBLISHED 

2745
02:21:31,730 --> 02:21:34,733
ON THE META-ANALYSIS OF VITAMIN 

2746
02:21:34,733 --> 02:21:36,668
D SUPPLEMENTATION IN FAV1.

2747
02:21:36,668 --> 02:21:41,173
YOU CAN SEE OVER ALL THERE'S A 

2748
02:21:41,173 --> 02:21:42,140
VARIABILITY OF EFFECT SIZES 

2749
02:21:42,140 --> 02:21:43,575
BASED ON STUDIES AND SEE THERE'S

2750
02:21:43,575 --> 02:21:45,811
A LARGE NUMBER OF STUDIES THAT 

2751
02:21:45,811 --> 02:21:47,779
HAVE BEEN PUBLISHED THAT HAVE 

2752
02:21:47,779 --> 02:21:48,980
LOOKED AT THIS QUESTION.

2753
02:21:48,980 --> 02:21:51,583
I THINK VERY ENCOURAGING IS THAT

2754
02:21:51,583 --> 02:21:53,285
WHEN YOU LOOK AT THE 

2755
02:21:53,285 --> 02:21:56,788
META-ANALYSIS RESULTS IT DOES 

2756
02:21:56,788 --> 02:21:58,290
SUGGEST BENEFIT OF VITAMIN D 

2757
02:21:58,290 --> 02:22:03,462
SUPPLEMENTATION ON F EV1.

2758
02:22:03,462 --> 02:22:06,264
VITAMIN C IS AN ANTIOXIDANT.

2759
02:22:06,264 --> 02:22:11,970
NOT AS MANY STUDIES ON VITAMIN D

2760
02:22:11,970 --> 02:22:15,607
BUT IT HAS RECEIVED SOME 

2761
02:22:15,607 --> 02:22:15,874
ATTENTION.

2762
02:22:15,874 --> 02:22:17,342
AGAIN, MUCH VARIABILITY IN THE 

2763
02:22:17,342 --> 02:22:18,744
STUDIES THAT HAVE BEEN COMPLETED

2764
02:22:18,744 --> 02:22:19,745
TO DATE.

2765
02:22:19,745 --> 02:22:20,812
IF YOU LOOK AT THE TOP PART OF 

2766
02:22:20,812 --> 02:22:25,117
THE PANEL YOU CAN SEE VITAMIN C 

2767
02:22:25,117 --> 02:22:28,553
SUPPLEMENTATION LESS THAN 400 

2768
02:22:28,553 --> 02:22:29,921
MILLIGRAMS, AGAIN, FEW STUDIES 

2769
02:22:29,921 --> 02:22:31,256
SO HARD TO DRAW CONCLUSION BUT 

2770
02:22:31,256 --> 02:22:33,191
THEY'VE BEEN INCONCLUSIVE TO 

2771
02:22:33,191 --> 02:22:33,792
SHOW BENEFIT.

2772
02:22:33,792 --> 02:22:37,729
IF YOU THINK OF VITAMIN C OF 

2773
02:22:37,729 --> 02:22:38,897
GREATER THAN 400 MILLIGRAM 

2774
02:22:38,897 --> 02:22:42,601
SUPPLEMENTATION THERE'S A TREND 

2775
02:22:42,601 --> 02:22:44,803
TO SUGGEST PERHAPS THIS 

2776
02:22:44,803 --> 02:22:45,404
ANTIOXIDANT SUPPLEMENTATION 

2777
02:22:45,404 --> 02:22:50,208
COULD HAVE BENEFIT IN PATIENTS 

2778
02:22:50,208 --> 02:22:52,811
WITH CHRONIC LUNG DISEASE SUCH 

2779
02:22:52,811 --> 02:22:57,516
AS COPD IN FE V1 AND THE STUDY 

2780
02:22:57,516 --> 02:22:59,050
REMAINS QUITE SMALL.

2781
02:22:59,050 --> 02:23:00,819
AGAIN, LIMITING OUR ABILITY TO 

2782
02:23:00,819 --> 02:23:08,827
DRAW DEFINITIVE CONCLUSIONS.

2783
02:23:08,827 --> 02:23:13,265
I WANT TO POINT TO ONE STUDY 

2784
02:23:13,265 --> 02:23:15,801
THAT IS VERY OLD BUT SIMILAR TO 

2785
02:23:15,801 --> 02:23:18,537
THE STUDY OF FATTY ACID 

2786
02:23:18,537 --> 02:23:21,373
SUPPLEMENTATION IN PREGNANCY A 

2787
02:23:21,373 --> 02:23:24,342
LANDMARK STUDY TO SHOW THE 

2788
02:23:24,342 --> 02:23:28,814
BENEFIT OF NUTRIENT 

2789
02:23:28,814 --> 02:23:33,819
SUPPLEMENTATION IN NEPAL LOOKING

2790
02:23:33,819 --> 02:23:42,194
AT PATIENTS SHOWING AN IMPROVED 

2791
02:23:42,194 --> 02:23:44,463
LUNG FUNCTION IN OFFSPRING AND 

2792
02:23:44,463 --> 02:23:46,264
TRULY THE VITAMIN A ARM THAT 

2793
02:23:46,264 --> 02:23:46,898
SHOWED POTENTIAL FOR IMPROVEMENT

2794
02:23:46,898 --> 02:23:48,233
OF LUNG FUNCTION.

2795
02:23:48,233 --> 02:23:49,468
THANK YOU.

2796
02:23:49,468 --> 02:23:52,737
YOU CAN ALSO SEE THE POSTPARTUM 

2797
02:23:52,737 --> 02:23:57,375
LEVELS OF RETINOL HAD A STRONG 

2798
02:23:57,375 --> 02:23:58,577
CORRELATION WITH THE POSSIBLE 

2799
02:23:58,577 --> 02:23:59,978
BENEFIT AND IMPROVEMENT OF LUNG 

2800
02:23:59,978 --> 02:24:00,512
FUNCTION.

2801
02:24:00,512 --> 02:24:04,316
THE STUDY HIGHLIGHTS BOTH 

2802
02:24:04,316 --> 02:24:07,052
IMPORTANT INTEREST IN TIMING OF 

2803
02:24:07,052 --> 02:24:08,587
SUPPLEMENTATION WITH PREGNANCY 

2804
02:24:08,587 --> 02:24:11,656
BEING A PARTICULARLY VULNERABLE 

2805
02:24:11,656 --> 02:24:15,494
TIME THAT MAY IMPROVE OFFSPRING 

2806
02:24:15,494 --> 02:24:19,865
AND LOOKING AT THE APPROPRIATE 

2807
02:24:19,865 --> 02:24:21,867
LEVEL OF SUPPLEMENTATION SHOWING

2808
02:24:21,867 --> 02:24:23,435
ACHIEVING HIGHER LEVELS COULD 

2809
02:24:23,435 --> 02:24:24,603
LEAD TO HIGHER BENEFIT.

2810
02:24:24,603 --> 02:24:26,972
ONLY A COUPLE MORE SLIDES.

2811
02:24:26,972 --> 02:24:32,177
I DO ALSO WANT TO NOTE THE 

2812
02:24:32,177 --> 02:24:34,779
CARROT TRIAL WHERE WE ASSUME 

2813
02:24:34,779 --> 02:24:38,850
SUPPLEMENTATION WITH CAROTENE 

2814
02:24:38,850 --> 02:24:40,819
AND VITAMIN A WOULD BENEFIT LUNG

2815
02:24:40,819 --> 02:24:44,689
CANCER AND HAD SURPRISING RESULT

2816
02:24:44,689 --> 02:24:48,793
SHOWING A POTENTIAL INCREASE IN 

2817
02:24:48,793 --> 02:24:51,530
LUNG CANCER DEATH MAKING US SURE

2818
02:24:51,530 --> 02:24:53,198
TO BE SURE FROM OBSERVATIONAL 

2819
02:24:53,198 --> 02:24:55,467
STUDIES TO CLINICAL STUDIES WITH

2820
02:24:55,467 --> 02:24:57,636
PAUSE AND THOUGHT ABOUT DATA AND

2821
02:24:57,636 --> 02:25:00,972
THE NEED FOR INTERVENTIONAL 

2822
02:25:00,972 --> 02:25:03,875
TRIALS TO DRAW CORRECT 

2823
02:25:03,875 --> 02:25:08,813
CONCLUS

2824
02:25:08,813 --> 02:25:11,116
CONCLUSIONS.

2825
02:25:11,116 --> 02:25:12,817
THERE ARE OUTCOME IN SMALL 

2826
02:25:12,817 --> 02:25:15,887
STUDIES THAT LOOKED AT NUTRITION

2827
02:25:15,887 --> 02:25:18,857
SUPPLEMENTATION IN TERMS OF 

2828
02:25:18,857 --> 02:25:20,725
IMPROVING BODY WEIGHT AND GRIP 

2829
02:25:20,725 --> 02:25:22,627
STRENGTH IN COPD AND 

2830
02:25:22,627 --> 02:25:24,262
EXERCISE-INDUCED FATIGUE AND 

2831
02:25:24,262 --> 02:25:26,798
PERHAPS COMBINED WITH MUSCLE 

2832
02:25:26,798 --> 02:25:29,200
STRENGTH TRAINING IMPROVED 

2833
02:25:29,200 --> 02:25:30,068
MUSCLE STRENGTH IN COPD.

2834
02:25:30,068 --> 02:25:33,738
AGAIN I THINK THE STUDIES ARE 

2835
02:25:33,738 --> 02:25:35,440
LIMITED THAT OF AND NEED TO DO A

2836
02:25:35,440 --> 02:25:38,543
BETTER JOB MOVING FORWARD AS THE

2837
02:25:38,543 --> 02:25:39,978
FIELD HAS ADVANCED IN TERMS OF 

2838
02:25:39,978 --> 02:25:44,983
IDENTIFYING THE PATIENTS THAT 

2839
02:25:44,983 --> 02:25:47,819
COULD BENEFIT AND THINK WHAT 

2840
02:25:47,819 --> 02:25:49,521
SUPPLEMENTATION COULD BE 

2841
02:25:49,521 --> 02:25:50,288
BENEFICIAL AND THERE ARE 

2842
02:25:50,288 --> 02:25:52,724
POTENTIAL NON-RESPIRATORY 

2843
02:25:52,724 --> 02:25:55,026
OUTCOMES IN PATIENT WITH CHRONIC

2844
02:25:55,026 --> 02:25:57,996
LUNG DISEASE SUCH AS EXERCISE 

2845
02:25:57,996 --> 02:25:59,864
ENDURANCE THAT MAY BE WORTH 

2846
02:25:59,864 --> 02:26:01,700
CONSIDERING BUT FEW THAT LOOKED 

2847
02:26:01,700 --> 02:26:03,802
AT STANDARDIZED RESPIRATORY 

2848
02:26:03,802 --> 02:26:04,936
OUTCOMES TO BEST ADDRESS PATIENT

2849
02:26:04,936 --> 02:26:05,670
NEED.

2850
02:26:05,670 --> 02:26:07,172
FOR THE CONCLUSIONS, UNDER 

2851
02:26:07,172 --> 02:26:09,741
SERVED POPULATIONS ARE AT 

2852
02:26:09,741 --> 02:26:10,575
INCREASED RISK.

2853
02:26:10,575 --> 02:26:14,679
I BEG US AS A COMMUNITY TO MAKE 

2854
02:26:14,679 --> 02:26:16,414
SURE THE INTERVENTION STUDY 

2855
02:26:16,414 --> 02:26:18,283
ADDRESS HEALTH DISPARITIES TO 

2856
02:26:18,283 --> 02:26:21,152
MAKE SURE WE ADDRESS THOSE MOST 

2857
02:26:21,152 --> 02:26:21,987
VULNERABLE AND THEREFORE THOSE 

2858
02:26:21,987 --> 02:26:25,457
MOST LIKELY TO BENEFIT.

2859
02:26:25,457 --> 02:26:27,826
OBSERVATIONAL EVIDENCE I THINK 

2860
02:26:27,826 --> 02:26:29,928
IS QUITE LARGE BUT THERE IS 

2861
02:26:29,928 --> 02:26:35,233
TRULY A NEED FOR INTERVENTION 

2862
02:26:35,233 --> 02:26:42,507
STUDIES THAT ARE LARGER TO GUIDE

2863
02:26:42,507 --> 02:26:42,874
RECOMMENDATIONS.

2864
02:26:42,874 --> 02:26:44,542
FEW STUDIES HAVE SHOWN SUPPORT 

2865
02:26:44,542 --> 02:26:47,779
FOR VITAMIN C OR D IN COPD.

2866
02:26:47,779 --> 02:26:50,281
I THINK PROMISING STUDIES EXIST 

2867
02:26:50,281 --> 02:26:52,550
AND OTHERS SPHERES SUCH AS 

2868
02:26:52,550 --> 02:26:54,319
ASTHMA AND LUNG FUNCTION BUT 

2869
02:26:54,319 --> 02:26:57,756
AGAIN MANY CHRONIC LUNG DISEASES

2870
02:26:57,756 --> 02:27:00,558
I BELIEVE BASED ON THE DATA 

2871
02:27:00,558 --> 02:27:02,293
SHOWN IN THIS SYMPOSIUM TO DATE 

2872
02:27:02,293 --> 02:27:03,795
AND LITERATURE SUGGESTS THERE 

2873
02:27:03,795 --> 02:27:05,196
COULD BE BENEFIT IN OTHER 

2874
02:27:05,196 --> 02:27:06,665
CHRONIC LUNG DISEASES.

2875
02:27:06,665 --> 02:27:08,700
IT'S INTERESTING I WAS GIVEN A 

2876
02:27:08,700 --> 02:27:10,802
TALK ON SUPPLEMENTATION OF 

2877
02:27:10,802 --> 02:27:11,536
NUTRIENTS BECAUSE I TRULY 

2878
02:27:11,536 --> 02:27:17,075
BELIEVE AS WE WERE TALKING ABOUT

2879
02:27:17,075 --> 02:27:25,917
HERE WITH METABOLOMICS AS A 

2880
02:27:25,917 --> 02:27:28,820
FIELD WE SHOULD THINK OF MORE 

2881
02:27:28,820 --> 02:27:30,588
COMPREHENSIVE DIETARY 

2882
02:27:30,588 --> 02:27:33,191
INTERVENTIONS TO BE MOST 

2883
02:27:33,191 --> 02:27:33,491
BENEFICIAL.

2884
02:27:33,491 --> 02:27:34,059
I'LL STOP THERE.

2885
02:27:34,059 --> 02:27:39,964
THANK YOU SO MUCH.

2886
02:27:39,964 --> 02:27:42,967
>> THANK YOU VERY MUCH, 

2887
02:27:42,967 --> 02:27:43,568
DR. HANSEL.

2888
02:27:43,568 --> 02:27:44,803
WE'RE GOING TO MOVE TO OUR NEXT 

2889
02:27:44,803 --> 02:27:46,104
SPEAKER NOW.

2890
02:27:46,104 --> 02:27:51,342
I'D LIKE TO INTRODUCE 

2891
02:27:51,342 --> 02:27:53,878
DR. SALVATORE CARBONE ASSOCIATE 

2892
02:27:53,878 --> 02:27:55,747
PROFESSOR FROM THE DEPARTMENT OF

2893
02:27:55,747 --> 02:27:58,950
KINESIOLOGY AND HEALTH SCIENCES,

2894
02:27:58,950 --> 02:27:59,451
VIRGINIA COMMONWEALTH 

2895
02:27:59,451 --> 02:28:00,285
UNIVERSITY.

2896
02:28:00,285 --> 02:28:00,919
WELCOME AND I'LL HAND IT OVER TO

2897
02:28:00,919 --> 02:28:06,958
YOU.

2898
02:28:06,958 --> 02:28:07,592
>> WONDERFUL.

2899
02:28:07,592 --> 02:28:11,296
THANK YOU VERY MUCH FOR THE 

2900
02:28:11,296 --> 02:28:14,299
INVITATION AND ALSO FOR THE 

2901
02:28:14,299 --> 02:28:14,999
WONDERFUL PRESENTATION RIGHT 

2902
02:28:14,999 --> 02:28:18,970
BEFORE MINE.

2903
02:28:18,970 --> 02:28:20,305
I THINK THERE WILL BE SOME MINOR

2904
02:28:20,305 --> 02:28:24,476
OVERLAP BUT THE ULTIMATE GOAL IS

2905
02:28:24,476 --> 02:28:25,744
TO IMPROVE THE QUALITY OF THE 

2906
02:28:25,744 --> 02:28:27,278
EVIDENCE WITH NUTRITION AND 

2907
02:28:27,278 --> 02:28:31,649
RESPIRATORY HEALTH.

2908
02:28:31,649 --> 02:28:34,652
I'LL TALK RIGHT NOW SPECIFICALLY

2909
02:28:34,652 --> 02:28:37,255
DISCUSS THE ROLE OF NUTRITION 

2910
02:28:37,255 --> 02:28:40,825
INTERVENTION IN RESPIRATORY 

2911
02:28:40,825 --> 02:28:44,796
FITNESS AND CARDIORESPIRATORY 

2912
02:28:44,796 --> 02:28:47,132
FITNESS.

2913
02:28:47,132 --> 02:28:55,240
HERE ARE MY DISCLOSURES AND THE 

2914
02:28:55,240 --> 02:28:56,307
MAIN TOPICS.

2915
02:28:56,307 --> 02:28:57,542
WE'LL FOCUS ON CARDIO FITNESS 

2916
02:28:57,542 --> 02:28:59,477
AND DEFINITIONS AND WHY IT'S 

2917
02:28:59,477 --> 02:29:00,712
IMPORTANT TO MEASURE WHEN 

2918
02:29:00,712 --> 02:29:04,149
POSSIBLE AND WHY THIS IS 

2919
02:29:04,149 --> 02:29:06,284
IMPORTANT ALSO CONSIDERING THE 

2920
02:29:06,284 --> 02:29:10,588
CONTRIBUTION OF CARDY FITNESS IN

2921
02:29:10,588 --> 02:29:12,824
REGARDS TO REDUCED QUALITY OF 

2922
02:29:12,824 --> 02:29:14,959
LIFE AND INTERVENTIONS WITHOUT 

2923
02:29:14,959 --> 02:29:18,029
ENERGY RESTRICTION IN ABSENCE OF

2924
02:29:18,029 --> 02:29:20,799
WEIGHT LOSS IMPLEMENTED TO 

2925
02:29:20,799 --> 02:29:26,404
IMPROVE CRF.

2926
02:29:26,404 --> 02:29:29,240
FIRST I WANT TO INTRODUCE CRF 

2927
02:29:29,240 --> 02:29:31,509
WHICH IS THE CARDIOVASCULAR 

2928
02:29:31,509 --> 02:29:32,811
RESPIRATORY AND MUSCULAR 

2929
02:29:32,811 --> 02:29:34,078
RESPONSE TO EXERCISE.

2930
02:29:34,078 --> 02:29:36,447
IT'S IMPORTANT THAT A FEW YEARS 

2931
02:29:36,447 --> 02:29:37,916
AGO THE AMERICAN HEART OF 

2932
02:29:37,916 --> 02:29:40,819
ASSOCIATION RELEASED A STATEMENT

2933
02:29:40,819 --> 02:29:42,921
THAT MADE A CASE FOR 

2934
02:29:42,921 --> 02:29:44,489
CARDIORESPIRATORY FITNESS TO BE 

2935
02:29:44,489 --> 02:29:49,894
USED AS A CLINICAL VITAL SIGN.

2936
02:29:49,894 --> 02:29:55,300
THERE'S OXYGEN CONSUMPTION WITH 

2937
02:29:55,300 --> 02:29:57,836
THE CARDIO PULMONARY EXERCISE 

2938
02:29:57,836 --> 02:30:02,440
TESTING IN PATIENTS WITH COPD OR

2939
02:30:02,440 --> 02:30:03,274
OTHER CHRONIC DISEASE WE'RE 

2940
02:30:03,274 --> 02:30:04,843
UNABLE TO REACH THE PLATEAU 

2941
02:30:04,843 --> 02:30:08,813
BETWEEN THE WORK RATES DURING 

2942
02:30:08,813 --> 02:30:12,784
THE EXERCISE TEST AND TALK ABOUT

2943
02:30:12,784 --> 02:30:17,388
PEAK OXEN CONSUMPTION IN 

2944
02:30:17,388 --> 02:30:20,258
PRESENCE OF AN AN EFFORT.

2945
02:30:20,258 --> 02:30:23,094
FOLLOWING THE EQUATION IT'S 

2946
02:30:23,094 --> 02:30:26,030
CALCULATED WITH THE PRODUCT OF 

2947
02:30:26,030 --> 02:30:28,666
CARDIAC OUTPUT AND OXYGEN 

2948
02:30:28,666 --> 02:30:30,335
DIFFERENCE WHICH PROVIDES AN 

2949
02:30:30,335 --> 02:30:32,804
ASSESSMENT OF OXYGEN EXTRACTION.

2950
02:30:32,804 --> 02:30:41,546
YOU CAN SEE ON THE RIGHT YOU CAN

2951
02:30:41,546 --> 02:30:43,081
APPRECIATE LUNGS PLAY A ROLE IN 

2952
02:30:43,081 --> 02:30:45,250
THE OXYGEN PATHWAY.

2953
02:30:45,250 --> 02:30:47,318
SO ANY LIMITATION COULD 

2954
02:30:47,318 --> 02:30:50,855
CONTRIBUTE TO A REDUCED VO2 

2955
02:30:50,855 --> 02:30:51,055
PEAK.

2956
02:30:51,055 --> 02:30:54,859
WHEN WE CONDUCT A CARDIO 

2957
02:30:54,859 --> 02:30:57,729
PULMONARY TEST WE'RE ABLE TO 

2958
02:30:57,729 --> 02:31:03,635
ASSESS OTHER PARAMETERS THAT 

2959
02:31:03,635 --> 02:31:05,203
PROVIDE INSIGHTS TO THE 

2960
02:31:05,203 --> 02:31:07,138
LIMITATIONS OF PATIENTS AND NOT 

2961
02:31:07,138 --> 02:31:09,307
ONLY WE'RE ABLE TO ASSESS THE 

2962
02:31:09,307 --> 02:31:12,810
OVER ALL VO2 PEAK OR CARDIO 

2963
02:31:12,810 --> 02:31:14,412
FITNESS BUT DETERMINE WHAT'S 

2964
02:31:14,412 --> 02:31:16,147
LIMITING AND SHOULD TARGET WITH 

2965
02:31:16,147 --> 02:31:17,815
OUR INTERVENTION.

2966
02:31:17,815 --> 02:31:20,151
WHEN VO2 PEAK CAN BE MEASURED 

2967
02:31:20,151 --> 02:31:24,289
DUE TO THE LACK OF GAS EXCHANGE 

2968
02:31:24,289 --> 02:31:27,492
ANALYSIS WE CAN ESTIMATE THE 

2969
02:31:27,492 --> 02:31:29,727
CARDIO FITNESS THROUGH METABOLIC

2970
02:31:29,727 --> 02:31:33,331
TASK WHERE ONE EQUALS TO 

2971
02:31:33,331 --> 02:31:34,532
MILLIMETERS PER MINUTE OF VO2 

2972
02:31:34,532 --> 02:31:38,069
PEAK.

2973
02:31:38,069 --> 02:31:40,605
SO LIKE I SAID CARDIO PULMONARY 

2974
02:31:40,605 --> 02:31:42,473
TESTING PROVIDES INSIGHT INTO 

2975
02:31:42,473 --> 02:31:47,779
THE UNDERLYING CAUSES.

2976
02:31:47,779 --> 02:31:49,414
WHY IS IT IMPORTANT?

2977
02:31:49,414 --> 02:31:51,683
WITH REGARDS TO RESPIRATORY 

2978
02:31:51,683 --> 02:31:54,519
DISEASE, EVERY INCREASE WHICH IS

2979
02:31:54,519 --> 02:31:55,920
A SMALL NUMBER OF MET IS 

2980
02:31:55,920 --> 02:32:00,692
ASSOCIATED WITH A 6% RELATIVE 

2981
02:32:00,692 --> 02:32:02,393
RISK OF RELATED MORTALITY AND 

2982
02:32:02,393 --> 02:32:04,829
LOOKING AT INCIDENTS 

2983
02:32:04,829 --> 02:32:08,232
PARTICULARLY COPD INS DEPENDS 

2984
02:32:08,232 --> 02:32:11,903
THERE'S AS A LINEAR RELATIONSHIP

2985
02:32:11,903 --> 02:32:12,837
BETWEEN RISK WITH EVERY MET 

2986
02:32:12,837 --> 02:32:14,939
INCREASE BEING ASSOCIATED WITH A

2987
02:32:14,939 --> 02:32:17,041
10% RELATIVE RISK REDUCTION FOR 

2988
02:32:17,041 --> 02:32:19,477
THE RISK OF COPD.

2989
02:32:19,477 --> 02:32:20,611
CLINICALLY WHAT IS AN IMPORTANT 

2990
02:32:20,611 --> 02:32:23,147
IMPROVEMENT IN CRF IF WE ASSESS 

2991
02:32:23,147 --> 02:32:26,617
IT OVER TIME IN AN INDIVIDUAL, 

2992
02:32:26,617 --> 02:32:28,186
REALLY IN DATA FROM HEART 

2993
02:32:28,186 --> 02:32:30,822
FAILURE STUDY LARGE RANDOMIZED 

2994
02:32:30,822 --> 02:32:33,624
CONTROL TRIAL SUGGESTS ANY 

2995
02:32:33,624 --> 02:32:37,729
IMPROVEMENT EVEN 5% OF CRF IS 

2996
02:32:37,729 --> 02:32:39,630
CONSIDERED HIGHLY CLINICALLY 

2997
02:32:39,630 --> 02:32:40,798
SIGNIFICANT ASSOCIATES WITH 

2998
02:32:40,798 --> 02:32:44,802
LOWER RISK FOR CARDIOVASCULAR 

2999
02:32:44,802 --> 02:32:50,875
MORTALITY AND HOSPITALIZATION.

3000
02:32:50,875 --> 02:32:56,080
BUT IN ADDITION TO PREVENTION OF

3001
02:32:56,080 --> 02:32:56,814
RESPIRATORY DISEASE MORTALITY 

3002
02:32:56,814 --> 02:33:01,352
AND WHAT QUALITY OF LIFE AND IT 

3003
02:33:01,352 --> 02:33:03,921
DRIVES QUALITY OF LIFE 

3004
02:33:03,921 --> 02:33:06,057
PARTICULARLY IN PATIENT WITH 

3005
02:33:06,057 --> 02:33:06,257
COPD.

3006
02:33:06,257 --> 02:33:09,761
IN A STUDY OVER 10 YEARS AGO IF 

3007
02:33:09,761 --> 02:33:11,696
THE AUTHOR HAS SHOWN PATIENTS 

3008
02:33:11,696 --> 02:33:14,766
WITH COPD PRESENT A DRAMATICALLY

3009
02:33:14,766 --> 02:33:19,837
LOWER VO2 PEAK COMPARED TO 

3010
02:33:19,837 --> 02:33:22,640
HEALTHY CONTROLS IN ABSOLUTE 

3011
02:33:22,640 --> 02:33:26,344
VALUE IN MILLIMETERS PER MINUTE 

3012
02:33:26,344 --> 02:33:32,817
AND THE VO2 IS ADJUSTED TO 

3013
02:33:32,817 --> 02:33:35,586
COMPARE BODY SIZES AND THE 

3014
02:33:35,586 --> 02:33:36,621
AUTHORS ASSESSED OXYGEN 

3015
02:33:36,621 --> 02:33:39,390
CONSUMPTION DURING ACTIVITIES OF

3016
02:33:39,390 --> 02:33:41,125
DAILY LIVING.

3017
02:33:41,125 --> 02:33:44,195
WHAT THEY FOUND IN PANEL A IS 

3018
02:33:44,195 --> 02:33:46,264
PATIENTS WITH COPD UTILIZED A 

3019
02:33:46,264 --> 02:33:48,800
SIMILAR AMOUNT OF OXYGEN TO 

3020
02:33:48,800 --> 02:33:52,236
CONDUCT ACTIVITIES OF DAILY 

3021
02:33:52,236 --> 02:33:58,743
LIVING BUT THE PERCENTAGE OF 

3022
02:33:58,743 --> 02:34:01,612
PEAK VO2 IS HIGH IN SOME ALMOST 

3023
02:34:01,612 --> 02:34:04,382
90% OF THEIR MAX WHICH YOU CAN 

3024
02:34:04,382 --> 02:34:07,452
IMAGINE IS LIMITING THE 

3025
02:34:07,452 --> 02:34:08,619
ACTIVITIES THAT YOU CONDUCT 

3026
02:34:08,619 --> 02:34:10,421
BECAUSE EVEN JUST BY PUTTING 

3027
02:34:10,421 --> 02:34:12,824
THEIR CLOTHES ON OUR CLEANING 

3028
02:34:12,824 --> 02:34:15,827
THE DISHES OR FLOOR THEY'RE ALL 

3029
02:34:15,827 --> 02:34:18,663
RIGHT ALMOST 70 TO 80% OF THEIR 

3030
02:34:18,663 --> 02:34:21,299
MAX WHICH DOES NOT ALLOW THEM TO

3031
02:34:21,299 --> 02:34:22,733
CONDUCT THIS TYPE OF ACTIVITY 

3032
02:34:22,733 --> 02:34:28,239
FOR A LONG PERIOD OF TIME.

3033
02:34:28,239 --> 02:34:29,740
THERE'S INDIVIDUALS PRESENTING 

3034
02:34:29,740 --> 02:34:35,446
LOWER VO2 PEAK SUGGESTING BY 

3035
02:34:35,446 --> 02:34:36,814
IMPROVING NUTRITIONAL STATUS WE 

3036
02:34:36,814 --> 02:34:46,290
CAN IMPROVE VO2 PEAK AS WELL.

3037
02:34:46,290 --> 02:34:50,361
HOW CAN WE IMPROVE DIET QUALITY 

3038
02:34:50,361 --> 02:34:51,329
AND CRF.

3039
02:34:51,329 --> 02:34:56,601
THERE'S A STUDY IN HEALTHY 

3040
02:34:56,601 --> 02:35:00,238
INDIVIDU

3041
02:35:00,238 --> 02:35:02,373
INDIVIDUALS WE'RE SHOWING IN 

3042
02:35:02,373 --> 02:35:03,241
INDIVIDUALS WITHOUT COPD OR 

3043
02:35:03,241 --> 02:35:06,310
HEART DISEASE INDIVIDUALS THAT 

3044
02:35:06,310 --> 02:35:09,280
PRESENTED GREATER ADHERENCE TO 

3045
02:35:09,280 --> 02:35:15,486
HEALTHIER DIETARY PATTERN 

3046
02:35:15,486 --> 02:35:22,026
SHOWING ADHERENCE TO A HEALTHY 

3047
02:35:22,026 --> 02:35:26,030
INDEX AND MEDITERRANEAN SCORE 

3048
02:35:26,030 --> 02:35:27,098
WAS ASSOCIATED WITH THE PEAK AND

3049
02:35:27,098 --> 02:35:29,267
GREATER ADHERENCE TO THE DIETARY

3050
02:35:29,267 --> 02:35:33,905
PATTERN WAS ALSO ASSOCIATED WITH

3051
02:35:33,905 --> 02:35:38,409
LOWER SLOPE SUGGESTING A GREATER

3052
02:35:38,409 --> 02:35:43,214
PULMONARY VASCULAR FUNCTION 

3053
02:35:43,214 --> 02:35:46,250
THERE'S ANY ASSOCIATION WITH 

3054
02:35:46,250 --> 02:35:47,752
GREATER PULMONARY VASCULAR 

3055
02:35:47,752 --> 02:35:48,019
FUNCTION.

3056
02:35:48,019 --> 02:35:53,991
WHAT ABOUT IN PATIENTS WITH 

3057
02:35:53,991 --> 02:35:58,563
ACTUAL DISEASE WITH COPD?

3058
02:35:58,563 --> 02:36:01,933
THE PEAK WAS USED MORE ROUTINELY

3059
02:36:01,933 --> 02:36:05,903
IN PATIENTS WITH COPD AND TEST 

3060
02:36:05,903 --> 02:36:08,639
MORE CONSISTENTLY OVER STUDIES.

3061
02:36:08,639 --> 02:36:10,107
SOME DATA I'LL PRESENT WILL BE 

3062
02:36:10,107 --> 02:36:12,577
FROM OVER 20 YEARS AGO BUT ONE 

3063
02:36:12,577 --> 02:36:15,179
OF THE NUTRIENTS I WOULD SAY 

3064
02:36:15,179 --> 02:36:18,983
INVESTIGATED THE MOST WITH 

3065
02:36:18,983 --> 02:36:24,422
REGARDS TO PATIENTS WITH COPD IS

3066
02:36:24,422 --> 02:36:24,789
SUPPLEMENTATION.

3067
02:36:24,789 --> 02:36:26,457
IN THE META-ANALYSIS ON THE LEFT

3068
02:36:26,457 --> 02:36:30,394
SIDE OF THE SLIDE YOU CAN SEE 

3069
02:36:30,394 --> 02:36:36,434
OVER ALL THE EVIDENCE DOES NOT 

3070
02:36:36,434 --> 02:36:37,635
SUPPORT THAT SUPPLEMENTATION 

3071
02:36:37,635 --> 02:36:39,337
IMPROVES PEAK IN PATIENTS WITH 

3072
02:36:39,337 --> 02:36:40,438
COPD.

3073
02:36:40,438 --> 02:36:42,173
IN THE OTHER STUDY ON THE RIGHT 

3074
02:36:42,173 --> 02:36:46,477
SIDE YOU CAN SEE ANOTHER STUDY 

3075
02:36:46,477 --> 02:36:49,480
WHERE THE NITRATE IS 

3076
02:36:49,480 --> 02:36:51,148
SUPPLEMENTED TO ENHANCE PATIENTS

3077
02:36:51,148 --> 02:36:53,851
WITH COPD AND THE PEAK MET WAS 

3078
02:36:53,851 --> 02:36:58,256
NOT SIGNIFICANTLY GREATER IN 

3079
02:36:58,256 --> 02:37:00,091
PATIENTS RANDOMIZED AND THERE 

3080
02:37:00,091 --> 02:37:03,761
WAS SOME POTENTIAL TREND THAT 

3081
02:37:03,761 --> 02:37:05,263
SUGGESTED PATIENTS MAY BE ABLE 

3082
02:37:05,263 --> 02:37:07,765
TO MAINTAIN HIGHER LEVEL OF 

3083
02:37:07,765 --> 02:37:09,533
EXERCISE CAPACITY FOR LONGER 

3084
02:37:09,533 --> 02:37:14,038
PERIOD OF TIME.

3085
02:37:14,038 --> 02:37:14,905
HOWEVER, DID NOT RESULT IN 

3086
02:37:14,905 --> 02:37:15,673
QUALITY OF LIFE.

3087
02:37:15,673 --> 02:37:18,743
THE EVIDENCE DOES NOT SEEM TO 

3088
02:37:18,743 --> 02:37:20,811
SUPPORT THE SUPPLEMENTATION AT 

3089
02:37:20,811 --> 02:37:25,349
LATEST WITH REGARDS TO VO2 PEAK.

3090
02:37:25,349 --> 02:37:30,688
IN ADDITION TO INTERVENTION AND 

3091
02:37:30,688 --> 02:37:31,989
THIS HAS BEEN THOUGHT A BIT IS 

3092
02:37:31,989 --> 02:37:36,794
THE POLY UNSATURATED FATTY 

3093
02:37:36,794 --> 02:37:37,561
ACIDS.

3094
02:37:37,561 --> 02:37:40,264
PATIENTS WITH COPD WERE 

3095
02:37:40,264 --> 02:37:44,835
RANDOMIZED TO RECEIVING 

3096
02:37:44,835 --> 02:37:47,371
SUPPLEMENTATION OF A MIX OF 

3097
02:37:47,371 --> 02:37:49,473
POLLEE UNSATURATED FATTY ACIDS 

3098
02:37:49,473 --> 02:37:53,644
INCLUDING EPA AND DHA IN 

3099
02:37:53,644 --> 02:38:04,188
ADDITION TO PULMONARY CAPACITY 

3100
02:38:09,527 --> 02:38:12,797
IN THE POPULATION.

3101
02:38:12,797 --> 02:38:16,334
WHETHER THIS MIGHT BE DIFFERENT 

3102
02:38:16,334 --> 02:38:18,235
IN PATIENTS NOT UNDERGOING THIS 

3103
02:38:18,235 --> 02:38:20,071
IS UNKNOWN IN PATIENTS WITH VO2 

3104
02:38:20,071 --> 02:38:27,511
PEAK.

3105
02:38:27,511 --> 02:38:32,550
ANOTHER INTERESTING STUDY WITH 

3106
02:38:32,550 --> 02:38:36,053
YOU UTILIZING CREATINE 

3107
02:38:36,053 --> 02:38:44,795
SUPPLEMENTATION AND THEY WERE 

3108
02:38:44,795 --> 02:38:47,465
RANDOMIZED WITH GLUCOSE SOLUTION

3109
02:38:47,465 --> 02:38:51,502
AND CREATINE SUPPLEMENTATION 

3110
02:38:51,502 --> 02:38:53,571
RESULTS IN MORE FAVORABLE BODY 

3111
02:38:53,571 --> 02:39:02,113
COMPOSITION AND IMPROVEMENTS IN 

3112
02:39:02,113 --> 02:39:06,016
SKELETAL MUSCLE STRENGTH AND 

3113
02:39:06,016 --> 02:39:08,285
THERE WAS NO PEAK WITH CREATINE 

3114
02:39:08,285 --> 02:39:09,320
SUPPLEMENTATION AND THE STUDY 

3115
02:39:09,320 --> 02:39:11,522
WAS A SMALL SAMPLE AND 

3116
02:39:11,522 --> 02:39:13,324
APPROPRIATELY POWERED TRIALS TO 

3117
02:39:13,324 --> 02:39:19,063
LOOK AT DIFFERENCES IN VO 2 PEAK

3118
02:39:19,063 --> 02:39:20,030
ARE SOMETIMES IN THE HUNDREDS 

3119
02:39:20,030 --> 02:39:22,066
AND THERE'S A POSSIBILITY THE 

3120
02:39:22,066 --> 02:39:25,836
STUDY WAS LIKELY UNDER POWERED 

3121
02:39:25,836 --> 02:39:29,206
AND WILL REQUIRE A RANDOMIZED 

3122
02:39:29,206 --> 02:39:31,842
TRIAL TO SEE IF CREATINE 

3123
02:39:31,842 --> 02:39:32,676
SUPPLEMENTATION WOULD BE 

3124
02:39:32,676 --> 02:39:36,847
BENEFICIAL IN THIS POPULATION.

3125
02:39:36,847 --> 02:39:39,683
COLLECTED EVERYDAY IN REGARDS TO

3126
02:39:39,683 --> 02:39:46,490
THE INTERVENTION WITH VO2 PEAK 

3127
02:39:46,490 --> 02:39:48,292
AND THERE HASN'T BEEN MACHINE 

3128
02:39:48,292 --> 02:39:50,694
PROGRESS EXCEPT A COUPLE SMALL 

3129
02:39:50,694 --> 02:39:50,928
STUDIES.

3130
02:39:50,928 --> 02:39:52,129
HOPEFULLY THIS WILL STIMULATE 

3131
02:39:52,129 --> 02:39:53,531
SOME OF THE PEOPLE HERE IN THE 

3132
02:39:53,531 --> 02:39:55,633
AUDIENCE TO CONDUCT MORE 

3133
02:39:55,633 --> 02:39:57,902
RESEARCH FOCUSSING ON THE VO2 

3134
02:39:57,902 --> 02:39:59,270
PEAK CONSIDERING THE IMPORTANCE 

3135
02:39:59,270 --> 02:39:59,804
OF THE PARAMETERS IN THE 

3136
02:39:59,804 --> 02:40:04,775
POPULATION.

3137
02:40:04,775 --> 02:40:06,677
SO AS I GROUP WE'RE PARTICULARLY

3138
02:40:06,677 --> 02:40:08,279
INTERESTED IN THE ROLE OF 

3139
02:40:08,279 --> 02:40:09,713
UNSATURATED FATTY ACID IN THE 

3140
02:40:09,713 --> 02:40:12,950
FORM OF FOOD.

3141
02:40:12,950 --> 02:40:16,253
THIS IS REALLY FOLLOWING THE 

3142
02:40:16,253 --> 02:40:17,421
PRESENTATION AND MENTIONED THE 

3143
02:40:17,421 --> 02:40:18,889
IMPORTANCE OF UTILIZING FOOD 

3144
02:40:18,889 --> 02:40:21,158
INSTEAD OF DIETARY SUPPLEMENTS.

3145
02:40:21,158 --> 02:40:22,359
IN THIS WE'RE PARTICULARLY 

3146
02:40:22,359 --> 02:40:26,130
INTERESTED IN WORKING WITH 

3147
02:40:26,130 --> 02:40:28,699
PATIENTS WITH OVERLAPSE WITH 

3148
02:40:28,699 --> 02:40:30,801
PATIENTS WITH COPD.

3149
02:40:30,801 --> 02:40:36,507
MANY PATIENTS DID HAVE COPD.

3150
02:40:36,507 --> 02:40:43,347
WHAT WE FOUND IN ANALYSIS AND 

3151
02:40:43,347 --> 02:40:44,014
PRESENTED FAVORABLE EXERCISE 

3152
02:40:44,014 --> 02:40:45,850
CAPACITY AND BETTER BODY 

3153
02:40:45,850 --> 02:40:50,688
COMPOSITION AND FUNCTION.

3154
02:40:50,688 --> 02:40:54,992
WE CONDUCTED AND WE FOUND THAT 

3155
02:40:54,992 --> 02:40:58,762
WHEN MICE WERE FED WITH HIGH FAT

3156
02:40:58,762 --> 02:41:04,435
DIETS THE ONES EATING HIGH 

3157
02:41:04,435 --> 02:41:08,506
UNSATURATED FATTY ACIDED DID NOT

3158
02:41:08,506 --> 02:41:11,475
GAIN WEIGHT BUT HAD BETTER 

3159
02:41:11,475 --> 02:41:12,309
CARDIAC FUNCTION AND THIS 

3160
02:41:12,309 --> 02:41:14,445
PRELIMINARY DATA LED TO US THE 

3161
02:41:14,445 --> 02:41:17,047
PILOT STUDY A SINGLE ARM STUDY 

3162
02:41:17,047 --> 02:41:20,818
IN A SMALL STUDY SUPPLEMENTED 

3163
02:41:20,818 --> 02:41:25,689
THE DIET WITH FOOD SUCH AS EXTRA

3164
02:41:25,689 --> 02:41:28,425
VIRGIN OLIVE OIL AND NUTS AND 

3165
02:41:28,425 --> 02:41:31,495
WERE LOADING PATIENTS WITH THE 

3166
02:41:31,495 --> 02:41:37,768
MINIMUM OF FOUR TABLESPOONS FOR 

3167
02:41:37,768 --> 02:41:40,804
CONSUMPTION AND DIET WAS 

3168
02:41:40,804 --> 02:41:43,741
IMPROVED WHICH WAS ACCESSIBLE 

3169
02:41:43,741 --> 02:41:45,609
WITH DIETARY RECALL AS WELL AS 

3170
02:41:45,609 --> 02:41:48,245
PLASMA FATTY ACID AND MO

3171
02:41:48,245 --> 02:41:54,919
MONOUNSATURATED FATTY ACID AND 

3172
02:41:54,919 --> 02:41:56,353
CHANGES IN CAPACITY.

3173
02:41:56,353 --> 02:42:00,291
THIS LED US TO THE STUDY A 

3174
02:42:00,291 --> 02:42:01,792
RANDOMIZED CROSSOVER STUDY TO 

3175
02:42:01,792 --> 02:42:03,360
DETERMINE WHETHER OUR INITIAL 

3176
02:42:03,360 --> 02:42:06,330
FINDING COULD BE REPLICATED IN A

3177
02:42:06,330 --> 02:42:07,364
RANDOMIZED CONTROL FASHION.

3178
02:42:07,364 --> 02:42:11,535
WE'RE ASSESSING BODY COMPOSITION

3179
02:42:11,535 --> 02:42:20,244
AND NON-INVASIVE OF DETERMINATES

3180
02:42:20,244 --> 02:42:21,779
AND WILL BREAK A CLINICAL 

3181
02:42:21,779 --> 02:42:27,685
SESSION NEXT WEEK AT THE HEART  

3182
02:42:27,685 --> 02:42:28,886
ASSOCIATION OF AMERICA.

3183
02:42:28,886 --> 02:42:31,822
IN CONCLUSION WE INVOLVE MORE 

3184
02:42:31,822 --> 02:42:33,691
CLINICIANS SUCH AS REGISTERED 

3185
02:42:33,691 --> 02:42:35,159
DIETITIANS TRAINED TO ASSESS 

3186
02:42:35,159 --> 02:42:37,127
NUTRITIONAL STATUS IN OUR 

3187
02:42:37,127 --> 02:42:42,166
PATIENTS INCLUDING PATIENTS WITH

3188
02:42:42,166 --> 02:42:43,534
RESPIRATORY DISEASE AND WERE 

3189
02:42:43,534 --> 02:42:46,503
ABLE TO OPTIMIZE THE ENERGY AND 

3190
02:42:46,503 --> 02:42:48,806
INTAKE WHICH WE KNOW WORKS AND 

3191
02:42:48,806 --> 02:42:50,040
UNDERGOING THAT INTERVENTION 

3192
02:42:50,040 --> 02:42:52,009
WILL IMPROVE IF IT MEETS THEIR 

3193
02:42:52,009 --> 02:42:53,677
ENERGY AND PROTEIN REQUIREMENTS.

3194
02:42:53,677 --> 02:42:55,546
ONCE WE HAVE ACHIEVED THIS, WE 

3195
02:42:55,546 --> 02:42:58,549
CAN FINALLY DETERMINE WHETHER WE

3196
02:42:58,549 --> 02:43:00,784
CAN OPTIMIZE THE DIETARY PATTERN

3197
02:43:00,784 --> 02:43:01,752
IN THE POPULATION WHICH AT THIS 

3198
02:43:01,752 --> 02:43:05,322
POINT WE DO NOT KNOW WHETHER 

3199
02:43:05,322 --> 02:43:07,891
THERE'S ANY DIETARY PATTERNS 

3200
02:43:07,891 --> 02:43:10,561
WITH REGARDS TO IMPROVEMENT IN 

3201
02:43:10,561 --> 02:43:11,795
RESPIRATORY FITNESS AND QUALITY 

3202
02:43:11,795 --> 02:43:14,865
OF LIFE AND CLINICAL OUTCOMES.

3203
02:43:14,865 --> 02:43:16,600
SO I REALLY HOPE IN THE FUTURE 

3204
02:43:16,600 --> 02:43:20,337
WE'LL SEE MORE MECHANISTIC TYPE 

3205
02:43:20,337 --> 02:43:22,573
CLINICAL TRIALS USING VO2 PEAK 

3206
02:43:22,573 --> 02:43:28,112
AS A SURROGATE OF OUTCOMES AND 

3207
02:43:28,112 --> 02:43:30,614
UTILIZING DIETARY STRATEGIES BIG

3208
02:43:30,614 --> 02:43:34,985
CONTROL FEEDING STUDIES AND 

3209
02:43:34,985 --> 02:43:36,420
LONG-TERM FREE LIVING STUDIES 

3210
02:43:36,420 --> 02:43:38,956
AND THIS LACKS IN THE FIELD AND 

3211
02:43:38,956 --> 02:43:40,557
WE TEND TO DO SHORT TERM STUDIES

3212
02:43:40,557 --> 02:43:42,993
AND MIGHT MISS THE OPPORTUNITY 

3213
02:43:42,993 --> 02:43:45,195
TO REALLY ADDRESS THE BARRIERS 

3214
02:43:45,195 --> 02:43:48,465
RELATED TO LONG-TERM ADHERENCE.

3215
02:43:48,465 --> 02:43:52,603
IF THE BARRIERS ARISE WE'RE 

3216
02:43:52,603 --> 02:43:55,072
WILLING TO FIND ALTERNATIVE 

3217
02:43:55,072 --> 02:43:57,007
STRATEGIES BUT IF IT WORKS IN 

3218
02:43:57,007 --> 02:43:59,677
IMPROVING RESPIRATORY FITNESS WE

3219
02:43:59,677 --> 02:44:02,012
NEED TO SUPPORT MULTI-CENTERED 

3220
02:44:02,012 --> 02:44:03,080
RANDOMIZED TRIALS FOR SUPPORT 

3221
02:44:03,080 --> 02:44:04,548
AND FUNDING TO DETERMINE WHETHER

3222
02:44:04,548 --> 02:44:07,251
THE INTERVENTIONS WERE ALSO ON 

3223
02:44:07,251 --> 02:44:08,786
CLINICAL OUTCOMES SUCH AS ALL 

3224
02:44:08,786 --> 02:44:10,554
CAUSE MORTALITY AND RESPIRATORY 

3225
02:44:10,554 --> 02:44:16,560
DISEASE RELATED MORTALITY.

3226
02:44:16,560 --> 02:44:24,268
THANK YOU FOR YOUR ATTENTION.

3227
02:44:24,268 --> 02:44:26,103
>> CAN NEXT DR. WOOD ON
THE 

3228
02:44:26,103 --> 02:44:27,504
EFFICACY OF HEALTHY DIETS IN 

3229
02:44:27,504 --> 02:44:28,772
PREVENTION AND CONTROL OF 

3230
02:44:28,772 --> 02:44:31,575
CHRONIC RESPIRATORY DISEASES.

3231
02:44:31,575 --> 02:44:32,209
I'LL TURN IT OVER TO YOU, 

3232
02:44:32,209 --> 02:44:38,248
DR. WOOD.

3233
02:44:38,248 --> 02:44:40,084
>> THANKS VERY MUCH, DR.
MA.

3234
02:44:40,084 --> 02:44:42,953
CAN YOU HEAR ME OKAY.

3235
02:44:42,953 --> 02:44:44,788
>> YES.

3236
02:44:44,788 --> 02:44:53,897
>> THANK YOU.

3237
02:44:53,897 --> 02:44:56,500
TODAY I'LL CONCENTRATE ON 

3238
02:44:56,500 --> 02:44:58,435
HEALTHY DIETS.

3239
02:44:58,435 --> 02:44:59,436
I HAVE NO DISCLOSURES.

3240
02:44:59,436 --> 02:45:06,977
BEFORE I START I WANTED TO PAINT

3241
02:45:06,977 --> 02:45:09,313
A BIT OF A PICTURE WHEN I USE 

3242
02:45:09,313 --> 02:45:10,948
THE TERM HEALTHY DIET AND THINGS

3243
02:45:10,948 --> 02:45:12,716
YOU LOOK FOR IN A PROFILE OF A 

3244
02:45:12,716 --> 02:45:15,753
HEALTHY DIET.

3245
02:45:15,753 --> 02:45:16,520
ONE IS ENERGY BALANCE BUT 

3246
02:45:16,520 --> 02:45:18,589
THERE'S OTHER THINGS SUCH AS 

3247
02:45:18,589 --> 02:45:20,190
CONSUMPTION OF HEALTHY FATS SO 

3248
02:45:20,190 --> 02:45:29,666
HIGH INTAKE OF OMEGA 3 AND LOW 

3249
02:45:30,167 --> 02:45:32,336
IN TAKE OF UNHEALTHY FATS AND A 

3250
02:45:32,336 --> 02:45:35,205
HIGH FIBER INTAKE AND HIGH 

3251
02:45:35,205 --> 02:45:37,374
ANTIOXIDANT INTAKE AND LOW 

3252
02:45:37,374 --> 02:45:39,943
INTAKE OF THINGS SUCH AS REFINED

3253
02:45:39,943 --> 02:45:41,278
CARBOHYDRATES, SODIUM AND 

3254
02:45:41,278 --> 02:45:41,512
ALCOHOL.

3255
02:45:41,512 --> 02:45:43,447
SO NOW I'M GOING TO TALK THROUGH

3256
02:45:43,447 --> 02:45:45,249
A FEW DIFFERENT DIETS WHICH YOU 

3257
02:45:45,249 --> 02:45:46,617
WOULD SEE THAT WOULD FIT IN THAT

3258
02:45:46,617 --> 02:45:51,655
PROFILE.

3259
02:45:51,655 --> 02:45:56,160
THE FIRST WAS ONE UNDERTAKEN IN 

3260
02:45:56,160 --> 02:46:00,230
OUR LABORATORY USING A HIGH 

3261
02:46:00,230 --> 02:46:05,402
VERSUS LOW FRUIT AND VEGETABLE 

3262
02:46:05,402 --> 02:46:08,572
DIET IN ADULTS AN THE PEOPLE 

3263
02:46:08,572 --> 02:46:11,241
WERE RANDOMIZED WITH HIGH FRUIT 

3264
02:46:11,241 --> 02:46:14,311
AND VEGETABLE OR LOW FRUIT AND 

3265
02:46:14,311 --> 02:46:16,647
VEGETABLE DIET, GREATER THAN 

3266
02:46:16,647 --> 02:46:20,417
SEVEN SERVINGS A DAY OF VERSUS 

3267
02:46:20,417 --> 02:46:21,985
LESS THAN THREE PER DAY.

3268
02:46:21,985 --> 02:46:26,023
AND THE RESULTS I WANTED TO 

3269
02:46:26,023 --> 02:46:27,124
SHARE FROM THAT TRIAL WERE FIRST

3270
02:46:27,124 --> 02:46:32,262
IF YOU HOOK AT THE GRAPH ON THE 

3271
02:46:32,262 --> 02:46:34,431
LEFT SIDE, THIG DEMONSTRATED 

3272
02:46:34,431 --> 02:46:36,600
WHAT HAPPENS IN PEOPLE WHO 

3273
02:46:36,600 --> 02:46:38,635
ADOPTED THIS DIET.

3274
02:46:38,635 --> 02:46:42,139
THEY HAD AN INCREASED IN 

3275
02:46:42,139 --> 02:46:43,674
SYSTEMIC INFLAMMATION AND COPD 

3276
02:46:43,674 --> 02:46:45,442
AND INCREASE IN AIRWAY 

3277
02:46:45,442 --> 02:46:49,713
INFLAMMATION REFLECTED IN 

3278
02:46:49,713 --> 02:46:51,148
INCREASING SPUTUM TOTAL CELL 

3279
02:46:51,148 --> 02:46:51,615
COUNT.

3280
02:46:51,615 --> 02:46:56,653
THE OTHER THING INTERESTING ON 

3281
02:46:56,653 --> 02:47:00,224
THE RIGHT SIDE DESCRIBING TIME 

3282
02:47:00,224 --> 02:47:01,291
TO EXACERBATION.

3283
02:47:01,291 --> 02:47:06,230
WE FOUND IF YOU LOOK AT THE 

3284
02:47:06,230 --> 02:47:07,731
SUBJECTS ON THE LOW FRUIT AND 

3285
02:47:07,731 --> 02:47:12,002
VEGETABLE DIET THEY HAD A 1.36 

3286
02:47:12,002 --> 02:47:14,872
TIMES INCREASED RISK OF HAVING 

3287
02:47:14,872 --> 02:47:16,673
AN EXACERBATION DURING THE 

3288
02:47:16,673 --> 02:47:26,884
INTERVENTION PERIOD.

3289
02:47:26,884 --> 02:47:30,320
IT WAS A THREE-MINUTE 

3290
02:47:30,320 --> 02:47:30,654
INTERVENTION.

3291
02:47:30,654 --> 02:47:32,723
WE ALSO -- THREE-MONTH 

3292
02:47:32,723 --> 02:47:34,191
INTERVENTION STUDY.

3293
02:47:34,191 --> 02:47:38,228
WE CONDUCTED A HIGH VERSUS LOW 

3294
02:47:38,228 --> 02:47:41,832
FRUIT AND VEGETABLE DIET IN 67 

3295
02:47:41,832 --> 02:47:43,700
CHILDREN AGE 3 TO 11 YEARS.

3296
02:47:43,700 --> 02:47:46,703
FOR ETHICAL REASONS WE ONLY 

3297
02:47:46,703 --> 02:47:48,639
RECRUITED CHILDREN WHO WERE 

3298
02:47:48,639 --> 02:47:51,308
USUALLY CONSUMING A LOW FRUIT 

3299
02:47:51,308 --> 02:47:55,479
AND VEGETABLE DIET AND HALF 

3300
02:47:55,479 --> 02:47:58,282
MAINTAINED THAT DIET WHERE THE 

3301
02:47:58,282 --> 02:48:00,183
OTHER HALF CONSUMED A HIGH 

3302
02:48:00,183 --> 02:48:03,553
VEGETABLE DIET AND 3.5 TO SEVEN 

3303
02:48:03,553 --> 02:48:04,721
SERVINGS TO FRUIT AND VEGETABLES

3304
02:48:04,721 --> 02:48:10,727
ADJUSTED FOR AGE.

3305
02:48:10,727 --> 02:48:17,067
THE K RESULTS WERE WERE ABLE TO 

3306
02:48:17,067 --> 02:48:19,536
ADJUST THIS IN THE COHORT.

3307
02:48:19,536 --> 02:48:22,172
ON THE FIRST THERE WAS THE GREEN

3308
02:48:22,172 --> 02:48:24,408
BARS ARE THE INTERVENTION GROUP 

3309
02:48:24,408 --> 02:48:27,077
AND SEE INCREASE IN FRUIT AND 

3310
02:48:27,077 --> 02:48:32,049
VEGETABLE INTAKE IN THE 

3311
02:48:32,049 --> 02:48:36,320
INTERVENTION GROUP.

3312
02:48:36,320 --> 02:48:43,794
THE SECOND IS THE NUTRIENTS 

3313
02:48:43,794 --> 02:48:45,529
DERIVED FROM FRUIT AND 

3314
02:48:45,529 --> 02:48:46,897
VEGETABLES AND THE THIRD SHOWS 

3315
02:48:46,897 --> 02:48:47,731
EXACERBATION RISK.

3316
02:48:47,731 --> 02:48:50,834
WHAT THIS IS SHOWING YOU IS THAT

3317
02:48:50,834 --> 02:48:52,736
THERE WAS IN THE INTERVENTION 

3318
02:48:52,736 --> 02:49:01,578
GROUP ONCE AGAIN THE GREEN BARS 

3319
02:49:01,578 --> 02:49:02,679
THERE WAS A DECREASE IN THE 

3320
02:49:02,679 --> 02:49:04,448
NUMBER OF CHILDREN WITH TWO OR 

3321
02:49:04,448 --> 02:49:07,684
MORE INTERVENTIONS DURING THE 

3322
02:49:07,684 --> 02:49:12,155
SIX MONTH INTERVENTION PERIOD AS

3323
02:49:12,155 --> 02:49:14,891
A RESULT OF THE HIGH FRUIT AND 

3324
02:49:14,891 --> 02:49:16,727
VEGETABLE DIET.

3325
02:49:16,727 --> 02:49:18,562
THERE'S THERE IS BEEN A COUPLE 

3326
02:49:18,562 --> 02:49:29,106
TRIALS IN COPD USING THIS  HIGH 

3327
02:49:29,339 --> 02:49:30,140
FRUIT AND VEGETABLE THE FIRST 

3328
02:49:30,140 --> 02:49:33,543
USED AN INTERVENTION WHERE THERE

3329
02:49:33,543 --> 02:49:39,182
WAS AN INCREASE OF ONE PORTION 

3330
02:49:39,182 --> 02:49:49,626
PER DAY OF HIGH FRUIT AND 

3331
02:49:50,794 --> 02:49:52,729
VEGETABLE AND THE RESULT IN THE 

3332
02:49:52,729 --> 02:49:58,735
TOP RIGHT HAPPENED CORNER.

3333
02:49:58,735 --> 02:50:00,337
RIGHT HAND CORNER THE LUNG 

3334
02:50:00,337 --> 02:50:01,738
FUNCTION THAT OCCURRED WAS 

3335
02:50:01,738 --> 02:50:04,241
REDUCED IN THE FRUIT AND 

3336
02:50:04,241 --> 02:50:06,009
VEGETABLE GROUP.IN THE COPD 

3337
02:50:06,009 --> 02:50:08,178
POPULATION YOU EXPECT 

3338
02:50:08,178 --> 02:50:09,446
PROGRESSIVE DECREASE IN LUNG 

3339
02:50:09,446 --> 02:50:10,747
FUNCTION AND THAT OCCURRED IN 

3340
02:50:10,747 --> 02:50:21,258
THE CONTROL GROUP BUT IN THE 

3341
02:50:21,658 --> 02:50:22,692
FRUIT AND VEGETABLE IT WAS 

3342
02:50:22,692 --> 02:50:25,095
REDUCED AND THAT'S PROMISING.

3343
02:50:25,095 --> 02:50:31,535
ANOTHER TRIAL PUBLISHED IN 2012.

3344
02:50:31,535 --> 02:50:33,870
IT'S A SMALL TRIAL IN COPD 

3345
02:50:33,870 --> 02:50:36,807
PATIENTS FOR 12 WEEKS AND USED 

3346
02:50:36,807 --> 02:50:40,710
AN INTERVENTION COMPARED TWO 

3347
02:50:40,710 --> 02:50:41,378
VERSUS FIVE FRUIT AND VEGETABLE 

3348
02:50:41,378 --> 02:50:44,147
SERVES PER DAY.

3349
02:50:44,147 --> 02:50:46,216
THEY DIDN'T SEE ANY EFFECT ON 

3350
02:50:46,216 --> 02:50:48,552
LUNG FUNCTION OR INFLAMMATION OR

3351
02:50:48,552 --> 02:50:49,953
OXIDATIVE STRESS.

3352
02:50:49,953 --> 02:50:51,788
WHETHER IT'S DUE TO THE SMALLER 

3353
02:50:51,788 --> 02:50:53,123
SAMPLE SIZE OR SHORT DURATION OF

3354
02:50:53,123 --> 02:50:59,396
THE TRIAL REMAINS TO BE SEEN.

3355
02:50:59,396 --> 02:51:01,965
SO NOW WE HAVE TO SWITCH GEARS 

3356
02:51:01,965 --> 02:51:03,800
AND TALK ABOUT SOME BIG 

3357
02:51:03,800 --> 02:51:06,269
CHALLENGES WE'VE DONE IN OUR LAB

3358
02:51:06,269 --> 02:51:12,042
WHERE WE USED IN ACUTE MODEL TO 

3359
02:51:12,042 --> 02:51:13,944
LOOK AT A FIX OF A FAST FOOD 

3360
02:51:13,944 --> 02:51:16,513
MEAL ON THE AIRWAYS.

3361
02:51:16,513 --> 02:51:21,485
WE USED 51A AAGE  ASTHMATIC ADU 

3362
02:51:21,485 --> 02:51:24,254
FOR FAST FOOD OR CONTROLLED 

3363
02:51:24,254 --> 02:51:24,454
MEAL.

3364
02:51:24,454 --> 02:51:28,158
THEY CONSUMED THE FEEL AND WERE 

3365
02:51:28,158 --> 02:51:33,730
GIVEN A BRONCHIAL DILATOR AND 

3366
02:51:33,730 --> 02:51:38,502
THE FAST FOOD MEAL WAS TWO BRECK

3367
02:51:38,502 --> 02:51:40,770
MUFFINS AND THE CONTROL WAS 

3368
02:51:40,770 --> 02:51:44,307
YOGURT.

3369
02:51:44,307 --> 02:51:46,776
THIS SHOWS THE K RESULTS.

3370
02:51:46,776 --> 02:51:50,580
ON THE LEFT SIDE WE'VE GOT THE 

3371
02:51:50,580 --> 02:51:55,352
FIX ON AIRWAY INFLAMMATION AND 

3372
02:51:55,352 --> 02:52:05,896
CAUSED AN INCREASE IN AIRWAY AND

3373
02:52:06,263 --> 02:52:15,071
AND THERE'S A RECEPTOR SHOWN TO 

3374
02:52:15,071 --> 02:52:17,207
BE ACTIVATED BY SATURATED FAT.

3375
02:52:17,207 --> 02:52:20,210
IN FOUR HOURS BOTH OF THOSE 

3376
02:52:20,210 --> 02:52:21,311
MARKERS OF AIRWAY INFLAMMATION 

3377
02:52:21,311 --> 02:52:21,645
INCREASED.

3378
02:52:21,645 --> 02:52:25,916
IF YOU LOOK AT THE CHART ON THE 

3379
02:52:25,916 --> 02:52:27,517
RIGHT-HAND SIDE THIS WAS AN 

3380
02:52:27,517 --> 02:52:28,785
UNEXPECTED AND INTERESTING 

3381
02:52:28,785 --> 02:52:29,452
FINDING.

3382
02:52:29,452 --> 02:52:34,724
LOOKING AT THE TIME COURSE THERE

3383
02:52:34,724 --> 02:52:41,431
YOU'VE GOT AT BASELINE AND 

3384
02:52:41,431 --> 02:52:46,803
LOOKING AT BRONCHIAL DILATION 

3385
02:52:46,803 --> 02:52:50,607
AND CONTROL THERE WAS AN 

3386
02:52:50,607 --> 02:52:52,809
INCREASE IN LUNG FUNCTION 

3387
02:52:52,809 --> 02:52:54,978
PROGRESS IN FOUR HOURS AND THERE

3388
02:52:54,978 --> 02:52:56,680
WAS AN INITIAL INCREASE IN LUNG 

3389
02:52:56,680 --> 02:52:58,181
FUNCTION AT TWO HOURS BUT THEN 

3390
02:52:58,181 --> 02:52:59,416
THAT DROPPED AWAY AT THREE AND 

3391
02:52:59,416 --> 02:53:01,918
FOUR HOURS SO AT FOUR HOURS THEY

3392
02:53:01,918 --> 02:53:03,954
WERE BACK TO BASELINE.

3393
02:53:03,954 --> 02:53:06,523
THAT WAS QUITE CLINICALLY 

3394
02:53:06,523 --> 02:53:10,393
IMPORTANT AND ONE SINGLE HIGH 

3395
02:53:10,393 --> 02:53:18,101
FAT MEAL CAN LEAD TO AN IMPAIRED

3396
02:53:18,101 --> 02:53:28,979
BRANK YAL DEL-- BRONCHIAL DILAT 

3397
02:53:34,918 --> 02:53:45,295
RESPONSE AND ADULTS WERE 

3398
02:53:46,329 --> 02:53:49,933
CONSUMING AN ISO CALORIC MEAL 

3399
02:53:49,933 --> 02:53:51,534
AND THE BASE VEHICLE WAS MARKED 

3400
02:53:51,534 --> 02:53:52,569
POTATO.

3401
02:53:52,569 --> 02:53:55,372
WE ADDED THAT DOUBLE CREAM FOR 

3402
02:53:55,372 --> 02:53:56,640
THE SATURATED FAT ARM AND 

3403
02:53:56,640 --> 02:54:00,510
SEPARATED OUT OIL FOR THE OMEGA 

3404
02:54:00,510 --> 02:54:04,247
6 FATTY ACID ARM AND SIMPLE 

3405
02:54:04,247 --> 02:54:05,081
CARBOHYDRATE WE USED WHITE JELLY

3406
02:54:05,081 --> 02:54:09,419
BEANS.

3407
02:54:09,419 --> 02:54:11,054
ONCE AGAIN WE LOOKED AT WHAT 

3408
02:54:11,054 --> 02:54:12,789
HAPPENED AFTER FOUR HOURS AND 

3409
02:54:12,789 --> 02:54:17,661
THIS CHART IN THE MIDDLE SHOWS 

3410
02:54:17,661 --> 02:54:19,062
WHAT HAPPENED SHOWS THE CHANGE 

3411
02:54:19,062 --> 02:54:24,401
IN SPUTUM CELLS AFTER FOUR 

3412
02:54:24,401 --> 02:54:26,202
HOURS.

3413
02:54:26,202 --> 02:54:30,073
AND SHOWS AND ONCE AGAIN THE 

3414
02:54:30,073 --> 02:54:35,645
CELL TYPE EFFECTED WAS 

3415
02:54:35,645 --> 02:54:38,148
NEUTROPHILS FOLLOWING THE FAT 

3416
02:54:38,148 --> 02:54:39,883
INTERVENTION.

3417
02:54:39,883 --> 02:54:42,252
WE CONFIRMED THE STUDY WITH THE 

3418
02:54:42,252 --> 02:54:44,020
SATURATED FAT COMPONENT DRIVING 

3419
02:54:44,020 --> 02:54:46,089
THE INCREASED AIRWAY 

3420
02:54:46,089 --> 02:54:46,489
NEUTROPHILS.

3421
02:54:46,489 --> 02:54:48,658
THAT NETWORK OF GENES YOU CAN 

3422
02:54:48,658 --> 02:54:52,796
SEE ON THE RIGHT-HAND SIDE 

3423
02:54:52,796 --> 02:54:57,233
DEMONSTRATES THIS IS ANALYSIS 

3424
02:54:57,233 --> 02:55:07,744
WHICH SHOWS GENES AND SO NOW 

3425
02:55:08,778 --> 02:55:13,350
I'LL MOVE ON TO ANOTHER TOPIC OF

3426
02:55:13,350 --> 02:55:13,550
DIET.

3427
02:55:13,550 --> 02:55:15,085
SO MEDITERRANEAN DIET IT 

3428
02:55:15,085 --> 02:55:19,622
INCLUDES A HIGH INTAKE OF FRUIT 

3429
02:55:19,622 --> 02:55:26,996
AND VEGETABLE, LEGUMES AND MOT  

3430
02:55:26,996 --> 02:55:31,134
MODERATE INTAKE OF OMEGA 3 FISH 

3431
02:55:31,134 --> 02:55:37,173
AND MEAT AND FATTY ACIDS.

3432
02:55:37,173 --> 02:55:39,943
AND IN ADULTS THERE WAS A 12 

3433
02:55:39,943 --> 02:55:42,746
WEEK STUDY THAT USED THE DIET IN

3434
02:55:42,746 --> 02:55:44,080
38 PEOPLE.

3435
02:55:44,080 --> 02:55:46,950
THE DIETARY BEHAVIOR CHANGES 

3436
02:55:46,950 --> 02:55:50,854
WERE ACHIEVED BUT THERE WERE 

3437
02:55:50,854 --> 02:55:55,592
MINIMAL CHANGES ON CLINICALLY 

3438
02:55:55,592 --> 02:55:59,095
OUTCOMES AND THE OFFICE 

3439
02:55:59,095 --> 02:56:00,630
CONCLUDED A LARGER TRIAL WAS 

3440
02:56:00,630 --> 02:56:01,898
NEEDED TO INTERROGATE THE 

3441
02:56:01,898 --> 02:56:04,934
EFFICACY OF THAT DIET IN THAT 

3442
02:56:04,934 --> 02:56:06,169
POPULATION.

3443
02:56:06,169 --> 02:56:08,805
IN CHILDREN THERE WAS ALSO A 

3444
02:56:08,805 --> 02:56:13,443
MEDITERRANEAN STUDY DONE IN A 

3445
02:56:13,443 --> 02:56:15,712
SIX-MONTH TRIAL, 64 CHILDREN SAW

3446
02:56:15,712 --> 02:56:18,681
A DECREASE IN AIRWAY 

3447
02:56:18,681 --> 02:56:19,015
INFLAMMATION.

3448
02:56:19,015 --> 02:56:22,752
ENOUGH TO SUGGEST THAT'S A DIET 

3449
02:56:22,752 --> 02:56:24,788
THAT WARRANTS FURTHER 

3450
02:56:24,788 --> 02:56:31,928
EXPLORATION IN ASTHMA.

3451
02:56:31,928 --> 02:56:33,930
SO LAST ONE I'D LIKE TO TALK 

3452
02:56:33,930 --> 02:56:37,367
ABOUT IS THE DASH FOR ASTHMA 

3453
02:56:37,367 --> 02:56:37,567
DIET.

3454
02:56:37,567 --> 02:56:42,305
THIS IS A BODY OF WORK THAT'S 

3455
02:56:42,305 --> 02:56:45,975
BEEN DRIVEN BY OUR CO-CHAIR 

3456
02:56:45,975 --> 02:56:47,477
PROFESSOR MA AND I'M SURE IT 

3457
02:56:47,477 --> 02:56:50,046
LOOKS FAMILIAR TO THE STUDY 

3458
02:56:50,046 --> 02:56:52,549
ORIGINALLY PUBLISHED IN 2016.

3459
02:56:52,549 --> 02:56:56,786
THIS DIET HAS A NUMBER OF 

3460
02:56:56,786 --> 02:56:58,021
DIFFERENT NUTRIENT TARGETS 

3461
02:56:58,021 --> 02:57:00,089
INCLUDING FAT, SATURATED FAT, 

3462
02:57:00,089 --> 02:57:02,859
PROTEIN, CHOLESTEROL, FIBER, 

3463
02:57:02,859 --> 02:57:04,794
MAGNESIUM, SODIUM, POTASSIUM.

3464
02:57:04,794 --> 02:57:07,363
THE INTERVENTION IS DELIVERED BY

3465
02:57:07,363 --> 02:57:09,365
A DIETICIAN BY BEHAVIOR CHANGE 

3466
02:57:09,365 --> 02:57:12,502
STRATEGIES AND THE FOCUS IS ON 

3467
02:57:12,502 --> 02:57:14,504
FRUIT AND VEGETABLES, LOW FAT 

3468
02:57:14,504 --> 02:57:16,940
DAIRY, TOTAL FAT AS A PERCENTAGE

3469
02:57:16,940 --> 02:57:19,876
OF ENERGY INTAKE AND SODIUM.

3470
02:57:19,876 --> 02:57:21,211
SO IN THE PILOT TRIAL THERE WAS 

3471
02:57:21,211 --> 02:57:22,745
SOME REALLY PROMISING RESULTS 

3472
02:57:22,745 --> 02:57:23,213
SHOWN THERE.

3473
02:57:23,213 --> 02:57:27,784
IT WAS A SIX-MONTH TRIAL OF 90 

3474
02:57:27,784 --> 02:57:28,785
PARTICIPANTS AND THERE WERE 

3475
02:57:28,785 --> 02:57:31,087
IMPROVEMENTS IN THE DASH DIET 

3476
02:57:31,087 --> 02:57:34,357
SCORE AND INCREASE IN FOOT AND 

3477
02:57:34,357 --> 02:57:35,124
VEGETABLES SERVED AND 

3478
02:57:35,124 --> 02:57:38,628
IMPROVEMENT IN THE ASTHMA 

3479
02:57:38,628 --> 02:57:39,996
QUALITY OF LIFE QUESTIONNAIRE 

3480
02:57:39,996 --> 02:57:42,866
BOTH IN OVER ALL AND ACTIVITIES 

3481
02:57:42,866 --> 02:57:46,970
DOMAIN.

3482
02:57:46,970 --> 02:57:49,639
ALSO INTERESTINGLY THERE WAS AN 

3483
02:57:49,639 --> 02:57:51,908
INCREASE IN THE PROPORTION OF 

3484
02:57:51,908 --> 02:57:55,278
PARTICIPANTS WHO SAW A 

3485
02:57:55,278 --> 02:57:56,779
CLINICALLY IMPORTANT DIFFERENCE 

3486
02:57:56,779 --> 02:58:00,583
IN ACQ ASTHMA QUALITY OF LIFE AT

3487
02:58:00,583 --> 02:58:05,588
SIX MONTHS.

3488
02:58:05,588 --> 02:58:09,125
THESE PROMISE IING RESULTS LED  

3489
02:58:09,125 --> 02:58:12,428
FUNDING OF AN NIH PROJECT TO 

3490
02:58:12,428 --> 02:58:16,232
FOLLOW UP AT THIS DIET IN A 

3491
02:58:16,232 --> 02:58:17,800
LARGER COHORT OF 325 

3492
02:58:17,800 --> 02:58:18,134
PARTICIPANTS.

3493
02:58:18,134 --> 02:58:22,105
I'M PRIVILEGED TO WORK ON THIS 

3494
02:58:22,105 --> 02:58:23,573
AND THE TRIAL WILL BE COMPLETED 

3495
02:58:23,573 --> 02:58:24,440
IN 2026.

3496
02:58:24,440 --> 02:58:26,976
WE'RE EXCITED TO SEE WHAT THE 

3497
02:58:26,976 --> 02:58:28,778
RESULTS FROM THAT TRIAL ARE 

3498
02:58:28,778 --> 02:58:36,786
GOING TO LEAD TO.

3499
02:58:36,786 --> 02:58:38,354
JUST TO SUMMARIZE IN TERMS OF 

3500
02:58:38,354 --> 02:58:40,790
WHOLE FOOD INTERVENTIONS, HIGH 

3501
02:58:40,790 --> 02:58:42,525
FRUIT AND VEGETABLE DIETS SHOW 

3502
02:58:42,525 --> 02:58:45,895
PROMISING RESULTS IN ADULTS AND 

3503
02:58:45,895 --> 02:58:50,934
CHILDREN WITH ASTHMA AND COPD.

3504
02:58:50,934 --> 02:58:52,802
THE MEDITERRANEAN DIET SHOWS 

3505
02:58:52,802 --> 02:58:54,604
PROMISING RESULTS IN CHILDHOOD 

3506
02:58:54,604 --> 02:58:57,073
ASTHMA AND THE DASH DIET HOLDS 

3507
02:58:57,073 --> 02:59:00,777
PROMISE IN TRIALS FOR ADULT WITH

3508
02:59:00,777 --> 02:59:07,183
ASTHMA AND CONVERSELY FAST FOOD 

3509
02:59:07,183 --> 02:59:08,785
AND SATURATED FAT IN PARTICULAR 

3510
02:59:08,785 --> 02:59:11,554
HAVE NEGATIVE OUTCOMES IN 

3511
02:59:11,554 --> 02:59:13,957
ASTHMA.

3512
02:59:13,957 --> 02:59:17,060
SO JUST TO FINISH WITH CURRENT 

3513
02:59:17,060 --> 02:59:18,294
RESEARCH GAPS.

3514
02:59:18,294 --> 02:59:19,529
SO THERE'S EXTENSIVE GAPS IN 

3515
02:59:19,529 --> 02:59:23,066
THIS SPACE.

3516
02:59:23,066 --> 02:59:27,470
IT'S REALLY LARGELY DUE TO THE 

3517
02:59:27,470 --> 02:59:28,371
COMPLEXITIES OF DELIVERING THESE

3518
02:59:28,371 --> 02:59:32,909
TYPES OF WHOLE FOOD 

3519
02:59:32,909 --> 02:59:33,343
INTERVENTIONS.

3520
02:59:33,343 --> 02:59:34,811
SO MANY MANY OPPORTUNITIES TO 

3521
02:59:34,811 --> 02:59:39,515
FILL IN SOME OF THOSE GAPS.

3522
02:59:39,515 --> 02:59:40,817
THE OPPORTUNITIES IN RESEARCH 

3523
02:59:40,817 --> 02:59:42,652
QUESTIONS SO I GUESS AS I'VE 

3524
02:59:42,652 --> 02:59:45,288
BEEN LISTENING TO SOME 

3525
02:59:45,288 --> 02:59:47,457
PRESENTATIONS, ONE OF THE KEY 

3526
02:59:47,457 --> 02:59:49,592
RESEARCH QUESTIONS THAT I THINK 

3527
02:59:49,592 --> 02:59:53,696
AND I HAVE IT INCLUDED ON THE 

3528
02:59:53,696 --> 02:59:57,634
LIST BUT HOW DO WE GET PEOPLE TO

3529
02:59:57,634 --> 02:59:59,068
MAKE THESE LONG-TERM AND 

3530
02:59:59,068 --> 03:00:00,803
SUBSTANTIAL CHANGES TO THEIR 

3531
03:00:00,803 --> 03:00:04,207
DIETS ON AN ONGOING BASIS?

3532
03:00:04,207 --> 03:00:07,677
I THINK WE NEED TO WORK WITH OUR

3533
03:00:07,677 --> 03:00:09,145
PUBLIC HEALTH COLLEAGUES IN HOW 

3534
03:00:09,145 --> 03:00:11,814
TO GET PEOPLE TO ADOPT HEALTHY 

3535
03:00:11,814 --> 03:00:14,017
DIETS AND BREAK DOWN BARRIERS 

3536
03:00:14,017 --> 03:00:14,217
THERE.

3537
03:00:14,217 --> 03:00:20,790
OTHER THINGS THAT I'VE LISTED 

3538
03:00:20,790 --> 03:00:23,660
ARE PROSPECTIVE STUDIES AND 

3539
03:00:23,660 --> 03:00:24,994
HEALTHY DIETS FOR DISEASE 

3540
03:00:24,994 --> 03:00:25,361
MANAGEMENT.

3541
03:00:25,361 --> 03:00:30,600
WE NEED MORE WORK UNDERSTANDING 

3542
03:00:30,600 --> 03:00:31,734
MECHANISMS OF HEALTHY DIET AND 

3543
03:00:31,734 --> 03:00:32,802
DISEASE PHENOTYPES.

3544
03:00:32,802 --> 03:00:38,741
THE IDEA OF PRECISION MEDICINE 

3545
03:00:38,741 --> 03:00:40,643
IS VERY LIKELY THAT DIFFERENT 

3546
03:00:40,643 --> 03:00:41,344
DISEASE PHENOTYPES WILL RESPOND 

3547
03:00:41,344 --> 03:00:44,080
TO DIETARY APPROACHES.

3548
03:00:44,080 --> 03:00:47,950
ONE EXAMPLE IS THE SATURATED FAT

3549
03:00:47,950 --> 03:00:52,789
HAS THE BIGGEST INFLUENCE ON 

3550
03:00:52,789 --> 03:00:58,528
AIRWAY NEUTROPHILS AND DISEASE 

3551
03:00:58,528 --> 03:00:59,095
FEEPT

3552
03:00:59,095 --> 03:01:04,767
PHENOTYPES AND HEALTHY DIET FOR 

3553
03:01:04,767 --> 03:01:10,440
OBESITY.

3554
03:01:10,440 --> 03:01:15,144
INDEPENDENT HOW CAN WE IMPROVE 

3555
03:01:15,144 --> 03:01:16,312
OBESITY JUST WITH DIET AND 

3556
03:01:16,312 --> 03:01:17,080
WEIGHT LOSS.

3557
03:01:17,080 --> 03:01:22,018
I'LL STOP THERE AND THANK YOU 

3558
03:01:22,018 --> 03:01:29,092
VERY MUCH AND I THINK UP TO ME 

3559
03:01:29,092 --> 03:01:32,795
TO INTRODUCE THE NEXT SPEAKER.

3560
03:01:32,795 --> 03:01:39,268
DR. PANDA IS AT THE SALK 

3561
03:01:39,268 --> 03:01:41,337
INSTITUTE AND TALK ABOUT TIME 

3562
03:01:41,337 --> 03:01:44,774
RESTRICTED FEEDING.

3563
03:01:44,774 --> 03:01:55,017
>> THANK YOU.

3564
03:01:57,120 --> 03:02:03,359
THANK YOU FOR INVITING ME.

3565
03:02:03,359 --> 03:02:04,827
THERE'S MY DISCLOSURE AND ARE 

3566
03:02:04,827 --> 03:02:12,835
TAKING ON TIME RESTRICTED 

3567
03:02:12,835 --> 03:02:20,777
FEEDING FOR LUNG OUTCOME AND 

3568
03:02:20,777 --> 03:02:25,715
DATA IN HUMAN INTERVENTION 

3569
03:02:25,715 --> 03:02:27,984
STUDIES FOR LUNG FUNCTION OR 

3570
03:02:27,984 --> 03:02:31,821
CARDIO PULMONARY FUNCTION.

3571
03:02:31,821 --> 03:02:33,623
HALF THE PRESENTATION IS FROM 

3572
03:02:33,623 --> 03:02:39,629
MICE AND I'LL PRODUCE THE TIME 

3573
03:02:39,629 --> 03:02:40,530
FEEDING.

3574
03:02:40,530 --> 03:02:45,034
BY REDUCE CALORIE INTAKE WE CAN 

3575
03:02:45,034 --> 03:02:48,805
IMPROVE HEALTH IN ANIMAL MODELS 

3576
03:02:48,805 --> 03:02:52,742
AND HUMANS ALSO IN ANIMALS TO 

3577
03:02:52,742 --> 03:02:54,243
HUMANS BY IMPROVING QUALITY OF 

3578
03:02:54,243 --> 03:03:01,083
DIET WE CAN IMPROVE HEALTH.

3579
03:03:01,083 --> 03:03:07,456
AND THE IDEA OF TIME RESTRICTED 

3580
03:03:07,456 --> 03:03:12,762
FEEDING CAN GO TO CIRCADIAN 

3581
03:03:12,762 --> 03:03:15,731
RHYTHM WITH AT DIFFERENT TIME OF

3582
03:03:15,731 --> 03:03:19,836
THE DAY THEY CAN LOOK AT 

3583
03:03:19,836 --> 03:03:21,904
DETOXIFICATION OF MOLECULES AND 

3584
03:03:21,904 --> 03:03:28,611
PHYSIOLOGIC METABOLISM BEHAVIOR 

3585
03:03:28,611 --> 03:03:30,847
EVEN LUNG FUNCTION.

3586
03:03:30,847 --> 03:03:34,250
ALMOST 12 YEARS AGO WE DID A 

3587
03:03:34,250 --> 03:03:35,218
VERY SIMPLE EXPERIMENT.

3588
03:03:35,218 --> 03:03:40,590
WE HAD FOUR GROUPS OF MICE SAME 

3589
03:03:40,590 --> 03:03:40,756
AGE.

3590
03:03:40,756 --> 03:03:43,059
MALE MICE.

3591
03:03:43,059 --> 03:03:53,569
THEY WERE FED NORMAL CHOW AND 

3592
03:04:00,409 --> 03:04:04,747
WERE GIVEN ACCESS EIGHT TO TEN 

3593
03:04:04,747 --> 03:04:07,717
HOURS AND EAT FOOD IN THAT TIME 

3594
03:04:07,717 --> 03:04:11,721
INTERVAL AND TWO HIGH-FAT DIET 

3595
03:04:11,721 --> 03:04:15,024
COHORT.

3596
03:04:15,024 --> 03:04:25,568
THE FOOD INTAKE AND LOOK AT THE 

3597
03:04:32,842 --> 03:04:43,319
SENSORY AND HOI  -- HOW THE BODY

3598
03:04:44,820 --> 03:04:45,054
METABOLIZES.

3599
03:04:45,054 --> 03:04:53,996
AND AFTER 18 WEEKS THERE WAS A 

3600
03:04:53,996 --> 03:04:59,502
BIG DIFFERENCE IN BODY WEIGHT.

3601
03:04:59,502 --> 03:05:03,439
THE HIGH FAT MICE HAD TIME 

3602
03:05:03,439 --> 03:05:05,808
INDUCED OBESITY AND BECAME VERY 

3603
03:05:05,808 --> 03:05:09,578
OBESE AND THE NORMAL CHOW TIME 

3604
03:05:09,578 --> 03:05:12,782
RESTRICTED HAD NO STATISTICAL 

3605
03:05:12,782 --> 03:05:15,351
SIGNIFICANCE IN BODY WEIGHT AND 

3606
03:05:15,351 --> 03:05:19,388
THE TIME RESTRICTED MICE WERE AS

3607
03:05:19,388 --> 03:05:21,457
HEAVY AS THE CHOW FED MICE.

3608
03:05:21,457 --> 03:05:23,059
THE EXPERIMENT WAS REPEATED 

3609
03:05:23,059 --> 03:05:26,963
THREE OR FOUR TIMES AND THEN THE

3610
03:05:26,963 --> 03:05:30,933
NEXT QUESTION WAS AND WHETHER 

3611
03:05:30,933 --> 03:05:37,606
THE FAT MICE HAD TIME RESTRICTED

3612
03:05:37,606 --> 03:05:47,750
FEEDING.

3613
03:06:00,229 --> 03:06:02,264
AND THEY LOST BODY WEIGHT IN THE

3614
03:06:02,264 --> 03:06:04,633
NEXT FEW WEEKS AND THE DARK BLUE

3615
03:06:04,633 --> 03:06:09,739
IS THE TIME OF THE TIME 

3616
03:06:09,739 --> 03:06:14,944
RESTRICTED GROUP THAT SUSTAINED 

3617
03:06:14,944 --> 03:06:19,048
LOW BODY WEIGHT AND AMONG THE 

3618
03:06:19,048 --> 03:06:19,915
NORMAL CHOW FED MICE THERE WAS 

3619
03:06:19,915 --> 03:06:23,085
NO DIFFERENCE IN THE BODY WEIGHT

3620
03:06:23,085 --> 03:06:27,189
BUT CHANGE IN LEAN MASS.

3621
03:06:27,189 --> 03:06:30,393
MICE THAT ATE NORMAL CHOW OR 

3622
03:06:30,393 --> 03:06:37,633
HIGH FAT IN TIME RESTRICTED 

3623
03:06:37,633 --> 03:06:47,443
GAINED MORE LEAN MASS AND TOO 

3624
03:06:47,443 --> 03:06:49,145
IMPACT THE MULTIPLE TISSUES WE 

3625
03:06:49,145 --> 03:06:52,782
DID A SIMPLE EXPERIMENT.

3626
03:06:52,782 --> 03:07:00,523
WE COLLECTED 22 ORGANS AND EVERY

3627
03:07:00,523 --> 03:07:06,529
TWO HOURS OF SAMPLES OF ORGANS 

3628
03:07:06,529 --> 03:07:08,464
AND BELIEVE YOU'LL GET DIFFERENT

3629
03:07:08,464 --> 03:07:11,233
TYPE OF DIFFERENCES IN GENE 

3630
03:07:11,233 --> 03:07:15,671
EXPRESSION THAT'S WHY THE 

3631
03:07:15,671 --> 03:07:16,472
24-HOUR SAMPLING WAS VERY 

3632
03:07:16,472 --> 03:07:16,806
IMPORTANT.

3633
03:07:16,806 --> 03:07:19,075
WE FOUND WHEN YOU DO THIS 

3634
03:07:19,075 --> 03:07:24,780
EXPERIMENT NEARLY 70% OF GENES 

3635
03:07:24,780 --> 03:07:26,949
ARE DIFFERENTIALLY EXPRESSED AND

3636
03:07:26,949 --> 03:07:30,619
ONE OF THE 22 IN YOUNG MALE 

3637
03:07:30,619 --> 03:07:30,820
MICE.

3638
03:07:30,820 --> 03:07:32,788
THEY REPEATED THIS IN FEMALE 

3639
03:07:32,788 --> 03:07:34,356
MICE.

3640
03:07:34,356 --> 03:07:35,658
THE MAGNITUDE IS DIFFERENT BUT 

3641
03:07:35,658 --> 03:07:38,027
THEN THE MESSAGE IS SIMILAR.

3642
03:07:38,027 --> 03:07:41,831
AND THIS EXPERIMENT IF YOU JUST 

3643
03:07:41,831 --> 03:07:46,068
LOOK AT ALL TIME POINTS AND FEED

3644
03:07:46,068 --> 03:07:48,003
THEM THEN THERE ARE FEW GENES 

3645
03:07:48,003 --> 03:07:53,209
LESS THAN 150 OR SO IN LUNGS 

3646
03:07:53,209 --> 03:07:56,078
THAT CHANGE BETWEEN BUT COULD DO

3647
03:07:56,078 --> 03:07:57,413
ANALYSIS WHERE WE ASKED 

3648
03:07:57,413 --> 03:08:00,182
SPECIFICALLY THE TIME DEPENDENT 

3649
03:08:00,182 --> 03:08:00,950
CHANGE IN GENE EXPRESSION.

3650
03:08:00,950 --> 03:08:04,787
THEN WE SEE A DIFFERENT RESULT.

3651
03:08:04,787 --> 03:08:07,189
BUT ANYWAY WITH THIS DIFFERENCE 

3652
03:08:07,189 --> 03:08:08,657
KEEPING IN MIND I'LL GIVE A 

3653
03:08:08,657 --> 03:08:08,891
SUMMARY.

3654
03:08:08,891 --> 03:08:14,396
SO NEXT SLIDE.

3655
03:08:14,396 --> 03:08:18,334
SO IF WE LOOK AT THE GENES 

3656
03:08:18,334 --> 03:08:22,505
UPREGULATED ARE MOSTLY A PROTEIN

3657
03:08:22,505 --> 03:08:24,540
FOLDING AND ALSO METABOLISM OF 

3658
03:08:24,540 --> 03:08:29,411
FATTY ACIDS.

3659
03:08:29,411 --> 03:08:33,782
AND THE GENES AND LEPTIN ARE 

3660
03:08:33,782 --> 03:08:37,620
NUMBER 1 AND IT'S PRODUCED FROM 

3661
03:08:37,620 --> 03:08:40,256
ADIPOSE TISSUES AND THE NEXT 

3662
03:08:40,256 --> 03:08:44,059
ONES ARE ALL INFLAMMATORY LIPIDS

3663
03:08:44,059 --> 03:08:49,865
SO I'M RESTRICTED EATING CAN 

3664
03:08:49,865 --> 03:08:55,704
REDUCE INFLAMOSOME.

3665
03:08:55,704 --> 03:08:58,174
IF WE LOOK AT THE PATHWAYS UNDER

3666
03:08:58,174 --> 03:09:00,776
EXPRESSED IN FIVE OR MORE 

3667
03:09:00,776 --> 03:09:02,811
TISSUES WE SEE A FEW THINGS AND 

3668
03:09:02,811 --> 03:09:04,280
POINT YOUR ATTENTION TO LUNGS 

3669
03:09:04,280 --> 03:09:06,749
BECAUSE OF THE THEME OF THE 

3670
03:09:06,749 --> 03:09:07,049
CONFERENCE.

3671
03:09:07,049 --> 03:09:12,788
WE FIND IT'S LESS IMMUNE 

3672
03:09:12,788 --> 03:09:23,332
RESPONSE IN LUNG TISSUE AND WE 

3673
03:09:27,870 --> 03:09:29,772
SEE THE GENE EXPRESSION DOESN'T 

3674
03:09:29,772 --> 03:09:31,340
CHANGE MUCH DURING DAY AND NIGHT

3675
03:09:31,340 --> 03:09:36,779
BUT WE HAVE GENE EXPRESSION AND 

3676
03:09:36,779 --> 03:09:39,248
ONE AT THE END OF THE DAY WHERE 

3677
03:09:39,248 --> 03:09:42,051
MICE ARE SLEEPING AND FASTING 

3678
03:09:42,051 --> 03:09:49,158
AND ONE RESPONSIBLE SO THESE 

3679
03:09:49,158 --> 03:09:51,927
SYNCHRONIZED PHYSIOLOGY AND 

3680
03:09:51,927 --> 03:09:54,964
METABOLISM AND PAPERS HAVE SHOWN

3681
03:09:54,964 --> 03:09:57,032
THIS BUT THEY ALSO HAVE PATHWAYS

3682
03:09:57,032 --> 03:09:59,969
ONLY FOR A FEW HOURS AND EXPRESS

3683
03:09:59,969 --> 03:10:01,337
FOR A FEW HOURS.

3684
03:10:01,337 --> 03:10:06,709
THAT'S THE TAKE HOME MESSAGE 

3685
03:10:06,709 --> 03:10:10,479
FROM THE ANALYSIS AND THEN I'LL 

3686
03:10:10,479 --> 03:10:14,283
SEE ADHERENCE AND FOR EXAMPLE IF

3687
03:10:14,283 --> 03:10:19,688
YOU'RE DOING A GENE EXPRESSION 

3688
03:10:19,688 --> 03:10:21,357
IN LUNGS YOU SEE THE GROUPS AND 

3689
03:10:21,357 --> 03:10:26,495
IF YOU DON'T TAKE TIME INTO 

3690
03:10:26,495 --> 03:10:36,438
CONSIDERATION BUT IF YOU DO THIS

3691
03:10:36,438 --> 03:10:44,546
IN LUNGS IT'S STRONGLY CIRCADIAN

3692
03:10:44,546 --> 03:10:44,847
A

3693
03:10:44,847 --> 03:10:46,915
AND HAVE SIMILAR RESULTS IN 

3694
03:10:46,915 --> 03:10:48,250
YOUNG ADOLESCENT FEMALES.

3695
03:10:48,250 --> 03:10:58,260
AND IF WE LOOK AT THE ANALYSIS 

3696
03:10:58,260 --> 03:11:04,833
THE ONES THAT ARE RESTRICTED FOR

3697
03:11:04,833 --> 03:11:11,340
EXAMPLE YOU SEE CELL ADHESION, 

3698
03:11:11,340 --> 03:11:14,310
NEW BLOOD VESSEL SIGNALLING.

3699
03:11:14,310 --> 03:11:15,611
WE'RE IN THE EARLY STAGE OF THE 

3700
03:11:15,611 --> 03:11:19,081
RESEARCH AND WE HAVEN'T LOOKED 

3701
03:11:19,081 --> 03:11:20,949
INTO THE LUNGS EXPRESSION 

3702
03:11:20,949 --> 03:11:23,352
CHANGES.

3703
03:11:23,352 --> 03:11:29,124
YOU CAN SEE THERE'S A HUGE MICE 

3704
03:11:29,124 --> 03:11:34,096
RESPONSE TO TIME-RESTRICTED 

3705
03:11:34,096 --> 03:11:34,330
FEEDING.

3706
03:11:34,330 --> 03:11:35,964
AND GENE EXPRESSION PATTERN FROM

3707
03:11:35,964 --> 03:11:36,765
DIFFERENT TIMES.

3708
03:11:36,765 --> 03:11:39,368
THIS IS THE HEAT MAP AND FOR 

3709
03:11:39,368 --> 03:11:44,773
EXAMPLE YOU CAN SEE THE TOP PART

3710
03:11:44,773 --> 03:11:47,376
IS IMMUNE AND INFLAMMASOME LIPID

3711
03:11:47,376 --> 03:11:48,777
GENES ARE MOSTLY HIGHLY 

3712
03:11:48,777 --> 03:11:50,479
EXPRESSED DURING THE DAYTIME 

3713
03:11:50,479 --> 03:12:00,923
WHEN MICE TYPICALLY SLEEP.

3714
03:12:14,737 --> 03:12:16,138
AND THE INITIAL PATHWAYS WHICH 

3715
03:12:16,138 --> 03:12:22,277
ARE ACTUALLY NOT INVOLVED IN SPM

3716
03:12:22,277 --> 03:12:26,482
BUT DO PRODUCE THESE WHETHER 

3717
03:12:26,482 --> 03:12:28,784
THEY FEED INTO PRO INFLAMMATORY 

3718
03:12:28,784 --> 03:12:30,018
RESULTS WOULD BE INTERESTING IN 

3719
03:12:30,018 --> 03:12:32,788
OTHER MOUSE MODELS.

3720
03:12:32,788 --> 03:12:40,429
THANK YOU.

3721
03:12:40,429 --> 03:12:43,165
OVER THE LAST 12 YEARS IN TIME 

3722
03:12:43,165 --> 03:12:44,533
RESTRICTED FEEDING AND ARE THERE

3723
03:12:44,533 --> 03:12:46,135
EFFECTS IN HUMANS?

3724
03:12:46,135 --> 03:12:51,774
ALMOST 12 YEARS AGO I WANTED TO 

3725
03:12:51,774 --> 03:12:53,942
ASK WHEN DO PEOPLE EAT AND IS 

3726
03:12:53,942 --> 03:12:55,811
THERE A DIFFERENCE FROM ONE DAY 

3727
03:12:55,811 --> 03:12:59,081
TO ANOTHER.

3728
03:12:59,081 --> 03:13:05,421
SO WE STARTED THIS AND PEOPLE 

3729
03:13:05,421 --> 03:13:09,558
CAN AND CAN RUN A STUDY AND RUN 

3730
03:13:09,558 --> 03:13:11,760
MULTIPLE STUDIES WITH MULTIPLE 

3731
03:13:11,760 --> 03:13:16,064
OUTCOMES AND INTERVENTIONS AND 

3732
03:13:16,064 --> 03:13:17,866
HAVE A PUBLIC FACING APP PEOPLE 

3733
03:13:17,866 --> 03:13:18,934
CAN DOWNLOAD AND SHARE DATA.

3734
03:13:18,934 --> 03:13:24,273
WE ASKED PEOPLE TO TAKE A 

3735
03:13:24,273 --> 03:13:34,817
PICTURE OF THEIR FOOD AND THEN 

3736
03:13:48,330 --> 03:13:52,201
AND WE PUT IT ON A CALORIE FOOD 

3737
03:13:52,201 --> 03:13:58,006
WE PUT IT ON THE PLOT AND WE 

3738
03:13:58,006 --> 03:14:06,281
ASKED PEOPLE TO AND YOU CAN SEE 

3739
03:14:06,281 --> 03:14:11,453
THIS OCCURS AND THIS WAS 

3740
03:14:11,453 --> 03:14:20,796
PARTICIPANTS EMPLOYEES OF UC SD 

3741
03:14:20,796 --> 03:14:31,340
AND YOU CAN COMBINE WEEKDAYS AND

3742
03:14:33,542 --> 03:14:35,177
WELCOME 

3743
03:14:35,177 --> 03:14:37,212
WELCOME BACKS THAT'S THE TYPICAL

3744
03:14:37,212 --> 03:14:42,284
DURATION WE FOUND AND THIS IS 

3745
03:14:42,284 --> 03:14:46,121
WHAT WE FOUND IN THE VALUE AND 

3746
03:14:46,121 --> 03:14:47,422
THAT'S WHAT WE SEE PEOPLE UNDER 

3747
03:14:47,422 --> 03:14:53,762
REPORT HOW MUCH THEY FAST OR 

3748
03:14:53,762 --> 03:14:56,765
UNDER REPORT HOW MUCH THEY EAT 

3749
03:14:56,765 --> 03:14:58,333
AND THIS IS FROM 157 

3750
03:14:58,333 --> 03:14:58,700
INDIVIDUALS.

3751
03:14:58,700 --> 03:15:03,705
LOOK AT THE PACIFIC TOURS COMING

3752
03:15:03,705 --> 03:15:06,708
IN YOU CAN KEEP CLICKING AND SEE

3753
03:15:06,708 --> 03:15:09,077
THE NUMBER OF PICTURES AROUND 

3754
03:15:09,077 --> 03:15:10,979
NUNE TIME AND DINNER TIME.

3755
03:15:10,979 --> 03:15:14,650
THERE'S FEW IN THE MIDDLE OF THE

3756
03:15:14,650 --> 03:15:16,151
NIGHT BUT GUESSTIMATING HOW MUCH

3757
03:15:16,151 --> 03:15:18,320
CALORIES ARE IN EACH PICTURE 

3758
03:15:18,320 --> 03:15:20,255
WHAT IS SURPRISING IS THE 

3759
03:15:20,255 --> 03:15:23,458
MIDNIGHT SNACKS ARE NOT SMALL, 

3760
03:15:23,458 --> 03:15:26,795
THEY'RE EXTREMELY BIG.

3761
03:15:26,795 --> 03:15:29,498
AND LOOK AT WHAT PEOPLE EAT 

3762
03:15:29,498 --> 03:15:38,473
NEARLY 50% OF ADULTS EAT DURING 

3763
03:15:38,473 --> 03:15:39,341
THIS PERIOD.

3764
03:15:39,341 --> 03:15:40,776
WE'VE BEEN COLLECTING DATA AND 

3765
03:15:40,776 --> 03:15:46,848
THERE ARE THOUSANDS OF 

3766
03:15:46,848 --> 03:15:51,286
PARTICIPANTS AND LOOK AT 20,000 

3767
03:15:51,286 --> 03:15:55,824
PLUS PARTICIPANTS AND THIS IS A 

3768
03:15:55,824 --> 03:16:01,530
TYPICAL GRAM AND TWO WEEKS OF 

3769
03:16:01,530 --> 03:16:08,770
DATA AND THIS PERSON IS 9.6 

3770
03:16:08,770 --> 03:16:10,372
HOURS AND TAKE THE TIME WHERE 

3771
03:16:10,372 --> 03:16:17,479
95% OF THE CALORIES CAME IN IT'S

3772
03:16:17,479 --> 03:16:20,782
12.1.

3773
03:16:20,782 --> 03:16:25,120
SO THIS IS THE MEDIUM IS 

3774
03:16:25,120 --> 03:16:29,257
INTERVALS IN THE WINDOW AND THE 

3775
03:16:29,257 --> 03:16:31,994
TIME SO AROUND 2:00 IN THE 

3776
03:16:31,994 --> 03:16:34,029
AFTERNOON SO PEOPLE TYPICALLY 

3777
03:16:34,029 --> 03:16:36,898
THAT'S THE MIDPOINT OF LOGGING 

3778
03:16:36,898 --> 03:16:44,306
NOT NECESSARILY CALORIE INTAKE.

3779
03:16:44,306 --> 03:16:46,074
PEOPLE ON AVERAGE EAT FOUR TO 

3780
03:16:46,074 --> 03:16:54,983
FIVE MEALS AND THE TOP 10% HAVE 

3781
03:16:54,983 --> 03:16:56,018
SEVEN MEALS OR DIFFERENT TIMES 

3782
03:16:56,018 --> 03:16:57,352
THEY LOG THUR FOOD.

3783
03:16:57,352 --> 03:17:00,489
AND SIMPLE THING IF WE ASK HOW 

3784
03:17:00,489 --> 03:17:02,991
MANY UNIQUE FOOD PEOPLE LOG THE 

3785
03:17:02,991 --> 03:17:08,230
NUMBER IS AROUND 55 OVER 14 

3786
03:17:08,230 --> 03:17:08,430
DAYS.

3787
03:17:08,430 --> 03:17:15,837
WE LOOKED AT THIS AND FIVE TO 

3788
03:17:15,837 --> 03:17:23,311
SIX DAYS OF DATA IS NOT ENOUGH.

3789
03:17:23,311 --> 03:17:28,383
AND IF WE TAKE THE TIME OF THE 

3790
03:17:28,383 --> 03:17:30,652
DAY I EXPECT YOU'LL SEE THE 

3791
03:17:30,652 --> 03:17:32,788
BREAKFAST ITEMS AT THE TOP AND 

3792
03:17:32,788 --> 03:17:38,393
END THE DAY WITH BEER AND DRINK 

3793
03:17:38,393 --> 03:17:38,927
WINE.

3794
03:17:38,927 --> 03:17:42,264
AND WE CAN ASK SIMPLE QUESTIONS 

3795
03:17:42,264 --> 03:17:47,536
FOR EXAMPLE ASK WHAT IS THE 

3796
03:17:47,536 --> 03:17:58,013
PREFERENCE OF THIS.

3797
03:17:58,013 --> 03:18:00,115
PEOPLE SAY YOU SHOULD NOT EAT 

3798
03:18:00,115 --> 03:18:08,790
LATE HAVING TO DO WITH CIRCADIAN

3799
03:18:08,790 --> 03:18:19,334
RHYTHM OR SLEEP AND EATING MORE 

3800
03:18:21,536 --> 03:18:27,275
PASTA AND BEER AND WIN AND ASK 

3801
03:18:27,275 --> 03:18:35,083
THE MALE VERSUS FEMALE AND 

3802
03:18:35,083 --> 03:18:37,018
SIMILARLY WE CAN ASK THE 

3803
03:18:37,018 --> 03:18:38,720
DIFFERENCE OF YOUNG VERSUS OLD.

3804
03:18:38,720 --> 03:18:46,628
WE HAVE NEARLY 5,000 PEOPLE AND 

3805
03:18:46,628 --> 03:18:47,262
WE CAN ALSO SEE THIS KIND OF 

3806
03:18:47,262 --> 03:18:57,372
DATA.

3807
03:18:58,140 --> 03:19:01,309
WE'RE VERY INTERESTED IN THIS 

3808
03:19:01,309 --> 03:19:04,179
STRATEGY WITH SHIFT WORKERS AND 

3809
03:19:04,179 --> 03:19:05,180
SAW THUR FOOD PREFERENCE 

3810
03:19:05,180 --> 03:19:11,253
DEPENDING ON TIME OF DAY WE GET 

3811
03:19:11,253 --> 03:19:11,853
DIFFERENT DIETS AND THE PUN 

3812
03:19:11,853 --> 03:19:20,128
ESTABLISHED SIGNAL.

3813
03:19:20,128 --> 03:19:23,431
WE HAD PEOPLE LOGGING THEIR 

3814
03:19:23,431 --> 03:19:24,366
SUPPLEMENT DATA.

3815
03:19:24,366 --> 03:19:25,967
WE WAKE UP AND TAKE THE 

3816
03:19:25,967 --> 03:19:28,804
MEDICATION AT THE TOP AND THEN 

3817
03:19:28,804 --> 03:19:36,778
AFTER THAT PEOPLE ARE TAKING 

3818
03:19:36,778 --> 03:19:47,322
ANTIHISTAMINES AND PEOPLE TAKE 

3819
03:19:56,164 --> 03:19:58,400
MEDICATION FOLLOWED.

3820
03:19:58,400 --> 03:20:00,268
WE HAVE 12 MILLION RECORDS AND 

3821
03:20:00,268 --> 03:20:03,271
TENS OF THOUSANDS OF INDIVIDUAL 

3822
03:20:03,271 --> 03:20:09,578
TRIALS GOING ON.

3823
03:20:09,578 --> 03:20:11,847
NOW THAT WE HAVE THE DAILY FOOD 

3824
03:20:11,847 --> 03:20:16,785
INTAKE AND MEDICATION AND 

3825
03:20:16,785 --> 03:20:18,753
SUPPLEMENT INTAKE AND PEOPLE ARE

3826
03:20:18,753 --> 03:20:19,588
WILLING TO SHARE THIS THROUGH 

3827
03:20:19,588 --> 03:20:28,964
THE APP AND NOW WE'RE USING A.I.

3828
03:20:28,964 --> 03:20:35,670
TO FIGURE OUT WHAT THAT YOU EAT 

3829
03:20:35,670 --> 03:20:38,840
AND WE CAN LOOK AT SIMILAR 

3830
03:20:38,840 --> 03:20:43,311
MEDICATIONS AND HOPEFULLY WE CAN

3831
03:20:43,311 --> 03:20:44,713
DO PERSONALIZED SUPPLEMENTS AND 

3832
03:20:44,713 --> 03:20:46,081
MED FOR ANY GIVEN INTERVENTION.

3833
03:20:46,081 --> 03:20:47,849
THANK YOU AND THAT SHOULD BE THE

3834
03:20:47,849 --> 03:20:55,056
LAST ONE.

3835
03:20:55,056 --> 03:20:56,558
THESE ARE SUMMARIES AND BOTTOM 

3836
03:20:56,558 --> 03:21:01,630
LINE IS WE NEED TRANSLATIONAL 

3837
03:21:01,630 --> 03:21:04,466
PROJECTS FOR THE IMPACT FOR TRE 

3838
03:21:04,466 --> 03:21:05,367
ON LUNG DISEASE.

3839
03:21:05,367 --> 03:21:07,502
>> THANK YOU, DR. PANDA.

3840
03:21:07,502 --> 03:21:09,838
NOW WE'LL MOVE TO THE LAST TALK 

3841
03:21:09,838 --> 03:21:15,010
IN THIS SESSION WHICH WILL BE 

3842
03:21:15,010 --> 03:21:24,786
PROVIDED BY DR. KATRI-TYPO AT 

3843
03:21:24,786 --> 03:21:26,354
CHILDREN'S HOSPITAL AND BAYLOR 

3844
03:21:26,354 --> 03:21:28,790
MEDICINE ON EFFICACY ON TARGETED

3845
03:21:28,790 --> 03:21:30,158
NUTRITION VEGS IN THE MANAGEMENT

3846
03:21:30,158 --> 03:21:32,494
OF INTENSIVE CARE PATIENTS.

3847
03:21:32,494 --> 03:21:38,733
I'LL TURN IT OVER TO YOU.

3848
03:21:38,733 --> 03:21:40,602
>> THANK YOU.

3849
03:21:40,602 --> 03:21:43,204
FIRST I'D LIKE TO THANK THE 

3850
03:21:43,204 --> 03:21:44,105
ORGANIZERS FOR THE OPPORTUNITY 

3851
03:21:44,105 --> 03:21:47,909
TO SPEAK AND CLOSE OUT THE 

3852
03:21:47,909 --> 03:21:49,678
CONFERENCE AND TALK ABOUT 

3853
03:21:49,678 --> 03:21:52,347
EFFICACY OF TARGETED NUTRIENT 

3854
03:21:52,347 --> 03:21:56,484
INTERVENTION AND MANAGEMENT OF 

3855
03:21:56,484 --> 03:21:57,819
INTENSIVE CARE PATIENTS AND THIS

3856
03:21:57,819 --> 03:22:01,957
IS WITH A BODY OF LITERATURE 

3857
03:22:01,957 --> 03:22:04,759
I'LL ONLY BE ABLE TO TOUCH ON 

3858
03:22:04,759 --> 03:22:08,763
BUT WE HIGHLIGHT THE KEY GAPS IN

3859
03:22:08,763 --> 03:22:14,970
KNOWLEDGE OR AREAS OF RESEARCH.

3860
03:22:14,970 --> 03:22:19,541
I'M NOT PRESENTING MY OWN 

3861
03:22:19,541 --> 03:22:21,676
RESEARCH BUT SUMMARY AND MY 

3862
03:22:21,676 --> 03:22:27,515
INTEREST IS PEDIATRIC PATIENT 

3863
03:22:27,515 --> 03:22:29,851
POPULATION.

3864
03:22:29,851 --> 03:22:32,787
YOU HEARD QUITE A LOT ABOUT THE 

3865
03:22:32,787 --> 03:22:36,791
ROLE OF MACRO AND MICRO NEWT 

3866
03:22:36,791 --> 03:22:39,361
REPRESENT AND ANTIOXIDANT 

3867
03:22:39,361 --> 03:22:40,462
THERAPIES FOR THE TREATMENT OF 

3868
03:22:40,462 --> 03:22:42,530
CHRONIC RESPIRATORY ILLNESS.

3869
03:22:42,530 --> 03:22:45,633
I WANT TO START WITH A THE 

3870
03:22:45,633 --> 03:22:48,403
VOLUME OF LITERATURE OF NEGATIVE

3871
03:22:48,403 --> 03:22:52,007
CLINICAL TRIALS OF 

3872
03:22:52,007 --> 03:22:54,943
SUPPLEMENTATION IN CRITICAL 

3873
03:22:54,943 --> 03:22:55,176
ILLNESS.

3874
03:22:55,176 --> 03:22:57,679
THERE'S THE SETTING OF ACUTE 

3875
03:22:57,679 --> 03:22:59,781
CRITICAL ILLNESS WHERE YOU'RE 

3876
03:22:59,781 --> 03:23:01,750
FACED WITH A PATIENT WITH A 

3877
03:23:01,750 --> 03:23:04,786
RAPIDLY CHANGING INFLAMMATORY 

3878
03:23:04,786 --> 03:23:06,321
PROFILE OR PATIENT POPULATION 

3879
03:23:06,321 --> 03:23:09,591
WITH INDIVIDUAL DIFFERENCES IN 

3880
03:23:09,591 --> 03:23:11,726
IMMUNE RESPONSE OR POTENTIAL TO 

3881
03:23:11,726 --> 03:23:13,428
RESPOND TO TREATMENTS.

3882
03:23:13,428 --> 03:23:18,199
ALL OF THIS IN COMBINATION MAY 

3883
03:23:18,199 --> 03:23:22,404
ALTER TREATMENT RESPONSE OF 

3884
03:23:22,404 --> 03:23:27,776
CLINICAL TRIALS AND IN THE RE-OX

3885
03:23:27,776 --> 03:23:29,411
TRIAL WHICH ASSESSED RANDOMIZED 

3886
03:23:29,411 --> 03:23:33,314
VENTILATED ICU PATIENTS TO 

3887
03:23:33,314 --> 03:23:40,688
GLUTAMINE AND ANTIOXIDANTS AND 

3888
03:23:40,688 --> 03:23:41,923
GLUTAMINE OR PLACEBO AND THERE 

3889
03:23:41,923 --> 03:23:44,459
WERE 28 DAY MORTALITY AND SIX 

3890
03:23:44,459 --> 03:23:47,896
MONTH MORTALITY ON PATIENTS WHO 

3891
03:23:47,896 --> 03:23:53,902
RECEIVED GLUTAMINE.

3892
03:23:53,902 --> 03:23:59,174
AND THERE WERE ACIDS COMPARED TO

3893
03:23:59,174 --> 03:24:00,308
PATIENTS WITH ACUTE LINE INJURY 

3894
03:24:00,308 --> 03:24:04,779
AND STOPPED FOR FUTILITY.

3895
03:24:04,779 --> 03:24:15,323
AND THE STUDY 14 ICUs HAD SAW AN

3896
03:24:18,793 --> 03:24:24,766
INCREASE IN THE GLUTAMINE 

3897
03:24:24,766 --> 03:24:27,569
STUDIES AND THERE WERE SMALLER 

3898
03:24:27,569 --> 03:24:30,004
RCTs COMPLETED AS WELL.

3899
03:24:30,004 --> 03:24:36,144
MACRO AND MICRO NUTRIENT RCTs 

3900
03:24:36,144 --> 03:24:41,616
DEMONSTRATED NO BENEFIT OR HARM.

3901
03:24:41,616 --> 03:24:48,990
ASCORBIC ACID WAS FOUND TO HAVE 

3902
03:24:48,990 --> 03:24:50,692
NO BENEFIT AND HOWEVER, THERE 

3903
03:24:50,692 --> 03:24:53,394
ARE SUB POPULATIONS OF 

3904
03:24:53,394 --> 03:24:54,329
CRITICALLY ILL PATIENTS WHO MAY 

3905
03:24:54,329 --> 03:24:55,763
STILL BENEFIT.

3906
03:24:55,763 --> 03:24:57,465
I WOULD PROPOSE AFTER WE GO 

3907
03:24:57,465 --> 03:25:00,368
THROUGH THE REST OF THE TALK 

3908
03:25:00,368 --> 03:25:03,805
THERE MAY BE ADDITIONAL REASONS 

3909
03:25:03,805 --> 03:25:10,411
TO PURSUE MICRO OR MACRO 

3910
03:25:10,411 --> 03:25:12,213
NUTRIENT KNOWLEDGE AND THE BASIC

3911
03:25:12,213 --> 03:25:13,047
INFORMATION WAS NOT PRESENT AND 

3912
03:25:13,047 --> 03:25:16,251
HAS BEEN WORKED ON SINCE.

3913
03:25:16,251 --> 03:25:22,257
AND SO FOR EXAMPLE SEVERE BURN 

3914
03:25:22,257 --> 03:25:32,800
PATIENTS WHO RECEIVE AND THERE 

3915
03:25:42,076 --> 03:25:46,414
WERE RCTs DONE AND ASSESSING THE

3916
03:25:46,414 --> 03:25:48,583
ROUTE OF NUTRITION IN 3,000 AND 

3917
03:25:48,583 --> 03:25:52,787
4,000 PATIENTS IN FRANCE AND 

3918
03:25:52,787 --> 03:25:57,592
THOSE IN SHOCK MORE HAD 

3919
03:25:57,592 --> 03:25:59,794
VENTILATION AND THEY HAD 

3920
03:25:59,794 --> 03:26:02,163
INCREASED COMPLICATIONS.

3921
03:26:02,163 --> 03:26:08,336
THE TRIALS FOLLOWED THE PRIOR 

3922
03:26:08,336 --> 03:26:18,012
NEGATIVE CLINICAL TRIALS FOR 

3923
03:26:18,012 --> 03:26:18,613
IMMUNONUTRITION.

3924
03:26:18,613 --> 03:26:23,218
IN REFLECT CRITICAL ILLNESS IT 

3925
03:26:23,218 --> 03:26:25,220
WAS FUNDAMENTAL MACRO NUTRIENT 

3926
03:26:25,220 --> 03:26:28,790
DELIVERY AND TIMING AND DOSE NOT

3927
03:26:28,790 --> 03:26:29,624
UNDERSTOOD.

3928
03:26:29,624 --> 03:26:30,825
WHEN OVERLAYING UPON ROUTE AND 

3929
03:26:30,825 --> 03:26:33,761
DOSE OF NUTRIENT DELIVERY WHEN 

3930
03:26:33,761 --> 03:26:35,997
OVERLAYING UPON THOSE UNKNOWNS 

3931
03:26:35,997 --> 03:26:38,099
THE MICRONUTRIENT OR 

3932
03:26:38,099 --> 03:26:39,867
ANTIINFLAMMATORY DIETS I THINK 

3933
03:26:39,867 --> 03:26:42,070
YOU PROBABLY HAVE LITTLE HOPE OF

3934
03:26:42,070 --> 03:26:44,772
DEMONSTRATE BEING A BENEFIT TO 

3935
03:26:44,772 --> 03:26:46,407
NUTRIENT DELIVERY IF YOU DON'T 

3936
03:26:46,407 --> 03:26:48,042
UNDERSTAND THE FUNDAMENTALS OF 

3937
03:26:48,042 --> 03:26:52,780
HOW IT WILL IMPACT PATIENT 

3938
03:26:52,780 --> 03:26:53,047
OUTCOMES.

3939
03:26:53,047 --> 03:26:56,551
SO WHAT WAS PUBLISHED MORE THAN 

3940
03:26:56,551 --> 03:26:59,354
3,000 PATIENTS IN FRANCE 

3941
03:26:59,354 --> 03:27:00,755
COMPARED LOW DOSE TO STANDARD 

3942
03:27:00,755 --> 03:27:02,724
DOSE NUTRITION AND NO DIFFERENCE

3943
03:27:02,724 --> 03:27:05,593
IN PRIMARY OUTCOMES BUT A TREND 

3944
03:27:05,593 --> 03:27:07,195
TOWARD IMPROVED MORTALITY IN THE

3945
03:27:07,195 --> 03:27:11,199
LOWER DOSE ARM AND IMPROVED TIME

3946
03:27:11,199 --> 03:27:15,036
TO MECHANICAL VENTILATION IN THE

3947
03:27:15,036 --> 03:27:15,670
LOWER DOSE ARM.

3948
03:27:15,670 --> 03:27:18,773
EARLY AGGRESSIVE NUTRITION IN 

3949
03:27:18,773 --> 03:27:20,908
CRITICAL ILLNESS SEEMS TO BE 

3950
03:27:20,908 --> 03:27:28,750
ASSOCIATED.

3951
03:27:28,750 --> 03:27:30,685
IN FACT THE STUDIES HAVE 

3952
03:27:30,685 --> 03:27:35,390
CONCLUSIONS BUT OTHERS HAVE ALSO

3953
03:27:35,390 --> 03:27:37,525
SHOWN PREVIOUSLY THAT THIS 

3954
03:27:37,525 --> 03:27:38,926
FEEDING DEMONSTRATES NO BENEFIT 

3955
03:27:38,926 --> 03:27:40,828
OR HARM AND THERE'S INTERACTION 

3956
03:27:40,828 --> 03:27:43,164
BETWEEN PROTEINS AND CALORIC 

3957
03:27:43,164 --> 03:27:47,001
DELIVERY THAT CRITICALLY ILL 

3958
03:27:47,001 --> 03:27:49,337
ADULTS WILL TOLERATE UNDER 

3959
03:27:49,337 --> 03:27:50,772
FEEDING IN THE SETTING OF 

3960
03:27:50,772 --> 03:27:52,507
PROTEIN ADEQUACY.

3961
03:27:52,507 --> 03:27:55,443
THIS IS THE SURVIVAL SPIRAL 

3962
03:27:55,443 --> 03:27:57,111
CURVE FROM A STUDY DEMONSTRATING

3963
03:27:57,111 --> 03:27:58,980
THE DIFFERENCE BETWEEN STANDARD 

3964
03:27:58,980 --> 03:28:00,882
AN PERMISSIVE UNDER FEEDING IN 

3965
03:28:00,882 --> 03:28:11,259
CRITICALLY ILL ADULTS.

3966
03:28:12,827 --> 03:28:15,029
AND THERE JOURNAL LOOKED AT THE 

3967
03:28:15,029 --> 03:28:16,798
ISSUE OF TIMING OF NUTRITION AND

3968
03:28:16,798 --> 03:28:18,166
THE POTENTIAL REASONS FOR LACK 

3969
03:28:18,166 --> 03:28:21,502
OF BENEFIT FROM EARLY FULL 

3970
03:28:21,502 --> 03:28:21,969
FEEDING.

3971
03:28:21,969 --> 03:28:24,172
THERE WAS A LOT OF HOPE EARLY IN

3972
03:28:24,172 --> 03:28:25,840
THE LITERATURE THAT EARLY FULL 

3973
03:28:25,840 --> 03:28:29,210
FEEDING IT ACHIEVING IT IN 

3974
03:28:29,210 --> 03:28:33,848
ADULTS WOULD IMPROVE SARCOPENIA 

3975
03:28:33,848 --> 03:28:35,817
AND VENTILATOR FREE DAYS AND THE

3976
03:28:35,817 --> 03:28:38,586
CONCEPT HAS EMERGED IN CRITICAL 

3977
03:28:38,586 --> 03:28:42,223
ILLNESS VERSUS RECOVERY AND 

3978
03:28:42,223 --> 03:28:46,327
PERHAPS PATIENTS DO NOT TOLERATE

3979
03:28:46,327 --> 03:28:47,962
EARLY AGGRESSIVE MACRO NUTRIENT 

3980
03:28:47,962 --> 03:28:49,464
DELIVERY BECAUSE OF THE STAGE OF

3981
03:28:49,464 --> 03:28:53,534
ACUTE CRITICAL ILLNESS AND IT IS

3982
03:28:53,534 --> 03:28:55,236
SOME SORT OF RECOGNITION OF WHEN

3983
03:28:55,236 --> 03:28:57,772
THE PATIENTS ARE SHIFTING FROM 

3984
03:28:57,772 --> 03:28:59,841
ACUTE CRITICAL ILLNESS TO 

3985
03:28:59,841 --> 03:29:02,577
RECOVERY THEY MAY BE RESPONSIVE 

3986
03:29:02,577 --> 03:29:04,312
AND READY TO RECEIVE FULL DOSE 

3987
03:29:04,312 --> 03:29:12,286
OF MACRO NUTRIENT DELIVERY.

3988
03:29:12,286 --> 03:29:14,288
SHIFTING IN TERMS OF MORE OF THE

3989
03:29:14,288 --> 03:29:16,357
STORY OF CARBOHYDRATE AND 

3990
03:29:16,357 --> 03:29:16,657
PROTEIN.

3991
03:29:16,657 --> 03:29:19,727
IN FACT RECENTLY THIS IS A STUDY

3992
03:29:19,727 --> 03:29:26,401
THAT I FOUND INTRIGUING 

3993
03:29:26,401 --> 03:29:31,906
PUBLISHED IN 2024 PLACING 93 

3994
03:29:31,906 --> 03:29:35,710
PATIENTS ON RANDOMIZED TO 

3995
03:29:35,710 --> 03:29:36,978
KETOGENIC OR CONTROLLED DIETS 

3996
03:29:36,978 --> 03:29:37,645
AND WHAT'S COMPELLING AND 

3997
03:29:37,645 --> 03:29:39,914
INTERESTING ABOUT THIS IS THEY 

3998
03:29:39,914 --> 03:29:45,186
ACHIEVED THE SAME CALORIC INTAKE

3999
03:29:45,186 --> 03:29:52,260
FOR THESE PATIENTS DID ACHIEVE 

4000
03:29:52,260 --> 03:29:52,994
KETOSIS IN THE PATIENT 

4001
03:29:52,994 --> 03:29:55,263
POPULATION AND HAD A LOWER 

4002
03:29:55,263 --> 03:29:56,764
REQUIREMENT FOR INSULIN AND DID 

4003
03:29:56,764 --> 03:30:00,334
NOT HAVE AN ELEVATION OF 

4004
03:30:00,334 --> 03:30:10,645
LACTATE.

4005
03:30:10,645 --> 03:30:13,347
AND THIS IS A SMALL STUDY 

4006
03:30:13,347 --> 03:30:15,016
DEMONSTRATED FEASIBILITY BUT NOT

4007
03:30:15,016 --> 03:30:19,086
EFFICACY AS A MANAGEMENT 

4008
03:30:19,086 --> 03:30:21,556
STRATEGY FOR INFLAMMATION AND IN

4009
03:30:21,556 --> 03:30:24,025
TERMS OF THE APPROPRIATE PROTEIN

4010
03:30:24,025 --> 03:30:27,562
LOAD AND MINIMAL CARBOHYDRATE 

4011
03:30:27,562 --> 03:30:31,699
LOAD ACHIEVED KETOSIS AND 

4012
03:30:31,699 --> 03:30:33,501
SURVIVAL PROBABILITY WAS HIGHER 

4013
03:30:33,501 --> 03:30:35,369
FOR THESE PATIENTS WHO RECEIVED 

4014
03:30:35,369 --> 03:30:39,440
THE KETOGENIC DIET.

4015
03:30:39,440 --> 03:30:42,210
WHEN WE LOOK AT PROTEIN ADEQUACY

4016
03:30:42,210 --> 03:30:43,578
THERE ARE STILL REMAINING 

4017
03:30:43,578 --> 03:30:45,046
SEVERAL QUESTIONS IN CRITICAL 

4018
03:30:45,046 --> 03:30:46,647
ILLNESS IN TERMS OF 

4019
03:30:46,647 --> 03:30:48,416
UNDERSTANDING OPTIMAL DOSE EARLY

4020
03:30:48,416 --> 03:30:50,918
AND LATE IN CRITICAL ILLNESS.

4021
03:30:50,918 --> 03:30:53,521
AND THE CURRENT GOALS THAT EXIST

4022
03:30:53,521 --> 03:30:56,757
ARE BASED ON LIMITED EVIDENCE.

4023
03:30:56,757 --> 03:30:58,559
NOR DO WE UNDERSTAND WHAT THE 

4024
03:30:58,559 --> 03:31:00,761
APPROPRIATE PROTEIN SOURCE 

4025
03:31:00,761 --> 03:31:09,737
SHOULD BE WHEY VERSUS SOY VERSUS

4026
03:31:09,737 --> 03:31:13,608
CASEIN AND IT WAS FOUND TO BE 

4027
03:31:13,608 --> 03:31:18,412
SUPERIOR FOR EXERCISE PROGRAMS 

4028
03:31:18,412 --> 03:31:26,053
DURING RECOVERY AND IT'S NOT 

4029
03:31:26,053 --> 03:31:28,489
KNOWN WHETHER IT'S BENEFICIAL IN

4030
03:31:28,489 --> 03:31:29,624
CRITICAL ILLNESS.

4031
03:31:29,624 --> 03:31:31,459
WHAT'S CLEAR IS THE CONCEPT OF 

4032
03:31:31,459 --> 03:31:34,295
ONE SIZE DOES NOT FIT ALL IN 

4033
03:31:34,295 --> 03:31:35,830
CRITICAL ILLNESS, THERE'S NO 

4034
03:31:35,830 --> 03:31:36,264
UNIVERSAL STANDARD.

4035
03:31:36,264 --> 03:31:38,633
WE HAVE GUIDELINES FOR NUTRITION

4036
03:31:38,633 --> 03:31:39,667
DELIVERY BUT LARGE PORTIONS OF 

4037
03:31:39,667 --> 03:31:42,436
THOSE GUIDELINES ARE BASED ON 

4038
03:31:42,436 --> 03:31:44,572
EXPERT OPINION OR LIMITED OR 

4039
03:31:44,572 --> 03:31:46,340
POOR QUALITY OF EVIDENCE.

4040
03:31:46,340 --> 03:31:48,843
AND SO REALLY THERE'S A NEED TO 

4041
03:31:48,843 --> 03:31:50,478
DEFINE PATIENT TYPE WITH 

4042
03:31:50,478 --> 03:31:54,048
DIFFERENTIAL MACRO AND NUTRIENT 

4043
03:31:54,048 --> 03:31:56,417
REQUIREMENTS IN RESPONSE TO 

4044
03:31:56,417 --> 03:31:58,119
TARGETED THERAPY AND AS WE'VE 

4045
03:31:58,119 --> 03:32:01,656
SEEN A FLUID RESPONSIVENESS AND 

4046
03:32:01,656 --> 03:32:04,458
VARIOUS ENDYO TYPES DEFINED 

4047
03:32:04,458 --> 03:32:09,964
WHERE PATIENTS MAY RESPOND 

4048
03:32:09,964 --> 03:32:13,868
DIFFERENTIALLY AND ARE THERE 

4049
03:32:13,868 --> 03:32:14,869
COMORBIDITIES THAT MAY INFLUENCE

4050
03:32:14,869 --> 03:32:16,771
NUTRITION AND THERE'S A NEED TO 

4051
03:32:16,771 --> 03:32:19,106
DEFINE SOME SORT OF DYNAMIC 

4052
03:32:19,106 --> 03:32:21,576
MARKER TO SELECT PATIENTS FOR 

4053
03:32:21,576 --> 03:32:23,277
SPECIFIC NUTRIENT INTERVENTIONS 

4054
03:32:23,277 --> 03:32:24,779
AND READINESS FOR ENHANCED 

4055
03:32:24,779 --> 03:32:25,379
NUTRITION.

4056
03:32:25,379 --> 03:32:28,783
WE'VE LEARNED FROM PRIOR STUDIES

4057
03:32:28,783 --> 03:32:32,253
NOW THAT UNDER FEEDING CALORIES 

4058
03:32:32,253 --> 03:32:34,055
AND APPROPRIATE PROTEIN 

4059
03:32:34,055 --> 03:32:36,257
PRESCRIPTION OR CURRENTLY 

4060
03:32:36,257 --> 03:32:38,225
UNDERSTAND PROTEIN PRESCRIPTION 

4061
03:32:38,225 --> 03:32:40,728
CONFERS TO BENEFITS TO PATIENTS 

4062
03:32:40,728 --> 03:32:45,800
BUT IN THE COURSE OF CRITICAL 

4063
03:32:45,800 --> 03:32:47,168
ILLNESS DOES AN INDIVIDUAL 

4064
03:32:47,168 --> 03:32:48,502
INCREASE READINESS FOR PROTEIN 

4065
03:32:48,502 --> 03:32:50,972
DELIVERY AND A NEED TO DEFINE 

4066
03:32:50,972 --> 03:32:53,841
ACUTE AND SUBACUTE AND CHRONIC 

4067
03:32:53,841 --> 03:32:56,777
NUTRIENT STRATEGIES IN CRITICAL 

4068
03:32:56,777 --> 03:32:58,279
ILLNESS ESPECIALLY WITH PATIENT 

4069
03:32:58,279 --> 03:32:58,879
WITH CHRONIC ILLNESS AND LUNG 

4070
03:32:58,879 --> 03:33:03,517
DISEASE.

4071
03:33:03,517 --> 03:33:06,053
THIS IS A GRAPHIC DESCRIPTION 

4072
03:33:06,053 --> 03:33:08,155
FROM A SUMMARY IN INTENSIVE CARE

4073
03:33:08,155 --> 03:33:11,492
MEDICINE THAT IN FACT THE 

4074
03:33:11,492 --> 03:33:12,360
INDIVIDUAL CONSIDERATIONS SUCH 

4075
03:33:12,360 --> 03:33:15,062
AS PREMORBID CONDITIONS NOT ONLY

4076
03:33:15,062 --> 03:33:18,799
PREMORBID NUTRITIONAL STATUS BUT

4077
03:33:18,799 --> 03:33:20,768
PREMORBID COMORBIDITIES IN TERMS

4078
03:33:20,768 --> 03:33:22,703
OF RESPIRATORY ILLNESS FOR 

4079
03:33:22,703 --> 03:33:27,742
PATIENTS WITH ACUTE LUNG INJURY 

4080
03:33:27,742 --> 03:33:34,248
IN THE RDS AND ARE THEY IN A 

4081
03:33:34,248 --> 03:33:40,521
RECOVERY OR POSTRECOVERY PHASE 

4082
03:33:40,521 --> 03:33:44,759
AND NUTRITIONAL NEEDS VARY IN 

4083
03:33:44,759 --> 03:33:50,965
POPULATIONS OF PATIENTS BUT 

4084
03:33:50,965 --> 03:33:52,767
GREAT INTERINDIVIDUAL 

4085
03:33:52,767 --> 03:33:55,036
DIFFERENCES IN PATIENT TOLERANCE

4086
03:33:55,036 --> 03:33:59,440
OF NUTRIENT INTERVENTIONS.

4087
03:33:59,440 --> 03:34:03,210
SO THERE'S BEEN SOME WORK TO TRY

4088
03:34:03,210 --> 03:34:03,911
TO UNDERSTAND BASELINE NUTRITION

4089
03:34:03,911 --> 03:34:05,479
RISK FOR PATIENTS WHO ARE 

4090
03:34:05,479 --> 03:34:07,481
CRITICALLY ILL.

4091
03:34:07,481 --> 03:34:08,783
WE HAVE SEVERAL SCORES DEVELOPED

4092
03:34:08,783 --> 03:34:16,691
IN CRITICAL ILLNESS AND THE 

4093
03:34:16,691 --> 03:34:22,563
NEWTRIC SCORE AND PANDORA AND 

4094
03:34:22,563 --> 03:34:24,598
NRS AND SOMETHING COMPREHENSIVE 

4095
03:34:24,598 --> 03:34:26,701
AT TIME OF ADMISSION TO THE ICU 

4096
03:34:26,701 --> 03:34:28,769
AND OVER THE TIME COURSE OF 

4097
03:34:28,769 --> 03:34:32,073
CRITICAL ILLNESS, SOME MARKER TO

4098
03:34:32,073 --> 03:34:33,908
ESTABLISH THAT SHIFT AND 

4099
03:34:33,908 --> 03:34:35,943
READINESS FOR INCREASED MACRO 

4100
03:34:35,943 --> 03:34:39,980
NUTRIENTS DELIVERY BECAUSE THE 

4101
03:34:39,980 --> 03:34:42,616
INITIAL STUDIES WHICH 

4102
03:34:42,616 --> 03:34:44,018
DEMONSTRATED EARLY UNDER 

4103
03:34:44,018 --> 03:34:46,020
NUTRITION AND LOWER PROTEIN 

4104
03:34:46,020 --> 03:34:48,723
TARGETS AS BEING BENEFICIAL TO 

4105
03:34:48,723 --> 03:34:51,525
PATIENTS STILL DID NOT TAKE INTO

4106
03:34:51,525 --> 03:34:53,627
ACCOUNT THE OVER ALL POTENTIAL 

4107
03:34:53,627 --> 03:34:54,628
DYNAMIC STATE OF INDIVIDUAL 

4108
03:34:54,628 --> 03:34:54,895
PATIENTS.

4109
03:34:54,895 --> 03:34:57,231
YOU'RE LOOKING AT A POPULATION 

4110
03:34:57,231 --> 03:35:01,502
OF PATIENTS WITH BENEFIT BUT WE 

4111
03:35:01,502 --> 03:35:05,039
STILL DON'T KNOW OF INDIVIDUAL 

4112
03:35:05,039 --> 03:35:07,308
PATIENTS.

4113
03:35:07,308 --> 03:35:10,678
SO WHAT THIS FIGURE IS 

4114
03:35:10,678 --> 03:35:12,079
DEMONSTRATING THIS RELATIONSHIP 

4115
03:35:12,079 --> 03:35:16,784
BETWEEN RISK OF HARM AND 

4116
03:35:16,784 --> 03:35:18,819
POTENTIAL BENEFIT BASED ON MACRO

4117
03:35:18,819 --> 03:35:21,522
NUTRIENT DELIVERY AND MAY BE A 

4118
03:35:21,522 --> 03:35:24,692
RISK OF HARM WHERE IN THE 

4119
03:35:24,692 --> 03:35:25,860
PREVIOUS STUDIES ANYWHERE FROM 

4120
03:35:25,860 --> 03:35:29,797
20% TO 50% OF CALORIE PROTEIN 

4121
03:35:29,797 --> 03:35:32,066
REQUIREMENTS PROVIDED DURING THE

4122
03:35:32,066 --> 03:35:33,901
FIRST WEEK OF CRITICAL ILLNESS 

4123
03:35:33,901 --> 03:35:36,203
AND THE POTENTIAL RISK OF HARM 

4124
03:35:36,203 --> 03:35:38,773
GOING HIGHER AND THE SPECTRUM 

4125
03:35:38,773 --> 03:35:40,307
DISEASE SEVERITY AND INDIVIDUAL 

4126
03:35:40,307 --> 03:35:41,842
SEVERITY OF ILLNESS AND 

4127
03:35:41,842 --> 03:35:43,544
RESPONSIVENESS WHERE THERE MAY 

4128
03:35:43,544 --> 03:35:46,814
BE SOME SWEET SPOT WE CAN 

4129
03:35:46,814 --> 03:35:49,350
IDENTIFY IN TERMS OF BALANCING 

4130
03:35:49,350 --> 03:35:51,252
RISK OF HARM AND POTENTIAL 

4131
03:35:51,252 --> 03:35:52,787
BENEFIT BASED ON SEVERITY OF 

4132
03:35:52,787 --> 03:35:58,959
ILLNESS.

4133
03:35:58,959 --> 03:36:05,966
YOU'LL BRIEFLY TOUCH ON THE 

4134
03:36:05,966 --> 03:36:10,738
MICROBIOME ON AACUTE ILLNESS AND

4135
03:36:10,738 --> 03:36:13,107
LITTLE IS DONE AND THERE'S 

4136
03:36:13,107 --> 03:36:14,275
MICROBIOME SIGNATURES ASSOCIATED

4137
03:36:14,275 --> 03:36:19,713
WITH CRITICAL ILLNESS AND MORE 

4138
03:36:19,713 --> 03:36:21,849
WORK TO DO AND WHETHER CHANGES 

4139
03:36:21,849 --> 03:36:24,151
THE ENTEROTYPE IS ASSOCIATED 

4140
03:36:24,151 --> 03:36:28,956
WITH IMPROVED OUTCOMES.

4141
03:36:28,956 --> 03:36:32,760
WE HEARD QUITE A LOT ABOUT THE 

4142
03:36:32,760 --> 03:36:38,632
GUT LUNG ACCESS AND THIS IS A 

4143
03:36:38,632 --> 03:36:42,770
FIGURE IN CELLULAR MICROBIOLOGY 

4144
03:36:42,770 --> 03:36:47,074
IN 2018 AND DYSBIOSIS ASSOCIATED

4145
03:36:47,074 --> 03:36:52,479
WITH ALTERED MICROBIOTA AND 

4146
03:36:52,479 --> 03:36:53,547
POTENTIATING LUNG DAMAGE AND 

4147
03:36:53,547 --> 03:36:54,815
INFLAMMATION THROUGH DIRECT AND 

4148
03:36:54,815 --> 03:36:58,185
SIGNALLING MOLECULES AND COULD 

4149
03:36:58,185 --> 03:37:05,192
RESTORE THE  MICROBIOTA AND 

4150
03:37:05,192 --> 03:37:11,098
ALTER THE LUNG INFLAMMATION.

4151
03:37:11,098 --> 03:37:12,766
THIS IS ANOTHER FIGURE 

4152
03:37:12,766 --> 03:37:16,770
DESCRIBING THE CONCEPT OF AN IN 

4153
03:37:16,770 --> 03:37:20,708
FLAMED LEAKY GUT WHICH THEN IS 

4154
03:37:20,708 --> 03:37:21,342
ASSOCIATED WITH FURTHER DOWN 

4155
03:37:21,342 --> 03:37:24,778
STREAM SIGNALLING IN TERMS OF 

4156
03:37:24,778 --> 03:37:28,515
LUNG INFLAMMATION AND COULD HAVE

4157
03:37:28,515 --> 03:37:30,851
POTENTIAL TREATMENTS AND 

4158
03:37:30,851 --> 03:37:35,322
MICROBIOTA TRANSPLANTATION AND 

4159
03:37:35,322 --> 03:37:37,892
PARTLY  POTENTIALLY NEXT 

4160
03:37:37,892 --> 03:37:43,097
GENERATION PRE OR PROBIOTICS AND

4161
03:37:43,097 --> 03:37:46,367
INCREASED FIBER INTAKE AND HAVE 

4162
03:37:46,367 --> 03:37:48,135
BETTER PHENOTYPE ASSOCIATED WITH

4163
03:37:48,135 --> 03:37:54,475
A WAY OR METHODOLOGY TO IMPROVE 

4164
03:37:54,475 --> 03:37:58,913
ACUTE LUNG INFLAMMATION THEREBY 

4165
03:37:58,913 --> 03:38:00,781
WE COULD AFFECT THE GUT TO TREAT

4166
03:38:00,781 --> 03:38:04,952
ACUTE LUNG INJURY.

4167
03:38:04,952 --> 03:38:06,887
THIS IS SOME OF THE WORK I DO.

4168
03:38:06,887 --> 03:38:11,458
THIS IS NOT MY STUDY BUT LOOKING

4169
03:38:11,458 --> 03:38:15,496
AT WHETHER PREBIOTIC FIBER 

4170
03:38:15,496 --> 03:38:16,463
IMPROVED CONCENTRATIONS TO 

4171
03:38:16,463 --> 03:38:19,366
REDUCE LUNG INFLAMMATION AND 

4172
03:38:19,366 --> 03:38:22,303
PEDIATRIC IN RVS AND THIS IS 

4173
03:38:22,303 --> 03:38:28,108
FOUNDATIONAL WORK DESCRIBING HOW

4174
03:38:28,108 --> 03:38:32,780
SODIUM BUTYRATE IS A PRODUCT OF 

4175
03:38:32,780 --> 03:38:39,987
MICRO ORGANISMS IN THE G.I. 

4176
03:38:39,987 --> 03:38:42,122
TRACT INCREASE INFLAMMATION.

4177
03:38:42,122 --> 03:38:45,893
THERE ARE A WHOLE HOST OF 

4178
03:38:45,893 --> 03:38:48,028
PREBIOTIC FIBERS AND THERE'S ONE

4179
03:38:48,028 --> 03:38:51,832
OF PARTICULAR INTEREST TO MYSELF

4180
03:38:51,832 --> 03:38:54,868
IS A SOLUBLE NON VISCOUS VIBER 

4181
03:38:54,868 --> 03:38:58,605
AND HAS PREBIOTIC EFFECTS AND IN

4182
03:38:58,605 --> 03:39:03,911
EARLY STUDIES IS DEMONSTRATED TO

4183
03:39:03,911 --> 03:39:08,749
IMPROVE ORGANISM AND LOOK AT 

4184
03:39:08,749 --> 03:39:14,488
FECAL BUTYRATE CONCENTRATION.

4185
03:39:14,488 --> 03:39:18,359
THERE'S A NUMBER OF GAPS IN NEED

4186
03:39:18,359 --> 03:39:21,261
ACROSS TRIALS IN TERMS OF MACRO 

4187
03:39:21,261 --> 03:39:22,096
NUTRIENT DELIVERY COMPARING HIGH

4188
03:39:22,096 --> 03:39:25,833
VERSUS LOW PROTEIN AN ENERGY 

4189
03:39:25,833 --> 03:39:29,903
DOSE AND THE SUBACUTE PHASE TO 

4190
03:39:29,903 --> 03:39:35,642
DETERMINE MICRO AND MACRO DOSE 

4191
03:39:35,642 --> 03:39:41,215
IN IL ILLNESS AND LOOKING AT 

4192
03:39:41,215 --> 03:39:43,517
CRITICAL ILLNESS WITH AND 

4193
03:39:43,517 --> 03:39:44,718
WITHOUT LUNG INJURY AND FURTHER 

4194
03:39:44,718 --> 03:39:48,322
WORK IN THE POTENTIAL EFFICACY 

4195
03:39:48,322 --> 03:39:52,960
OF KETO GENIC DIETS AND PRAG MAT

4196
03:39:52,960 --> 03:39:56,497
IG TRIALS UNTIL FULL NUTRITION 

4197
03:39:56,497 --> 03:39:57,531
IS ACHIEVED.

4198
03:39:57,531 --> 03:39:58,899
THERE'S SIGNIFICANT WORK NEEDED 

4199
03:39:58,899 --> 03:40:00,167
TO DETERMINE WHICH PATIENT 

4200
03:40:00,167 --> 03:40:02,936
GROUPS MAY BENEFIT FROM 

4201
03:40:02,936 --> 03:40:05,339
NUTRITIONAL INTERVENTIONS.

4202
03:40:05,339 --> 03:40:08,709
AND TO BE GUIDED BY CLINICAL OR 

4203
03:40:08,709 --> 03:40:12,146
BIOMARKER ASSESSMENT TOOLS TO 

4204
03:40:12,146 --> 03:40:13,180
DEFINE READINESS TO ADVANCE 

4205
03:40:13,180 --> 03:40:15,516
MACRO NUTRIENT DELIVERY OR 

4206
03:40:15,516 --> 03:40:18,318
READINESS FOR MICRO NUTRIENTS OR

4207
03:40:18,318 --> 03:40:20,120
OMEGA 3 FATTY ACIDS.

4208
03:40:20,120 --> 03:40:26,126
AND FURTHER WORK FOR THE 

4209
03:40:26,126 --> 03:40:29,296
GUT-LUNG AXIS AND HOW IT MAY BE 

4210
03:40:29,296 --> 03:40:34,068
USED TO IMPROVE CRITICAL 

4211
03:40:34,068 --> 03:40:36,570
ILLNESS.

4212
03:40:36,570 --> 03:40:38,072
PARTICULAR KNOWLEDGE GAPS WITHIN

4213
03:40:38,072 --> 03:40:40,774
THE LUNG-GUT AXIS ARE TO DESIGN 

4214
03:40:40,774 --> 03:40:41,508
NUTRIENT INTERVENTIONS TO 

4215
03:40:41,508 --> 03:40:48,782
INFLUENCE ACUTE LUNG DISEASE BY 

4216
03:40:48,782 --> 03:40:52,453
MANIPULATING THE  MICROBIOME 

4217
03:40:52,453 --> 03:40:53,787
NICHE AND ACUTE LUNG 

4218
03:40:53,787 --> 03:40:54,721
INFLAMMATION AND INJURY AND 

4219
03:40:54,721 --> 03:40:56,757
THERE ARE MULTIPLE PROMISING 

4220
03:40:56,757 --> 03:41:04,765
ANIMAL STUDIES WE NEED TO 

4221
03:41:04,765 --> 03:41:09,603
CONSIDER AN INFLUENCE 

4222
03:41:09,603 --> 03:41:10,704
IMMUNONUTRITION OVERLAID 

4223
03:41:10,704 --> 03:41:17,811
APPROPRIATE MACRO NEUTRIENT 

4224
03:41:17,811 --> 03:41:18,078
DELIVERY.

4225
03:41:18,078 --> 03:41:18,712
THAT'S MY LAST SLIDE.

4226
03:41:18,712 --> 03:41:19,446
THANK YOU VERY MUCH.

4227
03:41:19,446 --> 03:41:28,422
>> THANK YOU VERY MUCH.

4228
03:41:28,422 --> 03:41:29,289
I THINK WE'LL HAVE A SUMMARY OF 

4229
03:41:29,289 --> 03:41:39,500
THE SESSION.

4230
03:42:02,055 --> 03:42:03,524
>> THAT'S AN INTERESTING
SESSION

4231
03:42:03,524 --> 03:42:06,093
AND AN INTERESTING GROUP OF 

4232
03:42:06,093 --> 03:42:06,994
TALKS WHICH COVERED A LOT OF 

4233
03:42:06,994 --> 03:42:07,361
TERRITORY.

4234
03:42:07,361 --> 03:42:10,264
WE STARTED OFF WITH DR. HANSEL 

4235
03:42:10,264 --> 03:42:13,700
WHO SPOKE TO US ABOUT NUTRITION 

4236
03:42:13,700 --> 03:42:14,301
INTERVENTIONS IN UNDER SERVED 

4237
03:42:14,301 --> 03:42:21,275
POPULATIONS.

4238
03:42:21,275 --> 03:42:23,277
SHE PROVIDED EVIDENCE AROUND A 

4239
03:42:23,277 --> 03:42:27,014
NUMBER OF INTERVENTIONS, VITAMIN

4240
03:42:27,014 --> 03:42:32,486
C, OMEGA 3 AND VITAMIN D AND A 

4241
03:42:32,486 --> 03:42:34,254
AND COMING TO THE CONCLUSION 

4242
03:42:34,254 --> 03:42:36,757
MORE WORK NEEDS TO BE DONE IN 

4243
03:42:36,757 --> 03:42:40,761
UNDERSTANDING WHAT NUTRIENT 

4244
03:42:40,761 --> 03:42:43,263
SUPPLEMENTATION MAY BE HELPFUL 

4245
03:42:43,263 --> 03:42:44,364
IN COPD.

4246
03:42:44,364 --> 03:42:46,099
I THINK THAT THIS WOULD COME 

4247
03:42:46,099 --> 03:42:48,101
AWAY WITH THE CONCLUSION FROM 

4248
03:42:48,101 --> 03:42:48,769
DR. HANSEL'S WORK MORE NEEDS TO 

4249
03:42:48,769 --> 03:42:50,237
BE DONE.

4250
03:42:50,237 --> 03:42:56,777
AND WE THEN MOVED ON TO DR

4251
03:42:56,777 --> 03:43:01,248
DR. CARBONE'S PRESENTATION FOR 

4252
03:43:01,248 --> 03:43:04,751
INTERVENTIONS FOR 

4253
03:43:04,751 --> 03:43:07,087
CARDIORESPIRATORY FITNESS AND 

4254
03:43:07,087 --> 03:43:09,489
INTERESTING WORK TOWARD THE END 

4255
03:43:09,489 --> 03:43:11,358
OF THE TALK WITH REGARD TO 

4256
03:43:11,358 --> 03:43:11,992
CONTROLLED FEEDING STUDIES AND 

4257
03:43:11,992 --> 03:43:12,626
POTENTIAL OPPORTUNITIES IN THAT 

4258
03:43:12,626 --> 03:43:20,567
AREA.

4259
03:43:20,567 --> 03:43:23,170
MY TALK FOCUSSED ON HEALTHY 

4260
03:43:23,170 --> 03:43:26,807
DIETS AND CLINICAL TRIALS THAT 

4261
03:43:26,807 --> 03:43:28,775
HAVE BEEN USED TO UNDERSTAND THE

4262
03:43:28,775 --> 03:43:31,311
EFFECTS OF HEALTHY DIETS ON LUNG

4263
03:43:31,311 --> 03:43:32,179
DISEASE PARTICULARLY ASTHMA AND 

4264
03:43:32,179 --> 03:43:35,449
COPD.

4265
03:43:35,449 --> 03:43:36,783
AND MORE WORK NEED TO BE DONE 

4266
03:43:36,783 --> 03:43:39,453
THERE GIVEN THE LIMITED AMOUNT 

4267
03:43:39,453 --> 03:43:39,953
OF EVIDENCE THAT'S BEEN 

4268
03:43:39,953 --> 03:43:44,758
AVAILABLE TO DATE.

4269
03:43:44,758 --> 03:43:50,364
DR. PANDA TALKED TO US ABOUT 

4270
03:43:50,364 --> 03:43:52,766
TIME RESTRICTED FEEDING.

4271
03:43:52,766 --> 03:43:56,236
INTERESTING OBSERVATIONS THERE 

4272
03:43:56,236 --> 03:44:00,774
AROUND THE SYNERGISTIC 

4273
03:44:00,774 --> 03:44:02,175
INTERACTIONS WITH NUTRITION 

4274
03:44:02,175 --> 03:44:03,377
QUALITY AND CALORIC RESTRICTION 

4275
03:44:03,377 --> 03:44:08,315
AND THE BENEFIT FOR ADULTS TO 

4276
03:44:08,315 --> 03:44:09,883
BENEFIT FROM TIME-RESTRICTED 

4277
03:44:09,883 --> 03:44:10,350
FEEDING.

4278
03:44:10,350 --> 03:44:15,522
MORE HUMAN INTERVENTION STUDIES 

4279
03:44:15,522 --> 03:44:17,024
ARE NEEDED TO UNDERSTAND THE 

4280
03:44:17,024 --> 03:44:22,496
EFFECTS ON CARDIORESPIRATORY 

4281
03:44:22,496 --> 03:44:23,797
OUTCOMES.

4282
03:44:23,797 --> 03:44:26,433
AND TIMELY WE HEARD FROM 

4283
03:44:26,433 --> 03:44:29,770
DR. TYPPO AND HER WORK IDENTIFY 

4284
03:44:29,770 --> 03:44:35,642
LOTS OF IMPORTANT QUESTIONS 

4285
03:44:35,642 --> 03:44:37,511
AROUND THE ROLE OF NUTRITION AND

4286
03:44:37,511 --> 03:44:42,983
CRITICAL ILLNESS AND THE NEED TO

4287
03:44:42,983 --> 03:44:52,759
COMPARE HIGH VERSUS LOW INTAKE 

4288
03:44:52,759 --> 03:44:54,661
AND EFFICACY OF KETOGENIC DIETS 

4289
03:44:54,661 --> 03:45:02,235
AND THE NEED FOR PRAGMATIC 

4290
03:45:02,235 --> 03:45:03,370
TRIALS AND SUPPLEMENTING 

4291
03:45:03,370 --> 03:45:08,308
MICRONUTRIENT NEEDS.

4292
03:45:08,308 --> 03:45:17,084
SHE RAISED THE QUESTION OF WHICH

4293
03:45:17,084 --> 03:45:19,920
PATIENT GROUPS MAY BENEFIT AND 

4294
03:45:19,920 --> 03:45:27,427
THE GUT-LUNG AXIS AND MAY 

4295
03:45:27,427 --> 03:45:36,770
BENEFIT PATIENTS OF CRITICAL 

4296
03:45:36,770 --> 03:45:37,371
ILLNESS.

4297
03:45:37,371 --> 03:45:40,273
NOW WE'LL MOVE TO OPPORTUNITY 

4298
03:45:40,273 --> 03:45:41,675
FOR COMMENTS AND QUESTIONS FOR 

4299
03:45:41,675 --> 03:45:42,476
MATERIAL SHARED.

4300
03:45:42,476 --> 03:45:45,545
DR. MA, I DON'T KNOW IF YOU'VE 

4301
03:45:45,545 --> 03:45:49,149
BEEN ABLE TO CHECK THE CHAT AND 

4302
03:45:49,149 --> 03:45:51,017
SEE IF THERE'S ANY QUESTIONS.

4303
03:45:51,017 --> 03:45:56,123
>> I HAVEN'T SEEN SPECIFIC

4304
03:45:56,123 --> 03:46:02,195
QUESTIONS IN THE CHAT.

4305
03:46:02,195 --> 03:46:04,431
I CAN PUT YOUR QUESTIONS IN THE 

4306
03:46:04,431 --> 03:46:08,668
CHAT AND IN THE MEANTIME IF THE 

4307
03:46:08,668 --> 03:46:10,070
A/V TEAM CAN TAKE DOWN THE SLIDE

4308
03:46:10,070 --> 03:46:20,447
TO SEE THE PANELISTS.

4309
03:46:23,617 --> 03:46:26,286
I'LL START WITH A QUESTION FOR 

4310
03:46:26,286 --> 03:46:29,589
THE PANEL WITH SEVERAL THEMES 

4311
03:46:29,589 --> 03:46:30,824
THOUGH THE TALKS SPAN A BROAD 

4312
03:46:30,824 --> 03:46:32,926
SPECTRUM BUT I THINK THERE'S A 

4313
03:46:32,926 --> 03:46:36,730
COMMON THEME WHICH IS WE NEED 

4314
03:46:36,730 --> 03:46:38,398
MORE DEFINITIVE TRIALS IN TERMS 

4315
03:46:38,398 --> 03:46:45,539
OF LOOKING AT NUTRITION AND ITS 

4316
03:46:45,539 --> 03:46:50,544
EFFECTS IN RESPIRATORY CELLS AND

4317
03:46:50,544 --> 03:46:51,545
DEFINE WHICH DISEASE AND 

4318
03:46:51,545 --> 03:46:52,679
OUTCOMES BUT OVER ALL I THINK WE

4319
03:46:52,679 --> 03:46:55,849
HEARD FROM ALL THE SPEAKERS WE 

4320
03:46:55,849 --> 03:47:06,159
NEED MORE TRIALS.

4321
03:47:07,427 --> 03:47:08,628
>> THERE'S NUTRITION 

4322
03:47:08,628 --> 03:47:12,799
INTERVENTION WHETHER A DIETARY 

4323
03:47:12,799 --> 03:47:16,770
PATTERN OR YOU THINK GIVEN THE 

4324
03:47:16,770 --> 03:47:20,774
EVIDENCE PRESENTED CRASS THE 

4325
03:47:20,774 --> 03:47:31,318
SESSION TO JUSTIFY A MULTI-SITE 

4326
03:47:35,889 --> 03:47:37,824
DEFINITIVE INTERVENTION TRIAL TO

4327
03:47:37,824 --> 03:47:43,263
THE EFFICACY FOR SPECIFIC 

4328
03:47:43,263 --> 03:47:48,768
OUTCOMES IN CERTAIN NON-DISEASE 

4329
03:47:48,768 --> 03:47:50,837
AREAS.

4330
03:47:50,837 --> 03:47:52,772
>> MAYBE I CAN KICK OFF
WITH A 

4331
03:47:52,772 --> 03:47:56,176
COMMENT.

4332
03:47:56,176 --> 03:48:02,349
I THINK YES BUT I THINK THE BODY

4333
03:48:02,349 --> 03:48:04,985
OF EVIDENCE AROUND FRUIT AND 

4334
03:48:04,985 --> 03:48:08,922
VEGETABLES AS A PRIMARY AND 

4335
03:48:08,922 --> 03:48:11,958
SECONDARY INTERVENTION FOR 

4336
03:48:11,958 --> 03:48:13,393
RESPIRATORY DISEASES IS VERY 

4337
03:48:13,393 --> 03:48:16,429
STRONG AND NOT JUST BASED ON THE

4338
03:48:16,429 --> 03:48:17,697
CLINICAL TRIALS THAT I'VE 

4339
03:48:17,697 --> 03:48:21,334
PRESENTED TODAY BUT BASED ON THE

4340
03:48:21,334 --> 03:48:25,438
FACT THAT THERE'S A HUGE BODY OF

4341
03:48:25,438 --> 03:48:26,673
LITERATURE THAT SHOWS FRUIT AND 

4342
03:48:26,673 --> 03:48:32,712
VEGETABLES ARE ABLE TO REDUCE 

4343
03:48:32,712 --> 03:48:35,215
SYSTEMIC INFLAMMATION.

4344
03:48:35,215 --> 03:48:36,983
I THINK THAT THAT BODY OF 

4345
03:48:36,983 --> 03:48:41,988
EVIDENCE IN ADDITION TO THE 

4346
03:48:41,988 --> 03:48:45,125
EPIDEMIOLOGY THAT WE HAVE IN 

4347
03:48:45,125 --> 03:48:48,261
RESPIRATORY DISEASE AND THE 

4348
03:48:48,261 --> 03:48:48,895
EARLY INTERVENTION TRIALS I 

4349
03:48:48,895 --> 03:48:54,734
THINK IS READY TO BE TESTED.

4350
03:48:54,734 --> 03:48:57,037
TO ME THE REAL QUESTION IS NOT 

4351
03:48:57,037 --> 03:48:58,638
WHETHER OR NOT IT'S GOING TO BE 

4352
03:48:58,638 --> 03:48:59,806
AN EFFECTIVE INTERVENTION.

4353
03:48:59,806 --> 03:49:03,677
I THINK THE QUESTION IS HOW 

4354
03:49:03,677 --> 03:49:09,182
WOULD WE EVER TRANSLATE THAT TO 

4355
03:49:09,182 --> 03:49:10,350
EVERYDAY PRACTICE.

4356
03:49:10,350 --> 03:49:12,752
THERE'S BEEN INTERVENTIONS IN 

4357
03:49:12,752 --> 03:49:16,523
AUSTRALIA AND I'M ASSUMING WE 

4358
03:49:16,523 --> 03:49:19,759
USUALLY FOLLOW WHAT HAPPENS IN 

4359
03:49:19,759 --> 03:49:21,561
THE U.S. SO I ASSUME IT'S BEEN 

4360
03:49:21,561 --> 03:49:22,529
THE SAME IN THE U.S.

4361
03:49:22,529 --> 03:49:28,234
THERE'S BEEN SO MANY ATTEMPTS AT

4362
03:49:28,234 --> 03:49:31,571
TRYING TO CHANGE DIETARY HABITS 

4363
03:49:31,571 --> 03:49:34,708
ACROSS THE COMMUNITY.

4364
03:49:34,708 --> 03:49:42,449
THERE'S BEEN INTERVENTION AND 

4365
03:49:42,449 --> 03:49:44,317
STRATEGIES TO GET PEOPLE TO 

4366
03:49:44,317 --> 03:49:46,820
IMPROVE THEIR DIETARY INTAKE AND

4367
03:49:46,820 --> 03:49:49,522
STILL LESS THAN 5% OF THE 

4368
03:49:49,522 --> 03:49:51,257
POPULATION CONSUMES WHAT THE 

4369
03:49:51,257 --> 03:49:51,992
DIETARY RECOMMENDATION IS.

4370
03:49:51,992 --> 03:49:53,994
MY QUESTION ISN'T WHETHER OR NOT

4371
03:49:53,994 --> 03:49:54,661
THERE'S SOMETHING THAT'S READY 

4372
03:49:54,661 --> 03:49:57,631
TO BE TESTED IN A TRIAL.

4373
03:49:57,631 --> 03:50:00,767
MY QUESTION IS HOW WOULD WE THEN

4374
03:50:00,767 --> 03:50:01,501
ACTUALLY MAKE THAT STRATEGY THAT

4375
03:50:01,501 --> 03:50:09,275
COULD BE ADOPTED?

4376
03:50:09,275 --> 03:50:18,118
OR WOULD BE ADOPTED?

4377
03:50:18,118 --> 03:50:21,821
>> THAT'S A GOOD POINT AND
AS A 

4378
03:50:21,821 --> 03:50:23,423
FOLLOW-UP WHAT DO WE THINK THE 

4379
03:50:23,423 --> 03:50:26,126
ROLE OF INDUSTRY -- WE TALKED 

4380
03:50:26,126 --> 03:50:27,994
ABOUT SCIENTIFIC EVIDENCE 

4381
03:50:27,994 --> 03:50:34,267
THROUGHOUT THIS WORKSHOP AND 

4382
03:50:34,267 --> 03:50:36,770
WITH SOME CONNECTION TO HEALTH 

4383
03:50:36,770 --> 03:50:40,640
POLICY BUT I DON'T THINK WE 

4384
03:50:40,640 --> 03:50:42,876
NECESSARILY CAN COMMENT ON THE 

4385
03:50:42,876 --> 03:50:44,611
ROLE OF INDUSTRY.

4386
03:50:44,611 --> 03:50:46,346
AS YOU POINTED OUT DR. WOOD 

4387
03:50:46,346 --> 03:50:47,080
BEHAVIOR CHANGE IS HARD AND 

4388
03:50:47,080 --> 03:50:50,216
HARDER TO MAINTAIN.

4389
03:50:50,216 --> 03:50:52,752
WE'RE NOT GIVING UP ON THE 

4390
03:50:52,752 --> 03:50:57,657
SCIENCE OF BEING ABLE TO CHANGE 

4391
03:50:57,657 --> 03:50:59,559
AS IT RELATES TO LIFESTYLE 

4392
03:50:59,559 --> 03:51:01,695
BEHAVIORS IN EATING AND DIETARY 

4393
03:51:01,695 --> 03:51:02,562
CHANGE.

4394
03:51:02,562 --> 03:51:06,433
AT THE SAME TIME IT MAY BE TOO 

4395
03:51:06,433 --> 03:51:07,634
NARROW APPROACH AND MAY BE TOO 

4396
03:51:07,634 --> 03:51:11,404
MANY BARRIERS.

4397
03:51:11,404 --> 03:51:21,381
WHAT ARE INFLUENCERS IN 

4398
03:51:21,381 --> 03:51:22,048
TRANSLATING THE EVIDENCE WE 

4399
03:51:22,048 --> 03:51:28,755
CONTINUE TO GENERATE INTO 

4400
03:51:28,755 --> 03:51:31,424
ADOPTION?

4401
03:51:31,424 --> 03:51:38,231
>> ONE SPECIFIC ASPECT MAY
BE 

4402
03:51:38,231 --> 03:51:38,832
WHERE THE INDUSTRY IS HEAVILY 

4403
03:51:38,832 --> 03:51:46,840
INVOLVED.

4404
03:51:46,840 --> 03:51:48,541
IF WE START THEY WOULD BE ABLE 

4405
03:51:48,541 --> 03:51:49,242
TO IMPLEMENT THAT.

4406
03:51:49,242 --> 03:51:54,514
ONCE YOU START THERE THE 

4407
03:51:54,514 --> 03:52:04,057
QUESTION IS CAN INDUSTRY 

4408
03:52:04,057 --> 03:52:07,594
CONTINUE TO PROVIDE NUTRITION 

4409
03:52:07,594 --> 03:52:09,629
FOOD.

4410
03:52:09,629 --> 03:52:14,634
STARTING FROM THE HOSPITAL STAY.

4411
03:52:14,634 --> 03:52:24,511
THAT'S ONE.

4412
03:52:24,511 --> 03:52:34,154
AND RECOGNIZING THE CHANGES AND 

4413
03:52:34,154 --> 03:52:38,458
TRYING TO FIGURE OUT HOW TO 

4414
03:52:38,458 --> 03:52:40,627
INCREASE FIBER AND PROTEIN 

4415
03:52:40,627 --> 03:52:40,860
INTAKE.

4416
03:52:40,860 --> 03:52:43,897
THIS COULD BE ANOTHER SEGUE TO 

4417
03:52:43,897 --> 03:52:48,768
GET ATTENTION FROM INDUSTRY 

4418
03:52:48,768 --> 03:52:52,305
BECAUSE EVERYBODY'S TRYING TO 

4419
03:52:52,305 --> 03:52:52,539
MARKET.

4420
03:52:52,539 --> 03:53:02,916
THOSE ARE MY THOUGHTS.

4421
03:53:02,916 --> 03:53:06,085
>> GRANTED I'M NOT AN
ADULT 

4422
03:53:06,085 --> 03:53:14,961
INTENSISTIST -- IN TENSIVIST BUT

4423
03:53:14,961 --> 03:53:16,763
WE DECIDE EVERYTHING OUR 

4424
03:53:16,763 --> 03:53:18,932
PATIENTS ARE TAKING IN.

4425
03:53:18,932 --> 03:53:24,737
IT'S ALMOST SIMPLER IN SOME 

4426
03:53:24,737 --> 03:53:28,408
DEGREE BECAUSE I DON'T HAVE TO 

4427
03:53:28,408 --> 03:53:35,148
WORRY ABOUT PATIENT BEHAVIOR BUT

4428
03:53:35,148 --> 03:53:36,749
PRESCRIBER BEHAVIOR AND CREATING

4429
03:53:36,749 --> 03:53:42,121
A BODY OF EVIDENCE TO DETERMINE 

4430
03:53:42,121 --> 03:53:44,691
WHAT APPROPRIATE NUTRITIONAL 

4431
03:53:44,691 --> 03:53:48,461
STRATEGIES ARE AND IT'S A 

4432
03:53:48,461 --> 03:53:49,996
DIFFERENT PHILOSOPHY BECAUSE THE

4433
03:53:49,996 --> 03:53:50,663
FRUIT AND VEGETABLE OUT PATIENT 

4434
03:53:50,663 --> 03:53:53,466
MANAGEMENT IN TERMS OF 

4435
03:53:53,466 --> 03:53:59,405
INTERVENTION IS ABOUT DISEASE 

4436
03:53:59,405 --> 03:54:01,808
PRE  PROGRESSION AND HEALTH AND 

4437
03:54:01,808 --> 03:54:04,143
MIND SET RATHER THAN RESOLVING 

4438
03:54:04,143 --> 03:54:08,581
AN ACUTE ILLNESS WHICH IS A 

4439
03:54:08,581 --> 03:54:12,752
DIFFERENT PROBLEM THAT PROBABLY 

4440
03:54:12,752 --> 03:54:15,989
REQUIRES DIFFERENT APPROACHES.

4441
03:54:15,989 --> 03:54:19,893
I THINK IN THE ADULT CRITICAL 

4442
03:54:19,893 --> 03:54:25,465
CARE LITERATURE OF ESTABLISHING 

4443
03:54:25,465 --> 03:54:35,942
FUNDAMENTAL ISSUES AND THE 

4444
03:54:36,809 --> 03:54:40,380
PROBLEM IS OVERLAID WITH 

4445
03:54:40,380 --> 03:54:44,751
MICRONUTRIENTS AND OMEG OMEGA 3 

4446
03:54:44,751 --> 03:54:46,486
LOOKING AT THE TIMING FOR THE 

4447
03:54:46,486 --> 03:54:48,087
INDIVIDUAL PATIENT FOR WHEN 

4448
03:54:48,087 --> 03:54:49,389
THEY'RE READY TO RECEIVE OR WHEN

4449
03:54:49,389 --> 03:54:52,759
IS THE APPROPRIATE TIME FOR A 

4450
03:54:52,759 --> 03:54:54,060
PARTICULAR MICRO NUTRIENT 

4451
03:54:54,060 --> 03:54:54,327
NUTRITION.

4452
03:54:54,327 --> 03:54:57,497
I DON'T THINK THE STORY'S CLOSED

4453
03:54:57,497 --> 03:54:59,332
DESPITE WE SHOWED NEGATIVE 

4454
03:54:59,332 --> 03:54:59,899
TRIALS.

4455
03:54:59,899 --> 03:55:04,737
THOSE WERE OVERLAID UPON A 

4456
03:55:04,737 --> 03:55:07,106
PRACTICE WHERE THE COMMUNITY 

4457
03:55:07,106 --> 03:55:09,208
DIDN'T KNOW WHAT WAS APPROPRIATE

4458
03:55:09,208 --> 03:55:12,745
DOSE TIMING AND NOW THAT HAS 

4459
03:55:12,745 --> 03:55:13,446
STARTED TO BE INVOLVED.

4460
03:55:13,446 --> 03:55:15,949
IT MAY BE TIME TO ADDRESS THE 

4461
03:55:15,949 --> 03:55:18,751
ISSUES OF IMMUNONUTRITION.

4462
03:55:18,751 --> 03:55:20,687
HOPEFULLY WE CAN BUILD THE TOOL 

4463
03:55:20,687 --> 03:55:22,789
TO FY THE RIGHT PATIENT 

4464
03:55:22,789 --> 03:55:23,356
POPULATION.

4465
03:55:23,356 --> 03:55:25,792
AND THE IDEA WOULD HOPEFULLY BE 

4466
03:55:25,792 --> 03:55:28,761
YOU WOULD THEN PROVIDE PATIENTS 

4467
03:55:28,761 --> 03:55:30,396
WITH APPROPRIATE NUTRITIONAL 

4468
03:55:30,396 --> 03:55:32,398
COUNSELING SO WHEN THEY'RE HOME 

4469
03:55:32,398 --> 03:55:33,700
MANAGING THEIR CHRONIC LUNG 

4470
03:55:33,700 --> 03:55:36,736
INJURY AND ILLNESS, HOW TO BEST 

4471
03:55:36,736 --> 03:55:45,345
FEED THEMSELVES.

4472
03:55:45,345 --> 03:55:46,646
>> IT'S A DIFFERENT
PROBLEM 

4473
03:55:46,646 --> 03:55:47,814
YOU'VE GOT.

4474
03:55:47,814 --> 03:55:51,551
I WAS QUITE INTERESTED TO EXTEND

4475
03:55:51,551 --> 03:55:54,487
THIS THOUGHT TO DR. HANSEL.

4476
03:55:54,487 --> 03:55:58,658
SHE MUST HAVE HAD TO LEAVE.

4477
03:55:58,658 --> 03:56:01,294
DID SHE?

4478
03:56:01,294 --> 03:56:03,930
>> YES, SHE STEPPED AWAY 

4479
03:56:03,930 --> 03:56:04,230
TEMPORARILY.

4480
03:56:04,230 --> 03:56:06,899
>> OKAY.

4481
03:56:06,899 --> 03:56:12,405
ONE THING THAT OCCURRED TO ME 

4482
03:56:12,405 --> 03:56:17,443
WHEN DR. HANSEL WAS SPEAKING IT 

4483
03:56:17,443 --> 03:56:18,344
WAS INTERESTING THE INFLAMMATION

4484
03:56:18,344 --> 03:56:21,814
AROUND FOOD SECURITY HAS BEEN A 

4485
03:56:21,814 --> 03:56:25,084
KEY ISSUE FOR COPD PATIENTS AND 

4486
03:56:25,084 --> 03:56:26,919
SOMETHING WE SEE IN PATIENTS WE 

4487
03:56:26,919 --> 03:56:27,420
WORK WITH.

4488
03:56:27,420 --> 03:56:32,759
AGAIN IT MAKES YOU WONDER DO WE 

4489
03:56:32,759 --> 03:56:34,627
ACTUALLY NEED TO TREAT THE ROOT 

4490
03:56:34,627 --> 03:56:38,731
CAUSE AND ADDRESS THE FOOD 

4491
03:56:38,731 --> 03:56:39,465
SECURITY.

4492
03:56:39,465 --> 03:56:41,768
IF PEOPLE ARE FED BETTER QUALITY

4493
03:56:41,768 --> 03:56:47,573
DIET THEY WON'T HAVE THE 

4494
03:56:47,573 --> 03:56:54,514
MICRONUTRIENT DEEFFICIFICIENCIE 

4495
03:56:54,514 --> 03:56:55,715
SO MUCH COMES DOWN TO PEOPLE 

4496
03:56:55,715 --> 03:56:58,451
EATING POOR QUALITY DIETS.

4497
03:56:58,451 --> 03:57:00,753
DO WE NEED TO ADDRESS THAT 

4498
03:57:00,753 --> 03:57:01,888
RATHER THAN TRYING TO FIX THE 

4499
03:57:01,888 --> 03:57:09,195
PROBLEM THAT WE'VE GOT AT THE 

4500
03:57:09,195 --> 03:57:14,000
END OF THE LINE?

4501
03:57:14,000 --> 03:57:24,544
>> THE IDEA OF THE FOOD
INDUSTRY

4502
03:57:24,811 --> 03:57:32,919
AND LOOK AT PRODUCERS AND SEE 

4503
03:57:32,919 --> 03:57:43,362
WHETHER HOSPITALS CAN AND 

4504
03:57:44,263 --> 03:57:51,771
POPULATION HEALTH HAS ADDRESSED 

4505
03:57:51,771 --> 03:58:02,148
FRUIT AND VEGETABLES.

4506
03:58:29,609 --> 03:58:32,879
>> AND USING STUDIES TO 

4507
03:58:32,879 --> 03:58:33,513
CATEGORIZE PATTERNS IN SPECIFIC 

4508
03:58:33,513 --> 03:58:36,382
POPULATIONS.

4509
03:58:36,382 --> 03:58:39,652
>> THERE'S QUITE A FEW 

4510
03:58:39,652 --> 03:58:40,987
COLLABORATORS FROM AUSTRALIA 

4511
03:58:40,987 --> 03:58:44,223
THAT REACHED OUT AND USING THE 

4512
03:58:44,223 --> 03:58:44,390
APP.

4513
03:58:44,390 --> 03:58:49,295
OF COURSE THERE'S SOME COST 

4514
03:58:49,295 --> 03:58:49,996
INVOLVED.

4515
03:58:49,996 --> 03:58:51,564
SOMETIMES FOR YOUNG FACULTY WE 

4516
03:58:51,564 --> 03:58:56,269
HELP THEM BY GATHERING SOME DATA

4517
03:58:56,269 --> 03:59:06,679
IN FEASIBILITY STUDIES.

4518
03:59:09,048 --> 03:59:12,752
AND REACHING THAT POPULATION 

4519
03:59:12,752 --> 03:59:18,991
HOPEFULLY BY EARLY NEXT YEAR.

4520
03:59:18,991 --> 03:59:22,128
>> THERE'S ANOTHER
QUESTION 

4521
03:59:22,128 --> 03:59:26,132
ABOUT TO OBTAIN PRELIMINARY DATA

4522
03:59:26,132 --> 03:59:28,467
TO A CERTAIN POPULATION MAYBE 

4523
03:59:28,467 --> 03:59:31,237
THIS WAS STUDIED OR MAY OR NOT 

4524
03:59:31,237 --> 03:59:32,305
BENEFIT FROM INTERVENTION.

4525
03:59:32,305 --> 03:59:38,778
WHAT'S THE BEST VALIDATED AND 

4526
03:59:38,778 --> 03:59:40,179
FEASIBLE SURVEY TO CAPTURE 

4527
03:59:40,179 --> 03:59:40,980
PATTERNS OF SPECIALIZED 

4528
03:59:40,980 --> 03:59:49,589
POPULATIONS.

4529
03:59:49,589 --> 03:59:53,459
>> IT'S COUNTRY SPECIFIC.

4530
03:59:53,459 --> 03:59:55,127
I'D HAVE TO DEFER TO A 

4531
03:59:55,127 --> 03:59:56,462
U.S. EXPERT ON THAT.

4532
03:59:56,462 --> 04:00:00,766
I DON'T KNOW IF OTHERS HAVE USED

4533
04:00:00,766 --> 04:00:04,403
U.S.-BASED TOOLS.

4534
04:00:04,403 --> 04:00:09,909
>> I DON'T KNOW THERE'S
ONE BEST

4535
04:00:09,909 --> 04:00:17,917
SURVEY.

4536
04:00:17,917 --> 04:00:21,187
I THINK IT DEPENDS ON THE TOPIC 

4537
04:00:21,187 --> 04:00:23,956
OF YOUR RESEARCH AND DIMENSIONS 

4538
04:00:23,956 --> 04:00:25,758
YOU WANT TO CAPTURE AND THERE'S 

4539
04:00:25,758 --> 04:00:26,359
DIFFERENT VALIDATED SURVEY 

4540
04:00:26,359 --> 04:00:36,469
TOOLS.

4541
04:00:40,940 --> 04:00:42,308
THERE'S INTERESTING COMMENTS 

4542
04:00:42,308 --> 04:00:43,943
WITH THE LINK IN 

4543
04:00:43,943 --> 04:00:44,577
CARDIORESPIRATORY OUTCOME AND 

4544
04:00:44,577 --> 04:00:47,647
THIS IS AN INTERESTING POINT 

4545
04:00:47,647 --> 04:00:50,149
BECAUSE AS WE'RE TALKING ABOUT 

4546
04:00:50,149 --> 04:00:54,553
DIFFERENT TYPES OF NUTRITIONAL 

4547
04:00:54,553 --> 04:00:56,656
INTERVENTIONS, THEY'RE RELEVANT 

4548
04:00:56,656 --> 04:01:00,760
TO PROBABLY MOST CHRONIC 

4549
04:01:00,760 --> 04:01:04,397
INFLAMMATORY DISEASES INCLUDING 

4550
04:01:04,397 --> 04:01:06,866
CARDIOVASCULAR DISEASE AND 

4551
04:01:06,866 --> 04:01:07,967
DIABETES AND SO IT'S SOMETHING 

4552
04:01:07,967 --> 04:01:09,902
WE NEED TO START THINKING ABOUT 

4553
04:01:09,902 --> 04:01:12,738
SO MUCH IN ISOLATION ABOUT 

4554
04:01:12,738 --> 04:01:14,807
EFFECTS ON RESPIRATORY AND 

4555
04:01:14,807 --> 04:01:16,776
INTERVENTIONS THAT WILL HAVE 

4556
04:01:16,776 --> 04:01:21,180
WHOLE BODY EFFECTS.

4557
04:01:21,180 --> 04:01:23,516
I HAVEN'T REALLY COME ACROSS 

4558
04:01:23,516 --> 04:01:25,618
PEOPLE THINKING ALONG THESE 

4559
04:01:25,618 --> 04:01:28,754
LINES APPLYING FOR GRANTS AND 

4560
04:01:28,754 --> 04:01:31,590
SHARING CLINICAL TRIAL RESOURCES

4561
04:01:31,590 --> 04:01:33,526
TO USE ONE INTERVENTION TO 

4562
04:01:33,526 --> 04:01:36,329
CONVERT MULTIPLE DISEASES AND 

4563
04:01:36,329 --> 04:01:36,629
CONDITIONS.

4564
04:01:36,629 --> 04:01:39,298
I MEAN THEORETICALLY YOU COULD 

4565
04:01:39,298 --> 04:01:42,435
DO THAT COULDN'T YOU BECAUSE 

4566
04:01:42,435 --> 04:01:43,803
WITH YOU KNOW MOST PARTICULARLY 

4567
04:01:43,803 --> 04:01:46,939
IN OLDER PEOPLE THEY ARE HAVE 

4568
04:01:46,939 --> 04:01:47,606
MULTIPLE COMORBIDITIES.

4569
04:01:47,606 --> 04:01:48,774
THAT'S REALLY AN INTERESTING 

4570
04:01:48,774 --> 04:01:54,847
IDEA THAT WE COULD DEVELOP.

4571
04:01:54,847 --> 04:01:56,749
>> I AGREE.

4572
04:01:56,749 --> 04:01:59,852
AND IF I COULD GET OTHER TWO 

4573
04:01:59,852 --> 04:02:01,654
PANELISTS TO COMMENT ON THAT AS 

4574
04:02:01,654 --> 04:02:02,221
WELL.

4575
04:02:02,221 --> 04:02:09,628
ONE OF THE THEMES COMING OUT UP 

4576
04:02:09,628 --> 04:02:11,897
PRESENTATIONS IS THERE'S SOME OF

4577
04:02:11,897 --> 04:02:13,999
COMPLEXITY AND HETEROGENEITY 

4578
04:02:13,999 --> 04:02:16,769
INSTEAD OF ONE APPROACH FOR ONE 

4579
04:02:16,769 --> 04:02:17,370
CLINICAL CONDITION SPECIFIC 

4580
04:02:17,370 --> 04:02:20,906
OUTCOME IN THE CONTEXT OF TRIAL 

4581
04:02:20,906 --> 04:02:22,775
TO DEFINE THE PRIMARY OUTCOME DO

4582
04:02:22,775 --> 04:02:25,644
WE HAVE THE OPPORTUNITY TO THINK

4583
04:02:25,644 --> 04:02:30,616
ABOUT HOW WE RECONCEPTUALIZE 

4584
04:02:30,616 --> 04:02:31,250
NUTRITION HEALTH AND RESPIRATORY

4585
04:02:31,250 --> 04:02:35,254
HEALTH AND DISEASE TO TAKE ON A 

4586
04:02:35,254 --> 04:02:38,391
MORE TRANS DIAGNOSTIC AND TRANS 

4587
04:02:38,391 --> 04:02:39,692
DISCIPLINARY PERSPECTIVE AND 

4588
04:02:39,692 --> 04:02:43,496
WOULD THAT MOVE US FORWARD IN A 

4589
04:02:43,496 --> 04:02:45,664
CONCRETE WAY.

4590
04:02:45,664 --> 04:02:51,170
I'D LIKE TO HEAR YOUR THOUGHTS.

4591
04:02:51,170 --> 04:02:56,409
>> CERTAINLY IN TERMS OF
AN 

4592
04:02:56,409 --> 04:03:03,549
ACUTE ILLNESS AND MANIPULATE THE

4593
04:03:03,549 --> 04:03:07,353
GUT MICROBIOME AND USING THE 

4594
04:03:07,353 --> 04:03:17,797
G.I. TRACT AND THE GUT   

4595
04:03:18,397 --> 04:03:23,602
MICROBIOME AND ASSOCIATED WITH 

4596
04:03:23,602 --> 04:03:26,038
METABOLIC SYNDROME AND 

4597
04:03:26,038 --> 04:03:27,306
ATHEROSCLEROSIS AND FORMATION.

4598
04:03:27,306 --> 04:03:31,177
FOR PATIENTS WHO COME IN WITH 

4599
04:03:31,177 --> 04:03:38,451
COMORBIDITIIES THERE ARE WAYS T 

4600
04:03:38,451 --> 04:03:45,724
SAY YOU CAN MANIPULATE THE GUT 

4601
04:03:45,724 --> 04:03:47,726
MICROBIOME AND THERE BE IMPROVE 

4602
04:03:47,726 --> 04:03:58,237
PULMONARY AND CARDIAC HEALTH.

4603
04:04:04,810 --> 04:04:12,017
>> WITH HUMANS I REALIZE
THE 

4604
04:04:12,017 --> 04:04:17,957
FRAMEWORK OF CLINICAL STUDY IS 

4605
04:04:17,957 --> 04:04:20,125
STILL GEARED TOWARDS MEDICATIONS

4606
04:04:20,125 --> 04:04:24,730
THERE'S A DEFINE INCLUSIVE 

4607
04:04:24,730 --> 04:04:27,333
CRITERIA DEFINED OUTCOME AND WE 

4608
04:04:27,333 --> 04:04:33,239
USE A SIMILAR APPROACH FOR DIET 

4609
04:04:33,239 --> 04:04:39,078
AND LIFESTYLE INTERVENTION AND 

4610
04:04:39,078 --> 04:04:46,952
THAT HAS BENEFITS AND HOW TO 

4611
04:04:46,952 --> 04:04:48,087
CAPTURE THAT BENEFIT IS 

4612
04:04:48,087 --> 04:04:49,989
DIFFICULT WITHIN THE FRAMEWORK 

4613
04:04:49,989 --> 04:04:55,227
BECAUSE YOU CANNOT HAVE MORE 

4614
04:04:55,227 --> 04:05:04,003
THAN ONE OUTCOME RELATED TO EACH

4615
04:05:04,003 --> 04:05:06,605
OTHER.

4616
04:05:06,605 --> 04:05:08,674
IN THE STRUCTURE OF CLINICAL 

4617
04:05:08,674 --> 04:05:12,745
TRIAL MOST OF THE STUDIES FOR 

4618
04:05:12,745 --> 04:05:16,982
CARDIOVASCULAR OUTCOMES WE DO 

4619
04:05:16,982 --> 04:05:19,985
EXCLUDE SLEEP APNEA AND THOSE 

4620
04:05:19,985 --> 04:05:23,422
WHO ARE MODERATE OR MILD AND 

4621
04:05:23,422 --> 04:05:28,761
THEN THEY REALIZE THAT THEY HAVE

4622
04:05:28,761 --> 04:05:39,305
BETTER SLEEP AND BREATHING BUT 

4623
04:05:40,205 --> 04:05:44,743
WHEN IT COMES TO OUTCOMES IT 

4624
04:05:44,743 --> 04:05:46,211
BECOMES DIFFICULT TO CONVINCE 

4625
04:05:46,211 --> 04:05:51,850
THE REVIEWERS AND FUNDERS AND 

4626
04:05:51,850 --> 04:05:54,720
IRB AND THE WHOLE FRAMEWORK IS 

4627
04:05:54,720 --> 04:06:00,593
NOT GEARED TOWARDS DIET AND 

4628
04:06:00,593 --> 04:06:03,829
LIFESTYLE INTERVENTION.

4629
04:06:03,829 --> 04:06:08,734
THERE NEEDS TO BE TALK IN HOW TO

4630
04:06:08,734 --> 04:06:10,903
STRUCTURE THESE TRIALS.

4631
04:06:10,903 --> 04:06:17,576
PEOPLE WITH METABOLIC RESPONSES 

4632
04:06:17,576 --> 04:06:23,182
AND IMMUNE DYSFUNCTION SO THERE 

4633
04:06:23,182 --> 04:06:24,316
ARE MULTIPLE BENEFITS AND WE'RE 

4634
04:06:24,316 --> 04:06:24,850
MISSING TO CAPTURE THOSE 

4635
04:06:24,850 --> 04:06:28,954
BENEFITS.

4636
04:06:28,954 --> 04:06:30,789
>> THANK YOU, WELL SAID.

4637
04:06:30,789 --> 04:06:32,691
NOW WE'LL CLOSE SESSION 5 AND 

4638
04:06:32,691 --> 04:06:38,097
THE SPEAKERS IF YOU COULD STAY 

4639
04:06:38,097 --> 04:06:41,533
BECAUSE WE'LL HAVE A FINAL 

4640
04:06:41,533 --> 04:06:44,737
DISCUSSION SESSION WHERE WE'D 

4641
04:06:44,737 --> 04:06:47,106
LOVE TO BRING YOU BACK INCLUDING

4642
04:06:47,106 --> 04:06:49,141
SPEAKERS FROM YESTERDAY AND 

4643
04:06:49,141 --> 04:06:54,213
TODAY AND HAVE A STRATEGIC 

4644
04:06:54,213 --> 04:06:56,181
DISCUSSION.

4645
04:06:56,181 --> 04:07:01,020
SO IF THE A/V CAN BRING BACK THE

4646
04:07:01,020 --> 04:07:11,163
SLIDES.

4647
04:07:12,231 --> 04:07:12,731
THANK YOU.

4648
04:07:12,731 --> 04:07:14,733
FOR THE NEXT 15 MINUTES I'LL TRY

4649
04:07:14,733 --> 04:07:16,769
TO PROVIDE A SUMMARY OF WHAT WE 

4650
04:07:16,769 --> 04:07:18,404
HEARD BETWEEN THE TWO DAYS IN 

4651
04:07:18,404 --> 04:07:22,241
TERMS OF STATE OF SCIENCE, 

4652
04:07:22,241 --> 04:07:25,611
CHALLENGES AND OPPORTUNITIES IN 

4653
04:07:25,611 --> 04:07:28,247
NUTRITION RESEARCH FOR PULMONARY

4654
04:07:28,247 --> 04:07:31,283
HEALTH PROMOTION AND DISEASE 

4655
04:07:31,283 --> 04:07:31,750
PREVENTION AN CONTROL.

4656
04:07:31,750 --> 04:07:36,755
-- AND CONTROL.

4657
04:07:36,755 --> 04:07:38,791
I'LL TRY TO RECAP THE OBJECTIVES

4658
04:07:38,791 --> 04:07:41,460
AND STRUCTURE OF THE TWO-DAY 

4659
04:07:41,460 --> 04:07:43,529
WORKSHOP AND PROVIDE A SUMMARY 

4660
04:07:43,529 --> 04:07:45,931
OF THE CURRENT STAGE OF SCIENCE 

4661
04:07:45,931 --> 04:07:50,669
AS WE HEARD FROM A NUMBER OF 

4662
04:07:50,669 --> 04:07:52,738
OUTSTANDING PRESENTERS.

4663
04:07:52,738 --> 04:07:56,008
AS YOU ALL KNOW WE HAVE COVERED 

4664
04:07:56,008 --> 04:07:59,745
QUITE A BIT OF TERRITORY.

4665
04:07:59,745 --> 04:08:01,780
THE PRESENTATION TOPICS ACROSS 

4666
04:08:01,780 --> 04:08:04,750
MULTIPLE DOMAINS AND SCALES AND 

4667
04:08:04,750 --> 04:08:08,087
MULTIPLE LEVELS AND IT'S REALLY 

4668
04:08:08,087 --> 04:08:09,855
IMPOSSIBLE TO DO JUSTICE SO THE 

4669
04:08:09,855 --> 04:08:13,726
DEPTH AND THE BREADTH OF THE 

4670
04:08:13,726 --> 04:08:15,194
SCIENCE THAT'S BEEN PRESENTED 

4671
04:08:15,194 --> 04:08:19,331
BETWEEN THESE TWO DAYS.

4672
04:08:19,331 --> 04:08:24,737
BUT I THINK I'LL GIVE SOME OF MY

4673
04:08:24,737 --> 04:08:26,538
TAKEAWAYS, GRANTED THEY'RE 

4674
04:08:26,538 --> 04:08:28,006
INCOMPLETE AND POSSIBLY 

4675
04:08:28,006 --> 04:08:30,109
INACCURATE BUT IT'S AN 

4676
04:08:30,109 --> 04:08:32,211
OPPORTUNITY FOR OUR EXPERTS TO 

4677
04:08:32,211 --> 04:08:34,446
PROVIDE CORRECTIONS AS 

4678
04:08:34,446 --> 04:08:37,649
APPLICABLE AND TO EXTEND THE 

4679
04:08:37,649 --> 04:08:38,183
DISCUSSIONS THAT'S BEEN 

4680
04:08:38,183 --> 04:08:42,921
HAPPENING ACROSS THE SESSIONS.

4681
04:08:42,921 --> 04:08:44,757
I'LL ALSO TRY TO GIVE THOUGHTS 

4682
04:08:44,757 --> 04:08:46,992
IN TERMS OF COMMON THEMES.

4683
04:08:46,992 --> 04:08:49,661
WE HAVE HEARD ABOUT MAJOR 

4684
04:08:49,661 --> 04:08:50,496
CHALLENGES AND POTENTIAL 

4685
04:08:50,496 --> 04:08:52,498
OPPORTUNITIES AND THEN WE'LL 

4686
04:08:52,498 --> 04:08:55,834
OPEN FOR PANEL DISCUSSION WITH 

4687
04:08:55,834 --> 04:08:59,037
REGARD TO WHAT ARE SOME 

4688
04:08:59,037 --> 04:09:00,739
STRATEGIC QUESTIONS WE SHOULD 

4689
04:09:00,739 --> 04:09:02,841
ADDRESS IN ORDER TO REALLY MOVE 

4690
04:09:02,841 --> 04:09:13,185
THE FIELD FOR WARD.

4691
04:09:14,319 --> 04:09:17,456
THE GOAL IS TO ADVANCE NUTRITION

4692
04:09:17,456 --> 04:09:18,223
RESEARCH FOR LUNG DISEASE 

4693
04:09:18,223 --> 04:09:20,159
PROGRESSION AND CONTROL.

4694
04:09:20,159 --> 04:09:24,663
TO ACCOMPLISH THAT OVER ALL GOAL

4695
04:09:24,663 --> 04:09:27,666
WE HAD FIVE OBJECTIVES HOW WE 

4696
04:09:27,666 --> 04:09:32,704
STRUCTURED THE TWO-DAY WORKSHOP 

4697
04:09:32,704 --> 04:09:35,941
AND WE HAD FIVE SESSIONS AND WE 

4698
04:09:35,941 --> 04:09:38,076
HAD MULTIPLE PRESENTATIONS THAT 

4699
04:09:38,076 --> 04:09:39,878
CENTERED AROUND A THEME.

4700
04:09:39,878 --> 04:09:45,184
THE FIRST SESSION CENTERED ON 

4701
04:09:45,184 --> 04:09:46,785
EPIDEMIOLOGICAL EVIDENCE AND 

4702
04:09:46,785 --> 04:09:47,853
SECOND SESSION WAS ON CLIMATE 

4703
04:09:47,853 --> 04:09:50,856
CHANGE AND THIRD WAS ON 

4704
04:09:50,856 --> 04:09:55,928
UNDERLYING MECHANISMS AND THEN 

4705
04:09:55,928 --> 04:10:00,732
PROCESSED TO TALKING ABOUT 

4706
04:10:00,732 --> 04:10:02,835
PRECISION MEASURES AND END THE 

4707
04:10:02,835 --> 04:10:03,969
SESSION FOCUSSED ON INTERVENTION

4708
04:10:03,969 --> 04:10:14,246
TRIAL EVIDENCE.

4709
04:10:18,016 --> 04:10:21,320
SOME OF THE KEY TAKEAWAYS FROM 

4710
04:10:21,320 --> 04:10:23,155
EPIDEMIOLOGICAL EVIDENCE WAS 

4711
04:10:23,155 --> 04:10:26,892
CONSENSUS WE HEARD IN TERMS OF 

4712
04:10:26,892 --> 04:10:30,829
DIET INCLUDING DIET COMPOSITION,

4713
04:10:30,829 --> 04:10:32,531
QUALITY AND QUANTITY AS MORE 

4714
04:10:32,531 --> 04:10:35,000
IMPORTANT THAN ANY SINGLE FOOD 

4715
04:10:35,000 --> 04:10:36,235
OR NUTRIENT.

4716
04:10:36,235 --> 04:10:42,040
AND AT THE SAME TIME I THINK WE 

4717
04:10:42,040 --> 04:10:45,177
ALSO HEARD SOME INTERESTING 

4718
04:10:45,177 --> 04:10:46,211
EXCHANGES WITH REGARD TO THE 

4719
04:10:46,211 --> 04:10:49,615
POTENTIAL OF GOING TO IN ONE 

4720
04:10:49,615 --> 04:10:50,782
DIRECTION WITH DIETARY PATTERN 

4721
04:10:50,782 --> 04:10:52,918
STRATEGY TO FOCUS ON DIET OR 

4722
04:10:52,918 --> 04:10:56,054
THINK ABOUT SINGLE NUTRIENT OR 

4723
04:10:56,054 --> 04:11:01,994
FOODS GOING IN ONE DIRECTION TO 

4724
04:11:01,994 --> 04:11:03,428
THE EXCLUSION OF OTHER 

4725
04:11:03,428 --> 04:11:04,730
SCIENTIFIC AREAS THE DANGER IN 

4726
04:11:04,730 --> 04:11:08,000
THAT AND SHOULD HAVE A BALANCE 

4727
04:11:08,000 --> 04:11:09,434
AND MORE INTEGRATIVE APPROACHES 

4728
04:11:09,434 --> 04:11:19,278
AS WE THINK HOW TO PROCEED.

4729
04:11:19,278 --> 04:11:20,779
WE HEARD ABOUT OBSERVATIONAL 

4730
04:11:20,779 --> 04:11:24,549
EVIDENCE ON THE PROBABLE 

4731
04:11:24,549 --> 04:11:29,988
BENEFITS OF MARINE OMEGA 3 

4732
04:11:29,988 --> 04:11:31,924
PROFILES AND SHORT CHAIN FATTY 

4733
04:11:31,924 --> 04:11:34,159
ACIDS WHILE DATA IS STILL 

4734
04:11:34,159 --> 04:11:36,762
UNCLEAR ON THE POSSIBLE RISKS OF

4735
04:11:36,762 --> 04:11:40,732
SATURATED FATTY ACIDS.

4736
04:11:40,732 --> 04:11:43,535
AND THEN WE ALSO REALLY HEARD 

4737
04:11:43,535 --> 04:11:45,470
FROM TWO OUTSTANDING SPEAKERS 

4738
04:11:45,470 --> 04:11:48,173
WITH REGARD TO THE EVIDENCE OF 

4739
04:11:48,173 --> 04:11:51,643
POTENTIAL BENEFIT OF DIETARY 

4740
04:11:51,643 --> 04:11:53,679
ANTIOXIDANTS WHICH INCLUDE 

4741
04:11:53,679 --> 04:11:59,384
MICRONUTRIENT AND PHYTO 

4742
04:11:59,384 --> 04:12:00,752
NUTRIENTS FROM FOODS AND THROUGH

4743
04:12:00,752 --> 04:12:02,821
SUPPLEMENTATION AND THEIR 

4744
04:12:02,821 --> 04:12:05,590
BENEFITS FOR LUNG FUNCTION, 

4745
04:12:05,590 --> 04:12:06,792
ASTHMA CONTROL AND COPD 

4746
04:12:06,792 --> 04:12:08,760
PREVENTION AND CONTROL AND 

4747
04:12:08,760 --> 04:12:12,264
MANAGEMENT WHILE THERE'S NO 

4748
04:12:12,264 --> 04:12:14,433
EVIDENCE OF CLEAR HARM OF EXCESS

4749
04:12:14,433 --> 04:12:16,768
INTAKE.

4750
04:12:16,768 --> 04:12:19,738
I BORROWED THIS FROM DR. CA

4751
04:12:19,738 --> 04:12:22,908
DR. CARBONE'S TALK WHICH IS A 

4752
04:12:22,908 --> 04:12:23,976
THEME REPEATED THROUGHOUT THE 

4753
04:12:23,976 --> 04:12:25,177
WORKSHOP.

4754
04:12:25,177 --> 04:12:28,747
WE HAVE MANY GAPS AND THE GAPS 

4755
04:12:28,747 --> 04:12:32,017
ARE EXTENSIVE BECAUSE THERE'S 

4756
04:12:32,017 --> 04:12:33,852
MANY POSSIBLE EXPOSURES AND 

4757
04:12:33,852 --> 04:12:36,521
POSSIBLE OUTCOMES AND POSSIBLE 

4758
04:12:36,521 --> 04:12:42,828
MECHANISTIC PATHWAYS.

4759
04:12:42,828 --> 04:12:45,464
WE HAD TWO OUTSTANDING SPEAKERS 

4760
04:12:45,464 --> 04:12:50,469
WHO PRESENTED ON THE IMPACT OF 

4761
04:12:50,469 --> 04:12:51,303
CLIMATE CHANGE HUMAN NUTRITION 

4762
04:12:51,303 --> 04:12:56,308
AS WELL AS RESPIRATORY HEALTH.

4763
04:12:56,308 --> 04:12:57,843
AS WE KNOW CLIMATE CHANGE IS A 

4764
04:12:57,843 --> 04:12:59,845
GLOBAL CRISIS THAT NOT ONLY 

4765
04:12:59,845 --> 04:13:01,980
AFFECTS FOOD PRODUCTION AND 

4766
04:13:01,980 --> 04:13:04,249
CONSUMPTION AND THE ENTIRE FOOD 

4767
04:13:04,249 --> 04:13:08,053
SYSTEM LIFE CYCLE BUT ALSO OTHER

4768
04:13:08,053 --> 04:13:11,223
ASPECTS OF LIFE IN TERMS OF 

4769
04:13:11,223 --> 04:13:12,557
WATER, AIR QUALITY.

4770
04:13:12,557 --> 04:13:16,128
THERE ARE DIRECT AND INDIRECT 

4771
04:13:16,128 --> 04:13:17,529
EFFECTS OF CLIMATE CHANGE BOTH 

4772
04:13:17,529 --> 04:13:19,931
OF HUMAN NUTRITION AND 

4773
04:13:19,931 --> 04:13:22,601
RESPIRATORY HEALTH TO VARIOUS 

4774
04:13:22,601 --> 04:13:25,837
PATHWAYS AND THESE EFFECTS CAN 

4775
04:13:25,837 --> 04:13:27,806
BE MODIFIED BY EXTERNAL FACTORS 

4776
04:13:27,806 --> 04:13:29,307
SUCH AS CONFLICT OR FUEL AND 

4777
04:13:29,307 --> 04:13:33,879
OTHER RESOURCE SHORTAGES.

4778
04:13:33,879 --> 04:13:37,182
OF COURSE CLIMATE CHANGE AFFECTS

4779
04:13:37,182 --> 04:13:38,316
EVERYWHERE AND ALL PEOPLE AND 

4780
04:13:38,316 --> 04:13:41,586
THE EFFECTS ARE DIFFERENTIAL DUE

4781
04:13:41,586 --> 04:13:50,796
TO SYSTEMIC INEQUITY.

4782
04:13:50,796 --> 04:13:55,067
WE HAD FIVE OUTSTANDING 

4783
04:13:55,067 --> 04:13:56,968
PRESENTATIONS THAT WE CAN DRILL 

4784
04:13:56,968 --> 04:14:01,573
DOWN DEEPER TO POTENTIAL 

4785
04:14:01,573 --> 04:14:03,008
MECHANISMS UNDERLYING THE IMPACT

4786
04:14:03,008 --> 04:14:06,078
OF NUTRITION AND DIET AND LUNG 

4787
04:14:06,078 --> 04:14:07,479
DISEASE.

4788
04:14:07,479 --> 04:14:11,249
THERE WAS A GREAT TALK THAT 

4789
04:14:11,249 --> 04:14:15,087
PRESENTED RENEWED RESEARCH 

4790
04:14:15,087 --> 04:14:22,060
INTERESTS IN THERAPEUTIC KETOSIS

4791
04:14:22,060 --> 04:14:24,729
IN RELATION TO RESPIRATORY 

4792
04:14:24,729 --> 04:14:35,073
HEALTH AND DISEASE.

4793
04:14:41,813 --> 04:14:52,290
LOOKING AT MARINE FISH OILS AND 

4794
04:14:54,993 --> 04:14:56,495
LOOKED AT MALNUTRITION AND OVER 

4795
04:14:56,495 --> 04:14:59,064
AND UNDER NUTRITION AND HOW THEY

4796
04:14:59,064 --> 04:15:02,601
IMPACT CELL MEDIATED IMMUNITY 

4797
04:15:02,601 --> 04:15:06,037
AND INFLAMMATION WHILE ALSO 

4798
04:15:06,037 --> 04:15:09,975
POINTING OUT THERE'S A 

4799
04:15:09,975 --> 04:15:11,143
RECIPROCAL RELATIONSHIP BECAUSE 

4800
04:15:11,143 --> 04:15:12,811
INFLAMMATION LEADS TO 

4801
04:15:12,811 --> 04:15:20,152
MALNUTRITION.

4802
04:15:20,152 --> 04:15:24,222
AND THERE'S IMMUNE PATHWAYS IN 

4803
04:15:24,222 --> 04:15:27,092
PRO AND ANTI-INFLAMMATORY 

4804
04:15:27,092 --> 04:15:32,531
RESPONSES BUT RESPONSES 

4805
04:15:32,531 --> 04:15:33,165
SYSTEMICALLY INCLUDING IN THE 

4806
04:15:33,165 --> 04:15:36,735
LUNG THE MECHANISTIC PATHWAYS 

4807
04:15:36,735 --> 04:15:42,974
ARE BEING ADVOCATED AND THEY'RE 

4808
04:15:42,974 --> 04:15:46,878
LOOKING AT ANTIOXIDANTS, ZINC, 

4809
04:15:46,878 --> 04:15:48,680
DIETARY FIBER AND WE HEARD FROM 

4810
04:15:48,680 --> 04:15:53,952
A NUMBER OF SPEAKERS IN TERMS OF

4811
04:15:53,952 --> 04:15:57,489
FEEDING THE LUMP THROUGH THE 

4812
04:15:57,489 --> 04:16:00,959
GUT-LUNG AXIS AND METABOLITES 

4813
04:16:00,959 --> 04:16:04,729
CAN CHANGE LUNG IMMUNITY AND 

4814
04:16:04,729 --> 04:16:06,698
WOR

4815
04:16:06,698 --> 04:16:09,167
WORSEN LUNG DISEASE ONSET OR 

4816
04:16:09,167 --> 04:16:09,968
PROGRESSION AND HEARD THE 

4817
04:16:09,968 --> 04:16:12,537
IMPORTANCE OF TIME.

4818
04:16:12,537 --> 04:16:16,741
TIMING OF EATING OR CIRCADIAN 

4819
04:16:16,741 --> 04:16:23,148
REGULATION AND HOW THE CIRCADIAN

4820
04:16:23,148 --> 04:16:27,852
CLOCK REGULATION INTERACTS AND 

4821
04:16:27,852 --> 04:16:30,722
THE HEALTH IMPLICATION FOR 

4822
04:16:30,722 --> 04:16:31,723
RESPIRATORY DISEASE WITH THE 

4823
04:16:31,723 --> 04:16:35,994
EXAMPLE BY ONE OF OUR SPEAKERS 

4824
04:16:35,994 --> 04:16:39,698
AND ALSO WE HEARD HOW IT MAY 

4825
04:16:39,698 --> 04:16:41,533
ALSO EXPLAIN THE POTENTIAL 

4826
04:16:41,533 --> 04:16:44,736
EFFECTS OF TIME-RESTRICTED 

4827
04:16:44,736 --> 04:16:54,879
EATING.

4828
04:16:55,914 --> 04:17:01,920
THE NEXT SESSION DOVETAILED 

4829
04:17:01,920 --> 04:17:04,990
NICELY WITH THE MECHANISMS AND 

4830
04:17:04,990 --> 04:17:07,359
TALKS THAT FOCUSSED ON OMICS AND

4831
04:17:07,359 --> 04:17:11,830
HOW OMICS DATA HOLDS PROMISE FOR

4832
04:17:11,830 --> 04:17:16,768
NUTRITION BIOMARKER DEVELOPMENT 

4833
04:17:16,768 --> 04:17:27,512
IN PARTICULAR METABLOOLOMICS AN 

4834
04:17:32,817 --> 04:17:36,721
THERE'S A GREAT TALK THAT LOOKED

4835
04:17:36,721 --> 04:17:39,891
AT FATTY ACID DERIVED SPMs AND 

4836
04:17:39,891 --> 04:17:44,729
HOW THE NOVEL CLASS OF THE 

4837
04:17:44,729 --> 04:17:47,499
ENDOGENOUS REGULATORS OF 

4838
04:17:47,499 --> 04:17:49,768
INFLECTION AND INFLAMMATION AND 

4839
04:17:49,768 --> 04:17:52,737
THE EFFECT IN TERMS OF 

4840
04:17:52,737 --> 04:17:56,341
PROINFLAMMATORY RESPONSES AND 

4841
04:17:56,341 --> 04:17:56,875
STIMULATING INFLAMMATION 

4842
04:17:56,875 --> 04:17:57,409
RESOLUTION IN RESPIRATORY 

4843
04:17:57,409 --> 04:18:07,552
DISEASE.

4844
04:18:12,524 --> 04:18:17,028
AND A FOCUS OF BODY COMPOSITION 

4845
04:18:17,028 --> 04:18:22,233
AND USING BMI AND OTHER TYPES OF

4846
04:18:22,233 --> 04:18:26,137
MUSCLE MASS INDICES INCLUDING 

4847
04:18:26,137 --> 04:18:31,009
FAT FREE MASS INDEX AS WELL AS 

4848
04:18:31,009 --> 04:18:34,512
TAKING INTO ACCOUNT WHETHER THAT

4849
04:18:34,512 --> 04:18:44,956
OCCURRED UNINTENTIONALLY.

4850
04:18:45,390 --> 04:18:46,791
WE ENDED WITH NUTRITION TRIALS 

4851
04:18:46,791 --> 04:18:51,329
AND TERRITORY RANGING FROM 

4852
04:18:51,329 --> 04:18:52,931
NUTRITION THERAPY USING 

4853
04:18:52,931 --> 04:18:54,232
SUPPLEMENTATION AS WELL AS 

4854
04:18:54,232 --> 04:18:56,468
DIFFERENT DIETARY PATTERNS WITH 

4855
04:18:56,468 --> 04:19:00,205
A FOCUS ON INCREASED FRUIT AND 

4856
04:19:00,205 --> 04:19:02,707
VEGETABLE INTAKE AND HEALTHY 

4857
04:19:02,707 --> 04:19:05,777
FATS AND THEIR POTENTIAL 

4858
04:19:05,777 --> 04:19:07,545
BENEFITS FOR CHRONIC RESPIRATORY

4859
04:19:07,545 --> 04:19:10,548
DISEASES SUCH AS ASTHMA AND 

4860
04:19:10,548 --> 04:19:10,749
COPD.

4861
04:19:10,749 --> 04:19:17,255
AND ALSO A GREAT TALK IN TERMS 

4862
04:19:17,255 --> 04:19:26,164
OF ANIMAL MODELS AND LEVERAGING 

4863
04:19:26,164 --> 04:19:27,265
DIGITAL HEALTH TECHNOLOGIES TO 

4864
04:19:27,265 --> 04:19:28,466
BETTER MEASURE TIMING AND 

4865
04:19:28,466 --> 04:19:33,538
COMPOSITION OF DIETARY INTAKE 

4866
04:19:33,538 --> 04:19:44,082
OVER THE COURSE OF LONGITUDINAL 

4867
04:19:44,783 --> 04:19:46,251
FASHION AND HOW NUTRITION 

4868
04:19:46,251 --> 04:19:50,188
THERAPY NOT ONLY IN TERMS OF THE

4869
04:19:50,188 --> 04:19:53,725
IMPLICATION FOR CHRONIC LUNG 

4870
04:19:53,725 --> 04:19:56,761
DISEASE MANAGEMENT AND CRITICAL 

4871
04:19:56,761 --> 04:20:00,732
ILLNESS SETTINGS AND HOW THE 

4872
04:20:00,732 --> 04:20:07,005
EVIDENCE MAY HAVE GENERATED 

4873
04:20:07,005 --> 04:20:08,239
NEGATIVE RESULTS BUT INSTEAD OF 

4874
04:20:08,239 --> 04:20:10,108
WALKING AWAY FROM INTERVENTIONS 

4875
04:20:10,108 --> 04:20:14,746
DEMONSTRATED TO BE INEFFECTIVE 

4876
04:20:14,746 --> 04:20:16,548
IN THOSE PRIOR TRIALS HOW DO WE 

4877
04:20:16,548 --> 04:20:24,722
BUILD ON THE NEGATIVE FINDINGS 

4878
04:20:24,722 --> 04:20:27,959
AND LEVERAGE TOOLS AND 

4879
04:20:27,959 --> 04:20:32,730
TECHNOLOGIES TO DRILL DEEPER AND

4880
04:20:32,730 --> 04:20:34,766
POTENTIALLY IDENTIFY SPECIFIC 

4881
04:20:34,766 --> 04:20:36,134
SUBPOPULATIONS WHERE THOSE 

4882
04:20:36,134 --> 04:20:40,772
INTERVENTIONS MAY INDEED 

4883
04:20:40,772 --> 04:20:51,249
POTENTIALLY PROFILE BENEFIT.

4884
04:20:55,753 --> 04:20:57,121
IN TERMS OF CHALLENGES IF 

4885
04:20:57,121 --> 04:21:02,494
THERE'S TWO WORDS TO SUMMARIZE 

4886
04:21:02,494 --> 04:21:04,262
THE CHALLENGES ARE COMPLEXITY 

4887
04:21:04,262 --> 04:21:07,432
AND HETEROGENEITY.

4888
04:21:07,432 --> 04:21:10,702
AND THE CHALLENGES MANIFEST 

4889
04:21:10,702 --> 04:21:16,040
ACROSS ALL THREE MAJOR TOPICS 

4890
04:21:16,040 --> 04:21:19,711
COVERED IN THE DISCUSSION 

4891
04:21:19,711 --> 04:21:21,813
WHETHER IT'S NUTRITION AND 

4892
04:21:21,813 --> 04:21:23,181
DISEASE ARE THE UNDERLYING 

4893
04:21:23,181 --> 04:21:26,184
MECHANISMS AND THE SMALL CIRCLES

4894
04:21:26,184 --> 04:21:30,655
CAN REFLECT A SUBSET OF THE 

4895
04:21:30,655 --> 04:21:34,826
POTENTIAL FACTORS IN DIMENSIONS 

4896
04:21:34,826 --> 04:21:36,828
THAT MAKE THE DOMAINS COMPLEX 

4897
04:21:36,828 --> 04:21:41,332
AND HETEROGENEOUS.

4898
04:21:41,332 --> 04:21:42,700
WE KNOW CONTEXT MATTERS A LOT 

4899
04:21:42,700 --> 04:21:47,138
AND HEARD IN TERMS OF THE IMPACT

4900
04:21:47,138 --> 04:21:51,509
OF CLIMATE CHANGE ON NUTRITION 

4901
04:21:51,509 --> 04:21:58,716
AND RESPIRATORY HEALTH AND ALSO 

4902
04:21:58,716 --> 04:22:00,418
THE INFLUENCE OF SOCIAL 

4903
04:22:00,418 --> 04:22:01,986
DETERMINATES AND HOW TO BE 

4904
04:22:01,986 --> 04:22:04,022
INTENTIONAL AND TARGETED AS WE 

4905
04:22:04,022 --> 04:22:09,527
THINK ABOUT GOING FORWARD IN THE

4906
04:22:09,527 --> 04:22:15,466
FIELD TO GENERATE EVIDENCE IN 

4907
04:22:15,466 --> 04:22:17,235
UNDER SERVED POPULATIONS AND 

4908
04:22:17,235 --> 04:22:18,670
THERE'S MULTIPLE LEVELS OF 

4909
04:22:18,670 --> 04:22:24,742
INFLUENCES AND HOW DO WE HAVE 

4910
04:22:24,742 --> 04:22:31,382
THE STUDY DESIGNS TO TAKE INTO 

4911
04:22:31,382 --> 04:22:32,750
ACCOUNT GENERATE RIGOROUS 

4912
04:22:32,750 --> 04:22:42,927
EVIDENCE.

4913
04:22:43,995 --> 04:22:50,268
OUR CHARGE TO ADVANCE 

4914
04:22:50,268 --> 04:22:51,402
RESPIRATORY DISEASE IS A 

4915
04:22:51,402 --> 04:22:56,641
CHALLENGE AT THE SAME TIME WE 

4916
04:22:56,641 --> 04:22:57,575
HEARD ABOUT POTENTIAL 

4917
04:22:57,575 --> 04:23:00,745
OPPORTUNITIES TO TAKE A STEP 

4918
04:23:00,745 --> 04:23:07,151
FORWARD IN THIS FIELD.

4919
04:23:07,151 --> 04:23:08,753
WE HAD SOME DISCUSSION IN TERMS 

4920
04:23:08,753 --> 04:23:14,192
OF OPPORTUNITIES THINKING ABOUT 

4921
04:23:14,192 --> 04:23:17,261
REVOLUTIONARY WISE RESPIRATORY 

4922
04:23:17,261 --> 04:23:19,797
HEALTH AND DISEASE WITH RELATION

4923
04:23:19,797 --> 04:23:23,835
TO DIET AS THEIR ROLE FOR 

4924
04:23:23,835 --> 04:23:27,171
CONCEPTUALIZATION AND WE COULD 

4925
04:23:27,171 --> 04:23:31,376
REALLY LOOK AT OUR COLLEAGUES 

4926
04:23:31,376 --> 04:23:32,744
UNIN

4927
04:23:32,744 --> 04:23:35,046
RELATED DISCIPLINES IN THE 

4928
04:23:35,046 --> 04:23:36,481
RESEARCH FRAMEWORK WHICH IS NOT 

4929
04:23:36,481 --> 04:23:41,486
DIAGNOSTIC AND NOT MEANT TO 

4930
04:23:41,486 --> 04:23:44,756
REPLACE CURRENT DIAGNOSTIC 

4931
04:23:44,756 --> 04:23:52,730
SYSTEMS BUT TO TAKE INTO ACCOUNT

4932
04:23:52,730 --> 04:23:54,032
THE HETEROGENEITY IN EXPOSURE 

4933
04:23:54,032 --> 04:23:54,465
AND OUTCOMES.

4934
04:23:54,465 --> 04:24:00,738
WE HEARD ABOUT ADVANCES IN TERMS

4935
04:24:00,738 --> 04:24:08,746
OF TECHNOLOGICAL AND 

4936
04:24:08,746 --> 04:24:09,847
METHODOLOGICAL TECHNIQUE USING 

4937
04:24:09,847 --> 04:24:10,815
A.I. AND MACHINE LEARNING AND 

4938
04:24:10,815 --> 04:24:14,686
THE DIGITAL HEALTH TECHNOLOGIES 

4939
04:24:14,686 --> 04:24:16,788
HOW THAT TECHNOLOGIES MAKE HELP 

4940
04:24:16,788 --> 04:24:20,758
US ADVANCE HOW WE ASSESS HOW WE 

4941
04:24:20,758 --> 04:24:27,799
MEASURE OVERTIME.

4942
04:24:27,799 --> 04:24:30,401
HOW DO WE LEVERAGE AND OPTIMIZE 

4943
04:24:30,401 --> 04:24:36,207
EXISTING COHORT AND INTERVENTION

4944
04:24:36,207 --> 04:24:38,476
STUDIES AND THE AVAILABLE BIO 

4945
04:24:38,476 --> 04:24:40,745
BANKS TO ADDRESS QUESTIONS ABOUT

4946
04:24:40,745 --> 04:24:43,181
NUTRITION AND THE UNDERLYING 

4947
04:24:43,181 --> 04:24:43,481
MECHANISMS.

4948
04:24:43,481 --> 04:24:45,717
INSTEAD OF TRYING TO LOOK FOR 

4949
04:24:45,717 --> 04:24:50,254
THE NEXT COHORT STUDY AND BIO 

4950
04:24:50,254 --> 04:24:51,723
BANK WE COULD CREATE HOW COULD 

4951
04:24:51,723 --> 04:24:56,527
WE LEVERAGE AND OPTIMIZE THE 

4952
04:24:56,527 --> 04:25:00,031
RESOURCES THAT ALREADY EXIST.

4953
04:25:00,031 --> 04:25:01,899
WE HEARD ABOUT HOW DO WE 

4954
04:25:01,899 --> 04:25:05,937
SYNERGIZE AND ARE THERE 

4955
04:25:05,937 --> 04:25:07,805
OPPORTUNITIES TO PROMOTE 

4956
04:25:07,805 --> 04:25:10,875
SYNERGISTIC CO-LEARNING AND 

4957
04:25:10,875 --> 04:25:12,877
CO-DEVELOPMENT OF TRANSFORMATIVE

4958
04:25:12,877 --> 04:25:15,046
DISCOVERIES IN COLLABORATION 

4959
04:25:15,046 --> 04:25:18,349
WITH RESEARCHERS RELATED FIELD 

4960
04:25:18,349 --> 04:25:23,788
SUCH AS CARDIO METABOLIC 

4961
04:25:23,788 --> 04:25:24,055
MEDICINE.

4962
04:25:24,055 --> 04:25:31,496
I THINK THE NEXT POINT WE CAN 

4963
04:25:31,496 --> 04:25:35,933
HAVE DISCUSSION ON AS A PANEL IF

4964
04:25:35,933 --> 04:25:37,735
WE CAN PROVIDE RECOMMENDATIONS 

4965
04:25:37,735 --> 04:25:41,205
TO NIH WITH FUNDING PRIORITIES 

4966
04:25:41,205 --> 04:25:44,475
WHAT WOULD THOSE BE AND DO WE 

4967
04:25:44,475 --> 04:25:48,112
HAVE EVIDENCE TO JUSTIFY A 

4968
04:25:48,112 --> 04:25:50,314
CERTAIN TYPE OF STUDY FOR SEARCH

4969
04:25:50,314 --> 04:25:52,517
TYPES OF CONSORTIUM AND HOW DO 

4970
04:25:52,517 --> 04:25:56,521
WE MOVE FORWARD IN A TARGETED 

4971
04:25:56,521 --> 04:25:57,421
AND STRATEGIC FASHION.

4972
04:25:57,421 --> 04:25:59,724
I THINK I'LL END THERE AND THANK

4973
04:25:59,724 --> 04:26:03,828
YOU AND NOW WE'LL MOVE INTO THE 

4974
04:26:03,828 --> 04:26:04,629
PANEL DISCUSSION.

4975
04:26:04,629 --> 04:26:09,433
IF THE SPEAKERS AND MODERATE ERS

4976
04:26:09,433 --> 04:26:14,405
FROM YESTERDAY AND TODAY WOULD 

4977
04:26:14,405 --> 04:26:21,779
BE WILLING TO PARTICIPATE AND WE

4978
04:26:21,779 --> 04:26:24,749
CAN TAKE DOWN THE SLIDE.

4979
04:26:24,749 --> 04:26:28,085
AND I'LL INVITE THE SPEAKERS AND

4980
04:26:28,085 --> 04:26:38,095
MODERATORS STILL PRESENT.

4981
04:26:38,095 --> 04:26:40,464
>> PERHAPS WE CAN COPY THE

4982
04:26:40,464 --> 04:26:41,999
QUESTIONS INTO THE CHAT BOX.

4983
04:26:41,999 --> 04:26:52,410
>> THAT'S A GREAT IDEA.

4984
04:27:03,187 --> 04:27:05,590
VANESSA WOULD YOU LIKE TO KICK 

4985
04:27:05,590 --> 04:27:06,657
OFF THE DISCUSSION.

4986
04:27:06,657 --> 04:27:08,726
WE DID PREPARE A FEW QUESTIONS 

4987
04:27:08,726 --> 04:27:11,929
BUT WE CAN USE THOSE TO JUMP 

4988
04:27:11,929 --> 04:27:15,766
START AND I'M SURE WE'LL HAVE 

4989
04:27:15,766 --> 04:27:16,567
ADDITIONAL QUESTIONS FROM THE 

4990
04:27:16,567 --> 04:27:19,070
PANEL AS WELL.

4991
04:27:19,070 --> 04:27:20,571
>> THANK YOU SO MUCH.

4992
04:27:20,571 --> 04:27:21,906
PERHAPS FIRST I'D LIKE TO THANK 

4993
04:27:21,906 --> 04:27:25,243
YOU ALL AGAIN FOR SPENDING THE 

4994
04:27:25,243 --> 04:27:26,444
TWO DAYS WITH US DISCUSSING YOUR

4995
04:27:26,444 --> 04:27:30,581
RESEARCH AND YOUR INSIGHTS INTO 

4996
04:27:30,581 --> 04:27:32,750
HOW WE CAN ADVANCE THIS 

4997
04:27:32,750 --> 04:27:35,853
IMPORTANT SCIENTIFIC AGENDA 

4998
04:27:35,853 --> 04:27:37,421
NUTRITION AND RESPIRATORY 

4999
04:27:37,421 --> 04:27:37,655
HEALTH.

5000
04:27:37,655 --> 04:27:38,890
ONE OF MY FIRST THOUGHTS IS 

5001
04:27:38,890 --> 04:27:40,157
PERHAPS HOW CAN WE BUILD UP FROM

5002
04:27:40,157 --> 04:27:44,528
WHAT WE CURRENTLY HAVE TO 

5003
04:27:44,528 --> 04:27:46,163
OPTIMIZE THE EVIDENCE ON THE 

5004
04:27:46,163 --> 04:27:47,331
POSSIBLE LINK BETWEEN KNEW 

5005
04:27:47,331 --> 04:27:52,737
TRYING AND RESPIRATORY DISEASES 

5006
04:27:52,737 --> 04:27:54,772
AND LUNG HEALTH IN GENERAL 

5007
04:27:54,772 --> 04:27:55,239
TAKING INTO ACCOUNT 

5008
04:27:55,239 --> 04:27:57,909
OPPORTUNITIES FOR PRIMARY AND 

5009
04:27:57,909 --> 04:28:08,286
SECONDARY PREVENTION?

5010
04:28:09,387 --> 04:28:13,090
DO WE HAVE TO START FROM SCRATCH

5011
04:28:13,090 --> 04:28:16,627
OR CREATE NEW INDICATORS, 

5012
04:28:16,627 --> 04:28:17,428
BIOMARKERS.

5013
04:28:17,428 --> 04:28:20,631
THE IMPRESSION I HAVE SO FAR IS 

5014
04:28:20,631 --> 04:28:21,666
PERHAPS THERE'S OPPORTUNITIES TO

5015
04:28:21,666 --> 04:28:23,434
COMBINE EXISTING TOOLS IN 

5016
04:28:23,434 --> 04:28:24,001
EPIDEMIOLOGY WITH NOVEL 

5017
04:28:24,001 --> 04:28:27,038
BIOMARKERS OF NUTRITION INTAKE 

5018
04:28:27,038 --> 04:28:30,841
THAT CAN STRENGTHEN THE WAY IN 

5019
04:28:30,841 --> 04:28:36,314
WHICH WE MEASURE NUTRITION?

5020
04:28:36,314 --> 04:28:38,316
WE HAVE MANY EXPOSURES AND 

5021
04:28:38,316 --> 04:28:38,683
OUTCOMES.

5022
04:28:38,683 --> 04:28:42,320
HOW DO YOU THINK WE SHOULD 

5023
04:28:42,320 --> 04:28:44,722
PRIORITIZE THE RESEARCH AGENDA?

5024
04:28:44,722 --> 04:28:50,127
WHAT ARE YOUR THOUGHTS?

5025
04:28:50,127 --> 04:28:51,362
>> I KNOW AT OUR
INSTITUTION 

5026
04:28:51,362 --> 04:28:54,832
WE'RE PARTICIPATING IN THE LUNG 

5027
04:28:54,832 --> 04:28:56,867
COHORT STUDY A LONGITUDINAL 

5028
04:28:56,867 --> 04:28:59,070
STUDY LOOKING AT FROM POST 

5029
04:28:59,070 --> 04:29:01,672
ADOLESCENCE TO ADULT HAD THE IN 

5030
04:29:01,672 --> 04:29:08,379
LUNG FUNCTION AND PRESUMABLY 

5031
04:29:08,379 --> 04:29:12,683
BEHAVIOR MUST COME IN THE STUDY 

5032
04:29:12,683 --> 04:29:16,754
AND DOES SOMEBODY KNOW IF 

5033
04:29:16,754 --> 04:29:19,790
THERE'S QUESTIONNAIRES THROUGH 

5034
04:29:19,790 --> 04:29:20,958
ALA AND I BELIEVE NHLBI IS 

5035
04:29:20,958 --> 04:29:26,097
INVOLVED AS WELL.

5036
04:29:26,097 --> 04:29:28,733
>> I'LL JUMP IN.

5037
04:29:28,733 --> 04:29:31,068
I AGREE.

5038
04:29:31,068 --> 04:29:32,503
I THINK HAVING THESE CONSORTIUMS

5039
04:29:32,503 --> 04:29:36,741
OF STUDIES THAT ARE LOOKING AT 

5040
04:29:36,741 --> 04:29:37,775
NUTRITIONAL BIOMARKERS WOULD BE 

5041
04:29:37,775 --> 04:29:42,146
THE FIRST STEP TO LOOK AT WHAT 

5042
04:29:42,146 --> 04:29:43,948
THE BIOMARKERS ARE, IF THEY CAN 

5043
04:29:43,948 --> 04:29:45,816
BE CROSS VALIDATED IN DIFFERENT 

5044
04:29:45,816 --> 04:29:46,050
STUDIES.

5045
04:29:46,050 --> 04:29:48,719
I THINK THAT WOULD BE THE 

5046
04:29:48,719 --> 04:29:52,723
INITIAL STEP.

5047
04:29:52,723 --> 04:29:56,727
I DO THINK WHAT WE DO KNOW IS 

5048
04:29:56,727 --> 04:29:59,430
SOME METABOLITES ARE MUCH MORE 

5049
04:29:59,430 --> 04:30:01,198
TRANSIENT AND PROTEOMICS WE ARE 

5050
04:30:01,198 --> 04:30:02,833
FINDING THE SIGNATURES ARE MUCH 

5051
04:30:02,833 --> 04:30:03,968
MORE STABLE.

5052
04:30:03,968 --> 04:30:06,704
ALSO LOOKING AT OTHER OMIC 

5053
04:30:06,704 --> 04:30:07,505
MEASURES I THINK SHOULD ALSO BE 

5054
04:30:07,505 --> 04:30:17,882
AN AREA OF INVESTMENT.

5055
04:30:26,791 --> 04:30:30,928
>> TO DOVETAIL ON THAT IF
THE 

5056
04:30:30,928 --> 04:30:32,463
PANEL COULD SPEAK TO WHICH 

5057
04:30:32,463 --> 04:30:36,734
EMERGING MEASURES OF DIETARY 

5058
04:30:36,734 --> 04:30:39,670
INTAKE BASED ON URINE OR SERUM 

5059
04:30:39,670 --> 04:30:43,007
BASED BIOMARKERS SHOULD BE 

5060
04:30:43,007 --> 04:30:44,775
PRIORITIZED FOR FURTHER VALLING 

5061
04:30:44,775 --> 04:30:46,010
DAY FOR FUTURE EPIDEMIOLOGICAL 

5062
04:30:46,010 --> 04:30:56,487
STUDIES AND CLINICAL TRIALS?

5063
04:31:03,194 --> 04:31:04,728
>> I'M HAVING TROUBLE
GETTING MY

5064
04:31:04,728 --> 04:31:06,730
VIDEO GOING.

5065
04:31:06,730 --> 04:31:08,732
I WAS GOING TO SPEAK TO THE 

5066
04:31:08,732 --> 04:31:10,868
QUESTION ABOUT THE LUNG HEALTH 

5067
04:31:10,868 --> 04:31:11,102
COHORT.

5068
04:31:11,102 --> 04:31:15,172
AS FAR AS I KNOW THERE IS NO 

5069
04:31:15,172 --> 04:31:16,140
NUTRITION BEING COLLECTED AS 

5070
04:31:16,140 --> 04:31:26,684
PART OF THE LUNG HEALTH COHORT.

5071
04:31:29,820 --> 04:31:32,089
SOME COLLEAGUES AND I HAVE 

5072
04:31:32,089 --> 04:31:33,190
SUBMITTED A REQUEST FOR THAT AND

5073
04:31:33,190 --> 04:31:34,625
I AGREE IT'S A MISSED 

5074
04:31:34,625 --> 04:31:37,561
OPPORTUNITY GIVEN THE POINT IN 

5075
04:31:37,561 --> 04:31:39,430
THE LIFE SPAN THE LUNG HEALTH 

5076
04:31:39,430 --> 04:31:41,265
COHORT IS COLLECTING DATA ON 25 

5077
04:31:41,265 --> 04:31:44,602
TO 35 YEARS OF ABLE AND THE 

5078
04:31:44,602 --> 04:31:48,506
ATTAINMENT OF FUNCTION.

5079
04:31:48,506 --> 04:31:51,008
THAT WOULD BE A GREAT THING FOR 

5080
04:31:51,008 --> 04:31:53,544
THE NHLBI TO RE-EVALUATE AND 

5081
04:31:53,544 --> 04:32:00,718
CONSIDER IN PURSUING THAT.

5082
04:32:00,718 --> 04:32:02,920
>> ABSOLUTELY.

5083
04:32:02,920 --> 04:32:05,089
CAN YOU REMIND ME WHAT THE 

5084
04:32:05,089 --> 04:32:05,656
FOLLOW-UP TIME IS FOR BOTH 

5085
04:32:05,656 --> 04:32:11,495
COHORTS?

5086
04:32:11,495 --> 04:32:18,536
>> I THINK THAT JUST
RENEWED.

5087
04:32:18,536 --> 04:32:24,742
>> I THINK THERE'S A STUDY
BUT 

5088
04:32:24,742 --> 04:32:30,047
I'M ASSUMING AN ANCILLARY STUDY 

5089
04:32:30,047 --> 04:32:32,416
CAN BE PROPOSED.

5090
04:32:32,416 --> 04:32:33,450
I'LL BRING THE RECOMMENDATION 

5091
04:32:33,450 --> 04:32:34,251
BACK TO THE LEADERSHIP FOR THE 

5092
04:32:34,251 --> 04:32:37,821
DISCUSSION.

5093
04:32:37,821 --> 04:32:39,356
>> THAT WOULD BE AMAZING.

5094
04:32:39,356 --> 04:32:42,760
WE DID PROPOSE IT AS AN 

5095
04:32:42,760 --> 04:32:43,827
ANCILLARY STUDY.

5096
04:32:43,827 --> 04:32:45,462
WE HAVE NOT YET BEEN SUCCESSFUL.

5097
04:32:45,462 --> 04:32:48,732
IT WOULD BE GREAT IF IT WOULD BE

5098
04:32:48,732 --> 04:32:55,873
RECONSIDERED.

5099
04:32:55,873 --> 04:32:58,075
>> WE'VE ALSO BEEN WORKING
IN 

5100
04:32:58,075 --> 04:33:00,344
THE AREA FOR MANY YEARS AND IN 

5101
04:33:00,344 --> 04:33:04,081
ONE OF THE THINGS I'VE ALWAYS 

5102
04:33:04,081 --> 04:33:05,349
FOUND PECULIAR AND I KNOW SOME 

5103
04:33:05,349 --> 04:33:08,085
OF MY COLLEAGUES AGREE WITH ME 

5104
04:33:08,085 --> 04:33:10,387
IS HOW MANY IN THE PULMONARY 

5105
04:33:10,387 --> 04:33:10,988
WORLD JUST DON'T WANT TO DEAL 

5106
04:33:10,988 --> 04:33:18,062
WITH THE DIET.

5107
04:33:18,062 --> 04:33:20,965
IT'S ODD BECAUSE IT'S LIKE 

5108
04:33:20,965 --> 04:33:21,966
SINGING TO THE CHOIR HERE 

5109
04:33:21,966 --> 04:33:22,600
EVERYONE INFORMATIONS THERE'S 

5110
04:33:22,600 --> 04:33:23,000
PROMISE AN DATA.

5111
04:33:23,000 --> 04:33:27,838
IT'S NOT PERFECT.

5112
04:33:27,838 --> 04:33:30,474
WE HAVE STRUGGLED IN RESPIRATORY

5113
04:33:30,474 --> 04:33:32,610
MEETINGS AND TRYING TO GET 

5114
04:33:32,610 --> 04:33:36,180
ANYONE TO PAY ATTENTION AND 

5115
04:33:36,180 --> 04:33:38,282
THINKING A CLOSE COLLEAGUE IN 

5116
04:33:38,282 --> 04:33:40,117
PARIS WHO IS PULLING OUT HER 

5117
04:33:40,117 --> 04:33:44,722
HAIR AT THIS.

5118
04:33:44,722 --> 04:33:45,623
THIS WORKSHOP WILL HELP.

5119
04:33:45,623 --> 04:33:49,226
ONE OF THE THINGS WE CAN DO AS 

5120
04:33:49,226 --> 04:33:51,295
YOU KNOW YOU'RE PLANNING TO DO 

5121
04:33:51,295 --> 04:33:53,897
IS WRITE IT UP AND TELL THE 

5122
04:33:53,897 --> 04:33:55,532
NHLBI THIS IS IMPORTANT.

5123
04:33:55,532 --> 04:33:57,368
THAT I THINK WOULD REALLY HELP 

5124
04:33:57,368 --> 04:33:59,403
MOVE THE FIELD FORWARD.

5125
04:33:59,403 --> 04:34:00,738
THAT'S ONE OF THE MAIN REASONS I

5126
04:34:00,738 --> 04:34:04,742
WAS HAPPY TO PARTICIPATE.

5127
04:34:04,742 --> 04:34:07,811
IT'S LONG OVERDUE SO THANK YOU.

5128
04:34:07,811 --> 04:34:10,581
>> WE ALSO HAVE THE
SENTIMENT.

5129
04:34:10,581 --> 04:34:12,716
I COULD SEE PEOPLE'S SMILES WHEN

5130
04:34:12,716 --> 04:34:15,085
YOU WERE DESCRIBING THE FACT 

5131
04:34:15,085 --> 04:34:20,591
THAT NUTRITION IS STILL NOT VERY

5132
04:34:20,591 --> 04:34:22,126
POPULAR AMONGST RESPIRATORY 

5133
04:34:22,126 --> 04:34:22,860
EXPERTS.

5134
04:34:22,860 --> 04:34:24,728
I DO BELIEVE THERE IS AN 

5135
04:34:24,728 --> 04:34:28,065
OPPORTUNITY THERE AND I'M NOT 

5136
04:34:28,065 --> 04:34:30,000
SAYING BY ANY STRETCH NUTRITION 

5137
04:34:30,000 --> 04:34:32,736
IS THE SOLUTION BUT IT'S 

5138
04:34:32,736 --> 04:34:35,406
CERTAINLY SOMETHING THAT CAN 

5139
04:34:35,406 --> 04:34:37,141
HELP AND WE HAVE A GROWING BODY 

5140
04:34:37,141 --> 04:34:40,311
OF EVIDENCE THAT SUPPORTS THAT.

5141
04:34:40,311 --> 04:34:44,748
I THINK MAYBE NOW WE'VE INVITED 

5142
04:34:44,748 --> 04:34:47,718
SUCH AN INTERNATIONAL CADRE OF 

5143
04:34:47,718 --> 04:34:51,055
EXPERTS THERE MAY BE A STRONGER 

5144
04:34:51,055 --> 04:34:51,588
VOICE AS A RESULT OF THE 

5145
04:34:51,588 --> 04:35:00,731
MEETING.

5146
04:35:00,731 --> 04:35:00,998
THANK YOU.

5147
04:35:00,998 --> 04:35:07,771
OVER TO YOU.

5148
04:35:07,771 --> 04:35:10,674
>> I WANTED TO MAKE A
COUPLE 

5149
04:35:10,674 --> 04:35:11,141
COMMENTS.

5150
04:35:11,141 --> 04:35:14,945
ONE IS I'VE BEEN WORKING ON A 

5151
04:35:14,945 --> 04:35:19,116
GRANT PROPOSAL WITH ANN DIXON 

5152
04:35:19,116 --> 04:35:21,452
MULTIPLE YEARS ON GETTING 

5153
04:35:21,452 --> 04:35:23,387
NUTRITION AND DIET INTO THAT 

5154
04:35:23,387 --> 04:35:28,158
STUDY SO IT SOUND LIKE SOME 

5155
04:35:28,158 --> 04:35:30,227
LOBBYING AND BREAKING DOWN SOME 

5156
04:35:30,227 --> 04:35:32,896
POLITICAL BARRIERS MIGHT BE 

5157
04:35:32,896 --> 04:35:36,800
IMPORTANT THERE.

5158
04:35:36,800 --> 04:35:46,877
AND CLINICAL CONTEXT AS WELL AS 

5159
04:35:46,877 --> 04:35:51,148
NOT JUST IN THE RESEARCH CONTEXT

5160
04:35:51,148 --> 04:35:53,917
BUT GETTING DIETITIANS INTO THE 

5161
04:35:53,917 --> 04:35:56,153
CLINIC AND BECAUSE REALLY THE 

5162
04:35:56,153 --> 04:35:59,256
MAJORITY OF PATIENTS THAT COME 

5163
04:35:59,256 --> 04:36:02,192
THROUGH THE RESPIRATORY CLINIC 

5164
04:36:02,192 --> 04:36:03,560
HAVE NUTRITIONAL PROBLEMS.

5165
04:36:03,560 --> 04:36:07,631
A GOOD PORTION OF THEM AT LEAST 

5166
04:36:07,631 --> 04:36:08,732
HALF ARE OBESE.

5167
04:36:08,732 --> 04:36:12,302
VIRTUALLY ALL OF THEM HAVE GOT 

5168
04:36:12,302 --> 04:36:14,905
POOR DIET QUALITY AND SO THE 

5169
04:36:14,905 --> 04:36:17,641
OPPORTUNITY THERE TO HAVE A 

5170
04:36:17,641 --> 04:36:19,276
DIETITIAN IN A 

5171
04:36:19,276 --> 04:36:20,911
MULTI-DISCIPLINARY CLINIC IS 

5172
04:36:20,911 --> 04:36:24,715
HUGE.

5173
04:36:24,715 --> 04:36:25,816
IN AUSTRALIA WE HAD A LITTLE BIT

5174
04:36:25,816 --> 04:36:28,218
OF SUCCESS IN TERMS OF GETTING 

5175
04:36:28,218 --> 04:36:32,723
THAT RECOMMENDATION INTO 

5176
04:36:32,723 --> 04:36:34,191
GUIDELINES.

5177
04:36:34,191 --> 04:36:41,098
THE BRITISH THORACIC SOCIETY GOT

5178
04:36:41,098 --> 04:36:43,167
A DIETITIAN IN THE CLINIC TO 

5179
04:36:43,167 --> 04:36:44,968
DEAL WITH OBESE PATIENTS BUT 

5180
04:36:44,968 --> 04:36:48,238
IT'S A BIG OPPORTUNITY TO CHANGE

5181
04:36:48,238 --> 04:36:49,206
THE WAY THE RESPIRATORY 

5182
04:36:49,206 --> 04:36:49,706
COMMUNITY THINKS ABOUT 

5183
04:36:49,706 --> 04:36:59,883
NUTRITION.

5184
04:37:05,422 --> 04:37:12,262
>> IT'S SUCH A NARROW
LIMITED 

5185
04:37:12,262 --> 04:37:16,233
VIEW.

5186
04:37:16,233 --> 04:37:26,777
WHEN AND IT WAS INTERESTING AND 

5187
04:37:29,980 --> 04:37:32,716
PEOPLE AT BASE NOW WITH 

5188
04:37:32,716 --> 04:37:33,083
SARCOPENIA.

5189
04:37:33,083 --> 04:37:36,720
THESE ARE IMPORTANT POINTS FOR 

5190
04:37:36,720 --> 04:37:40,724
THE WORKSHOP SUM I HAVE.

5191
04:37:40,724 --> 04:37:41,592
-- SUMMARY.

5192
04:37:41,592 --> 04:37:49,967
>> THIS IS BEING RECORDED.

5193
04:37:49,967 --> 04:37:50,734
>> THERE'S AN OPPORTUNITY
TO 

5194
04:37:50,734 --> 04:37:54,104
LOOK AT THE EXISTING BODY OF 

5195
04:37:54,104 --> 04:37:54,371
EVIDENCE.

5196
04:37:54,371 --> 04:37:57,708
IF WE LOOK AT HOW NUTRITION AND 

5197
04:37:57,708 --> 04:37:59,610
OTHER CHRONIC DISEASES HAVE BEEN

5198
04:37:59,610 --> 04:38:02,012
DEVELOPED AND IF WE HOPE TO 

5199
04:38:02,012 --> 04:38:03,614
PRODUCE CLINICAL GUIDELINES OR 

5200
04:38:03,614 --> 04:38:05,949
HEALTH POLICY RECOMMENDATIONS 

5201
04:38:05,949 --> 04:38:07,951
WITH NEED TO SYNTHESIZE THE 

5202
04:38:07,951 --> 04:38:08,619
EVIDENCE.

5203
04:38:08,619 --> 04:38:12,256
WE'RE ALL AWARE THERE'S NOT 

5204
04:38:12,256 --> 04:38:13,790
SUFFICIENT RANDOMIZED CONTROL 

5205
04:38:13,790 --> 04:38:15,025
TRIALS WHICH ARE CONSIDERED THE 

5206
04:38:15,025 --> 04:38:18,462
GOLD STANDARD BUT I THINK 

5207
04:38:18,462 --> 04:38:22,232
THERE'S COHORT STUDIES CARRIED 

5208
04:38:22,232 --> 04:38:25,536
OUT AND THERE'S OPPORTUNITIES TO

5209
04:38:25,536 --> 04:38:31,675
SYNTHESIZE THAT INFLAMMATION AND

5210
04:38:31,675 --> 04:38:33,477
HOW STRONG IS THE BODY OF 

5211
04:38:33,477 --> 04:38:36,380
EVIDENCE WE HAVE SO FAR FOR 

5212
04:38:36,380 --> 04:38:37,814
VARIOUS RESPIRATORY OUTCOMES FOR

5213
04:38:37,814 --> 04:38:44,555
LUNG FUNCTION AND FOR ASTHMA OR 

5214
04:38:44,555 --> 04:38:45,956
CYSTIC FIBROSIS OR COPD WOULD BE

5215
04:38:45,956 --> 04:38:52,296
HELPFUL TO DO AND MORE 

5216
04:38:52,296 --> 04:38:55,432
CONSISTENTLY EXPLOIT DATA SETS 

5217
04:38:55,432 --> 04:38:59,136
AND COHORTS THAT HAVE DATA ON 

5218
04:38:59,136 --> 04:39:08,979
DIET AND RESPIRATORY OUTCOMES.

5219
04:39:08,979 --> 04:39:10,080
>> YOU MADE A COMMENT IN
THE 

5220
04:39:10,080 --> 04:39:10,647
CHAT.

5221
04:39:10,647 --> 04:39:12,950
WOULD YOU LIKE TO ELABORATE HOW 

5222
04:39:12,950 --> 04:39:14,952
THE COMMENTS AND CONDITIONS FROM

5223
04:39:14,952 --> 04:39:21,425
THIS WORKSHOP MAY BE USED FOR 

5224
04:39:21,425 --> 04:39:22,326
STRATEGIC FUNDING DECISION GOING

5225
04:39:22,326 --> 04:39:27,998
FORWARD?

5226
04:39:27,998 --> 04:39:30,467
>> UM, I CANNOT PROVIDE
ANYTHING

5227
04:39:30,467 --> 04:39:33,303
SPECIFIC AT THIS MOMENT BUT ANY 

5228
04:39:33,303 --> 04:39:36,440
RECOMMENDATIONS, COMMENTS WE 

5229
04:39:36,440 --> 04:39:42,045
WILL CERTAINLY BRING BACK FOR 

5230
04:39:42,045 --> 04:39:47,284
INTERNAL STAFF DISCUSSION AND 

5231
04:39:47,284 --> 04:39:54,491
HOPEFULLY WE'LL GET SOMETHING 

5232
04:39:54,491 --> 04:39:56,860
ACTIONABLE BUT WE HAVE CRITICAL 

5233
04:39:56,860 --> 04:39:58,228
QUESTIONS YOU GUYS RAISED SO 

5234
04:39:58,228 --> 04:40:00,697
WE'LL TRY TO ADDRESS THAT.

5235
04:40:00,697 --> 04:40:05,268
THAT'S WHY WE HAVE THIS WORKSHOP

5236
04:40:05,268 --> 04:40:08,338
TO PROVIDE ON KEY ISSUES WE NEED

5237
04:40:08,338 --> 04:40:14,111
TO SOLVE AND ALSO WHAT IS URGENT

5238
04:40:14,111 --> 04:40:21,785
TO DO COMPLEXITY WHEN THEY TAKE 

5239
04:40:21,785 --> 04:40:24,521
STEPS WHAT WE CAN DO NOW AND 

5240
04:40:24,521 --> 04:40:26,223
THREE YEARS LATER.

5241
04:40:26,223 --> 04:40:27,190
WE'LL TRY TO ADDRESS.

5242
04:40:27,190 --> 04:40:30,961
I THINK THE WORKSHOP IS THE 

5243
04:40:30,961 --> 04:40:31,528
BEGINNING OF THE WORK.

5244
04:40:31,528 --> 04:40:37,567
>> GREAT.

5245
04:40:37,567 --> 04:40:46,343
>> AND DR. PANDA.

5246
04:40:46,343 --> 04:40:56,286
>> I'D LIKE TO ADDRESS THE

5247
04:40:56,286 --> 04:40:57,654
IMPORTANCE OF NUTRITION TIMING.

5248
04:40:57,654 --> 04:41:01,124
IF WE LOOK AT OUR EXISTING DATA 

5249
04:41:01,124 --> 04:41:07,597
WE COLLECT FROM WHAT WE FIND IS 

5250
04:41:07,597 --> 04:41:10,267
WE'RE CONSUMING THE DIET BETWEEN

5251
04:41:10,267 --> 04:41:14,438
4:00 A.M. AND NOON AND 90% OF 

5252
04:41:14,438 --> 04:41:16,740
OUR DIET AFTER 7:00 P.M. IN MANY

5253
04:41:16,740 --> 04:41:17,040
POPULATION.

5254
04:41:17,040 --> 04:41:19,810
AS THE DAY GOES ON AND GET 

5255
04:41:19,810 --> 04:41:21,311
FURTHER TO THE BED TIME THE 

5256
04:41:21,311 --> 04:41:25,515
QUALITY OF NUTRITION ALSO GOES 

5257
04:41:25,515 --> 04:41:25,716
DOWN.

5258
04:41:25,716 --> 04:41:27,751
THAT MIGHT BE A POINT TO 

5259
04:41:27,751 --> 04:41:34,424
CONSIDER WHEN COLLECTING 

5260
04:41:34,424 --> 04:41:36,727
NUTRITION DATA AND LOOK AT 

5261
04:41:36,727 --> 04:41:40,464
AVOIDING FOOD THREE HOURS BEFORE

5262
04:41:40,464 --> 04:41:42,733
BED TIME WHICH CAN HAVE MUCH FAT

5263
04:41:42,733 --> 04:41:45,902
BECAUSE WHAT WE'RE FINDING IN 

5264
04:41:45,902 --> 04:41:48,371
MOST OF OUR STUDIES IT WILL 

5265
04:41:48,371 --> 04:41:50,807
IMPROVE THEIR SLEEP QUALITY AND 

5266
04:41:50,807 --> 04:41:54,444
WE KNOW THAT GETTING READY CLOSE

5267
04:41:54,444 --> 04:41:56,713
TO BED TIME HAS AN EFFECT ON 

5268
04:41:56,713 --> 04:42:00,717
CARDIOVASCULAR OUTCOME.

5269
04:42:00,717 --> 04:42:08,759
THE TIMING OF NUTRITION WHAT PEM

5270
04:42:08,759 --> 04:42:11,228
ARE EATING THREE TO FOUR HOURS 

5271
04:42:11,228 --> 04:42:12,729
BEFORE BED TIME AND HAS A HUGE 

5272
04:42:12,729 --> 04:42:20,737
IMPACT.

5273
04:42:20,737 --> 04:42:24,741
>> WE HAVE A COMMENT FROM
EMILY 

5274
04:42:24,741 --> 04:42:32,449
IN THE CHAT.

5275
04:42:32,449 --> 04:42:33,850
>> THE CANADIAN INSTITUTES
OF 

5276
04:42:33,850 --> 04:42:37,487
LUNG HEALTH HAS RECENTLY FUNDED 

5277
04:42:37,487 --> 04:42:41,825
SEVERAL LUNG HEALTH TEAM GRANTS 

5278
04:42:41,825 --> 04:42:47,364
ONE LED BY THE NGLI NETWORK AND 

5279
04:42:47,364 --> 04:42:50,634
HAS A ROLE AND INTENDS TO 

5280
04:42:50,634 --> 04:42:52,502
SUPPORT A PLATFORM FOR 

5281
04:42:52,502 --> 04:42:55,906
HARMONIZING AND IMPROVING ACCESS

5282
04:42:55,906 --> 04:42:59,409
TO NOT ONLY CANADIAN LUNG HEALTH

5283
04:42:59,409 --> 04:42:59,943
DATA.

5284
04:42:59,943 --> 04:43:02,112
IT'S AN EARLY PROCESS AND CAN 

5285
04:43:02,112 --> 04:43:07,217
HELP FACILITATE CONNECTIONS OR 

5286
04:43:07,217 --> 04:43:09,019
RESEARCH WITH NHLBI.

5287
04:43:09,019 --> 04:43:10,520
THAT'S PROMISING.

5288
04:43:10,520 --> 04:43:20,831
THANK YOU SO MUCH.

5289
04:43:24,801 --> 04:43:27,771
>> I GUESS I'LL MENTION
ONE 

5290
04:43:27,771 --> 04:43:29,005
THING THAT STOOD OUT TO ME 

5291
04:43:29,005 --> 04:43:31,107
THOUGHT THE TALKS IN THE LAST 

5292
04:43:31,107 --> 04:43:36,146
TWO DAYS IS THE NEED TO BE VERY 

5293
04:43:36,146 --> 04:43:38,849
CAREFUL AND VERY SPECIFIC ABOUT 

5294
04:43:38,849 --> 04:43:43,119
POPULATIONS THAT WE'RE STUDYING 

5295
04:43:43,119 --> 04:43:46,256
AND MAKING SURE THAT WE'RE NOT 

5296
04:43:46,256 --> 04:43:47,190
ONLY POWERED IN TERMS OF PEOPLE 

5297
04:43:47,190 --> 04:43:52,729
IN THE STUDIES BUT TIME.

5298
04:43:52,729 --> 04:43:54,197
THERE'S SO MANY STUDIES THAT 

5299
04:43:54,197 --> 04:43:55,832
SEEM LIKE THEY WERE DONE FOR 12 

5300
04:43:55,832 --> 04:43:58,268
WEEKS AND SEEMS LIKE WE NEED TO 

5301
04:43:58,268 --> 04:44:00,704
GO BACK TO THE DRAWING BOARD AND

5302
04:44:00,704 --> 04:44:04,241
FIGURE OUT HOW WE CAN DO LONGER 

5303
04:44:04,241 --> 04:44:06,676
STUDIES IN THESE MORE VULNERABLE

5304
04:44:06,676 --> 04:44:07,477
POPULATIONS SUCCESSFULLY AND 

5305
04:44:07,477 --> 04:44:08,979
LOOKING FOR PARTNERS TO HELP US 

5306
04:44:08,979 --> 04:44:14,384
DO THAT BECAUSE I FEEL LIKE A 

5307
04:44:14,384 --> 04:44:15,685
LOT OF THE DIFFICULTY WE'LL BE 

5308
04:44:15,685 --> 04:44:19,456
DOING IN ASCERTAINING TRUE 

5309
04:44:19,456 --> 04:44:20,857
EFFECT ARE DUE TO THOSE 

5310
04:44:20,857 --> 04:44:31,067
LIMITATIONS.

5311
04:44:34,638 --> 04:44:40,410
>> DIET IS RELATED TO THE
POINT 

5312
04:44:40,410 --> 04:44:41,745
A NUMBER OF PRESENTERS MADE 

5313
04:44:41,745 --> 04:44:44,714
WHICH IS HUMAN NUTRITION STUDIES

5314
04:44:44,714 --> 04:44:46,650
ARE HARD TO DO.

5315
04:44:46,650 --> 04:44:51,254
IT'S EVEN HARDER TO CONDUCT 

5316
04:44:51,254 --> 04:44:54,691
NUTRITION INTERVENTION OVER AN 

5317
04:44:54,691 --> 04:45:00,297
EXTENDED PERIOD OF TIME.

5318
04:45:00,297 --> 04:45:05,535
THERE'S ADHERENCE AND THEN ALSO 

5319
04:45:05,535 --> 04:45:07,270
IN TERMS OF DATA COLLECTION AND 

5320
04:45:07,270 --> 04:45:12,542
THE INTERVENTION AND AT THE SAME

5321
04:45:12,542 --> 04:45:17,580
TIME OUR COLLEAGUES IN OTHER 

5322
04:45:17,580 --> 04:45:18,982
FIELDS HAVE DONE LARGE SCALE 

5323
04:45:18,982 --> 04:45:20,750
NUTRITION INTERVENTIONS IN THE 

5324
04:45:20,750 --> 04:45:22,752
REAL WORLD.

5325
04:45:22,752 --> 04:45:26,589
WE NEED TO THINK ABOUT IN ORDER 

5326
04:45:26,589 --> 04:45:28,892
TO MOVE THIS FIELD FORWARD, 

5327
04:45:28,892 --> 04:45:30,827
WHICH AREA HAS THE MOST 

5328
04:45:30,827 --> 04:45:35,131
PROPOSITION FOR US TO DESIGN 

5329
04:45:35,131 --> 04:45:36,733
DEFINITIVE TRIALS FOR NOVEL 

5330
04:45:36,733 --> 04:45:41,438
COHORT STUDIES INCLUDING 

5331
04:45:41,438 --> 04:45:43,840
POTENTIALLY AND STUDIES AND USE 

5332
04:45:43,840 --> 04:45:50,380
THEM TO ANSWER NEW QUESTIONS.

5333
04:45:50,380 --> 04:45:53,149
I THINK TO ME WE'RE BEHIND THE 

5334
04:45:53,149 --> 04:45:57,487
TIME IN TERMS OF THINKING ABOUT 

5335
04:45:57,487 --> 04:45:59,723
INTERVENTION TRIALS THAT CAN 

5336
04:45:59,723 --> 04:46:01,191
REALLY GENERATE DEFINITIVE 

5337
04:46:01,191 --> 04:46:04,127
EVIDENCE FOR THE ROLE OF 

5338
04:46:04,127 --> 04:46:04,894
NUTRITION IN RELATION TO 

5339
04:46:04,894 --> 04:46:09,933
RESPIRATORY HEALTH.

5340
04:46:09,933 --> 04:46:13,269
>> I THINK WE'RE ALL AWARE
OF 

5341
04:46:13,269 --> 04:46:15,372
THE MANY FACTORS GOING INTO WHY 

5342
04:46:15,372 --> 04:46:17,774
WE'VE IN THE BEEN GREAT AT IT 

5343
04:46:17,774 --> 04:46:20,410
BUT I DO THINK THAT NO PRESSURE 

5344
04:46:20,410 --> 04:46:27,017
TO NIH RIGHT NOW BUT THE MONEY 

5345
04:46:27,017 --> 04:46:28,318
THAT IT TAKE TO DO LONG-TERM 

5346
04:46:28,318 --> 04:46:30,186
NUTRITION STUDIES ESPECIALLY 

5347
04:46:30,186 --> 04:46:32,722
ADDING IN OMICS APPROACHES IN 

5348
04:46:32,722 --> 04:46:34,557
THE SAMPLES OVER TIME WITH 

5349
04:46:34,557 --> 04:46:36,659
MULTIPLE SAMPLING PERIODS 

5350
04:46:36,659 --> 04:46:39,195
BECOMES A VERY LARGE SUM OF 

5351
04:46:39,195 --> 04:46:40,864
MONEY AS WELL AS TRYING TO GET 

5352
04:46:40,864 --> 04:46:43,500
VULNERABLE POPULATIONS WHICH 

5353
04:46:43,500 --> 04:46:44,667
REQUIRE DIFFERENT KINDS OF 

5354
04:46:44,667 --> 04:46:46,002
BARRIERS WE NEED TO REMOVE FOR 

5355
04:46:46,002 --> 04:46:50,373
THEM TO PARTICIPATE IN THE STUDY

5356
04:46:50,373 --> 04:46:56,312
AND INSENSITIVES AND NEED TO 

5357
04:46:56,312 --> 04:46:56,880
THINK HOW TO FUND THOSE 

5358
04:46:56,880 --> 04:47:03,753
EFFECTIVELY.

5359
04:47:03,753 --> 04:47:08,124
>> TO DOVETAIL ON WHAT YOU
HAD 

5360
04:47:08,124 --> 04:47:09,092
COMMENTED ON.

5361
04:47:09,092 --> 04:47:10,727
ONE OF THE EFFORTS WE'VE 

5362
04:47:10,727 --> 04:47:12,729
UNDERTAKEN IN PEDIATRIC CRITICAL

5363
04:47:12,729 --> 04:47:17,700
CARE NUTRITION IS TO BRING AN 

5364
04:47:17,700 --> 04:47:24,974
INTERNATIONAL WORK GROUP 

5365
04:47:24,974 --> 04:47:29,579
TOGETHER AND COLLECT PATIENT 

5366
04:47:29,579 --> 04:47:37,454
RISK FACTORS AND INDIVIDUAL 

5367
04:47:37,454 --> 04:47:46,796
STUDIES AND WHEN YOU'RE DOING A 

5368
04:47:46,796 --> 04:47:51,234
STUDY YOU COLLECT AND THEN LOOK 

5369
04:47:51,234 --> 04:47:53,470
AT LATER AT LEAST IN OUR FIELD 

5370
04:47:53,470 --> 04:47:55,605
THE EFFORT IS UNDERWAY SO THAT 

5371
04:47:55,605 --> 04:47:56,406
WE CAN BETTER UNDERSTAND WHAT WE

5372
04:47:56,406 --> 04:47:57,040
ARE DOING BECAUSE THE STUDIES 

5373
04:47:57,040 --> 04:48:07,217
ARE HARD.

5374
04:48:12,789 --> 04:48:23,199
>> THERE'S A TEAM WITH
WELL 

5375
04:48:25,335 --> 04:48:27,770
DEFINED COMMON DATA ELEMENT AND 

5376
04:48:27,770 --> 04:48:29,839
THIS REMINDS ME OTHER INSTITUTES

5377
04:48:29,839 --> 04:48:36,713
AT NIH THAT HAVE DONE THIS FOR 

5378
04:48:36,713 --> 04:48:44,721
EXAMPLE AND LONG-TERM REDUCTION 

5379
04:48:44,721 --> 04:48:52,595
MULTIPLE HEALTH BENEFITS.

5380
04:48:52,595 --> 04:49:03,106
AND THERE'S STUDIES AND ALSO 

5381
04:49:18,388 --> 04:49:23,893
THAT KIND OF OUTCOME WOULD MOVE 

5382
04:49:23,893 --> 04:49:28,665
THE FIELD AND THE INSTITUTE 

5383
04:49:28,665 --> 04:49:32,268
BEYOND WHAT THEY DO UNSMALL 

5384
04:49:32,268 --> 04:49:34,604
STUDIES AND THOSE HAVE PRODUCED 

5385
04:49:34,604 --> 04:49:36,039
ENOUGH EVIDENCE AND IT DOES 

5386
04:49:36,039 --> 04:49:37,240
MATTER FOR LUNG HEALTH AND 

5387
04:49:37,240 --> 04:49:44,647
HAVING THAT LAST STUDY WILL 

5388
04:49:44,647 --> 04:49:46,616
BRING ALL THE DATA TO MOVE IT 

5389
04:49:46,616 --> 04:49:46,849
FURTHER.

5390
04:49:46,849 --> 04:49:56,292
THANK YOU.

5391
04:49:56,292 --> 04:49:59,329
>> DO YOU THINK THERE ARE
OTHER 

5392
04:49:59,329 --> 04:50:00,263
QUESTIONS THAT WOULD PREPARE THE

5393
04:50:00,263 --> 04:50:04,934
WAY WE WOULD LIKE TO POSE TO THE

5394
04:50:04,934 --> 04:50:15,044
PANEL?

5395
04:50:15,044 --> 04:50:20,383
>> I DON'T HAVE ANY
PRESSING 

5396
04:50:20,383 --> 04:50:30,727
QUESTIONS TO SHARE.

5397
04:50:31,494 --> 04:50:34,697
I THINK WE CAN ADDRESS THE 

5398
04:50:34,697 --> 04:50:35,565
WORKSHOP.

5399
04:50:35,565 --> 04:50:37,634
I WONDER WHETHER YOU THINK IT 

5400
04:50:37,634 --> 04:50:41,237
WOULD BE USEFUL FOR US TO ASK 

5401
04:50:41,237 --> 04:50:44,340
PEOPLE TO GO AROUND AND GIVE US 

5402
04:50:44,340 --> 04:50:47,944
THEIR TOP TWO TAKEAWAYS AND TOP 

5403
04:50:47,944 --> 04:50:50,179
TWO RECOMMENDATIONS.

5404
04:50:50,179 --> 04:50:50,847
>> ABSOLUTELY AND PLEASE 

5405
04:50:50,847 --> 04:50:53,016
REMEMBER THIS IS BEING RECORDED 

5406
04:50:53,016 --> 04:50:57,520
SO IT'S GOING TO BE GREAT TO 

5407
04:50:57,520 --> 04:51:00,723
SHARE THAT WITH NHLBI AFTERWARD.

5408
04:51:00,723 --> 04:51:08,264
PLEASE FIRE AWAY.

5409
04:51:08,264 --> 04:51:18,641
>> I'LL OFFER MY
PERSPECTIVE 

5410
04:51:18,641 --> 04:51:27,717
FROM IT AND EPIDEMIOLOGICAL 

5411
04:51:27,717 --> 04:51:30,520
POINT OF VIEW THERE'S WELL 

5412
04:51:30,520 --> 04:51:32,622
DESIGN EPIDEMIOLOGICAL COHORT 

5413
04:51:32,622 --> 04:51:34,290
STUDIES INCLUDING OPTIMIZING THE

5414
04:51:34,290 --> 04:51:39,929
WAY IN WHICH WE MEASURE DIETARY 

5415
04:51:39,929 --> 04:51:43,266
INTAKE AND COMBINE TOOLS WITH 

5416
04:51:43,266 --> 04:51:47,370
THE BIOMARKERS WE HAVE REVEALED 

5417
04:51:47,370 --> 04:51:49,839
TODAY AND YESTERDAY.

5418
04:51:49,839 --> 04:51:52,408
THOSE ARE MY TWO TAKEAWAYS FROM 

5419
04:51:52,408 --> 04:52:02,885
WHAT WE REVIEWED YESTERDAY.

5420
04:52:05,321 --> 04:52:12,729
AND INCORPORATE THE SCIENTIFIC 

5421
04:52:12,729 --> 04:52:14,797
AGENDA WE'LL TALK ABOUT IN 

5422
04:52:14,797 --> 04:52:17,900
COMMUNICABLE DISEASE PREVENTION 

5423
04:52:17,900 --> 04:52:18,801
AND MANAGEMENT AND THAT 

5424
04:52:18,801 --> 04:52:20,703
CONSIDERATION SHOULD BE GIVEN TO

5425
04:52:20,703 --> 04:52:22,905
THE STUDY OF RESPIRATORY HEALTH 

5426
04:52:22,905 --> 04:52:24,107
AND NUTRITION.

5427
04:52:24,107 --> 04:52:27,243
WE MADE A CLEAR CONNECTION 

5428
04:52:27,243 --> 04:52:29,579
YESTERDAY BETWEEN CLIMATE CHANGE

5429
04:52:29,579 --> 04:52:39,889
AND FOOD SYSTEMS.

5430
04:52:46,129 --> 04:52:48,898
>> I CAN CALL ON EACH OF
YOU TO 

5431
04:52:48,898 --> 04:52:52,702
GIVE YOUR REMARKS AS I SEE YOU 

5432
04:52:52,702 --> 04:52:57,707
ON MY SCREEN.

5433
04:52:57,707 --> 04:53:04,680
DR. WOOD.

5434
04:53:04,680 --> 04:53:08,584
I THOUGHT I'D HAVE MORE TIME.

5435
04:53:08,584 --> 04:53:10,286
ONE THING THAT STOOD OUT IS A 

5436
04:53:10,286 --> 04:53:15,324
LOT OF THE THINGS WE'VE BEEN 

5437
04:53:15,324 --> 04:53:18,661
TALKING ABOUT DRUG TO RECTIFY 

5438
04:53:18,661 --> 04:53:19,562
AND ESTABLISH PROBLEMS THAT 

5439
04:53:19,562 --> 04:53:28,404
REALLY HAS STEMMED FROM 

5440
04:53:28,404 --> 04:53:38,848
UNHEALTHY AND THERE'S THE 

5441
04:53:42,952 --> 04:53:44,153
PRECISION NUTRITION.

5442
04:53:44,153 --> 04:53:46,923
THERE'S SO MUCH THERE TO USE 

5443
04:53:46,923 --> 04:53:51,928
PRECISION NUTRITION IN SPECIFIC 

5444
04:53:51,928 --> 04:53:53,329
POPULATIONS ONCE WE UNDERSTAND 

5445
04:53:53,329 --> 04:53:54,764
WHAT THE PRESCRIPTIONS SHOULD BE

5446
04:53:54,764 --> 04:54:05,208
FOR INDIVIDUAL SUB GROUPS.

5447
04:54:06,709 --> 04:54:07,143
>> THANK YOU.

5448
04:54:07,143 --> 04:54:09,912
DR. TYPPO.

5449
04:54:09,912 --> 04:54:12,348
>> THE FUNDAMENTAL
QUESTION OF 

5450
04:54:12,348 --> 04:54:17,787
READINESS OR AN INCREASE IN 

5451
04:54:17,787 --> 04:54:20,189
MACRO AND MICRO NUTRIENT 

5452
04:54:20,189 --> 04:54:24,093
DELIVERY IS FUNDAMENTAL TO DO 

5453
04:54:24,093 --> 04:54:25,495
ANY SUCCESSFUL CLINICAL TRIALS 

5454
04:54:25,495 --> 04:54:28,164
MOVING FORWARD AND NUTRITION IN 

5455
04:54:28,164 --> 04:54:31,534
THE ICU UNDERSTANDING SOME 

5456
04:54:31,534 --> 04:54:32,702
DYNAMIC BIOMARKER OR COMBINATION

5457
04:54:32,702 --> 04:54:34,170
OF FEATURES ABOUT PATIENTS AND 

5458
04:54:34,170 --> 04:54:35,705
THEIR ILLNESS THAT WOULD PREDICT

5459
04:54:35,705 --> 04:54:39,642
THEIR RESPONSE TO NUTRITIONAL 

5460
04:54:39,642 --> 04:54:40,676
INTERVENTIONS.

5461
04:54:40,676 --> 04:54:44,714
AND HAS TO PREDATE ANY TYPE OF 

5462
04:54:44,714 --> 04:54:50,853
PLANNING FOR AN INTERVENTIONAL 

5463
04:54:50,853 --> 04:54:54,891
TRIAL AND FUNDAMENTALLY THE AREA

5464
04:54:54,891 --> 04:55:00,730
OF GUT LUNG AXIS AND HOW 

5465
04:55:00,730 --> 04:55:02,265
NUTRITIONAL STRATEGIES INFLUENCE

5466
04:55:02,265 --> 04:55:07,270
THE GUT MICROBIOME IN PATIENTS 

5467
04:55:07,270 --> 04:55:10,973
CRITICALLY ILL AND RECEIVING A 

5468
04:55:10,973 --> 04:55:14,510
MULTITUDE OF OTHER THERAPIES AND

5469
04:55:14,510 --> 04:55:16,412
THERE'S INTERACTION AND 

5470
04:55:16,412 --> 04:55:19,015
INFLUENCE BETWEEN THE GUT 

5471
04:55:19,015 --> 04:55:21,384
INFLAMMATION AND INJURY AND HOPE

5472
04:55:21,384 --> 04:55:22,919
TO REDUCE ACUTE RESPIRATORY 

5473
04:55:22,919 --> 04:55:24,253
ILLNESS AND UNDERSTANDING THE 

5474
04:55:24,253 --> 04:55:26,522
ROLE OF THE GUT MICROBIOME IS 

5475
04:55:26,522 --> 04:55:28,724
PROCESS TO MAKING PROGRESS 

5476
04:55:28,724 --> 04:55:35,031
FORWARD.

5477
04:55:35,031 --> 04:55:40,069
>> THANK YOU.

5478
04:55:40,069 --> 04:55:40,503
DR. NORDGREN.

5479
04:55:40,503 --> 04:55:44,073
>> I THINK WE NEED TO
THINK VERY

5480
04:55:44,073 --> 04:55:45,474
CAREFULLY AND PRACTICALLY ABOUT 

5481
04:55:45,474 --> 04:55:46,742
STUDY DESIGNS IN THE RIGHT 

5482
04:55:46,742 --> 04:55:50,780
POPULATIONS FOR THE RIGHT AMOUNT

5483
04:55:50,780 --> 04:55:55,885
OF TIME WITH THE RIGHT FOOD OR 

5484
04:55:55,885 --> 04:55:56,218
SUPPLEMENTS.

5485
04:55:56,218 --> 04:55:57,086
I MENTIONED YESTERDAY I WORRY 

5486
04:55:57,086 --> 04:55:59,655
ABOUT THE ISSUES OF THE LACK OF 

5487
04:55:59,655 --> 04:56:00,623
REGULATION ON SUPPLEMENTS AND 

5488
04:56:00,623 --> 04:56:03,793
THINGS LIKE THAT AND THERE IS 

5489
04:56:03,793 --> 04:56:04,827
SOME FUNDING TO SUPPORT 

5490
04:56:04,827 --> 04:56:08,531
CERTAINLY STANDARDIZING THAT AND

5491
04:56:08,531 --> 04:56:09,799
ACROSS THE FIELD IN GENERAL 

5492
04:56:09,799 --> 04:56:11,267
THERE'S A LACK OF 

5493
04:56:11,267 --> 04:56:12,268
STANDARDIZATION IN DOSING TIMING

5494
04:56:12,268 --> 04:56:16,739
AND THINGS LIKE THAT I THINK ARE

5495
04:56:16,739 --> 04:56:18,641
LIMITATIONS.

5496
04:56:18,641 --> 04:56:21,611
MY SECOND TAKEAWAY TO SPEAK FOR 

5497
04:56:21,611 --> 04:56:23,045
THE MECHANISMS SESSION I WAS 

5498
04:56:23,045 --> 04:56:25,581
PART OF WE NEED TO THINK 

5499
04:56:25,581 --> 04:56:29,452
CAREFULLY HOW TO INTEGRATE 

5500
04:56:29,452 --> 04:56:32,221
PRECLINICAL MODELLING TO EXPLORE

5501
04:56:32,221 --> 04:56:34,023
THINGS WE'RE SEEING IN CLINICAL 

5502
04:56:34,023 --> 04:56:36,492
STUDIES AND EPIDEMIOLOGICAL 

5503
04:56:36,492 --> 04:56:38,494
STUDIES WHERE WE'RE SEEING 

5504
04:56:38,494 --> 04:56:42,465
EFFECTS BASED ON DIFFERENT 

5505
04:56:42,465 --> 04:56:44,700
HEALTH DISPARITIES AND BASED ON 

5506
04:56:44,700 --> 04:56:48,037
CO-EXPOSURES AND THINGS WE CAN 

5507
04:56:48,037 --> 04:56:49,572
MODEL IF WE'RE CAREFUL ABOUT 

5508
04:56:49,572 --> 04:56:50,706
THOSE MODEL SYSTEMS AND THEY'LL 

5509
04:56:50,706 --> 04:56:53,676
BE IMPORTANT TO UNDERSTAND SOME 

5510
04:56:53,676 --> 04:56:55,845
OF THOSE MORE COMPLEX AFFECTS 

5511
04:56:55,845 --> 04:56:59,115
THINKING ABOUT THINGS LIKE GUT 

5512
04:56:59,115 --> 04:57:04,720
LUNG AXIS OR HOST PRATH BETWEEN 

5513
04:57:04,720 --> 04:57:08,724
NUTRIENTS AND THINGS LIKE THAT.

5514
04:57:08,724 --> 04:57:13,095
>> DR. PANDA.

5515
04:57:13,095 --> 04:57:15,631
>> I THINK I MY TAKE HOME 

5516
04:57:15,631 --> 04:57:19,769
MESSAGE IS THERE'S A HUNGER FOR 

5517
04:57:19,769 --> 04:57:21,170
UNDERSTANDING THE LINK BETWEEN 

5518
04:57:21,170 --> 04:57:23,105
NUTRITION AND LUNG HEALTH BUT AT

5519
04:57:23,105 --> 04:57:28,711
THE SAME TIME ON THE CLINICAL 

5520
04:57:28,711 --> 04:57:33,683
CARE THERE'S LESS IN HEALTH CARE

5521
04:57:33,683 --> 04:57:36,118
PROVIDERS THAT NUTRITION CAN 

5522
04:57:36,118 --> 04:57:38,287
IMPROVE THE LUNG HEALTH.

5523
04:57:38,287 --> 04:57:48,698
ALONG THAT LINE I THINK WE NEED 

5524
04:57:48,698 --> 04:57:51,701
MORE MECHANISTIC STUDIES AND 

5525
04:57:51,701 --> 04:57:53,135
CLINICAL MODELS TO ESTABLISH 

5526
04:57:53,135 --> 04:57:56,605
SOME OF THE CONNECTIONS IN THE 

5527
04:57:56,605 --> 04:58:00,710
GUT LUNG AXIS WHETHER IT'S THE 

5528
04:58:00,710 --> 04:58:05,548
IMMUNE SYSTEM LUNG AXIS 

5529
04:58:05,548 --> 04:58:07,817
DIGESTIVE SYSTEM AND GUT AXIS 

5530
04:58:07,817 --> 04:58:11,187
AND THOSE FINDINGS TO MAKE IT 

5531
04:58:11,187 --> 04:58:15,925
MORE SOLID TO PRODUCE MORE 

5532
04:58:15,925 --> 04:58:20,396
HYPOTH

5533
04:58:20,396 --> 04:58:20,696
HYPOTHESIS.

5534
04:58:20,696 --> 04:58:22,498
THAT'S MY TAKE HOME MESSAGE.

5535
04:58:22,498 --> 04:58:23,232
>> THANK YOU.

5536
04:58:23,232 --> 04:58:30,372
DR. POINTER.

5537
04:58:30,372 --> 04:58:32,708
>> FROM THE NIH
PERSPECTIVE WHY 

5538
04:58:32,708 --> 04:58:34,143
SIGNIFICANCE AND INNOVATION ARE 

5539
04:58:34,143 --> 04:58:36,145
SCORE CRITERIA IN GRANT REVIEWS 

5540
04:58:36,145 --> 04:58:37,413
AND THINKING ABOUT MAYBE WE NEED

5541
04:58:37,413 --> 04:58:41,717
TO MARKET IT AND MAYBE THERE IS 

5542
04:58:41,717 --> 04:58:43,052
SOMETHING TO CONSIDER UNVERY 

5543
04:58:43,052 --> 04:58:44,487
SMALL EFFECTS FOR A LARGE 

5544
04:58:44,487 --> 04:58:45,588
PERCENTAGE OF THE POPULATION ARE

5545
04:58:45,588 --> 04:58:47,690
GOING TO HAVE A LARGE 

5546
04:58:47,690 --> 04:58:50,226
SIGNIFICANCE IN IMPACT.

5547
04:58:50,226 --> 04:58:52,027
A LOT OF US USE ANIMAL MODELS OR

5548
04:58:52,027 --> 04:58:55,498
IN VITRO STUDIES THAT TRY TO HIT

5549
04:58:55,498 --> 04:58:57,967
WITH A HAMMER NUTRITIONAL TYPE 

5550
04:58:57,967 --> 04:59:00,703
INTERVENTION AND MAYBE WE NEED 

5551
04:59:00,703 --> 04:59:02,838
TO THINK ABOUT IMPLEMENTING MORE

5552
04:59:02,838 --> 04:59:06,976
STUDIES LOOKING AT LONG-TERM 

5553
04:59:06,976 --> 04:59:11,313
OUTCOMES THAT RELATE TO NORM AL

5554
04:59:11,313 --> 04:59:17,419
NORMALISH DEVELOPMENT AND NOT 

5555
04:59:17,419 --> 04:59:19,755
INITIATED ONE A BLUNT INSTRUMENT

5556
04:59:19,755 --> 04:59:23,292
AND THINKING HOW TO IMPLEMENT 

5557
04:59:23,292 --> 04:59:28,264
HUMAN TRIALS THAT LIKE THE ONE 

5558
04:59:28,264 --> 04:59:29,231
COHORT STUDY TO ASSESS LONG-TERM

5559
04:59:29,231 --> 04:59:32,635
DIFFERENT TYPES OF NUTRITIONAL 

5560
04:59:32,635 --> 04:59:32,968
INTERVENTIONS.

5561
04:59:32,968 --> 04:59:35,838
DR. WOOD MAY HAVE BEEN THE ONLY 

5562
04:59:35,838 --> 04:59:37,506
PERSON WHO CITED IN A LUNG 

5563
04:59:37,506 --> 04:59:39,141
CANCER STUDY A NEGATIVE EFFECT 

5564
04:59:39,141 --> 04:59:41,510
OF THE INTERVENTIONS WE TALKED 

5565
04:59:41,510 --> 04:59:42,411
ABOUT TODAY.

5566
04:59:42,411 --> 04:59:43,913
CERTAINLY WE NEED TO BE CAREFUL 

5567
04:59:43,913 --> 04:59:45,481
BUT THERE APPEARS TO BE A GREAT 

5568
04:59:45,481 --> 04:59:47,850
DEAL OF SAFETY WITH THE 

5569
04:59:47,850 --> 04:59:48,717
NUTRITIONAL INTERVENTIONS SO 

5570
04:59:48,717 --> 04:59:50,986
MAYBE COMING UP WITH SOMETHING 

5571
04:59:50,986 --> 04:59:55,090
THAT'S REMINISCENT OF THE DASH 

5572
04:59:55,090 --> 04:59:56,358
DIET FOR THE LUNG AND 

5573
04:59:56,358 --> 05:00:00,830
IMPLEMENTING IT WIDELY AND NOT 

5574
05:00:00,830 --> 05:00:02,631
LOOKING AT CURING CANCER, CURING

5575
05:00:02,631 --> 05:00:04,700
COPD OR ASTHMA BUT PREVENTING 

5576
05:00:04,700 --> 05:00:05,968
THE GENERATION OF SOME OF THESE 

5577
05:00:05,968 --> 05:00:10,139
DECEASE OF -- DISEASES WOULD BE 

5578
05:00:10,139 --> 05:00:11,307
SIGNIFICANT AND INNOVATIVE.

5579
05:00:11,307 --> 05:00:17,680
>> THANK YOU.

5580
05:00:17,680 --> 05:00:26,722
DR. PRAKASH.

5581
05:00:26,722 --> 05:00:28,224
>> HOW ARE WE MEASURING
LUNG 

5582
05:00:28,224 --> 05:00:32,294
HEALTH AND IT'S NOT SPECIFIC TO 

5583
05:00:32,294 --> 05:00:34,496
NUTRITION BUT AS LUNG BIOLOGISTS

5584
05:00:34,496 --> 05:00:39,869
AND SOME THAT ARE LUNG BIOLO

5585
05:00:39,869 --> 05:00:41,270
BIOLOGISTS HOW CAN YOU TRACK IT 

5586
05:00:41,270 --> 05:00:43,339
IN INTERVALS TO KNOW WHETHER 

5587
05:00:43,339 --> 05:00:47,376
THESE DIETS ARE MAKING POSITIVE 

5588
05:00:47,376 --> 05:00:49,245
IMPACTS OR NOT AND IN DOING THAT

5589
05:00:49,245 --> 05:00:52,715
IN PATIENTS IN A NONINVASIVE AND

5590
05:00:52,715 --> 05:00:58,354
EASY WAY IS STILL A BIG 

5591
05:00:58,354 --> 05:00:58,921
CHALLENGE.

5592
05:00:58,921 --> 05:01:00,723
THERE ARE NO GOOD-BYE MARKERS NO

5593
05:01:00,723 --> 05:01:02,591
EASY MEASUREMENTS OR SOMETHING 

5594
05:01:02,591 --> 05:01:06,462
YOU CAN TRACK HIKE YOUR WEIGHT 

5595
05:01:06,462 --> 05:01:09,698
OR SOMETHING SIMPLE.

5596
05:01:09,698 --> 05:01:11,433
THAT'S SOMETHING THAT I WISH 

5597
05:01:11,433 --> 05:01:13,602
THERE WAS MORE WORK BEING DONE 

5598
05:01:13,602 --> 05:01:14,270
ON THAT.

5599
05:01:14,270 --> 05:01:15,604
AND THEN NOT CONNECTED TO THE 

5600
05:01:15,604 --> 05:01:18,507
WORK I DO BUT LISTENING TO ALL 

5601
05:01:18,507 --> 05:01:21,243
THE OTHER SPEAKERS MAYBE THE 

5602
05:01:21,243 --> 05:01:25,114
APPROACH INSTEAD OF DOING THESE 

5603
05:01:25,114 --> 05:01:27,249
INTERVENTION DIET STUDIES LIKE 

5604
05:01:27,249 --> 05:01:30,519
WHAT INTEREST DR. PANDA IS DOING

5605
05:01:30,519 --> 05:01:31,353
COLLECTING INFORMATION FIRST AND

5606
05:01:31,353 --> 05:01:32,955
FOREMOST WHAT PEOPLE ARE EATING 

5607
05:01:32,955 --> 05:01:35,557
AND WHEN AND DERIVE CALORIE AND 

5608
05:01:35,557 --> 05:01:37,259
NUTRIENT INFORMATION FROM THAT 

5609
05:01:37,259 --> 05:01:39,194
AND AT LEAST THAT MAY GIVE US 

5610
05:01:39,194 --> 05:01:40,596
BROAD UNDERSTANDING OF WHICH 

5611
05:01:40,596 --> 05:01:43,565
GROUPS GO ON TO DEVELOP WHAT 

5612
05:01:43,565 --> 05:01:47,369
KIND OF LUNG DISEASES AND MAYBE 

5613
05:01:47,369 --> 05:01:50,472
THAT IS CONNECTED TO THE KIND OF

5614
05:01:50,472 --> 05:01:52,508
FOOD THEY'RE EATING AND THEN I'M

5615
05:01:52,508 --> 05:01:55,177
HAPPY TO HEAR MULTIPLE SPEAKERS 

5616
05:01:55,177 --> 05:01:58,247
ECHO THE IMPORTANCE OF THE GUT 

5617
05:01:58,247 --> 05:02:00,349
LUNG AXIS AND INDIRECTLY I THINK

5618
05:02:00,349 --> 05:02:02,284
THEY'RE ALSO SAYING WE SHOULD 

5619
05:02:02,284 --> 05:02:04,720
THINK ABOUT COLLECTING 

5620
05:02:04,720 --> 05:02:08,724
MICROBIOME INFORMATION BECAUSE 

5621
05:02:08,724 --> 05:02:10,159
THE DIET THERE'S PARTS THAT 

5622
05:02:10,159 --> 05:02:13,896
EFFECT THE BODY NOT THROUGH THE 

5623
05:02:13,896 --> 05:02:16,732
MICROBIOME BUT LARGE PARTS THAT 

5624
05:02:16,732 --> 05:02:18,801
DEPEND ON WHAT BACTERIA AND 

5625
05:02:18,801 --> 05:02:20,135
MICROBES THAT ARE PROCESSING 

5626
05:02:20,135 --> 05:02:21,370
WHAT YOU'RE EATING AND THAT'S 

5627
05:02:21,370 --> 05:02:24,707
CONVERTED TO WHAT THE BODY IS 

5628
05:02:24,707 --> 05:02:25,040
ABSORBING.

5629
05:02:25,040 --> 05:02:26,375
INTEGRATING THAT INFORMATION IN 

5630
05:02:26,375 --> 05:02:27,009
WITH THE DIET INFORMATION I 

5631
05:02:27,009 --> 05:02:33,716
THINK IS GOING TO BE IMPORTANT.

5632
05:02:33,716 --> 05:02:37,052
>> YOU THANK YOU.

5633
05:02:37,052 --> 05:02:38,721
DR. DUVALL.

5634
05:02:38,721 --> 05:02:40,456
>> IT'S INTERESTING TO
HEAR 

5635
05:02:40,456 --> 05:02:40,956
EVERYBODY'S PERSPECTIVE.

5636
05:02:40,956 --> 05:02:45,127
I'M TRYING TO PULL TOGETHER THE 

5637
05:02:45,127 --> 05:02:47,997
THREADS OF EMERGING BIOMARKERS 

5638
05:02:47,997 --> 05:02:52,267
AND NEW TECHNOLOGIES TO UNCOVER 

5639
05:02:52,267 --> 05:02:54,603
BIOMARKERS WITH PRECISION 

5640
05:02:54,603 --> 05:02:57,573
NUTRITIONAL ASSESSMENTS AND 

5641
05:02:57,573 --> 05:02:58,173
MECHANISMS UNDERLYING THAT.

5642
05:02:58,173 --> 05:02:59,675
WITH THE TAIL END OF WHAT WE 

5643
05:02:59,675 --> 05:03:03,078
HEARD ABOUT TODAY WHICH IS WE 

5644
05:03:03,078 --> 05:03:05,047
REALLY NEED ADDITIONAL 

5645
05:03:05,047 --> 05:03:07,816
NUTRITIONAL INTERVENTION TRIALS 

5646
05:03:07,816 --> 05:03:11,320
AND THINKING AS WAS JUST 

5647
05:03:11,320 --> 05:03:13,088
MENTIONED FROM THE NIH'S 

5648
05:03:13,088 --> 05:03:14,123
PERSPECTIVE ABOUT WHAT WHAT IS 

5649
05:03:14,123 --> 05:03:14,456
ATTRACTIVE.

5650
05:03:14,456 --> 05:03:17,860
AND I KEEP COMING BACK TO THE 

5651
05:03:17,860 --> 05:03:20,429
FACT THAT IN PARTICULAR THE 

5652
05:03:20,429 --> 05:03:25,234
NHLBI HAS SPENT A LOT OF MONEY 

5653
05:03:25,234 --> 05:03:27,102
SUPPORTING RESEARCH FOCUSSING ON

5654
05:03:27,102 --> 05:03:28,904
LUNG HEALTH AND DISEASE 

5655
05:03:28,904 --> 05:03:30,506
LONGITUDINALLY.

5656
05:03:30,506 --> 05:03:34,476
LOTS OF LARGE COHORTS IN ASTHMA 

5657
05:03:34,476 --> 05:03:36,445
AND ACOPD AND INFECTIOUS DISEASE

5658
05:03:36,445 --> 05:03:40,249
AND THOSE SORTS OF THINGS AND IN

5659
05:03:40,249 --> 05:03:46,755
TYING THOSE THREADS TOGETHER IN 

5660
05:03:46,755 --> 05:03:52,728
THE WORKSHOP DO WE GO TO BIO 

5661
05:03:52,728 --> 05:03:53,962
SPECIMENS THAT EXIST INTERROGATE

5662
05:03:53,962 --> 05:03:56,932
THEM WITH NEW EMERGING 

5663
05:03:56,932 --> 05:03:59,301
TECHNOLOGIES WE'VE DISCUSSED IN 

5664
05:03:59,301 --> 05:04:01,003
THIS FORUM.

5665
05:04:01,003 --> 05:04:04,573
IDENTIFY THE MOST PROMISING 

5666
05:04:04,573 --> 05:04:07,042
POTENTIAL BIOMARKERS FOR 

5667
05:04:07,042 --> 05:04:11,280
INTERVENTION AND THEN PROPOSE A 

5668
05:04:11,280 --> 05:04:12,714
TARGETED INTERVENTION WHETHER IT

5669
05:04:12,714 --> 05:04:19,188
BE A DASH DIET FOR THE LUNG OR 

5670
05:04:19,188 --> 05:04:23,525
MENTIONED OR OMEGA 3 

5671
05:04:23,525 --> 05:04:27,029
INFLAMMATION IN DISEASE X AND Y 

5672
05:04:27,029 --> 05:04:28,197
SEEMS THE THREADS COME TOGETHER 

5673
05:04:28,197 --> 05:04:28,764
TOWARDS THAT AS A POTENTIAL 

5674
05:04:28,764 --> 05:04:36,705
APPROACH.

5675
05:04:36,705 --> 05:04:38,173
>> THANK YOU.

5676
05:04:38,173 --> 05:04:41,410
DR. GOWDY.

5677
05:04:41,410 --> 05:04:44,480
>> I'D ECHO WHAT OTHER
SPEAKERS 

5678
05:04:44,480 --> 05:04:46,381
HAVE SAID AND WHERE MY MIND GOES

5679
05:04:46,381 --> 05:04:50,018
WITH THE MESSAGES IS PRECISION 

5680
05:04:50,018 --> 05:04:51,487
NUTRITION BECAUSE I THINK 

5681
05:04:51,487 --> 05:04:55,357
THERE'S VARIABILITY WHETHER IT'S

5682
05:04:55,357 --> 05:04:56,692
GENETIC OR EXPOSURE WITH PEOPLE 

5683
05:04:56,692 --> 05:04:59,294
AND UNDERSTANDING HOW ONE PERSON

5684
05:04:59,294 --> 05:05:01,630
METABOLIZES THE DIETARY NUTRIENT

5685
05:05:01,630 --> 05:05:05,534
VERSUS ANOTHER MIGHT HELP US 

5686
05:05:05,534 --> 05:05:08,737
UNDERSTAND IF THAT IS A GOOD 

5687
05:05:08,737 --> 05:05:09,538
INTERVENTION WITH LUNG DISEASE 

5688
05:05:09,538 --> 05:05:12,741
BASED ON WHAT THE PERSON IS 

5689
05:05:12,741 --> 05:05:13,675
STARTING WITH.

5690
05:05:13,675 --> 05:05:19,181
I THINK THERE'S A LOT OF UTILITY

5691
05:05:19,181 --> 05:05:20,816
FOR INTEGRATING NUTRITIONAL 

5692
05:05:20,816 --> 05:05:23,185
BIOMARKERS IN.

5693
05:05:23,185 --> 05:05:24,153
AS MENTIONED THERE'S A LOT OF 

5694
05:05:24,153 --> 05:05:25,487
EXISTING BIO REPOSITORIES IF WE 

5695
05:05:25,487 --> 05:05:27,389
KNEW WHAT WE COULD LOOK FOR WE 

5696
05:05:27,389 --> 05:05:29,191
COULD UTILIZE.

5697
05:05:29,191 --> 05:05:32,161
THERE'S THE BIO LINK AT NHLBI 

5698
05:05:32,161 --> 05:05:35,164
HAS WITH SEPSIS PATIENTS OR ARDS

5699
05:05:35,164 --> 05:05:38,066
PATIENTS THAT HAS MULTIPLE 

5700
05:05:38,066 --> 05:05:38,834
COHORTS.

5701
05:05:38,834 --> 05:05:40,002
IF WE KNEW WHAT TO LOOK FOR WITH

5702
05:05:40,002 --> 05:05:43,071
DIET WE MAY BE ABLE TO UTILIZE 

5703
05:05:43,071 --> 05:05:44,706
SOME OF THOSE EXISTING BIO 

5704
05:05:44,706 --> 05:05:50,646
REPOSITORIES.

5705
05:05:50,646 --> 05:05:51,680
>> DR. BHUPATHIRAJU.

5706
05:05:51,680 --> 05:05:56,718
>> I THINK I AGREE WITH
WHAT SHE

5707
05:05:56,718 --> 05:05:58,954
SAID MAKING USE OF THE BIO 

5708
05:05:58,954 --> 05:06:03,659
REPOSITORIES WOULD BE CRITICAL 

5709
05:06:03,659 --> 05:06:07,596
AND THE NIDDK IS ONE WHERE WE 

5710
05:06:07,596 --> 05:06:09,865
DEPOSIT BIOMARKER DATA BUT 

5711
05:06:09,865 --> 05:06:13,302
REALLY THE TAKEAWAYS ARE 

5712
05:06:13,302 --> 05:06:14,670
EXPANDING BIOMARKER DISCOVERY 

5713
05:06:14,670 --> 05:06:18,607
AND NOT IDENTIFYING DIETARY 

5714
05:06:18,607 --> 05:06:20,642
BIOMARKERS FROM OBSERVATIONAL 

5715
05:06:20,642 --> 05:06:22,811
DATA AND UNDERSTANDING THE 

5716
05:06:22,811 --> 05:06:25,514
PHARMACO KINETICS AND HOW THEY 

5717
05:06:25,514 --> 05:06:27,849
BEHAVE IS IMPORTANT TO BE 

5718
05:06:27,849 --> 05:06:29,551
INTEGRATED IN CLINICAL PRACTICE.

5719
05:06:29,551 --> 05:06:34,823
I THINK ANOTHER KEY POINT I 

5720
05:06:34,823 --> 05:06:39,695
WOULD LIKE TO EMPHASIZE IS 

5721
05:06:39,695 --> 05:06:44,032
MAKING SURE WE INCLUDE ADEQUATE 

5722
05:06:44,032 --> 05:06:46,235
REPRESENTATION IN UNDER 

5723
05:06:46,235 --> 05:06:48,804
REPRESE

5724
05:06:48,804 --> 05:06:54,776
REPRESENTED POPULATIONS IN 

5725
05:06:54,776 --> 05:06:56,044
RESEARCH.

5726
05:06:56,044 --> 05:06:58,180
>> DR. CAMARGO.

5727
05:06:58,180 --> 05:07:03,151
>> I TRIED TO IN MY
PRESENTATION

5728
05:07:03,151 --> 05:07:05,587
OUTLINE A BASIC APPROACH I'LL 

5729
05:07:05,587 --> 05:07:08,690
SUMMARIZE HERE AND IDENTIFY THE 

5730
05:07:08,690 --> 05:07:11,693
MOST PROMISING EXPOSURES AND 

5731
05:07:11,693 --> 05:07:13,228
OUTCOMES AND CHASE THAT.

5732
05:07:13,228 --> 05:07:16,498
I DON'T THINK WE HAVE TO LIMIT 

5733
05:07:16,498 --> 05:07:19,167
OURSELVES TO ONE THING BUT I DO 

5734
05:07:19,167 --> 05:07:23,605
HEAR AND I'LL PRESENT THIS BY 

5735
05:07:23,605 --> 05:07:26,241
ANALOGY IMAGINE IF THE 

5736
05:07:26,241 --> 05:07:29,645
CARDIOLOGISTS WERE TALKING ABOUT

5737
05:07:29,645 --> 05:07:30,479
HOW FRUIT AND VEGETABLE WERE 

5738
05:07:30,479 --> 05:07:34,516
RELATED TO FIBRILLATION AND 

5739
05:07:34,516 --> 05:07:37,386
SOMEBODY SAID I THINK FISH ARE 

5740
05:07:37,386 --> 05:07:40,022
IMPORTANT FOR HEART FAILURE.

5741
05:07:40,022 --> 05:07:41,890
THERE'S SO MUCH GOING ON THAT 

5742
05:07:41,890 --> 05:07:44,893
IT'S VERY HARD FOR ME TO EVEN 

5743
05:07:44,893 --> 05:07:50,966
FOCUS.

5744
05:07:50,966 --> 05:07:52,668
WE HAVE TO ORGANIZE THIS AND THE

5745
05:07:52,668 --> 05:07:55,170
WORKSHOP DID IT WELL AND PARTLY 

5746
05:07:55,170 --> 05:07:57,306
WHY I FOUND IT SO HELPFUL 

5747
05:07:57,306 --> 05:08:00,275
BECAUSE YOU ORGANIZED THINGS SO 

5748
05:08:00,275 --> 05:08:00,709
NICELY.

5749
05:08:00,709 --> 05:08:02,944
FOR EXPOSURES WE'RE TALKING 

5750
05:08:02,944 --> 05:08:04,980
ABOUT DIETARY PATTERNS LIKE DASH

5751
05:08:04,980 --> 05:08:06,381
IS A GOOD ONE AND JUN YOU KNOW 

5752
05:08:06,381 --> 05:08:07,416
THAT BECAUSE I'M WORKING WITH 

5753
05:08:07,416 --> 05:08:10,585
YOU ON A PROJECT RIGHT NOW.

5754
05:08:10,585 --> 05:08:14,056
IN TERMS OF FOOD, FRESH FRUIT 

5755
05:08:14,056 --> 05:08:15,490
AND VEGETABLES IS PROBABLY THE 

5756
05:08:15,490 --> 05:08:15,991
BEST BET.

5757
05:08:15,991 --> 05:08:17,693
IN TERMS OF NUTRIENTS THERE'S 

5758
05:08:17,693 --> 05:08:19,594
MANY BUT I WOULD SAY OMEGA 3 

5759
05:08:19,594 --> 05:08:21,596
SEEMS LIKE A PROMISING ONE.

5760
05:08:21,596 --> 05:08:23,298
THEN WE GET TO THE OUTCOMES AND 

5761
05:08:23,298 --> 05:08:27,002
ARE WE TALKING ABOUT ASTHMA, 

5762
05:08:27,002 --> 05:08:28,270
COPD, LUNG CANCER?

5763
05:08:28,270 --> 05:08:30,238
I WOULD START WITH THINGS BIG 

5764
05:08:30,238 --> 05:08:31,640
AND COMMON AND PEOPLE LIKE TO 

5765
05:08:31,640 --> 05:08:36,345
FUND LIKE ASTHMA AND COPD.

5766
05:08:36,345 --> 05:08:38,747
KNOW ARE WE TALKING ABOUT 

5767
05:08:38,747 --> 05:08:39,815
INCIDENT DISEASE OR MODIFICATION

5768
05:08:39,815 --> 05:08:44,453
AND KEEP MIXING THESE AND HOPING

5769
05:08:44,453 --> 05:08:47,956
THE APPLE WILL HELP EVERYONE AND

5770
05:08:47,956 --> 05:08:48,590
EVERYTHING.

5771
05:08:48,590 --> 05:08:49,257
IT WON'T.

5772
05:08:49,257 --> 05:08:51,226
MOREOVER WE DON'T FLOW IF WE 

5773
05:08:51,226 --> 05:08:53,128
SHOULD GIVE ONE APPLE OR FIVE 

5774
05:08:53,128 --> 05:08:55,497
AND DON'T KNOW IF WE SHOULD GIVE

5775
05:08:55,497 --> 05:08:58,100
IT DAILY OR ONCE A WEEK.

5776
05:08:58,100 --> 05:09:00,535
THERE'S SO MANY THINGS WE DON'T 

5777
05:09:00,535 --> 05:09:00,736
KNOW.

5778
05:09:00,736 --> 05:09:02,270
ONCE WE HAVE THOSE PROMISING 

5779
05:09:02,270 --> 05:09:03,739
EXPOSURES AND OUTCOMES AND WE 

5780
05:09:03,739 --> 05:09:06,541
HAVE TO KNOW WHERE THEY ARE ON 

5781
05:09:06,541 --> 05:09:07,175
THE GRID.

5782
05:09:07,175 --> 05:09:10,045
THEN WE CON NUMBER THE 

5783
05:09:10,045 --> 05:09:11,279
ASSOCIATION OF EPIDEMIOLOGIC 

5784
05:09:11,279 --> 05:09:14,883
STUDIES I'M ALL FOR DIET 

5785
05:09:14,883 --> 05:09:15,250
MECHANISMS.

5786
05:09:15,250 --> 05:09:17,719
ONE THING I LEARNED IS HOW MUCH 

5787
05:09:17,719 --> 05:09:19,054
PROGRESS IS MADE IN THE FIELD 

5788
05:09:19,054 --> 05:09:20,689
OVER THE LAST DECADE.

5789
05:09:20,689 --> 05:09:22,491
I'VE BEEN DOING OTHER STUFF FOR 

5790
05:09:22,491 --> 05:09:26,061
A WHILE AND IT'S FUN TO LISTEN 

5791
05:09:26,061 --> 05:09:26,795
TO THE MECHANISTIC WORK WHICH 

5792
05:09:26,795 --> 05:09:28,930
SUPPORTS THE IDEAS WE'RE TALKING

5793
05:09:28,930 --> 05:09:30,399
ABOUT.

5794
05:09:30,399 --> 05:09:35,670
WHAT'S THE POINT OF THE 

5795
05:09:35,670 --> 05:09:35,937
MECHANISM?

5796
05:09:35,937 --> 05:09:38,240
IN MY OPINION I'D OPTIMIZE THE 

5797
05:09:38,240 --> 05:09:40,709
INTERVENTION OF THAT FUTURE 

5798
05:09:40,709 --> 05:09:43,478
TRIAL.

5799
05:09:43,478 --> 05:09:45,814
THAT'S WHAT I WANT.

5800
05:09:45,814 --> 05:09:47,783
PEOPLE WANT TO PROVIDE A PILL 

5801
05:09:47,783 --> 05:09:49,451
THAT PROVIDES EVERYTHING.

5802
05:09:49,451 --> 05:09:51,386
MAYBE COME LATER BUT IF THAT'S 

5803
05:09:51,386 --> 05:09:53,789
YOUR GOAL IT WILL FLATTEN THE 

5804
05:09:53,789 --> 05:09:59,828
ENTIRE ENTERPRISE IN MY OPINION.

5805
05:09:59,828 --> 05:10:03,165
ULTIMATELY THEY COME TO TRIALS.

5806
05:10:03,165 --> 05:10:08,703
I'LL ARGUE WE TEND TO BE 

5807
05:10:08,703 --> 05:10:11,306
PESSIMISTIC BECAUSE IT IS HARD 

5808
05:10:11,306 --> 05:10:13,141
AND AND LOOK AT THE 

5809
05:10:13,141 --> 05:10:13,809
CARDIOLOGISTS AND WHAT THEY'VE 

5810
05:10:13,809 --> 05:10:19,147
DONE AND THE CANCER FOLKS AND 

5811
05:10:19,147 --> 05:10:29,458
WHAT THEY'VE DONE.

5812
05:10:32,494 --> 05:10:42,938
AND WE PARTAKE AND SPIROMETRY 

5813
05:10:43,738 --> 05:10:46,808
OME AND SO I'LL STOP THERE BUT 

5814
05:10:46,808 --> 05:10:50,979
THANK YOU AND I THINK I'VE 

5815
05:10:50,979 --> 05:10:52,113
TOUCHED AND THERE'S A TRIAL 

5816
05:10:52,113 --> 05:10:56,685
THAT'S THE AGENDA I HOPE COMES 

5817
05:10:56,685 --> 05:10:59,554
OUTS OF THE WORKSHOP.

5818
05:10:59,554 --> 05:11:01,022
>> THANK YOU SO MUCH.

5819
05:11:01,022 --> 05:11:11,566
I THINK IT BRING US CLOSE TO AND

5820
05:11:11,900 --> 05:11:13,168
I THINK WE THANK YOU FOR YOUR 

5821
05:11:13,168 --> 05:11:15,437
PARTICIPATION AND GREAT 

5822
05:11:15,437 --> 05:11:16,505
CONTRIBUTION AND TO THE AUDIENCE

5823
05:11:16,505 --> 05:11:22,477
WE THANK YOU FOR TAKING THE TIME

5824
05:11:22,477 --> 05:11:26,081
TO JOIN US AND AS YOU HEARD THIS

5825
05:11:26,081 --> 05:11:27,516
IS ONLY THE BEGINNING.

5826
05:11:27,516 --> 05:11:31,887
WE HOPE THIS IS THE BEGINNING 

5827
05:11:31,887 --> 05:11:34,289
FOR US TO HOPE ELEVATE FURTHER 

5828
05:11:34,289 --> 05:11:36,691
THE IMPORTANCE OF NUTRITION 

5829
05:11:36,691 --> 05:11:41,897
RESEARCH AND RESPIRATORY HEALTH 

5830
05:11:41,897 --> 05:11:48,937
AND AND THERE WILL BE A PROPOSAL

5831
05:11:48,937 --> 05:11:55,176
FROM THE WORKSHOP AND TRY TO 

5832
05:11:55,176 --> 05:11:57,312
PUSH FORWARD AND GET GET 

5833
05:11:57,312 --> 05:11:59,848
PUBLISHED IN A TIMELY FASHION 

5834
05:11:59,848 --> 05:12:04,619
BUT I WILL GIVE YOU THE FLOOR, 

5835
05:12:04,619 --> 05:12:05,921
TO CLOSE OUT THE WORKSHOP.

5836
05:12:05,921 --> 05:12:11,226
>> BEFORE I CLOSE OUT I DO
SEE 

5837
05:12:11,226 --> 05:12:16,731
ONE COMMENT IN THE CLASS.

5838
05:12:16,731 --> 05:12:23,505
MAYBE YOU ADDRESS THE QUESTION 

5839
05:12:23,505 --> 05:12:33,949
FROM DR. PANDA AND OTHER 

5840
05:12:36,318 --> 05:12:39,588
INDIRECT MEASUREMENT OF ON 

5841
05:12:39,588 --> 05:12:40,722
INSTRUCTIVE SLEEP APNEA CAN GIVE

5842
05:12:40,722 --> 05:12:43,825
A WEALTH OF INFORMATION AND 

5843
05:12:43,825 --> 05:12:46,895
INSIGHT TO INDIVIDUAL HEALTH.

5844
05:12:46,895 --> 05:12:49,531
AND MAYBE TO ELEVATE YOUR 

5845
05:12:49,531 --> 05:12:52,300
COMMENTS AND HAVE MORE 

5846
05:12:52,300 --> 05:12:53,234
DISCUSSION TO CLOSE OUT.

5847
05:12:53,234 --> 05:12:57,372
WE HAVE A LITTLE MORE TIME.

5848
05:12:57,372 --> 05:13:00,642
>> I WAS THINKING THERE'S
MANY 

5849
05:13:00,642 --> 05:13:05,647
WEARABLES THESE DAYS.

5850
05:13:05,647 --> 05:13:09,718
OF COURSE THE LONGITUDINAL DATA 

5851
05:13:09,718 --> 05:13:13,054
HAS A WEALTH OF INFORMATION.

5852
05:13:13,054 --> 05:13:16,458
AND WHAT WE DO IN STUDIES 

5853
05:13:16,458 --> 05:13:25,200
COMBINING TIMING WITH CONTINUE 

5854
05:13:25,200 --> 05:13:30,472
GLUCOSE MEASURE AND ACTIVITY 

5855
05:13:30,472 --> 05:13:37,012
FROM THERE WE WE'RE SEEING WHERE

5856
05:13:37,012 --> 05:13:41,983
TIMING EFFECTS BLOOD GLUCOSE AND

5857
05:13:41,983 --> 05:13:42,183
SLEEP.

5858
05:13:42,183 --> 05:13:43,451
IT WILL BE INTERESTING TO THINK 

5859
05:13:43,451 --> 05:13:47,489
ABOUT HOW TO USE THE WEARABLES 

5860
05:13:47,489 --> 05:13:57,932
AND HOW THAT DATA CAN BE 

5861
05:14:01,336 --> 05:14:02,237
DEPOSITED AND THEY'VE PARTNERED 

5862
05:14:02,237 --> 05:14:07,275
WITH COMPANIES LEADING TO THE 

5863
05:14:07,275 --> 05:14:14,349
IDEA OF INPUT TO PLANNERS TO 

5864
05:14:14,349 --> 05:14:14,582
DESIGN.

5865
05:14:14,582 --> 05:14:17,986
SIM LAURELL NOW THERE'S MANY 

5866
05:14:17,986 --> 05:14:23,491
START PHONES AND WEARABLES 

5867
05:14:23,491 --> 05:14:28,697
BEGINNING TO COLLECT QUALITY 

5868
05:14:28,697 --> 05:14:33,334
DATA AND POLLUTION MIGHT EFFECT 

5869
05:14:33,334 --> 05:14:33,668
HEALTH.

5870
05:14:33,668 --> 05:14:35,203
I'M MISSING A LOT OF OPPORTUNITY

5871
05:14:35,203 --> 05:14:40,942
HERE AND THIS IS WHERE I THINK 

5872
05:14:40,942 --> 05:14:43,311
THEY ASKED ABOUT PARTNERSHIP 

5873
05:14:43,311 --> 05:14:44,612
WITH INDUSTRY AND WHERE 

5874
05:14:44,612 --> 05:14:47,282
PARTNERSHIP WITH INDUSTRY IS 

5875
05:14:47,282 --> 05:14:51,252
PRODUCING OR COLLECTING THE 

5876
05:14:51,252 --> 05:14:51,786
WEARABLE DATA AND WILL BE 

5877
05:14:51,786 --> 05:14:52,687
USEFUL.

5878
05:14:52,687 --> 05:14:56,691
THANK YOU.

5879
05:14:56,691 --> 05:15:00,195
>> THANK YOU VERY MUCH.

5880
05:15:00,195 --> 05:15:04,699
WE A LAST COMMENT IN THE CHAT.

5881
05:15:04,699 --> 05:15:08,470
EVERYONE HAS ACKNOWLEDGED USING 

5882
05:15:08,470 --> 05:15:13,541
NUTRITION AS A FACTOR IN FOOD 

5883
05:15:13,541 --> 05:15:18,046
INTAKE TO BIOLOGY OUTCOME IS 

5884
05:15:18,046 --> 05:15:19,481
DIFFICULT BECAUSE IT'S A LIFE 

5885
05:15:19,481 --> 05:15:21,382
LONG CHANGE OVER THE LIFE SPAN 

5886
05:15:21,382 --> 05:15:23,284
AND EVERYONE HAS TO EAT SO 

5887
05:15:23,284 --> 05:15:24,719
DESIGNING A HUMAN STUDY IS 

5888
05:15:24,719 --> 05:15:28,690
DIFFICULT BECAUSE YOU MUST 

5889
05:15:28,690 --> 05:15:31,426
STANDARDIZE DATA COLLECTION AND 

5890
05:15:31,426 --> 05:15:33,795
KNOWING ABOUT FOOD IN THE 

5891
05:15:33,795 --> 05:15:39,234
CONTEXT OF OUR METRICS ON THE 

5892
05:15:39,234 --> 05:15:42,070
INTERACTION OF THE COMPOUND IS 

5893
05:15:42,070 --> 05:15:43,738
IMPORTANT BY VARIABLE AND 

5894
05:15:43,738 --> 05:15:47,108
INDIVIDUAL RESPOND TO THE 

5895
05:15:47,108 --> 05:15:52,714
DIETARY PATTERN BEING STUDY WE 

5896
05:15:52,714 --> 05:15:56,718
MUST LOOK AT WHAT IS ON PLATE 

5897
05:15:56,718 --> 05:15:58,453
AND DATA DESIGN AND ANALYSIS 

5898
05:15:58,453 --> 05:16:02,157
NEED TO BE CONSIDERED FOR THE 

5899
05:16:02,157 --> 05:16:06,161
VARIABILITY OF IMPACT.

5900
05:16:06,161 --> 05:16:08,863
SEEMS A GOOD POINT.

5901
05:16:08,863 --> 05:16:11,332
>> ALL TRUE AND ONLY
SOLVED WITH

5902
05:16:11,332 --> 05:16:12,066
THOUGHTFUL CONSIDERATION AND 

5903
05:16:12,066 --> 05:16:15,703
FUNDING.

5904
05:16:15,703 --> 05:16:18,006
THIS CONFERENCE IS NOT GOING TO 

5905
05:16:18,006 --> 05:16:23,878
JUST SAY HEY CHEW ON SOME AM 

5906
05:16:23,878 --> 05:16:25,413
APPLES OR SOMETHING THAT LOOKS 

5907
05:16:25,413 --> 05:16:28,583
LIKE A VEGETABLE AND WE'LL CHECK

5908
05:16:28,583 --> 05:16:29,517
YOUR LUNG.

5909
05:16:29,517 --> 05:16:31,052
I HOPE NOT BECAUSE THE RESULT 

5910
05:16:31,052 --> 05:16:32,420
WILL BE NUL.

5911
05:16:32,420 --> 05:16:36,691
ALL EXCELLENT POINTS AND TO DO 

5912
05:16:36,691 --> 05:16:38,793
THE WORK WE REQUIRE PRELIMINARY 

5913
05:16:38,793 --> 05:16:40,862
DATA WHICH SUPPORTS CHASING SOME

5914
05:16:40,862 --> 05:16:46,134
IDEA AND THEN WE NEED LARGE 

5915
05:16:46,134 --> 05:16:47,569
AMOUNTS OF FUNDING TO IMPLEMENT 

5916
05:16:47,569 --> 05:16:48,803
IT WITH THE RIGOR REQUIRED TO 

5917
05:16:48,803 --> 05:16:49,838
MEET THE CHALLENGE.

5918
05:16:49,838 --> 05:16:50,805
IT'S POSSIBLE BECAUSE OTHER 

5919
05:16:50,805 --> 05:16:52,707
PEOPLE ARE DOING IT.

5920
05:16:52,707 --> 05:16:55,710
WE CAN LEARN AND BE MOTIVATED BY

5921
05:16:55,710 --> 05:16:57,579
THEM AND THE MECHANISTIC WORK IS

5922
05:16:57,579 --> 05:17:00,114
PRETTY IMPRESSIVE.

5923
05:17:00,114 --> 05:17:02,450
THERE'S SOMETHING GOING ON.

5924
05:17:02,450 --> 05:17:05,086
>> I TOTALLY AGREE.

5925
05:17:05,086 --> 05:17:05,286
OKAY.

5926
05:17:05,286 --> 05:17:07,088
I THINK WE HAVE A FEW MINUTES 

5927
05:17:07,088 --> 05:17:11,426
LEFT I'M GOING TO CLOSE OUT THE 

5928
05:17:11,426 --> 05:17:11,659
MEETING.

5929
05:17:11,659 --> 05:17:17,732
THIS IS A VERY EXCITING 

5930
05:17:17,732 --> 05:17:18,099
WORKSHOP.

5931
05:17:18,099 --> 05:17:23,805
I LEARNED A LOT FROM THE EXPERT.

5932
05:17:23,805 --> 05:17:31,212
I WANT TO THANK OUR CO-CHAIRS 

5933
05:17:31,212 --> 05:17:38,620
FOR OUTSTANDING WORK FOR THE 

5934
05:17:38,620 --> 05:17:40,521
ORGANIZATION OF THE ENTIRE 

5935
05:17:40,521 --> 05:17:43,057
WORKSHOP AND THANK OUR 

5936
05:17:43,057 --> 05:17:45,627
MODERATORS AND SPEAKERS WITH 

5937
05:17:45,627 --> 05:17:49,297
THEIR EXTRAORDINARY INPUT FOR 

5938
05:17:49,297 --> 05:17:50,198
THE WORKSHOP.

5939
05:17:50,198 --> 05:17:51,699
I CAN'T SAY THANK YOU ENOUGH AND

5940
05:17:51,699 --> 05:17:56,704
I WANT TO THANK THE PARTICIPANTS

5941
05:17:56,704 --> 05:18:00,108
FOR THE WORKSHOPS.

5942
05:18:00,108 --> 05:18:04,579
I THINK OUR DIVISION DIRECTOR 

5943
05:18:04,579 --> 05:18:15,123
SAID WE'LL PUBLISH THE EXECUTIVE

5944
05:18:16,024 --> 05:18:26,467
SUMMARY A NOW WEEKS AND WE'RE 

5945
05:18:28,603 --> 05:18:30,705
TRYING TO PUBLISH THE WHITE 

5946
05:18:30,705 --> 05:18:31,773
PAPER HOPEFULLY WITHIN A YEAR OR

5947
05:18:31,773 --> 05:18:39,047
EARLIER WOULD BE GREAT.

5948
05:18:39,047 --> 05:18:42,116
I WANT TO MENTION THE WORKSHOP 

5949
05:18:42,116 --> 05:18:46,554
WAS VIDEOCASTED IN THE NIH 

5950
05:18:46,554 --> 05:18:49,390
VIDEOCAST PLATFORM AND THE 

5951
05:18:49,390 --> 05:18:51,059
RECORDING WILL BE AVAILABLE IN 

5952
05:18:51,059 --> 05:18:54,128
THE PAST EVENTS.

5953
05:18:54,128 --> 05:18:56,097
MAYBE JACKIE CAN POST THAT IN 

5954
05:18:56,097 --> 05:18:56,998
THE CHAT.

5955
05:18:56,998 --> 05:19:00,702
IN CASE YOU WANT TO LOOK AT THAT

5956
05:19:00,702 --> 05:19:05,173
OR TRAINEES OR COLLEAGUES WANT 

5957
05:19:05,173 --> 05:19:07,575
TO LOOK AT A SLIDE OR VIDEO YOU 

5958
05:19:07,575 --> 05:19:07,875
CAN DO THAT.

5959
05:19:07,875 --> 05:19:16,718
 AS SAID BEFORE WE'LL BRING ALL 

5960
05:19:16,718 --> 05:19:21,055
THE IDEAS AND RECOMMENDATIONS 

5961
05:19:21,055 --> 05:19:25,626
BACK TO OUR INTERNAL DISCUSSION.

5962
05:19:25,626 --> 05:19:30,932
WE HOPE SOME WILL BE IMPLEMENTED

5963
05:19:30,932 --> 05:19:32,200
IN THE NEXT FEW YEARS.

5964
05:19:32,200 --> 05:19:33,067
THANK YOU AND HAVE A GREAT REST 

5965
05:19:33,067 --> 05:19:43,277
OF THE DAY.