GOOD MORNING IT IS MY
PLEASURE TO WELCOME YOU TO THE
FINAL MEETING OF THE 2025
DIETARY GUIDELINES ADVISORY
COMMITTEE.
I'M JANET DEJESUS THE DESIGNATED
FEDERAL OFFICER OF THE COMMITTEE
FROM THE OFFICE OF THE ASSISTANT
FOR HEALTH AT THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES.
TODAY'S MEETING WILL INCLUDE A
DISCUSSION OF THE COMMITTEE'S
DRAFT SCIENTIFIC REPORT WHICH
THEN WE'LL FINALIZE AFTER THE
MEETING AND SUBMIT TO THE
SECRETARIES OF HHS AND USDA.
TODAY IS A VIRTUAL MEETING FOR
EVERYONE.
WE HAVE 17 OF 20 MEMBERS JOINING
US REMOTELY FOR THIS MEETING.
TODAY WE DO NOT HAVE DR. STEVE
ABRAMS, VALERIE BLUEBIRD AND
TERESA FUNG.
AS A REMINDER THIS IS THE CHARGE
FOR THE 2025 DIETARY GUIDELINES
ADVISORY COMMITTEE.
WE ASK THEM TO EXAMINE THE
EVIDENCE ON NUTRITION AND HEALTH
ACROSS THE LIFE SPAN, DEVELOP A
REPORT THAT OUTLINES SCIENTIFIC
FINDINGS WHICH CONTAINS THEIR
INDEPENDENT SCIENCE-BASED ADVICE
AND FINALLY AS I MENTIONED
THEY'LL SUBMIT THE REPORT TO THE
SECRETARIES FOR CONSIDERATION AS
THE DEPARTMENT'S UPDATE THE
DIETARY GUIDELINES FOR THE NEXT
EDITION.
WE STARTED WITH THE FIRST
MEETING IN FEBRUARY 2023 AND NOW
AT THE IS SEVENTH AND FINAL
MEETING AND APPRECIATIVE OF THE
WONDERFUL WORK THAT'S BEEN
HAPPENING.
IT IS NOW MY PLEASURE TO
INTRODUCE SECRETARY XAVIER
BECERRA FROM DEPARTMENT OF
HEALTH AND HUMAN SERVICES AND
FOLLOWING THAT WE'LL HAVE
REMARKS FROM SECRETARY VILSACK
FROM THE DEPARTMENT OF
AGRICULTURE.
THANK YOU.
GOOD MORNING AND THANK YOU FOR
BEING OF THE SCIENTIFIC REPORT
MEETING OF THE 2025 DIETARY
GUIDELINES ADVISORY COMMITTEE AN
HONOR TO BE A PARTNER WITH TOM
VILSACK AND HIS TEAM AS WE MOVE
TO PUT INTO PRACTICE THE WORK OF
THIS ESTEEMED COMMITTEE AND
SPECIAL THANKS TO THE MEMBERS
FOR YOUR TIME, DEDICATION AND
YOUR INVALUABLE DIRECTION.
THE DIETARY GUIDELINES SERVE AS
THE FOUNDATION FOR OUR NATION'S
NUTRITION PROGRAMS, STANDARDS
AND EDUCATION.
THEY PROVIDE HEALTH
PROFESSIONALS WITH THE GUIDANCE
AND RESOURCES TO ASSIST THE
PUBLIC IN CHOOSING AN OVER ALL
HEALTHY DIET THAT WORKS FOR
THEM.
AND THESE GUIDELINES HELP USDA,
HHS AND SO MANY OTHERS TO TAILOR
OUR POLICIES TO BEST SERVE THE
AMERICAN PEOPLE.
YOUR WORK OVER THE PAST 20
MONTHS AND EXPERTISE YOU
CONTRIBUTED, WELL, THEY
LITERALLY WILL SHAPE AMERICA.
THE REPORT YOU DELIVER WILL
ENSURE THE NEXT EDITION IS BASED
ON THE MOST CURRENT SCIENTIFIC
EVIDENCE AND MEDICAL KNOWLEDGE
AND FUTURE GUIDELINES FACTOR IN
SOCIO ECONOMIC, STATUS, RACE,
ETHNICITY AND CULTURE.
NOW FOR ME THIS IS VERY
PERSONAL.
WHEN HE WAS YOUNG, MY FATHER WAS
A FARM WORKER.
MANY OF THE FRESH FRUITS AND
VEGETABLES HE HARVESTED WERE OUT
OF HIS REACH AT THE GROCERY
STORE.
LIKE YOU'RE WORK, HIS WORK WAS
INDISPENSABLE AND BECAUSE OF
YOUR WORK, WE WILL CONTINUE TO
REINFORCE THE FUNDAMENTAL
PRINCIPLE THAT EVERY FAMILY
DESERVES ACCESS TO THE
NUTRITIOUS FOODS THAT OPEN THE
DOOR TO GOOD HEALTH AND BETTER
LIFE.
THANK YOU AGAIN TO THE COMMITTEE
MEMBERS FOR CONTRIBUTING SO MUCH
OF YOUR ENERGY AND EXPERTISE TO
THIS IMPORTANT PROCESS AND TO
THE AMERICAN PEOPLE, THANK YOU
FOR SHARING YOUR VOICES WITH US
IN THIS PROCESS.
THE COMMITTEE RECEIVED MORE THAN
9900 PUBLIC COMMENTS.
THE MOST EVER RECEIVED BY A
DIETARY GUIDELINES COMMITTEE.
ONCE THE COMMITTEE DELIVERS IT'S
REPORT TO HHS AND USDA, BE
ANOTHER OPPORTUNITY FOR THE
PUBLIC TO COMMENT.
THESE WILL BE CONSIDERED AS WE
WORK TO DEVELOP THE NEXT EDITION
OF THE DIETARY GUIDELINES FOR
AMERICANS.
AT THE DEPARTMENT OF HEALTH AND
HUMAN SERVICES WE'RE BIG
BELIEVERS THAT FOOD IS MEDICINE.
ACCESS TO HEALTHY FOOD IS LIFE
CHANGING AND OFTEN LIFE SAVING.
I'M PROUD TO BE DOING THIS
IMPORTANT WORK ALONGSIDE ALL OF
YOU TO HELP AMERICANS ACCESS AND
ENJOY A HEALTHY DIET AND THE
HEALTH BENEFITS THAT RESULT.
THANK YOU AND I LOOK FORWARD TO
RECEIVING YOUR REPORT.
>> GOOD MORNING, EVERYONE.
I JOIN SECRETARY BECERRA IN DEEP
APPRECIATE FOR THE ADVISORY
COMMITTEE FOR YOUR SCIENTIFIC
EXPERTISE, THOUGHTFUL
DELIBERATION AND UNWAVERING
DEDICATION SINCE YOU FIRST
CONVENED IN FEBRUARY OF 2023.
AS YOU PREPARE TO SUBMIT YOUR
REPORT, THANK YOU FOR CARVING
OUT TIME TODAY FOR PREVIEWING
IT.
THE SCIENTIFIC QUESTION WE
OPPOSED TO YOU COVERED MANY
TOPICS AND GROUND.
IT WAS A TALL ORDER BUT A
NECESSARY ONE REFLECTING THE
NEEDS OF THIS COUNTRY AND
FEDERAL AGENCIES INCLUDING
USDA'S 16 ASSISTANCE PROGRAMS
THAT SERVE ONE IN FOUR AMERICANS
ANNUALLY.
WE WORKED TO ENSURE CHILDREN,
INDIVIDUALS AND FAMILIES ACROSS
THE COUNTRY HAVE EQUITABLE
ACCESS TO HEALTHY, SAFE AND
AFFORDABLE FOODS THAT PROMOTE
HEALTH AND WELL BEING WHILE
BUILDING A MORE RESILIENT FOOD
SYSTEM.
THE DIETARY GUIDELINES HELP MANY
UP DATE THE WIC PACKAGE THAT
INCREASE ACCESS TO FRUITS AND
VEGETABLES AND REDUCE ADDED
SUGAR IN OUR SCHOOL MEALS.
FOR SNAP BENEFITS WE'RE MAKING
IT EASIER TO ACCESS HEALTHY
FOODS AND MODERNIZE TO REFLECT
REALITIES AND DIETARY GUIDANCE
AND WORKING TO PROVIDE NUTRITION
EDUCATION RESOURCES TO HELP
FAMILIES MAXIMIZE THEIR BENEFITS
AND PREPARE NUTRITIOUS, BUDGET
FRIENDLY MEALS.
STRUCTURAL INEQUITIES MAKE IT
DIFFICULT FOR MANY TO EAT
HEALTHY AND I THANK YOU
UNDERWORK FOR AN EQUITY LENS.
THANK YOU FOR CONSIDERING SOCIO
ECONOMIC POSITION, RACE,
ETHNICITY AND CULTURE.
AND FOR FORMING THE HEALTH
EQUITY WORKING GROUP TO WORK
ACROSS ALL OUR SUBCOMMITTEES SO
EQUITY BECOMES INTRINSIC IN ALL
YOU DO.
YOUR WORK MATTERS.
IT WILL INFORM EVIDENCE-BASED
UPDATES TO THE NEXT EDITION OF
THE DIETARY GUIDELINES FOR
AMERICANS.
THE AREAS YOU'VE IDENTIFIED FOR
FURTHER NUTRITION RESEARCH ARE
EQUALLY IMPORTANT FOR FUTURE
GUIDELINES.
YOU'VE ALSO REVIEWED 9900 PUBLIC
COMMENTS OVER TWO YEARS.
MORE THAN ANY PREVIOUS
COMMITTEE.
THANK YOU TO THE PUBLIC AND TO
THE ORGANIZATIONS AND
INDIVIDUALS WHO SUBMITTED
COMMENTS AND YOUR VOICE IS
ESSENTIAL TO THIS MULTI-YEAR
PROCESS.
FINALLY, A BIG THANK YOU TO THE
HHS AND USDA STAFF WHO HAVE
SUPPORTED THIS COMMITTEE'S WORK.
I KNOW WHAT THIS TEAM DOES EVERY
DAY REQUIRES MANY AREAS OF
EXPERTISE AND STEADFAST
COMMITTEE.
THANK YOU FOR THE ROLES YOU'VE
HAD IN THE DEVELOP, OF THE
2025-2030 EDITION OF THE DIETARY
GUIDELINES FOR AMERICANS.
I LOOK FORWARD TO RECEIVING THIS
COMMITTEE'S SCIENTIFIC REPORT.
THIS IS AN EXTRAORDINARILY
IMPORTANT SET OF RECOMMENDATIONS
YOU'LL MAKE.
AND IT WILL HELP GUIDE SO MANY
OPPORTUNITIES FOR BETTER
NUTRITION FOR ALL AMERICA.
SO THANK YOU FOR EVERYTHING
YOU'VE DONE AND EVERYTHING YOU
WILL CONTINUE TO DO IN THE
FORMATION OF THESE GUIDELINES.
>> THANK YOU FOR THOSE REMARKS.
AND NOW I'D LIKE TO TURN IT OVER
TO DR. ANGELA ODOMS-YOUNG FOR
THE CHAIR'S REMARKS AND
INTRODUCTION.
>> THANK YOU SO MUCH, JANET.
THIS IS REALLY AN EXCITING
MEETING.
SINCE WE MET IN FOR MEETING
SEVEN OF COURSE A LOT OF HAS
HAPPENED.
IT'S REALLY OUR PLEASURE TO HAVE
AN OPPORTUNITY TO PARENT THE
REPORT.
SO WELCOME.
IT'S COMING DOWN TO A CLOSE
AFTER TWO YEARS OF WORK AND
ENGAGEMENT AND VERY VIBRANT
DISCUSSIONS.
ME PREVIOUS EVIDENCE WAS REVIEW
OF THE EVIDENCE AND THIS MEETING
WILL INCLUDE A BRIEF OVERVIEW OF
EACH CHAPTER DESCRIBING THE
EVIDENCE ON DIET AND HEALTH AND
OUTLINE OUR ADVICE TO HHS, USDA
FOR THE NEXT EDITION OF THE
DIETARY GUIDELINES.
THE INFORMATION INCLUDING
REPORTINGS, PREVIOUS MEETING ARE
AVAILABLE AT DIETARY
GUIDELINES.gov AND THE WORK WE
PRESENTED THIS MEETING IS A
DRAFT AND I WANT THE PUBLIC TO
JUST TAKE NOTE OF THAT.
IT CAN BE REVISED BASED ON
DISCUSSIONS AT THE MEETINGS AND
THE REPORT IS CONSIDERED A DRAFT
UNTIL IT'S SUBMITTED TO HHS AND
USDA.
SO JUST A REMINDER WE HAD
SEVERAL APPROACHES TO EXAMINE
THE EVIDENCE.
DATA ANALYSIS WHICH REALLY
CENTERED ON USE OF STATISTICAL
METHODS FOCUSSED ON NATIONAL
DATA SETS LITHE NHANES TO
DESCRIBE THE CURRENT HEALTH AND
DIETARY INTAKES IN THE U.S.
THIS APPROACH HELPS THE
COMMITTEE ENSURE ITS
RECOMMENDATIONS ARE PRACTICAL,
RELEVANT AND ACHIEVABLE.
AS SECRETARY VILSACK MENTIONED
THE IDEA OF EQUITABLE OR
EQUITABLE ACCESS TO A SAFE AND
HEALTHY FEDERAL HEALTHY AND SAFE
ACCESS TO HEALTHY AND SAFE
OPTIONS, SORRY, I CAN'T, BUT
THIS IDEA OF HAVING
RECOMMENDATIONS THAT ARE
PRACTICAL, RELEVANT AND
ACHIEVABLE REALLY HELPS US THINK
ABOUT THAT AND ALSO OUR
COMMITTEE REALLY APPLIED A
HEALTH EQUITY LENS TO ALL THESE
APPROACHES.
THE SECOND WAS SYSTEMATIC
REVIEWS, GOLD STANDARD WHERE WE
DID AN EVIDENCE SYNTHESIS TO
REALLY LOOK AT ANSWERS TO
NUTRITION QUESTIONS OF PUBLIC
HEALTH IMPORTANCE, USES
SYSTEMATIC, RIGOROUS PROTOCOLS
ALSO POSTED AT DIETARY
GUIDELINES.gov.
REALLY THIS IDEA OF PROTOCOL
DRIVEN METHODS TO SEARCH FOR AND
EVALUATE SYNTHESIZING AND GRADE
THE STRENGTH OF THE ELIGIBLE
BODY OF EVIDENCE.
WE'LL TALK A LOT ABOUT THIS
THROUGHOUT THE MEETING AND ALSO
AS WE GET TO OUR INTEGRATION
DISCUSSION.
THIS APPROACH ALLOWS ANSWERING
THE SCIENTIFIC QUESTIONS BY
REVIEWING THE EVIDENCE FOR ALL
RELEVANT STUDIES PUBLISHED ON A
PARTICULAR TOPIC.
AND THEN LASTLY FOOD PATTERN
MODELLING USED TO ILLUSTRATE
CHANGES HOW THE AMOUNTS AND
TYPES OF FOODS AND BEVERAGES IN
THE DIETARY PATTERNS INCLUDING
FLEXIBILITIES MIGHT AFFECT
MEETING NUTRIENT NEEDS.
AND IT'S USED TO DEVELOP
QUANTITATIVE DIETARY PATTERNS
THAT REFLECT HEALTH-PROMOTING
PATTERNS IDENTIFIED IN
SYSTEMATIC REVIEWS AND MEET
ENERGY AND NUTRIENT
REQUIREMENTS.
SO THIS APPROACH ALLOWS THE
COMMITTEE TO MAKE
RECOMMENDATIONS TO INFORM THE
DEVELOPMENT OF DIETARY PATTERNS
FOR THE U.S. POPULATION.
SO, A LOT OF WHAT WE'RE DOING TO
DO TODAY IS REALLY THINK ABOUT
THE INTEGRATION ACROSS THE
DIFFERENT APPROACHES AS WELL AS
THE DIFFERENT TOPIC AREAS.
SO WE HAVE REALLY SEVERAL LEVELS
OF INTEGRATION.
SO INTEGRATION AS I MENTIONED
AND WHEN WE THINK ABOUT THOSE
KEY TOPICS, INTEGRATION ACROSS
FOOD PATTERN MODELLING AND
SYSTEMATIC REVIEWS AND ULTIMATE
INTEGRATION ACROSS ALL THE WORK
OF THE COMMITTEE.
IT WILL ALLOW US TO THINK MORE
BROADLY HOW THE PUZZLE PIECES
FIT TOGETHER.
SO FROM CONCLUSION STATEMENTS TO
ADVICE, THE IDEA OF THE
INTEGRATION OF EVIDENCE SO THE
COMMITTEE LOOKS ACROSS ALL OF
THE CONCLUSION STATEMENTS AND
WE'RE GOING TO TALK A LOT ABOUT
THAT TODAY TO THINK ABOUT THE
TOTALITY OF OUR SCIENTIFIC
REVIEW TO DEVELOP THE
OVERARCHING ADVICE FOR HHS AND
USDA TO CONSIDER WHEN THEY
DEVELOP THE DIETARY GUIDELINES.
REALLY THIS IDEA OF INTEGRATION
WILL HELP INFORM THAT
DEVELOPMENT AS WELL AS THE IDEA
OF THINKING ABOUT FUTURE
DIRECTIONS, ADVICE TO
AGENCIES -- SO AS WE LOOK ACROSS
CONCLUSION STATEMENTS WE CAN
THINK MORE BROADLY AND
HOLISTICALLY.
SO JUST A REMINDER OF THE
SUBCOMMITTEE STRUCTURE, THE
COMMITTEE FORMED FOUR
SUBCOMMITTEES, DIETARY PATTERNS
AND SPECIFIC DIETARY COMPONENTS
ACROSS LIFE STAGES, DIET AND
PREGNANCY AND BIRTH THROUGH
ADOLESCENCE, FOOD PATTERN
MODELLING AND DATA ANALYSIS AND
STRATEGIES FOR INDIVIDUALS AND
FAMILIES RELATED TO DIETARY
QUALITY AND WEIGHT MANAGEMENT.
ADDITIONALLY, WE HAD TWO
CROSS-CUTTING WORKING GROUPS,
HEALTH EQUITY WORKING GROUP AND
THE IDEA OF EQUITABLE GUIDANCE
THAT APPLIES TO ALL AMERICANS.
IT HELPS SUPPORT PEOPLE ACROSS
THE LIFE STAGE CONTINUUM IN
MEETING THEIR DIETARY NEEDS AND
META-ANALYSIS WORKING GROUP
WHICH ADDRESSED TOPICS WHICH
WERE RELEVANT TO THE MULTIPLE
SUBCOMMITTEES.
SO EACH SUBCOMMITTEE AND WORKING
GROUP WAS COMPRISED OF SIX TO
EIGHT COMMITTEE MEMBERS WITH ONE
MEMBER SERVING AS THE CHAIR OF
EACH SUBCOMMITTEE OR WORKING
GROUP.
REALLY THE WORK WAS DIVIDED
ACROSS WHERE DIFFERENT
SUBCOMMITTEE MEMBERS TOOK THE
LEAD ON DIFFERENT AREAS REALLY
DEMONSTRATING THE BROAD
EXPERTISE INCLUDED ON THIS
COMMITTEE.
EACH SUBCOMMITTEE INCLUDED
MEMBERS FROM THE HEALTH EQUITY
WORKING GROUP TO APPLY THE
HEALTH EQUITY LENS AND THE
WORKING GROUPS CONDUCTED THEIR
WORK BETWEEN COMMITTEE MEETINGS
AND PROVIDED UPDATES AT
COMMITTEE MEETINGS FOR THE FULL
COMMITTEE DISCUSSION.
SO THANK YOU, THANK YOU, THANK
YOU.
WE CAN'T SAY THANK YOU ENOUGH TO
THE PEER REVIEWERS AS WELL AS
THOSE WHO SUBMITTED PUBLIC
COMMENTS.
THE COMMITTEE SYSTEMATIC REVIEWS
INCLUDING FOOD PATTERN MODELLING
REPORTS HAVE UNDER GONE EXTERNAL
PEER REVIEW AND PEER REVIEWERS
REALLY COME FROM A BROAD
PERSPECTIVE THAT IS RELEVANT TO
THE COMMITTEE'S WORK.
ADDITIONALLY ALL REVIEWS ARE
REVIEWED BY INTERAGENCY PARTNERS
AND AS FAR AS PUBLIC COMMENTS,
APPROXIMATELY 9,900 COMMENTS
WERE RECEIVED DURING THIS
COMMENT PERIOD.
SO WE REALLY APPRECIATE THE
ACTIVE ENGAGEMENT BY THE PUBLIC.
THE PUBLIC WAS INVITED TO
PROVIDE COMMENTS TO THE
COMMITTEE ON ALL ASPECTS OF OUR
WORK FROM JANUARY 19, 2023 TO
OCTOBER 2024.
WE APPRECIATE YOUR CONSISTENT
ENGAGEMENT.
SO THE REPORT OUTLINE IS AS
FOLLOWS.
THE FIRST IS EXECUTIVE SUMMARY
AND THEN WE'RE SETTING THE
STABLE IN CROSS-CUTTING THEMES
WITH HEALTH EQUITY AND
NUTRITION.
IN C WE DIG DEEPER IN THE
METHODOLOGY USED TO INFORM THE
COMMITTEE'S WORK AND FUTURE
DIRECTIONS AND THE APPENDICES
INCLUDING COMMENTS, GLOSSARY OF
TERMS AND BIO SKETCHES OF OUR
COMMITTEE, MEMBERS OF THE
SUBCOMMITTEES AND WORKING GROUPS
AND ACKNOWLEDGEMENTS.
SO CHAPTER 1 CURRENT DIETARY
INTAKES AND PREVALENCE OF
NUTRIENT-RELATED CHRONIC HEALTH
CONDITIONS, DIETARY PATTERNS,
BEVERAGES, FOOD SOURCES OF
SATURATED FAT, COMPLIMENTARY
FEEDING AND FEEDING STYLES AND
PRACTICES DURING CHILDHOOD.
SO YOU'LL SEE IN THE COMMITTEE'S
WORK IT'S NOT ONLY ABOUT THE
COMPOSITION OF FOODS SEVERAL SUB
GROUPS LOOK AT THE HOW.
SO COMPLIMENTARY FEEDING AND
FEEDING STYLES DURING CHILDHOOD
IS ONE OF THE SUBCOMMITTEE
CONSIDERING QUESTIONS AND
FREQUENCY OF MEALS AND PORTION
SIDE AND CHAPTER 8, CULTURALLY
TAILORED DIETARY INTERVENTIONS
AND 9, PROFILE DEVELOPMENT AND
10, FOOD GROUP AND SUB GROUP
ANALYSTSES AND SIMULATIONS AND
CHAPTER 12, THE PROPOSED DIETARY
PATTERNS.
WE'LL TALK ABOUT CHAPTER B OUR
HEALTH EQUITY LENS AND
NUTRITION.
B, CHAPTER 12 THE CURRENT
INTAKES OF PREVALENCE OF
NUTRITION-RELATED CHRONIC
CONDITIONS.
D PARTB, CHAPTER 12 THE CURREN
INTAKES OF PREVALENCE OF
NUTRITION-RELATED CHRONIC
CONDITIONS.
PARTDPARTPART D AND SIMULATIONS
AND PART D PROPOSED DIETARY P
PATTE
PATTERNS.
I'M GOING TO TURN IT OVER TO
SAMEERA TO TALK ABOUT THE HEALTH
EQUITY LENS DISCUSSED AND
DESCRIBED IN PART B, CHAPTER 3.
I'LL TURN IT OVER TO YOU.
THANK YOU SO MUCH.
>> THANK YOU, ANGELA.
GOOD MORNING, I'M SAMIRA
TALEGAWKAR AND I CHAIR THE
HEALTH EQUITY WORKING GROUP.
I WANT TO TAKE THE OPPORTUNITY
TO THANK ALL COMMITTEE MEMBERS
AND EXPRESS OUR GRATITUDE TO THE
WONDERFUL HHS STAFF FOR UNENDING
SUPPORT AND ASSISTANCE AS WE
CONDUCTED OUR DELIBERATIONS.
AND OUR GOAL OF CENTERING HEALTH
EQUITY IN THE SCIENTIFIC REVIEW
WAS TO HELP DEPARTMENTS OF
HEALTH AND HUMAN SERVICES AND
AGRICULTURE TO DEVELOP
GUIDELINES THAT CAN SUPPORT
PEOPLE ACROSS ALL BACKGROUNDS IN
ACHIEVING A HEALTHY DIETARY
PATTERN.
THIS LENS WAS APPLIED PRIOR TO
THE COMMITTEE BEING APPOINTED
MEANING HHS AND USDA SELECTED
THIS COMMITTEE BASED NOT JUST ON
ITS PROFESSIONAL CREDENTIALS BUT
REFLECTION OF THE GENDER,
RACIAL, ETHNIC AND GEOGRAPHIC
DIVERSITY OF THE U.S. AND SPA
EXPERTISE IN RESEARCH AND
PRACTICE WITH DIVERSE
POPULATIONS.
IT'S STRUCTURED BY ECONOMIC,
SOCIAL, CULTURAL AND BIOLOGICAL
FACTORS OFTEN OUTSIDE AN
INDIVIDUAL'S CONTROL.
THEREFORE CENTERING EQUITY MEANS
PROVIDING GUIDANCE TO PROMOTE
PATTERNS FOR INDIVIDUALS,
FAMILIES AND ORGANIZATIONS
ACROSS DIFFERENT ENVIRONMENTS
AND CONTEXTS INCLUDING THOSE WHO
CHOOSE HEALTHFUL FOODS.
AFTER CONSIDERING OTHER CONCEPTS
AND FRAMEWORKS SUCH AS FROM THE
WHITE HOUSE HEALTH EQUITY TASK
FORCE AND CDC AND USDA THEY
COMMITTEE USED HEALTH EQUITY
EXPERTISE TO DEVELOP ITS OWN
DEFINITION OF HEALTH EQUITY.
IT IS STATED HERE.
THE COMMITTEE DEFINED HEALTH
EQUITY AS A STATE IN WHICH
EVERYONE HAS A FAIR AND JUST
OPPORTUNITY TO ATTAIN THE
HIGHEST LEVEL OF HEALTH.
THIS INCLUDES THE CONSISTENT AND
SYSTEMATIC TREATMENT OF ALL
INDIVIDUALS IN A FAIR, JUST AND
IMPARTIAL MANNER.
INCLUDING INDIVIDUALS WHO BELONG
TO COMMUNITIES NA HAVE OFTEN
BEEN DENIED TREATMENT SUCH AS
BLACK, HISPANIC, LATINO, ASIAN
AMERICAN, NATIVE HAWAIIAN AND
PACIFIC ISLANDER PERSONS AND
OTHER PERSONS OF COLOR, MEMBERS
OF RELIGIOUS MINORITIES, WOMEN
AND GIRLS AND PERSONS AFFECTED
BY PERSISTENT INEQUALITY AND
POVERTY OR INDIVIDUALS THAT
BELONG TO MULTIPLE SUCH
COMMUNITIES.
WHILE THERE'S A CHAPTER
DEDICATED HEALTH EQUITY AND
NUTRITION I WANT TO EXPLAIN THE
HEALTH EQUITY YOU'LL SEE AT
OTHER REPORTS SUCH AS THE ONE ON
THE SLIDE.
THIS IS EXAMPLES OF WORK HEALTH
EQUITY CONSIDERATIONS STRONGLY
FACTORED INTO THE COMMITTEE'S
CONCLUSIONS REFLECTING THE
APPROACH THE COMMITTEE TOOK TO
INCORPORATING LEATH EQUITY IN
THE REVIEW OF THE SCIENCE.
SINCE A PICTURE'S WORTH A
THOUSAND WORDS THE COMMITTEE
DEVELOPED AN INFO GRAPHIC TO
VISUALIZE THE HEALTH EQUITY INTO
REVIEW.
WE PREVIOUSLY REVIEWED THIS
VISUAL AND BEEN UPDATED BASED ON
ONGOING FEEDBACK.
I WOULD LIKE TO DRAW YOUR
ATTENTION TO NEW TEXT ADDED TO
THE TOP BOX ON THE RIGHT TO
INTRODUCE THE VISUAL.
THE TEXT I'LL READ WHAT IT SAYS
IN THE GREEN BOX IT STATES OUR
DEFINITION WHICH IS THE
COMMITTEE DEFINES HEALTH EQUITY
AS A STATE IN WHICH EVERYONE HAS
A FAIR AND JUST OPPORTUNITY TO
ATTAIN THE HIGHEST LEVEL OF
HEALTH.
THROUGHOUT ITS REVIEW OF THE
SCIENCE, THE COMMITTEE CENTERED
HEALTH EQUITY AS A GUIDING
PRINCIPLE REVIEWING EVIDENCE ON
NUTRITION AND HEALTH THROUGH A
LENS OF HEALTH EQUITY AMONG
DIFFERENT POPULATION GROUPS AND
ACROSS THE LIFE SPAN WILL
INCREASE THE POTENTIAL OF THE
DIETARY GUIDELINES FOR AMERICANS
TO PROVIDE GUIDANCE AND SUPPORTS
THE U.S. POPULATION ACROSS
DIVERSE, RACIAL AND/OR ETHNIC
SOCIO ECONOMIC AND BACKGROUNDS
TO MEET DIETARY NEEDS.
IN ADDITION TO DEFINITION,
YOU'LL ALSO NOTICE THE WHOLE
PROCESS WHERE HEALTH EQUITY WAS
APPLIED DURING OUR
DELIBERATIONS.
THE FIRST ONE IS WHERE WE LIST
OUT HOW THE HEALTH EQUITY LENS
WAS APPLIED CONSIDERING SOCIO
ECONOMIC POSITION, RACE,
ETHNICITY AND CULTURE.
ON THE USING RIGOROUS SCIENTIFIC
APPROACHES WHICH ANGELA
PREVIOUSLY MENTIONED THE
COMMITTEE EXAMINES THE
RELATIONSHIP BETWEEN HEALTH
THROUGH THE LIFE SPAN, STUDIES
AND NATIONALLY REPRESENTATIVE
SURVEYS AND SURVEILLANCE
PROVIDED THE INFORMATION AND
DATA FOR THE PROCESS.
FOR THE DISCUSSION THE SYNTHESIS
OF THE COMMITTEE'S FINDINGS AND
CONSIDERATION OF PUBLIC FINDINGS
LED TO THE DIETARY PATTERNS
AFTER WHICH DIET STIMULATIONS
WERE EXAMINED TO EVALUATE THE
PROPOSED DIETARY PATTERNS
CONSIDERING AVAILABILITY AND THE
SELECTION AND CONSUMPTION OF
FOODS AND BEVERAGES.
THIS HAS BUILD UP TO THE
DEVELOPMENT OF OUR SCIENTIFIC
REPORT WITH ADVICE FOR
CONSIDERATION TO FEDERAL
ACTIONS.
-- FEDERAL AGENCIES.
NOW, BELOW THE INFO GRAPHIC WE
PROVIDE AN EXAMPLE OF EACH
APPROACH IN REVIEWING THE
EVIDENCE RELATED TO
CARDIOVASCULAR DISEASE.
SO FOR DATA ANALYSIS, WE
UTILIZED NATIONALLY
REPRESENTATIVE DATA TO
UNDERSTAND CARDIOVASCULAR HEALTH
ACROSS LIFE STAGES AND SOCIO
DEMOGRAPHIC GROUPS.
WITHIN SYSTEMATIC REVIEWS WE
UPDATED THE SYSTEMATIC REVIEW ON
THE RELATIONSHIP BETWEEN
PATTERNS AND CARDIOVASCULAR
DISEASE AND CONFIRMED THE
CONCLUSION STATEMENT TO BE
GRADED AS STRONG.
GIVEN THE LARGE BODY OF EVIDENCE
ON THE TOPIC, WE CONDUCTED
ADDITIONAL ANALYSES WHICH
ALLOWED US FOR THE EXAMINATION
OF A SUBSET OF STUDIES FOR
GREATER ETHNIC AND SOCIO
ECONOMIC DIVERSITY AND THE
FINDINGS WERE CONSISTENT WITH
THE OVER ALL CONCLUSION.
LASTLY, FOR FOOD PATTERN
MODELLING TO INVESTIGATE HOW A
PATTERN ASSOCIATED WITH A LOWER
RISK OF CARDIOVASCULAR DISEASE
COULD BE ACHIEVED WITH A VARIETY
OF FOODS INCLUDING THOSE
IDENTIFIED FOR SELECT AMERICAN
INDIAN AND NATIVE ALASKAN DIETS.
SO IN SUMMARY, THIS COMMITTEE
WAS THE FIRST TO EMPLOY A
COMPREHENSIVE AND SYSTEMATIC
APPROACH TO INCORPORATING HEALTH
EQUITY BY CONSIDERING FACTORS
REFLECTING SOCIAL DETERMINATES
OF HEALTH.
HOWEVER, IT WAS LIMITED BY THE
EXTENT TO WHICH FACTORS SUCH AS
RACE, ETHNICITY AND SOCIO
ECONOMIC POSITION AND CULTURE
ARE AVAILABLE IN RESEARCH
EXAMINING DIET AND HEALTH.
THESE POINT TO THE NEED FOR
RESEARCH MORE INCLUSIVE OF
POPULATION GROUPS IN THE
U.S. AND TO THE IMPORTANCE OF
STANDARDIZED CONSISTENT
MEASURING AND REPORTING ON
FACTORS THAT CHARACTERIZE THE
POPULATIONS BEING STUDIED.
SUFFICIENT FUNDING AS WELL AS
ENGAGEMENT WITH PARTNERS THROUGH
ALL STAGES OF THE RESEARCH
PROCESS ARE CRITICAL SUPPORTS
FOR ACHIEVING INCLUSIVE
RESEARCH.
HOWEVER, DESPITE THESE
LIMITATIONS THE COMMITTEE HAS
CONFIDENCE IT WAS ABLE TO CENTER
HEALTH EQUITY TO SUPPORT ALL
PEOPLE IN THE U.S. ACROSS
RACIAL, ETHNIC AND SOCIO
ECONOMIC BACKGROUNDS IN
ACHIEVING A HEALTHY DIETARY
PATTERNS.
ACHIEVING THIS WORK FALLS ON
FUTURE ADVISORY COMMITTEES,
FEDERAL AGENCIES AND THE FIELD
OF NUTRITION AS A WHOLE.
SO IF THERE'S ANY DISCUSSION I'M
HAPPY TO TAKE QUESTIONS OR
DISCUSS ANYTHING.
>> I'M GOING TO ASK THE
COMMITTEE TURN ON THEIR CAMERAS
SO WE CAN SEE THEM I'M GOING TO
TAKE THE LEAD AND THANK YOU,
SAMEERA FOR OUTSTANDING
LEADERSHIP OF HEALTH EQUITY
WORKING GROUP.
THOUGH WE'RE ON ZOOM WE CAN
STILL BE ANIMATED, GUYS.
SO WE'RE GOING TO OPEN IT UP NOW
FOR QUESTIONS AND DISCUSSIONS.
ARE THERE ANY QUESTIONS OR
COMMENTS FOR SAMEERA OR THE
WORKING GROUP IN GENERAL?
WELL, WHILE PEOPLE ARE THINKING,
SAMEERA, I'M GOING TO ASK YOU A
QUESTION.
YOU COMMENTED ON THE INTENT AND
ENTHUSIASM AND WILL OF THE
WORKING GROUP TO REALLY BE ALL
INCLUSIVE IN THEIR EXAMINATION
OF THE EVIDENCE.
BUT THE COMMITTEE WAS
CONSTRAINED BY THE EVIDENCE
AVAILABLE.
WERE THERE PARTICULAR AREAS
WHERE YOU FEEL IF YOU HAD THE
EARS OF THE FEDERAL GOVERNMENT
AND YOU HAD THE EARS OF THE
PRIVATE SECTOR, WHERE WOULD YOU
BE DIRECTING RESOURCES TO FILL
IN THE GAP?
>> I WOULD SAY PRIORITIZE THE
NHANES.
THAT IS AN IMMENSE FEDERAL
RESOURCE.
UNFORTUNATELY FOR SOME OF THE
POPULATION GROUPS WE WERE
INTERESTED IN STUDYING, WE DID
NOT HAVE ENOUGH REPRESENTATION
SO THERE IS ANY WAY IN WHICH IT
CAN BE EXPANDED TO INCLUDE MORE
POPULATION GROUPS THAT WOULD BE
HELPFUL.
I THINK THAT WOULD ALSO HELP IN
CAPTURING SOME OF OUR CULTURAL
FOODS SINCE CERTAIN POPULATION
GROUPS DO EASE DIFFERENTLY FROM
THE GENERAL POPULATION.
I THINK FUNDING NHANES OR
PRIORITIZING NHANES IS REALLY
IMPORTANT.
OTHER CONSIDERATIONS INCLUDE FOR
EXAMPLE IN SYSTEMATIC REVIEWS WE
FOUND WE STARTED OUT WITH
WANTING TO EXAMINE EVERYTHING BY
ALL THESE OR CONSIDER SOCIO
ECONOMIC POSITION AND GEOGRAPHY
AND WE REALIZED EARLY ON WE DID
NOT HAVE THE ABILITY TO ACTUALLY
LOOK AT THE DATA IN THAT MANNER.
SO EXCEPT FOR CBD WHERE WE MADE
A CONCERTED EFFORT AND WE HAD
ALL THE STUDIES WHERE WE COULD
LOOK AT THE DIFFERENT GROUPS
REPRESENTED IN THE U.S., WE
ACTUALLY I THINK WERE
CONSTRAINED BY LACK OF DATA IN
OTHERS.
I GUESS, HOLLY, YOU HAVE --
>> I JUST WANTED TO ADD AND
THANK YOU, SAMEERA.
GREAT RESPONSE.
SARAH, I THINK THIS IS A GREAT
QUESTION AND I THINK ONE THAT
WE'LL PROBABLY TALK ABOUT OVER
THE NEXT TWO DAYS.
I ALSO WOULD THINK THAT WE
SHOULD THANK OUR FUNDING
AGENCIES AND PUBLICATION OUTLETS
THAT WORK IN THE AREA OF HEALTH
TO REALLY THINK ABOUT SHOULD
THERE BE SOME RECOMMENDATIONS
FOR RESEARCHERS ABOUT THE
BROADNESS OF THE MEASURES THAT
WE COLLECT TO BETTER UNDERSTAND
THE POPULATIONS THAT WE ARE
WORKING WITH IN THE RESEARCH
THAT'S BEING CONDUCTED.
THAT WOULD BE SOMETHING ELSE FOR
THE BROADER SCIENTIFIC COMMUNITY
TO THINK ABOUT.
>> ABSOLUTELY.
THANK YOU SO MUCH.
I APPRECIATE THE FACT WE'RE
LOOKING AT DIVERSITY AND ACROSS
METRICS.
HAVE YOU THOUGHT ABOUT OR
CONSIDERED USING THE ALL OF US
DATA SETS WHICH GETS INTO
GENOMIC DATA AND BEYOND RACE AS
A SOCIAL CONSTRUCT AND HIGHER
LEVEL OF CONSIDERING
CONSIDERATION AS WE LOOK AT
SOCIAL DETERMINATES AND HEALTH
AND THAT IN TERMS OF
CONSIDERATION AS WE LOOK AT THE
METRIC.
>> I DON'T THINK WE HAVE DATA I
THINK IT'S STILL IN THE DATA
COLLECTION PHASE.
I KNOW YOU MIGHT HAVE SOME MORE
KNOWLEDGE REGARDING ALL OF US.
I THINK THIS IS A REALLY
INTERESTING FUTURE DIRECTION
RECOMMENDATION BECAUSE SO
SAMEERA'S POINT, IT'S AT THE
DATA COLLECTION STAGE AND MY
UNDERSTANDING, I DON'T KNOW IF
THEY'VE EVEN STARTED COLLECTION
ON NON-CHILDREN.
I BELIEVE RIGHT NOW THE FOCUS IS
ON ADULTS WITH THE INTENT OF
INCLUDING CHILDREN.
I THINK THERE IS A GOOD
RECOMMENDATION TO EXPAND OUR
DATABASES LEVERAGE.
GREAT SUGGESTION.
THANK YOU, FATIMA.
>> GREAT PRESENTATION, SAMEERA.
I JUST WANTED TO FOLLOW-UP ON
WHAT WE CAN DO IN THE FUTURE FOR
MORE STANDARDIZED MEASURES FOR
SOCIO ECONOMIC CONDITION.
ESPECIALLY ONES THAT COULD BE
UNDERSTOOD BY LOW LITERACY
POPULATIONS DOING CHILD OR A
ADOLESCENT WORK.
THAT'S SOMETHING THAT'S MISSING
RIGHT NOW.
>> THANK YOU.
>> ANYMORE QUESTIONS FOR
SAMEERA?
OKAY.
WELL, SAMEERA, THANK YOU FOR
YOUR LEADERSHIP.
I'M SURE WE WILL BE HEARING FROM
YOU THROUGHOUT THE TWO DAYS AND
I AM NOW GOING TO HAND IT OVER
TO HEATHER TO DISCUSS DATA
ANALYSIS.
I ASK THE COMMITTEE TO TURN
THEIR CAMERA OFF.
>> THANK YOU SO MUCH, SARAH.
SO BEFORE I GET STARTED, I'M
HEATHER EICHER-MILLER.
I AM CO-LEADING THE SUBCOMMITTEE
3, WHICH IS FOCUSSED ON DIETARY
ANALYSIS AND FOOD PATTERN
MODELLING AND CO-LEADING WITH
CHRIS TAYLOR, WHO WE'LL HEAR
FROM LATER TODAY.
MY PORTION IS HEADING THE
DIETARY INTAKE AND DATA ANALYSIS
PART OF THE WORK THAT WE DID.
AND I REALLY WANTED TO RECOGNIZE
ALL OF OUR SUBCOMMITTEE MEMBERS
WHO HAVE PUT SO MUCH INTO THIS
AND REALLY BEEN ENGAGED AND
ADDED ALONG WITH OUR STOOF FROM
HHS AND FDA AND I'LL PROVIDE AN
UPDATE ON DIETARY INTAKES AND
PREVALENCE OF NUTRITION RELATED
CHRONIC HEALTH CONDITIONS PART
D.
WE PRESENTED SUMMARY EVIDENCE
AND DRAFT CONCLUSION STATEMENTS
AT SOME OF THOSE PRIOR MEETINGS.
SO TODAY WE'RE GOING TO FOCUS ON
OUR DISCUSSION AND TAKE AWAY
MESSAGES FROM THAT.
ALSO OUR DRAFT ADVICE TO THE
DEPARTMENT AND OUR FUTURE
DIRECTION SECTION FOR THIS
CHAPTER.
SO WE CAN MOVE ON.
JUST TO KIND OF REMIND YOU OF
ABOUT WHAT WE WORKED ON WITH
DATA ANALYSIS AND APPROACHES
THAT GO IN THE EVIDENCE WE
REVIEWED.
SO FOR DATA ANALYSIS, WE
EVALUATED DIETARY INTAKES AND
PATTERNS WHICH ARE THE
CONSUMPTION OF NUTRIENT FOODS
AND BEVERAGES CRITICAL TO
MEETING NUTRIENT NEEDS ESSENTIAL
FOR HEALTH THROUGHOUT OUR LIFE
SPAN.
WE ALSO EVALUATED THE PREVALENCE
OF NUTRITION-RELATED CHRONIC
HEALTH CONDITIONS.
AND SO THESE CONDITIONS AND
THEIR RISK FACTORS ARE
PRESENTING MAJOR CHALLENGES TO
US AND OUR PUBLIC HEATH AS A
POPULATION.
BUT WE DO HAVE THE POTENTIAL TO
PREVENT THESE.
SO WE ARE REVIEWING THAT.
WE REVIEWED THAT PREVALENCE
INFORMATION IN OUR REPORT.
THE THIRD THING WE DID WAS
EVALUATE AND CLASSIFY NUTRIENTS
OF PUBLIC HEALTH CONCERNS.
SO, IN ORDER TO DO THIS AS A
CLASSIFICATION OF NUTRIENT OF
PUBLIC HEALTH CONCERN IS A WAY
TO HIGHLIGHT CERTAIN NUTRIENT
THAT WE NEED GREATER ATTENTION
OF IN THE U.S. AND BASED ON POOR
INTAKE OR UNDER OR OVER
CONSUMPTION AND THEN THE
MANIFESTATION OF PREVALENCE OF
CHRONIC HEALTH CONDITIONS IN THE
U.S. THAT ARE RELATED HERE.
WE CAN PUT THESE TOGETHER TO
HIGHLIGHT THE CERTAIN NUTRIENTS
THAT ARE AFFECTING A LARGE
PORTION OF THE POPULATION AT
CRITICAL TIMES.
THEN WE CONSIDERED HEALTH EQUITY
IN OUR EVALUATION OF THE DATA.
SO AS SAMEERA JUST GAVE AN
EXCELLENT OVERVIEW OF THE WORK,
WE ALSO USED THIS APPROACH IN
OUR DATA ANALYSIS TO EXPAND
LOOKING AT DIFFERENT GROUPS BY
SOCIO DEMOGRAPHIC STATUS,
SEVERAL KINDS OF CHARACTERISTICS
ALONG WITH LIFE STAGE APPROACH
CARRIED FORWARD FROM THE LAST
COMMITTEE.
SO NOW LET'S MOVE ON TO REVIEW
FOR YOU THE FOUR QUESTIONS THAT
WE ANSWERED USING THE DATA
ANALYSIS APPROACH.
THE FIRST WAS WHAT ARE THE
CURRENT PATTERNS OF FOOD AND
BEVERAGE INTAKE.
ALSO, WHAT ARE THE CURRENT
INTAKES OF FOOD GROUPS,
NUTRIENTS AND DIETARY COMPONENTS
AND WHAT IS THE CURRENT
PREVALENCE OF NUTRITION-RELATED
CHRONIC HEALTH CONDITIONS AND
WHICH COMPONENTS REPRESENT A
SUBSTANTIAL PUBLIC HEALTH
CONCERN BECAUSE OF EITHER UNDER
CONSUMPTION OR OVER CONSUMPTION?
THOSE ARE THE ONES THAT ARE THEN
HIGHLIGHTED AS NUTRIENTS OF
PUBLIC HEALTH CONCERN.
WE CONDUCTED THE ANALYSES TO
GATHER THE INFORMATION TO
ADDRESS THESE QUESTIONS AND
RELIED HEAVILY ON THE NATIONAL
HEALTH AND NUTRITION EXAMINATION
SURVEY OR NHANES ALONG WITH
OTHER DATA SOURCES FOR
ADDRESSING THESE QUESTIONS.
AND WE'VE ALREADY IN PRIOR
MEETINGS DISCUSSED OVERVIEWED
THE STRENGTH AND LIMITATIONS OF
THAT DATA SO I WON'T GO THROUGH
THAT TODAY.
I ALSO WANTED TO MENTION THE
WORK WE PRESENTED BEFORE IS
AVAILABLE TO REVIEW AND THAT
WILL ALSO BE IN OUR SCIENTIFIC
REPORT AS WELL.
SO, NOW I WANT TO REVIEW THE KEY
THEMES THAT CAME OUT OF
SUMMARIZING ALL THAT DATA
ANALYSIS WORK AND OUR DISCUSSION
AND OUR HIGHLIGHTING OF CERTAIN
OF THE RESULTS.
SO, TO START OUR OVER ARCHING
TAKE HOME MESSAGE FROM ALL OF
THIS WORK WAS THAT DIETARY
INTAKE IN THE U.S. DOES NOT
ALIGN WITH THE RECOMMENDATIONS
IN THE DIETARY GUIDELINES FOR
AMERICANS 2020 TO 2025.
AMONG ANY OF THE LIFE STAGES OR
ANY OF THE SOCIO DEMOGRAPHIC
GROUPS WE LOOKED AT AND DESPITE
OUR AGE OR WHAT OTHER
CHARACTERISTICS WE HAVE, WE'RE
ALL HAVING A POOR DIET.
WE ALSO HAVE CONDITIONS AND RISK
FACTORS THROUGHOUT OUR LIFE
SPANS.
IT'S NOT JUST AT THE ENDS OF
LIFE THESE ARE EFFECTING US,
IT'S THROUGHOUT OUR LIVES
STARTING UP CHILDHOOD AND
ADOLESCENCE AND IT'S A BIG
CONCERN FOR THE FUTURE OF OUR
COUNTRY AND FUTURE HEALTH.
SECONDLY, WE WANTED TO HIGHLIGHT
THOUGH WE DIDN'T FIND MAJOR
DIFFERENCES IN DIETARY INTAKE,
SINCE THE 2020 COMMITTEE'S
REVIEWS, THERE WERE SOME THINGS
AND CHANGES WE WANTED TO REVIEW.
ONE THING IN CHILDREN,
ADOLESCENCE AND RESULTS THERE
WAS A POSITIVE SHIFT IN BEVERAGE
PATTERNS TO HAVE MORE WATER AND
LESS SUGAR SWEETENED BEVERAGES.
THIS IS SOMETHING WE WANT TO
BUILD ON.
PERHAPS WE CAN USE WHAT WE'VE
ACCOMPLISHED TO GAIN MORE IN
THIS WAY.
WE ALSO FOUND THAT FOR
ADOLESCENTS THIS WAS AN INCREASE
IN VEGETABLE BUT DAIRY AND
FORTIFIED SOY INTAKE WAS LOWER
FOR ADOLESCENTS AND ALSO FOR
ADULTS.
AND OUR INTAKE OF NUTRIENTS WERE
LOWER.
I WANTED TO SHOW A PORTRAYAL OF
WHAT THE INTAKE DATA LOOKED LIKE
AND FAMILIAR TO RESULTS WE
SHOWED BEFORE BUT JUST TO REMIND
YOU OF OUR LOOK AT THESE FOOD
GROUP INTAKES AND THEIR SUBGROUP
INTAKES AND THE THIS IS FOR THE
ENTIRE POPULATION AGES 1 AND
OLDER.
HERE YOU CAN SEE ALL THOSE
DIFFERENT GROUPS SHOWN ON THE X
AXIS AND THE BARS REPRESENT 100%
OF THE POPULATION.
THEIR ORIENTATION AROUND THE
ZERO LINE THAT'S IN THE MIDDLE
OF THE Y AXIS IS SHOWING YOU HOW
MUCH OF THE POPULATION IS
CONSUMING UNDER THE
RECOMMENDATION WHICH IS SHOWN IN
THE COLORS BLUE OR YELLOW OF
THOSE BARS OR AT OR ABOVE THE
RECOMMENDATION WHICH ARE SHOWN
IN GREEN AND ORANGE IN THOSE
BARS.
SO, JUST TO INTERPRET THIS THEN,
WE SAW THAT MOST INDIVIDUALS 1
AND OLDER WERE CONSUMING BELOW
THE RECOMMENDATIONS FOR FRUITS,
VEGETABLES, WHOLE GRAINS, SEED
FOOD, NUTS, SEEDS AND SOY AND
FORTIFIED SOY ALTERNATIVES.
THESE ARE KEY FOOD GROUPS THAT
ARE GIVING US REALLY IMPORTANT
NUTRIENTS THAT WERE WE'RE NOT
GETTING ENOUGH OF.
ALSO, I WANT TO POINT OUT HERE
TOO THAT WE HAVE THESE TWO
GROUPS FOR REFINED GRAINS AND
OILS WE SHOULDN'T CONSUME IN
EXCESS OF CERTAIN AMOUNTS BUT
FOR THOSE YOU CAN SEE THAT MOST
INDIVIDUALS ARE CONSUMING AT OR
ABOVE THE RECOMMENDATION.
SO FOR EXAMPLE FOR REFINED
GRAINS WE WANT TO MAKE ONLY HALF
OF OUR GRAINS REFINED.
SO, JUST TO POINT OUT THAT IN
COMPARISON TO WHOLE GRAINS WHICH
IS RIGHT BESIDE IT ON THE LEFT
YOU CAN SEE THOSE TWO ARE KIND
OF MIRROR IMAGES OF EACH OTHER
FLIPPED IN A SENSE.
SO THOSE TWO THINGS ARE THINGS
THAT IN ALL THESE PATTERNS WE'D
LIKE TO MAKE SOME SHIFTS.
GET MORE WHOLE GRAINS, GET LESS
REFINED GRAINS, FOR EXAMPLE.
FINALLY IN THIS GRAPH, I ALSO
WANT TO POINT OUT THAT MOST OF
US ARE ALSO MEETING OR EXCEEDING
RECOMMENDATIONS FOR MEET,
POULTRY AND EGGS WHICH IS
DRIVING OUR TOTAL PROTEIN FOODS
IN TAKE WHICH ARE ALSO SHOWN
SIDE BY SIDE THERE.
IN CONCLUSION THERE'S A LOT OF
SHIFTS HERE WE'D LIKE TO MAKE TO
TRY TO IMPROVE DIETARY INTAKE IN
THE ENTIRE POPULATION.
MOVING ON.
SO ANOTHER AREA WE WANT TO
EMPHASIZE IN OUR REVIEW OF THE
EVIDENCE IS THE IMPORTANCE OF A
HEALTHY DIETARY PATTERN
THROUGHOUT THE LIFE SPAN.
AND WE SAW THAT DIETARY INTAKES
WERE NOT ALIGNED WITH THE
GUIDANCE AT ANY AGES.
SO MANY HEALTH PROMOTING
NUTRIENTS AND COMPONENTS WE'RE
UNDER CONSUMING LIKE WE JUST SAW
FOR THE FOOD GROUPS AND SUB
GROUPS.
WHILE THERE ARE OTHERS THAT ARE
HURTING OUR HEALTH THAT WE'RE
OVER CONSUMING.
AND THOSE ARE THINGS WE NEED TO
LIMIT LIKE SATURATED FATS,
SODIUM AND ADDED SUGAR THAT ARE
FOUND IN MANY OF THE FOODS THAT
WE'RE EATING.
WE ALSO SAW THAT WITH REGARD TO
THOSE CHRONIC HEALTH OUTCOMES,
OBESITY IS A MAJOR HEALTH ISSUE
FOR US AND IMPACTING OUR CHILD
AND ADOLESCENT AGE GROUPS WITH
36% OF CHILDREN 2-19 BEING OBESE
AND 41% OF ADULTS AGES 20 AND
OLDER.
AS YOU MAY BE AWARE, OBESITY IS
ALSO A BACKGROUND OR RISK FACTOR
FOR SEVERAL OTHER CHRONIC HEALTH
OUTCOMES.
SO IN ADDITION TO OBESITY WE
ALSO SAW THAT PRE-DIABETES,
HYPERTENSION, UNFAVORABLE LIPID
PROFILES AND METABOLIC SYNDROME
ARE CHRONIC RISK FACTORS AND
ALSO HIGH AMONG OUR DIFFERENT
POPULATION AGE GROUPS.
MOVING FORWARD, IN THE NEXT
SLIDE JUST TO SHOW YOU AN
EXAMPLE OF THOSE INTAKES ACROSS
THE DIETARY PATTERNS ACROSS THE
LIFE SPAN.
I WANTED TO AGAIN SHOW THIS
GRAPH OF INDICATING DIETARY
QUALITY THROUGH OUR METRIC OF
THE HEALTHY EATING INDEX, 2020.
THE HEALTHY EATING INDEX SCORE
OF 100 INDICATES FULL ALIGNMENT
WITH THE DIETARY GUIDELINES FOR
AMERICANS.
AND HERE WE SEE THAT SPOTTED ON
THE Y AXIS WITH THE DIFFERENT
POPULATION GROUPS STARTING WITH
THE FULL POPULATION AGES 2 AND
OLDER AND THEN BREAKING DOWN BY
AGE GROUP AFTER THAT ACROSS THE
DIFFERENT AGE GROUPS AND FOR THE
YOUNGEST AGE GROUP WE ARE USING
THE HEI TODDLER INDEX.
YOU CAN SEE THE SCORES
THROUGHOUT THE LIFE SPAN ARE
WITHIN A BAND THAT DOESN'T DIP
BELOW 40 AND DOESN'T GO ABOVE 65
OR SO.
IT'S KIND OF A TIGHT BAND BUT
THE DIFFERENCES BETWEEN 40 AND
65 WOULD BE MEANINGFUL
DIFFERENCES FOR HEALTH.
YOU CAN SEE THE VERY YOUNGEST
STAGES AND OLDEST AGES TEND TO
HAVE HIGHER DIETARY QUALITY
SCORES WHEREAS OUR FOR CHILDREN
AROUND 5 THROUGH 18 AND EVEN
INTO THE YOUNG ADULT AGES.
THESE ARE CRITICAL TIMES OF
GROWTH AND DEVELOPMENT IN THE
LIFE SPAN.
IS RAND WE HAVE IMPACT OF
NUTRITIONAL ADEQUACIES OF GROWTH
AND DEVELOPMENT AND THERE COULD
BE FURTHER RAMIFICATIONS OF
THAT.
FOR EXAMPLE FOR INSTANCE
INCLUSIVELY HUMAN MILK FED, WE
SAW THAT IRON CONTINUED TO BE A
NUTRIENT OF PUBLIC HEALTH
CONCERN DUE TO ITS ROLE IN
COGNITION AND BRAIN DEVELOPMENT.
WE ALSO FOUND THAT FOR
ADOLESCENTS, THEIR INTAKES ARE
THE POOREST THROUGHOUT THE WHOLE
LIFE SPAN.
DESPITE THIS TIME BEING REALLY
IMPORTANT FOR CONTINUED
DEVELOPMENT OF YOU'LL PARTS OF
OUR BODIES BUT ESPECIALLY FOR
BONE, WHERE WE'RE GAINING OUR
FINAL ADULT HEIGHT AND LAYING
DOWN BONE MINERAL CONTENT THAT
WILL THEN START TO DECREASE
ACROSS THE REST OF OUR ADULT
LIFE SPAN.
IT'S A CRITICAL TIME FOR THIS
KIND OF FINALIZING GROWTH.
ADOLESCENT FEMALES HAVE IRON
CONCERNS WE HAVE SEVERAL
NUTRIENTS OF PUBLIC COMMENT
CONCERN AND THOSE INCLUDE IRON
FOR PREGNANCY AND IODINE FOR
PREGNANCY AND FOLATE FOR PRE
PRECON -- PRECONCEPTION AND THE
FIRST TRIMESTER.
NOT ONLY DO WE HAVE THE EMBRYO
AND FETUS DEVELOPING DURING THIS
TIME BUT HEALTH OF THE BIRTHING
PARENT IS IMPACTED NOW AND SOME
OF THOSE IMPACTS COULD LAST INTO
LATER LIFE.
MOVING FORWARD SO ANOTHER POINT
OF OUR DISCUSSION WE WANTED TO
BRING OUT HERE IS ENVIRONMENTAL
INFLUENCES.
THOUGH WE LOOK AT INTAKE AND
HAVE INTAKE DATA AND WHEN WE
TALK ABOUT INTAKES IT SUGGESTS
THAT THESE OUR INTAKE IS OUR
PERSONAL CHOICE AND DUE TO OUR
BEHAVIOR BUT WE WANT TO
RECOGNIZE THAT ALTHOUGH THAT IS
A COMPONENT OF INTAKE, THE FOOD
ENVIRONMENT AND INFLUENCES
AROUND US WHERE WE LIVE, WHERE
WE WORK, WHERE WE GO TO SCHOOL,
ALL THESE PLACES THEY'LL HEAVILY
IMPACT OUR CHOICES.
SO WE CAN'T MAKE HEALTHFUL
CHOICES IF OUR ENVIRONMENT IS
NOT GIVING US FOODS THAT WE
COULD CHOOSE THAT WOULD BE
HELPFUL.
SO THIS IS REALLY WE THINK
PLAYING A BIG ROLE THAT WE NEED
TO RECOGNIZE.
THERE'S SO MANY FASHTS WITHIN
OUR ENVIRONMENT THAT ARE
INFLUENCING US.
WE HAVE THE COST OF FOOD, THE
AVAILABILITY, THE PHYSICAL
CLOSENESS OF FOOD TO HOW
ACCESSIBLE IT IS AND CULTURES
AND TASTE PREFERENCES AND THE
TIME AND SKILL SET WE HAVE
PREPARING FOODS AND THEN THE
SOCIAL SYSTEMS AROUND US.
SO WE NEED TO ADDRESS THESE
FACTORS IF WE'RE GOING TO TRY TO
IMPROVE OUR DIETARY INTAKES AND
WE NEED TO IMPROVE THE HEALTH OF
THOSE CHOICES IN OUR
ENVIRONMENT.
AND I THINK WE DISCUSSED HOW
THIS WILL LIKELY TAKE CONCERTED
PRIORITIZATION AND EFFORTS
ACROSS MANY DIFFERENT SECTORS TO
DO THIS WORK OF IMPROVING OUR
ENVIRONMENT.
MOVING FORWARD, SO ALSO IN OUR
EVALUATION OF THE DATA ANALYSIS
DATA, I MENTIONED BEFORE WE
CONSIDERED HEALTH EQUITY AND WE
BROKE DOWN OUR DATA FOR OUR -- A
FEDERAL ANALYST DID THIS TO
BREAK IT DOWN BY SOCIO
DEMOGRAPHIC FACTORS.
WHEN WE EVALUATED THAT, A BIG
TAKE HOME WAS WHAT I ALREADY
MENTIONED, ALL GROUPS WERE
HAVING POOR PATTERNS AND POOR
DIETARY INTAKE BUT WE ALSO DID
FIND THERE WERE SOME SIGNIFICANT
DIFFERENCES AND WE COULDN'T
ALWAYS TEST FOR SIGNIFICANT
DIFFERENCES BUT DID FIND THERE
WERE SOME BY CERTAIN
CHARACTERISTICS.
AND SOMETIMES THE MAGNITUDE OF
THOSE DIFFERENCES WAS ENOUGH TO
LIKELY BE MAKING A DIFFERENCE TO
HEALTH.
ONE OF THOSE FINDINGS WAS THAT
WHEN WE LOOKED AT RACE ETHNICITY
WE SAW THE NON-HISPANIC ASIAN
GROUP AGES 2 AND OLDER HAD A
HIGHER DIET QUALITY SCORE THAN
ANY OTHER RACE AND ETHNIC GROUP.
WE ALSO FOUND THAT THOSE WITH
HOUSEHOLD INCOMES LESS THAN 131%
OF THE POVERTY LEVEL AND WITH
LOW FOOD SECURITY MIGHT BE A
HIGHER RISK FOR NUTRIENT
INADEQUACY.
WE ALSO FOUND THERE WERE SOME
DIFFERENCES IN THE RATES OF
NUTRITION-RELATED CHRONIC HEALTH
CONDITIONS IN THE U.S.
AND OVERALL THESE WERE HIGH BUT
THERE WERE SOME DIFFERENCES IN
THOSE RANKS THAT WERE ACROSS
SOCIO DEMOGRAPHIC GROUPS.
GOING FORWARD, I ALSO WANTED TO
MENTION AND JUST REMIND YOU THAT
WE DID ALSO TRY TO CONSIDER TRE
IMPACT OF THE COVID-19 PANDEMIC
ON OUR RESULTS.
AND SO THE NORMAL FEDERAL
COLLECTION OF DIETARY INTAKE
DATA WAS DISRUPTED DURING THE
PANDEMIC.
SO WE DIDN'T HAVE ACCESS TO DATA
FROM MARCH 2020 THROUGH DECEMBER
2022 BUT WE CONDUCTED AN
EVIDENCE SCAN TO LOOK FOR OTHER
PUBLISHED STUDIES THAT MIGHT
HAVE BEEN ABLE TO GIVE US
INSIGHT ON THE POPULATION
INTAKES DURING THIS TIME
HOWEVER, OUR FINDING FROM THAT
WORK WAS THAT THERE WAS
INSUFFICIENT RESEARCH AVAILABLE
INCLUDING NO NATIONALLY
REPRESENTATIVE STUDIES TO GIVE
US THAT INFORMATION.
SO THIS TWO THINGS.
ONE, IT HIGHLIGHTS HOW IMPORTANT
THAT NATIONAL DATA COLLECTION IS
FOR US TO BE GETTING THIS
INFORMATION AND DOES LEAVE US
WITH A GAP IN OUR UNDERSTANDING
OF WHAT HAPPENED FOR INTAKES
DURING THE PANDEMIC.
WE DO RECOGNIZE THE DIETARY PAD
ERN COU-- PATTERN COULD HAVE BE
AFFECTED.
THAT CONCLUDES OUR DISCUSSION
AND AT THIS TIME I WILL GO AHEAD
AND SHARE OUR DRAFT ADVICE TO
THE DEPARTMENTS.
SO, HERE FIRST JUST TO MENTION
OUR CROSS-SECTIONAL RESULT AND
PROVIDE PRACTICAL EVIDENCE
SUPPORTING THE DIVERSITY OF
POPULATION TO ACHIEVE DIETARY
RECOMMENDATIONS AND TO IMPROVE
HEALTH.
AND THE REASON WE KEEP SAYING
THIS DATA IS SO PRACTICAL IS
BECAUSE IT REALLY GROUNDS US ON
WHERE WE'RE STARTING FROM.
FROM THIS INTAKE DATA WE KNOW
WHAT INTAKES LOOK LIKE AND WHAT
THE BASELINE IS AND THINK MORE
STRATEGICALLY HOW TO IMPROVE
FROM THAT STARTING POINT.
SO THEREFORE, WE PROVIDE THE
FOLLOWING RECOMMENDATION TO THE
DEPARTMENT AS THE DIETARY
GUIDELINES FOR AMERICANS 2025 TO
2030 IS DEVELOPED.
SO FIRST, WE WOULD URGE THE
DEPARTMENTS TO RECOGNIZE THAT
THE DIETARY INTAKES ACROSS THE
SOCIO DEMOGRAPHIC GROUPS
INCLUDING AGE, SEX, RAGE AND/OR
ETHNICITY AND FOOD SECURITY
STATUS ARE DIFFERENT.
THAT'S ONE OF OUR MAJOR FINDINGS
IS THAT WE DID SEE SOME
DIFFERENCES THERE AND ALSO SOME
DATA THAT WE COULDN'T GET
STATISTICAL DIFFERENCES FROM BUT
WE CAN LOOK AT THE RANGES AND
SEE HOW THEY'RE VARYING.
THAT'S REALLY IMPORTANT TO MEET
PEOPLE WHERE THEY ARE.
OUR COUNTRY INCLUDES A GREAT
DIVERSITY OF DIFFERENT GROUPS
AND SO WE NEED TO LOOK AT THAT
DATA TO UNDERSTAND WHERE EACH OF
THOSE GROUPS ARE STARTING FROM.
SO OVER ARCHING THAT IS THAT
WE'RE ALL EATING POORLY.
THAT'S OUR FIRST ADVICE.
OUR SECOND ADVICE IS TO JUST
CONSIDER AND KEEP IN MIND THE
POOR HEALTH AND HIGH PREVALENCE
OF NUTRITION-RELATED CHRONIC
DISEASES AMONG ADULTS AS WELL AS
THE HIGH PREVALENCE OF THESE
INDICATORS AND RISK FACTORS OF
POOR HEALTH AMONG CHILDREN AND
ADULTS.
AND THAT'S REALLY THE PIECE THAT
WE NEED A LASER FOCUS TO
IMPROVE.
JUST HOW CAN WE GET HEALTH TO BE
BETTER IN THE U.S. AND WE NEED
TO REMEMBER WHERE WE ARE
STARTING FROM THERE.
THIRDLY, WE WANT TO EMPHASIZE
THAT THERE'S CERTAIN SPECIAL
CONSIDERATIONS RELATED TO
NUTRIENTS AND DIETARY COMPONENTS
OF PUBLIC HEALTH CONCERN AND
THAT POSE SPECIAL CHALLENGES TO
VULNERABLE LIFE STAGES AND AS I
MENTIONED, INFANCY, CHILDHOOD,
ADOLESCENCE AND PREGNANCY AND
LACTATION ARE SOME OF THOSE.
WE HAVE A LOT OF GROWTH AND
DEVELOPMENT GOING ON DURING THAT
TIME BUT SOME POOR INTAKES.
SO, MOVING FORWARD THEN WE ALSO
HAVE A FEW FUTURE DIRECTIONS WE
WANTED TO SURE SPLIT BETWEEN
THIS SLIDE OVERVIEWING
RECOMMENDATIONS FOR FEDERAL
AGENCIES AND RECOMMENDATIONS FOR
FUTURE COMMITTEES.
AND SO WITH REGARD TO OUR FUTURE
DIRECTIONS WE IDENTIFIED DATA
ANALYSIS TO FEDERAL AGENCIES.
ONE OF THOSE THAT ARE TOP ONE
HAS BEEN MENTIONED BEFORE, BUT
WE'RE EMPHASIZING THAT AGAIN.
AND THAT IS THE PRIORITIZATION
OF INVESTMENT IN THE HIGH
QUALITY DATA THAT IS GENERATED
FOR US USING THE AND A HALF
HEALTH AND NUTRITION EXAMINATION
SURVEY OR NHANES.
THIS IS REALLY CRITICAL AND
INTAKE AND WITH CHRONIC HEALTH
OUTCOMES IN THE POPULATION.
AND WE CAN'T TELL IF WE'RE
IMPROVING THINGS IF WE CAN'T
CONTINUALLY BE MONITORING THAT.
AND SO THIS IS REALLY IMPORTANT
TO DO ALONG WITH THAT THERE ARE
OTHER DATABASES AND COMPONENTS
OF THAT SYSTEM SUCH AS THE FOOD
AND NUTRIENT DATABASE FOR
DIETARY STUDIES WHICH IS OUR
MAIN PLACE FOR INFORMATION ON
WHAT ARE IN THOSE FOODS PEOPLE
ARE REPORTING IN NHANES.
WHAT IS THE COMPOSITION OF THOSE
FOODS?
AND WE NEED TO WITH JUST
RECOMMENDATION THAT KEEPS BEING
UPDATED WITH CURRENT MARKET DATA
OF THE FOODS OUT THERE IN THE
FOOD SUPPLY.
WE NEED TO MAKE SURE THAT WE'RE
CAPTURING THOSE IN THE NUTRIENT
AND FOOD COMPOSITION DATABASES.
ALSO, ALONG WITH CONTINUING TO
PRIORITIZE NHANES, WE WANT TO
MAKE SURE AS SAMEERA MENTIONED
WE'RE INCLUDING DOING A BETTER
JOB INCLUDING ALL THE DIFFERENT
CULTURES AND GROUPS IN OUR
POPULATION.
SO, SOME OF THAT DATA RIGHT NOW
IS NOT BEING CAPTURED IN A WAY
IT CAN BE REPRESENTATIVE.
THAT'S ONE THING WE HOPE THAT
COULD HAPPEN IN THE FUTURE.
WE RECOGNIZE THAT FOR EXAMPLE
THINKING ABOUT SOME OF OUR
DIFFERENT RACE ETHNIC GROUPS FOR
EXAMPLE, NON-HISPANIC ASIAN
GROUPS, THAT COULD INCLUDE
PEOPLE FROM WITH BACKGROUNDS
FROM INDIA OR WITH BACKGROUNDS
FROM JAPAN OR OTHER AREAS OF THE
WORLD THAT ARE ALL INCLUDED IN
ASIA.
SO, IT'S VERY DIVERSE AND IT'S
LIKE THAT FOR ALL THE OTHER
RACE/ETHNIC GROUPS AS WELL.
SO WE REALLY CAN'T CAPTURE THAT
WITH SUPPORT OF REGULAR UPDATES
TO THE DIETARY REFERENCE INTAKE
INFORMATION AND GETTING THOSE
SENTINEL VALUES FOR NUTRIENT
INTAKE.
THEY SHOULD BE KEEPING UPDATED
BASED ON THE CURRENT RESEARCH
AND CONTINUING TO IMPROVE THE
FEDERAL HUMAN MILK COMPOSITION
INITIATIVE SO WE HAVE A BETTER
UNDERSTANDING OF WHAT ALL
NUTRIENTS ARE IN HUMAN MILK AND
SHARE RECOMMENDATIONS FOR FUTURE
COMMITTEES AND CONSIDER HEALTH
COUNTY ON DATA ANALYSIS AND WE
COULDN'T FIND SIGNIFICANT
DIFFERENCES IN THE DIETARY
PATTERNS AMONG THE DIFFERENT
GROUPS.
AND THEN WE ALSO WANT TO
PRIORITIZE IN THE NEXT COMMITTEE
POTENTIALLY THERE COULD BE MORE
STATISTICAL TESTING TO MAKE SURE
THAT THOSE -- SOME OF THOSE
DIFFERENT RANKS THAT WE'RE
SEEING SIGNIFICANT DIFFERENCES
OR INDICATION OF THE MAGNITUDE
OF DIFFERENT RANKS.
AND I THINK THAT WRAPS UP THIS
PRESENTATION.
SO, NOW I'D LOVE TO BE ABLE TO
ENTERTAIN ANY QUESTIONS OR
COMMENTS.
>> HEATHER, FIRST OF ALL, THANK
YOU FOR ALL YOUR TERRIFIC
LEADERSHIP AND YOU DID A GREAT
JOB.
YOU DID A GREAT JOB AND I ALSO
JUST WANT TO DO A HUGE CALL OUT
TO THE STAFF THAT REALLY WORKED
WITH THE COMMITTEE SO CLOSELY TO
COMPILE THE DATA.
I'M JUST GOING TO TAKE THE
PURVIEW OF THE CHAIR HERE WHILE
EVERYONE GETS THEIR CAMERA ON
FROM THE COMMITTEE AND ASK HAVE
YOU CONSIDERED THE FOLLOWING FOR
EITHER ADVICE AND BEVERAGE
CONSUMPTION AND THERE'S AN AGE
GROUP CLASS AND ALL POSITIVE
TRENDS AND LEARN HOW AND WHY
THAT HAPPENED WE CAN THEN BE
APPLYING MORE BROADLY TO THE
ENTIRE DIETARY PATTERN.
I KNOW THERE ARE QUESTIONS BUT I
KNOW YOU'LL HAVE A GREAT ANSWER.
>> THAT WAS AN INTERESTING
FINDING FOR US AND UNFORTUNATELY
WE DIDN'T -- WE WERE CONSTRAINED
TO DATA ANALYSIS HERE.
BUT I THINK THAT IS SOMETHING
NOW FOR MAYBE OTHER
INVESTIGATORS TO HELP PROVIDE
INFORMATION ON IS KIND OF LIKE
HELPING UNDERSTAND WHY THAT IS
HAPPENING AND WERE THERE CERTAIN
POLICY SHIFTS THAT HELPED US DO
THAT OR WERE THERE OTHER FACTORS
THAT LED TO THAT AND PERHAPS
OTHER COMMITTEE OF THAT BUILDING
ON THAT AND IF WE CAN DO THAT
LET'S DO MORE OF IT.
>> GREAT, THANK YOU.
OTHER QUESTIONS FOR HEATHER.
>> THANKS, HEATHER, THAT WAS A
GREAT PRESENTATION.
I HAVE A FEW QUESTIONS BUT I'M
GOING TO START WITH ONE BUT ONE
IS DID THE SUBCOMMITTEE TALK
ANYMORE AND LOOKING AT THE FOOD
ENVIRONMENT.
SO I THINK THOUGHTS ABOUT THIS
BROADER CONTEXT HAVING SUCH AN
INFLUENCE ON OVER ALL
CONSUMPTION BUT WE DON'T REALLY
LOOK AT IT.
I KNOW SUBCOMMITTEE 4 TRIED TO
DO A LITTLE BIT ABOUT THIS AT
MORE OF THE HOUSEHOLD LEVEL
WHICH WE WEREN'T ABLE TO DO BUT
JUST WONDERING WHETHER BROADER
CONVERSATIONS ABOUT THAT OUR
THOUGHTS ABOUT RECOMMENDATIONS
SPECIFIC IN THAT AREA.
>> YEAH, THAT IS REALLY I THINK
A BIG TOPIC TO BE ADDRESSED.
AND IT'S VERY IMPORTANT.
I FEEL LIKE AS FAR AS FOR DATA
ANALYSIS, WE WERE MORE CONCERNED
ABOUT JUST MAKING SURE THAT
WE'RE TAKING CARE AND
INTERPRETING THE RESULTS WE HAVE
AND I DO FEEL LIKE WHEN WE'RE
TALKING ABOUT INTAKES IT JUST
YOU KIND OF THINK ABOUT THE
PERSON FOR THAT.
YOU HAVE A TENDENCY TO ASSIGN
THAT CHOICE TO THE PERSON BUT
IT'S REALLY THAT WE NEED TO
REMEMBER THAT SO MANY OTHER
THINGS ARE INFLUENCING THAT
CHOICE.
AND I FEEL LIKE THAT IS -- I
THINK SUBCOMMITTEE 4 DID GREAT
WORK TO PERHAPS MORE DIRECTLY
ADDRESS THAT QUESTION AND WE CAN
DO WITH THIS KIND OF DATA
ANALYSIS BUT I HOPE THAT PART OF
THE DIETARY GUIDELINE COMMITTEE
I HOPE THAT GROWS FOR THE NEXT
COMMITTEE AND THERE COULD BE
GREATER MORE DETAILED EVALUATION
OF THE FOOD ENVIRONMENT.
I THINK CHERYL HAD A HAND.
>> THANK YOU FOR THE BEAUTIFUL
PRESENTATION ON BEHALF OF THE
COMMITTEE.
WHAT'S NICE AND STRIKING ME AT
THIS POINT IS THE VARIOUS
SOURCES OF INFORMATION THAT WE
GET TO USE TO INFLUENCE THE
REPORT.
WE HAVE OUR REVIEW OF THE
LITERATURE, WE CAN RELY ON
AUTHORITATIVE SOURCES AND DO OUR
OWN ANALYSIS FROM SURVEILLANCE
SYSTEMS AND TAKES US BACK TO
WHAT HOLLIE JUST RAISED IF WE
STRIVE TO INCREASE THE HEALTHY
EATING INDEX AND LOOK AT INDEX
SCORES AND OVER ALL PUBLIC
HEALTH.
SO WHILE I ENTERED THE PROCESS
HOPEFUL ON THIS EXAMINATION OF
THE DATA WE WOULD SEE THE
HEALTHY EATING INDEXES GO UP, WE
ARE FINDING THEY'RE REMAINING
FLAT AND TROUBLESOME WHEN
DIETARY GUIDELINES GET SET.
I WANT TO RAISE FOR ALL OF US
AND THE PROCESS MOSQUE FORWARD
THE INTENTIONALITY AROUND MOVING
AWAY FROM THIS ASSIGNMENT OF
CHOICE TO THE PERSON BECAUSE I
THINK WE HAVE RATHER EXTENSIVE
HISTORY OF SEEING THE SAME
RESULT.
WE'RE ABOUT TO CLOSE OUT THE
PROCESS.
I'M HOPEFUL THAT RAISING THE HEI
ONCE AGAIN AS THE COMMITTEE HAS
DONE HERE AND ONCE AGAIN IN A
MORE EXPLICIT WAY AROUND HEALTH
EQUITY INDICATORS AND EXAMINING
SOCIO ECONOMIC POSITION AND
SEEING DIFFERENCES IN THE
VARIABLES AS WELL AS
RACE/ETHNICITY IN THE OTHER
CHARACTERI IISTICS GETTING US T
ADDRESS THE STRUCTURES WE SEE
HERE.
IT'S MORE OF A COMMENTS AND
INTEGRATIVE THOUGHT THAT'S
OCCURRING TO ME AS I'M SEEING
THE PRESENTATION FROM YOUR
COMMITTEE AT THIS STAGE OF OUR
DELIBERATIONS.
>> AND THANK YOU FOR MENTIONING
THE SYSTEMATIC REVIEW FINDINGS
AND INTEGRATING THAT.
THANK YOU FOR THE COMMENT.
DIDI.
>> THANK YOU HEATHER FOR
REMINDING US.
I THINK THESE ARE IMPORTANT DATA
THAT GET PRESENTED ALONGSIDE OUR
DIET WORK TO UNDERSTAND WHERE
AMERICANS' HEALTH ARE AND WHERE
THERE'S BEEN MAYBE MODEST
IMPROVEMENTS AND WHERE WE HAVE
WORK TO BE DONE.
I HAVE TWO THOUGHTS.
THE FIRST IS RELATED TO THE
SUBGROUP ANALYSIS WE'VE BEEN
ABLE TO CONDUCT AND HOPEFULLY
CAN EXPAND ON AND FUTURE YEARS
AS DATA KIND OF GET MORE
COMPREHENSIVE.
IF WE'RE LOOKING TO IMPROVE OVER
ALL HEI, WHICH I AGREE WITH
CHERYL IS A METRIC NA IS CAUSAL
AND WILL BE REALLY IMPORTANT TO
WATCH, THAT WE MAKE SURE THAT AS
WE IMPROVE OR ADDRESS THINGS
SYSTEMATICALLY THAT WE RAISE ALL
GROUPS EQUALLY AND DON'T
EXACERBATE ANY DISPARITIES.
EVERYONE SEEMS TO BE DOING
PRETTY POORLY BUT THERE ARE SOME
GAPS AND MAKING SURE THOSE GAPS
DON'T WIDEN AND INDIVIDUALS GET
LEVEL BEHIND IF THERE ARE
EFFECTIVE STRATEGIES IS
SOMETHING WE NEED TO MONITOR.
AND THE SECOND POINT I WANTED TO
JUST MAKE IS THE FOOD
ENVIRONMENT WE KNOW INCLUDES
THAT AND THE TREND IS AN
INTERESTING ONE.
THAT'S A FOOD OR COMPONENT OF
OUR DIET WHERE THERE IS AN
OBVIOUS SUBSTITUTION OF WATER OR
OTHER THINKS AND FEW FOODS HAVE
THAT READILY AVAILABLE TO JUST
HAVE THIS EXACT SAME BEHAVIOR
THROUGHOUT THE DAY BUT IN A
HEALTHY WAY AND NEEDS TO BE AS
EASY AS CHOOSING WATER WHEN IT
COMES TO FOOD.
THERE'S SO MUCH WE ANALYZED
ACROSS OUR DATA ANALYSIS IN
TERMS OF THE FOODS AND HEALTH
OUTCOMES THAT POINT TO THE FOODS
RATHER THAN THE BEHAVIOR AND
WITHOUT ADDED SUGARS AND SODIUM
AND SATURATED FAT BECOMES
DIFFICULT TO FIND THIS
ALTERNATIVE OR HEALTHY OPTION
THAT IS REALLY AND LOOKING AT
NUTRIENTS OF PUBLIC HEALTH
CONCERN.
THEE FOODS HAVE TO BE AVAILABLE
FOR THE EQUAL SWAP TO BE MADE
AND I THINK WE'VE SEEN OVER THE
LAST SEVERAL YEARS THEM GET
WORSE.
THEY ARE REALLY NEED TO AT THE
FOOD LEVEL AND NOT RELYING ON
INDIVIDUAL BEHAVIOR GET BETTER
AT THE SAME TIME.
SO IMPLEMENTATION SCIENCE AT THE
FOODS AND MANUFACTURING AND
INDUSTRIES AS WELL AS THE
BEHAVIOR I THINK IS REALLY
IMPORTANT TRYING FIGURE OUT HOW
ANYONE CAN BENEFIT NOT THOSE WHO
CAN JUST AFFORD OR MAKE THE MORE
DIFFICULT SUBSTITUTION.
THANK YOU, I APPRECIATE YOU
PRESENTING THE DATA AGAIN IN THE
SUMMARIES.
>> THANKS, DIDI.
IT'S IMPORTANT TO THINK ABOUT
THOSE DIFFERENT ASPECTS AS WELL.
HEL ENE.
>> THANK YOU, HEATHER.
IT WAS A WONDERFUL PRESENTATION
AND ALL OF HAVE YOU RAISED
WONDERFUL COMMENTS AND I WANTED
TO ECHO CHERYL AND DIDI.
I THINK MY QUESTION WOULD BE HOW
DO YOU ENVISION EXPENDING THAT
DATA ANALYSIS PORTION OF THE
PROCESS SO THAT WE GET TO THOSE
WIDER SCOPE OF THE QUESTIONS
THAT WERE ASKED WHICH INCLUDED
WHAT COMPONENT WILL HELP US
UNDERSTAND THE HEALTHY CHEF AND
DID YOU GIVE AN EXAMPLE OF THE
VEGETABLES WITH ADULTS AND HOW
DID THAT SHIFT HAPPEN AND HOW
CAN WE EXPAND THAT PROCESS TO
GET TO THE HOW?
AND WHETHER THAT COULD BE
INCLUDED IN THE DRAFT ADVICE FOR
THE DEPARTMENTS?
THANK YOU.
>> I WELCOME MANY AND I DO KIND
OF AND HEALTH I'M NOT SURE WE
HAVE ALL THE DATA TO REALLY
ADDRESS THAT FOOD ENVIRONMENT.
AND WE COULD PERHAPS DRAW FROM
LOOKING AT WHAT ALREADY HAS BEEN
BUT OUT THERE IN THE LITERATURE
IN SEARCH RESEARCH TOPICS.
FOOD PURCHASING DATA AND
THINKING ABOUT QUANTIFYING MORE
OF THE FOOD ENVIRONMENT AND WHAT
KINDS OF STORES AND WHAT KIND OF
FOOD HAVE AVAILABLE IN THE
STORES AND ENVIRONMENT AND ALSO
THINKING ABOUT THE PROGRAMS
SERVING A BIG PORTION OF OUR
YOUTH AND EVEN WHEN THAT FOOD IS
HELPFUL WHERE OTHER FOODS ARE
COMING FROM.
SO I THINK THERE'S A LOT OF
THINGS THAT COULD BE INCLUDED AS
PART OF THAT LOOK.
THANKS, A LOT HEATHER, THAT WAS
REALLY GREAT.
I DID WANT TO JUST BRING YOUR
ATTENTION TO A FEW REPORTS THAT
MIGHT BE GOOD TO LOOK AT IN THE
RECOMMENDATIONS.
THEY'RE OLDER NOW BUT I THINK IT
WAS A NASEM REPORT AND HAD A
CHAPTER ON MARKETING AND TALKED
ABOUT THE EXTERNAL FACTORS.
IT WAS FOCUSSED ON OBESITY BUT A
LOT OF THAT IS DIET RELATED AND
THERE WAS A REPORT THAT FOLLOWED
THAT EVALUATING OBESITY
PREVENTION EFFORTS.
IN THAT REPORT THERE WERE A LOT
OF RECOMMENDATIONS FOR HOW WE
COULD MAKE MEASUREMENTS OF THE
ENVIRONMENT MORE ROBUST.
IT MAY BE GOOD POINTING BACK TO
THOSE.
THEY'RE KIND OF OLD NOW.
I THINK AT THE TIME THEY ARE
WERE DONE THE INFLUENCE OF OTHER
TYPES OF MARKETING LIKE
INFLUENCERS AND SOCIAL MEDIA WAS
NOT SUCH A BIG THING IN THE
ENVIRONMENT NOW AND MAY BE GOOD
TO REFER TO IN THE DISCUSSION
SECTION THERE.
>> THANKS SO MUCH.
YEAH, IT'S VERY HELPFUL.
HOLLIE.
>> THIS IS MY SECOND QUESTION OR
THOUGHT.
IT'S MORE OF A THOUGHT AND THIS
IS RELATED TO THE COMMENTS FROM
THE SUBCOMMITTEE ABOUT DRAFT ADD
VASE TO DEPARTMENTS AND THIS IS
DUE TO THE NUTRITION RELATED
LEATH CONDIT-- HEALTH CONDITION
ONE THING I STRUGGLED WITH AS WE
WORKED TOGETHER OVER THE LAST 20
MONTHS IS JUST THE CHALLENGE OF
THINKING OF THE DIETARY
GUIDELINES TRADITIONALLY AS
BEING SOMETHING THAT FOCUSES ON
GUIDELINE TO HELP WITH THE
PREVENTION OF DISEASE BUT WE'RE
AT A PLACE RIGHT NOW IN WHICH A
LARGE COMPONENT OF OUR
POPULATION IS SUFFERING FROM
CHRONIC HEALTH CONDITIONS.
SO OVER WEIGHT AND OBESITY IS
ONE OF THOSE CHRONIC HEALTH
CONDITIONS.
HOW TO CREATE THE BALANCE
BETWEEN GUIDANCE GIVEN TO
BALANCE WHERE WE CROSS INTO A
MEDICAL FOCUS WITH THE
GUIDELINES WHILE AT THE SAME
TIME IMPROVING THE HEALTH OF THE
POPULATION.
I'M NOT SURE THERE WERE
BROADER -- I KNOW IT'S A
COMPLICATED COMMENT, QUESTION, I
DON'T KNOW IF THAT WAS THOUGHT
ABOUT WHERE TO GO WITH THAT FROM
THE SUBCOMMITTEE
>> HOLLIE, HOLD ON TO THAT IDEA
I THINK IT'S GOING TO COME UP
WHEN WE TALK ABOUT INTEGRATION
AND YOU TOUCHED ON THE BROADER
CROSS-CUTTING THEMES WE'LL BE
DISCUSSING TOMORROW.
I THINK COLLECTIVELY THIS
CONVERSA
CONVERSATION.
SORRY TO INTERRUPT.
>> THANK YOU.
THAT WAS GREAT.
ED.
>> ONE THING I'M SURPRISED AT IS
LOOKING ACROSS SOCIO DEMOGRAPHIC
GROUPS, THE PERCENTAGE OF
INDIVIDUALS BELOW RECOMMENDED
INTAKES ARE RELATIVELY
CONSISTENT.
I WOULD HAVE EXPECTED A LITTLE
BIT MORE DIFFERENCE.
WE THINK COST AND AVAILABILITY
ARE A BIG ISSUE AND THEY ARE,
OBVIOUSLY, I WOULD HAVE EXPECTED
MORE DIFFERENCES BY SOCIO
DEMOGRAPHIC GROUPS I'M NOT SURE
WHAT THAT TELLS US THAT THE
UNDERLYING REASONS WHY OUR DIET
IS POOR.
AND ACROSS THERE'S OTHER
CULTURAL ISSUES.
I DON'T KNOW IF YOU HAVE
THOUGHTS OR OTHER PEOPLE HAVE
THOUGHTS ABOUT THAT.
I'M SURPRISED BY THE LACK OF
MORE ON THIS.
THANK YOU.
>> THANK YOU FOR POINTING THAT
OUT.
SOME THINGS WE'RE SURPRISED OF
WHEN WE LOOKED AT THAT DATA FOR
ALL THE DIFFERENT WAYS THAT WE
BROKE IT DOWN.
JUST THAT REALLY THERE WERE
SOME -- WE DON'T WANT TO
UNDERMINE THERE WERE SOME
DIFFERENCES BUT JUST KIND OF
OVERWHELMINGLY HOW POOR DIETS
WERE.
AND I THINK IT'S GOT TO BE
THINGS THAT ARE IMPACTING ALL OF
US.
AND CERTAINLY LIKE MANY THINGS
IN THE ENVIRONMENT ARE MAKING A
DIFFERENCE AND PERHAPS ALL THESE
TOGETHER AND WE'RE GROUPING
PEOPLE IN THESE MASSIVE GROUPS
STILL.
LIKE EVEN WHEN WE BREAK DOWN BY
DIFFERENT FACTORS THEY'RE SO
BROAD.
IT CAN BE MORE DIFFICULT TO KIND
OF SEE WHAT THINGS MIGHT BE
MAKING MORE OF AN IMPACT.
BUT YEAH, I WELCOME OTHERS TO
COMMENT TOO OF COURSE.
ANGELA.
>> I WAS WONDERING IN THE
INTEGRATION OF ADVICE TO THE
DEPARTMENTS THE IDEA OF
INTERSECTIONALITY AS WELL AS
COMBINING RACE AND DISABILITY OR
LOOKING AT DISAG GREGATION OF
DEFINITION OF DRIVERS.
AND WE SEPARATE RACE, ETHNICITY
AND INCOME AS A PROXY FOR
DRIVERS.
CAPTURING THE DRIVERS AND I'VE
SEEN A COUPLE PAPERS RECENTLY
THAT DISAGGREGATE SUB GROUPS IN
THIS IDEA MAYBE HOW PEOPLE HAVE
DIFFERENT HISTORIES, DIFFERENT
EXPERIENCES AND THE INTERSECTION
BETWEEN SOCIAL DETERMINATES AND
CULTURE AND THINKING HOW THEY
INTERSECT.
>> THANK YOU SO MUCH.
MAYBE IN THE NEXT MAYBE WE COULD
DO MORE.
CHRISTINA.
>> GOING BACK TO THE COMMENT.
YOU DID BRING IT UP WHEN YOU
MENTIONED ABOUT THE ENVIRONMENT
AND THE BUILT ENVIRONMENT AND I
THINK IT WAS SAD THEY COULDN'T
DO THAT LOOKING AT THE HOME
ENVIRONMENT AT LEAST BUT I THINK
THE NEXT COMMITTEE AND WE DO
RECOMMEND THAT IN YOU'RE
RECOMMENDING AS WELL I WANT TO
ECHO WE SHOULD BE LOOKING AT THE
ENVIRONMENT BECAUSE EVERYBODY --
THAT WILL EXPLAIN SOME OF THE
RESULTS THAT THE HEALTHY EATING
IS SIMILAR ACROSS SOCIO ECONOMIC
STATUS AND RAND REALITYING THE
HOME AND BUILT ENVIRONMENT AND
GROCERY SHOPPING IN THE SCHOOLS
AND IN GENERAL I THINK THAT'S
KEY.
>> THANK YOU, CHRISTINA.
>> WITH HEALTH EQUITY AND I'M
GOING TO PUT YOU ON THE SPOT AND
ASK YOU TO EXPAND A BIT.
SAMEERA IN HER PRESENTATION
DISCUSSED HOW THE WORKING GROUP
AND THE VARIOUS SUBCOMMITTEES
WERE CONSTRAINED BY THE DATA
THEY HAD AVAILABLE AT HAND.
AND I WANT TO EMPHASIZE THIS IS
A GREATER OPPORTUNITY, HEATHER,
IN THE DATA ANALYSIS CHAPTER TO
CALL OUT THE QUESTIONS WE
COULDN'T ANSWER BECAUSE THE DATA
SIMPLY WEREN'T THERE.
SAMEERA, DO YOU WANT TO COMMENT
A BIT ON THAT?
>> I THINK IT IS IN THE CHAPTER
AND I THINK YOU WERE PART OF THE
PROCESS BUT STARTED WITH A HUGE
LIST OF VARIABLES WE WANTED TO
LOOK AT.
LENGTH OF STATE AND DISABILITY
STATUS AND A WHOLE LIST WE
THOUGHT WAS VERY IMPORTANT AND
PROBABLY WOULD HELP EXPLAIN SOME
OF THE DIFFERENCES BUT
UNFORTUNATELY WE WERE
CONSTRAINED TO GIVEN ONE, SOME
DATA WASN'T THERE AND WE WEREN'T
ABLE TO HONE IN ON GRANULAR DATA
AND PROBABLY THE DATA ARE
COLLECTED BUT WE COULDN'T ACCESS
THE DATA.
THAT'S MORE THAN CONCERN WE
REAREAL
EDIZED -- REALIZED WE DON'T
HAVE ACCESS.
WE STARTED WITH A LONG LIS AND
HAD TO KEEP CUTTING IT DOWN TO
ABOUT WHAT WAS FEASIBLE GIVEN
THE DATA WE MAD AND THE FACT
THAT SOMETIMES WE CANNOT LOOK
APT THE SUBGROUP DIFFERENCES.
ANOTHER CONCERN UP IS THE
INTERSECTIONALITY, HEATHER YOU
MENTIONED PREVIOUSLY, IT'S NOT
JUST ONE WE'RE IN DIFFERENT
DOMAINS AND CAN'T CAPTURE THAT
EITHER.
THOSE WERE SOME CONCERNS.
WE WANTED TO DO THE BEST WE CAN
AND WE DID WITH THE DATA WE HAD
BUT SOME OF THE DATA WERE NOT
THERE.
>> NEW.
>> THANK YOU.
WE LOOK AT THE DATA AND WERE
MORE ASPIRATIONAL.
>> THE PLIGHT OF ALL
RESEARCHERS, RIGHT, HEATHER?
ANYMORE QUESTIONS FOR HEATHER ON
THIS CHAPTER ON DATA ANALYSIS?
CHERYL.
>> NOT SO MUCH A QUESTION AS A
COMMENT.
IN THAT THIS DISCUSSION IS
REALLY RAISING I THINK THE
OPPORTUNITY FOR US TO NOT ONLY
THINK ABOUT WHAT WE DON'T HAVE
AND WHERE WE WEREN'T ABLE TO DO
ANALYSES BUT WHAT WE CAN SEE AND
HAVE BEEN SEEING IN THE TREND
DATA AROUND THE HEALTHY EATING
INDEX FOR A LONG TIME.
LET'S NOT LOSE SIGHT OF THE FACT
THAT IT IS VERY CLEAR IF WE
CONTINUE TO ASSIGN THE CHOICE OF
GETTING THESE HEALTHY DIETARY
PATTERNS TO BE CONSUMED OR
LOOKING AT MICRONUTRIENT AND
MACRO NUTRIENT INTAKE AND IF WE
CONTINUE TO FOCUS THERE WE'LL
CONTINUE TO SEE THE RESULTS WE
HAVE.
WE HAVE A LONG STANDING AMOUNT
OF DATA COLLECTION AND ANALYSIS
PROCESS THAT IS POINTING US AWAY
FROM THAT APPROACH.
SO THIS IDEA THAT WE ARE GOING
TO MEET PEOPLE WHERE THEY ARE
AND LOOK AT THE ENVIRONMENTS IN
WHICH THEY'RE FUNCTIONING AND
HOW THEY CONTRIBUTE TO THE ROLE
OUT AND IMPLEMENTATION AND
PEOPLE'S ABILITY TO MEET
RECOMMENDATIONS.
I THINK WE WANT TO CONTINUE TO
AMPLIFY AND NOT STAGGER BECAUSE
OF THE VARIOUS THINGS WE CAN'T
YET ELUCIDATE.
>> THANKS, CHERYL.
ANGELA.
>> I AGREE WITH CHERYL.
IT MADE ME THINK LOOKING AT THE
SYSTEM SCIENCE REPORT THAT
HHS -- I KNOW WE USED SOME
SYSTEM SCIENCE BUT THINKING
ABOUT THE INCREASED
METHODOLOGIES AVAILABLE EVEN
WITHIN THE DIETARY GUIDELINES
COMMITTEE AND ONE OF THE
RECOMMENDATIONS THAT COULD BE
PARTICULARLY IMPORTANT IN
THINKING ABOUT THE
INTERSECTIONALITY AND
INTERSECTIONALITY OF SCIENCE AND
OTHER TYPES OF DATA LIKE EVEN
QUALITATIVE DATA.
WE MENTIONED THE LAST THAT COULD
BE INCORPORATED IN A WAY WHERE
WE CAN LOOK SYNERGISTICALLY
LOOKING AT WAYS TO APPLY THE
APPROACHES AND QUALITATIVE,
WHICH I THINK IS CRITICALLY
IMPORTANT AND THE ADVANCED
METHODS IN THAT SPACE AS WELL.
>> I THINK THE OTHER THING TO
NOT LOSE IN THIS BROADER PROCESS
WE'RE SEEING THE GENERALLY POOR
INTAKES ACROSS THE BOARD.
BUT AT THE SAME TIME, WE'RE
SEEING THE DATA OF POOR HEALTH
OUTCOMES, HIGHER RATES OF
CHRONIC DISEASE AND THESE ARE --
CAN'T BE DISENTANGLES AND
IDENTIFYING THE PATTERNS ARE
HAPPENING AND PERVASIVE AND
SEEING CHRONIC DISEASES
PERVASIVE ACROSS THE POPULATION
AND THEY'RE HAPPENING TOGETHER
BUT WE HAVE TO CONSIDER PUTTING
THE EFFORTS TOGETHER.
IF WE'RE GOING TO DO DISEASE
PREVENTION AND MANAGEMENT, IT'S
GOING TO HAVE TO INCLUDE
NUTRITION AND IMPROVE DIET AND
ACCESS AFFORDABILITY AND
ETCETERA.
AND SEEING A LOT OF THESE
EFFORTS EMERGING BUT WE'RE NOT
GOING TO SOLVE CHRONIC DISEASE
WITHOUT THE DIETARY COMPONENT.
OFTEN TIMES THE DIETARY
COMPONENT IS LEFT OUT OF THESE
IN MANY APPROACHES.
THE DATA STRENGTHENS THE LINKAGE
BETWEEN THE LIFESTYLE FACTORS
THAT CONTRIBUTE TO HEALTH
OUTCOMES AND SEEING HAPPEN AND
FROM OUR ADVICE AND OUR APPROACH
AND POLICIES, NEED TO FACTOR
THIS IN AS A FRONT LINE PORTION
OF OUR APPROACHES OPPOSED TO A
SECONDARY FACTOR.
>> YES, GREAT POINT.
THANK YOU, EVERYBODY.
AND ANY OTHER COMMENTS OR
QUESTIONS?
OKAY.
WELL, AGAIN, THANK YOU HEATHER
AND YOUR TEAM AND THE STAFF,
FANTASTIC.
SO, WE'RE YES, THANK YOU.
WE'RE GOING TO TAKE A BREAK
HERE.
I THINK THIS IS A REALLY GOOD
PLACE TO TAKE A BREAK AND WE'RE
GOING TO COME BACK TO OUR
COMPUTERS AFTER 1:15 EASTERN
STANDARD TIME AND I HOPE THE
COMMITTEE HAS TIME TO REALLY
NEWTAL ON WHAT WE'VE DISCUSSED
AND THEN WE'LL COME BACK AND
WE'LL HAVE A GREAT DISCUSSION ON
DIETARY PATTERNS.
SO WE LOOK FORWARD TO SEEING OUR
AUDIENCE BACK HERE AT 1:15.
THANK YOU.
EVERYONE, WELCOME BACK TO THE
COMMITTEE AND STAFF AND WELCOME
BACK TO OUR AUDIENCE.
OUR NEXT SPEAKER IS GOING TO BE
RECORDING OR TWO SPEAKERS, MY
APOLOGIES WILL BE REPORTING OUT
ON THE FIRST PART OF PART D
CHAPTER 2 ON DIETARY PATTERNS.
WITHOUT FURTHER ADO I'LL ASK
DEANNA AND ED TO TAKE OVER AND
ASK THE COMMITTEE TO TURN OFF
THEIR CAMERAS DURING THE
PRESENTATION.
THANK YOU.
>> THANKS, SARAH AND GOOD
AFTERN
AFTERNOON.
FIRST I'D LIKE TO THANK THE WORK
GROUP MEMBERS AND STAFF WHO
HELPED PULL THIS TOGETHER AND
THIS IS THE FIRST OF THREE
PRESENTATIONS FOR OUR WORK
GROUP.
YOU'LL SEE THE OTHER TWO ON
BEVERAGES AND SOURCES OF
SATURATED FAT TOMORROW.
I'M HAPPY TO BE PRESENTING WITH
ED GIOVANNUCCI.
WE LOOK AT PERCENT OF CALORIES
FROM CARBOHYDRATE OR PROTEIN.
THE SO THE NUTRIENT PROFILE OR
ANY GIVEN DIETARY PATTERN CAN
VARY SIGNIFICANTLY.
DIETARY ARE FOOD PATTERNS
REFLECT CULTURAL AND NORMS AND
PREFERENCES AND THERE'S FOOD
AVAILABILITY AS OUR DISCUSSION
PRIOR TO THE BREAK, COOKING
METHODS AND FOOD PROCESSING
TECHNIQUE AND CLIMATE AND
AGRICULTURAL PRODUCTION AND
SOCIO ECONOMIC FACTORS,
ADVERTISING AND MARKETING AND
RELIGIOUS BELIEFS.
SO YOU CAN SEE IN TERMS OF
LOOKING ACROSS FOOD PATTERNS,
THERE REALLY IS A VARIETY.
RESEARCH THAT EVALUATES EXPOSURE
TO THE CONSUMPTION OF ANY
DIETARY PATTERN CAN CAPTURE
INDIVIDUALS' COLINIAR BEHAVIOR
AND ADDITIVE, SYNERGISTIC
EFFECTS IN THE OVER ALL DIET
MATRIX.
BECAUSE PEOPLE CONSUME FOODS
RATHER
RATHER THAN NUTRIENTS LOOKING AT
HABITUAL DIET CAN BE TRANSLATED
TO PRACTICAL GUIDANCE REGULARLY
INCORPORATED TO DAILY LIFE.
WHAT WE EAT EVERY DAY THE
PATTERNS INFLUENCE THE HEALTH
OUTCOMES.
SO MUST OF THE SYSTEMATIC
REVIEWS QUESTIONS ON DIETARY
PATTERNS AND HEALTH OUTCOMES FOR
THIS SCIENTIFIC REPORT WERE
REVIEWED BY PREVIOUS COMMITTEES.
THERE WAS ONE NEW SYSTEMATIC
REVIEW OF DIETARY PATTERNS.
THAT'S THE SECOND ONE YOU'LL SEE
ON IS THE SCREEN.
WE EXAMINED DIETARY PATTERNS
WITH VARIATION AMOUNTS OF ULTRA
PROCESSED FOODS AND GROWTH
ADIPOSITY AND RISK OF OBESITY
ACROSS THE LIFE SPAN.
WE INCLUDE THE FOLLOWING LIFE
STAGES FOR THIS QUESTION.
INFANTS AND YOUNG CHILDREN UP TO
24 MONTHS, CHILDREN AND
ADOLESCENTS AND ADULTS AND OLDER
ADULTS AND INDIVIDUALS DURING
PREGNANCY AND POSTPARTUM.
WE APPLIED A HEALTH EQUITY LENS
TO ALL OF OUR SYSTEMATIC
REVIEWS.
BUT WHEN WE WERE ABLE TO
IDENTIFY AN OPPORTUNITY TO
CONSIDER HEALTH EQUITY TO AN
EVEN GREATER EXTENT IN OUR
REVIEW ON DIETARY PATTERNS
CONSUMED BY ADULTS AND OLDER
ADULTS AND RISK OF
CARDIOVASCULAR DISEASE.
SO YOU SAW THAT IN SAMEERA'S
PRESENTATION.
THERE WERE MANY ADVANCES TO
USING THE DIETARY PATTERNS AND
CARDIOVASCULAR DISEASE OUTCOME
FOR THIS PURPOSE.
THEY INCLUDE THE WELL
ESTABLISHED AND ROBUST BODY OF
LITERATURE ON THIS TOPIC.
THE EXISTING STRONG CONCLUSIONS
FOR THE RELATIONSHIP AND THE
NUMBER OF STUDIES THAT INCLUDED
CARDIOVASCULAR DISEASE OUTCOMES
FOR DIVERSE POPULATIONS.
WHEN POSSIBLE, WE FORMULATED
CONCLUSION STATEMENTS SEPARATELY
FOR DIFFERENT LIFE STAGES.
SO YOU'LL SEE THAT IN THE NEXT
FEW SLIDES.
SO HERE'S A LIST OF OUR
QUESTIONS.
WE HAD MORE CONCLUSION
STATEMENTS THAN THESE QUESTIONS
BECAUSE SEVERAL OF THESE HAD
DIFFERENT LIFE STAGES.
SO YOU CAN SEE THE FIRST SIX
SYSTEMATIC REVIEWS ON DIETARY
PATTERNS LOOKED ACROSS CHRONIC
DISEASES AND COGNITIVE DECLINE.
THESE WERE ASSESSED IN LIFE
STAGE ACROSS THE LIFE STAGES
WHEREVER POSSIBLE.
THE NEXT GROUP OF SCIENTIFIC
QUESTIONS, CONCERNS, DIETARY
PATTERNS DURING PREGNANCY AND
MATERNAL AND CHILD OUTCOMES.
THESE ARE SPECIFIC TO THAT STAGE
OF LIFE.
THE LAST GROUP WAS THE
SYSTEMATIC REVIEW ON PATTERNS
WITH VARYING AMOUNTS OF ULTRA
PROCESSED FOOD I DESCRIBED
PREVIOUSLY.
SO I WILL PRESENT THESE TODAY.
WE GROUP THEM IN TERMS OF OUR
INTEGRATION BY THE DIRECTION OF
ASSOCIATION BETWEEN THE DIETARY
PATTERNS AND HEALTH OUTCOME.
SO WE HAD FOUR DIFFERENT
CATEGORIES SO THE FIRST ONE I'LL
DESCRIBE ARE DIETARY PATTERNS
ASSOCIATED WITH BENEFICIAL
HEALTH OUTCOMES.
THESE WERE WHERE THE DIETARY
PATTERNS WERE ASSOCIATED WITH
IMPROVED HEALTH.
THE SECOND GROUP IS UNFAVORABLE
ASSOCIATIONS BETWEEN DIETARY
PATTERNS AND HEALTH OUTCOMES.
THOSE WERE DIETARY PATTERNS
ASSOCIATED WITH LOWER HEALTH
OUTCOMES.
THERE WAS ONE CONCLUSION
STATEMENT THAT WE FOUND NO
ASSOCIATION BETWEEN DIETARY
PATTERNS AND HEALTH OUTCOMES.
AND THEN WE HAD SEVERAL DIETARY
PATTERN HEALTH OUTCOME
RELATIONSHIPS FOR WHICH A
CONCLUSION STATEMENT COULD NOT
BE DRAWN.
AND THAT WILL BE THE LAST SLIDE
IN MY SERIES.
SO, LOOKING AT THESE THE FIRST
GROUP ARE DIETARY PATTERNS
CONSUMED BY ADULTS AND OLDER
ADULTS.
SO, AS YOU CAN SEE THESE WERE
DIETARY PATTERNS ACROSS THE
BOARD HERE THAT INCLUDED HIGHER
AMOUNTS OF FRUITS, VEGETABLES,
WHOLE GRAINS, BEANS, PEAS,
LENTILS AND FISH AMONG OTHER
DIETARY CONSTITUENTS YOU'LL HEAR
ABOUT LATER.
SO WE HAD SIX OF THESE IN TERMS
OF DIETARY PATTERNS CONSUMED BY
ADULTS AND OLDER ADULTS.
THE ASSOCIATION BETWEEN DIETARY
PATTERNS CONSUMED BY ADULTS AND
OLDER ADULTS IN CARDIOVASCULAR
DISEASE AND LOWER RISK OF TYPE
II DIABETES WERE BOTH GRADED AS
STRONG.
SO WE HAD ROBUST RESEARCH FOR
THOSE.
THE NEXT FOUR WERE ALL GRADED
WITH LOWER OWE BREAST CANCER AND
LOWER RISK OF BREAST CANCER.
THE NEXT IS IN SCHIRN AND ADD
LESS EN AND WE HAD TWO
CONCLUSION STATEMENTS FOR THEM.
SO DIETARY PATTERNS CONSUMED BY
CHILDREN AND ADOLESCENTS WERE
ASSOCIATED LOWER SYSTOLIC AND
TRIGLYCERIDES LATER IN LIFE AND
DIETARY PATTERNS CONSUMED BY
CHILDREN AND ADOLESCENTS WERE
ASSOCIATED WITH FAVORABLE GROWTH
PATTERNS AND ADIPOSITY AND THE
GRADING FOR THESE RANGED FROM
LIMITED TO MODERATE.
THE LAST GROUP OF DIETARY
PATTERNS AND HEALTH OUTCOMES ARE
DIETARY PATTERNS CONSUMED DURING
PREGNANCY AND LOWER RISK OF
EXCESSIVE WEIGHT GAIN AND LOWER
RISK OF DIABETES MELLITUS AND
THE RISK IS LOWER FOR ADULTS AND
THERE'S A LACK OF EVIDENCE
PARTICULARLY IN CHILDREN,
ADOLESCENTS AND PREGNANT
INDIVIDUALS AS I'VE MENTIONED,
INFANTS AND YOUNG CHILDREN UP TO
24 MONTHS OF AGE BUT ALSO
POSTPARTUM INDIVIDUALS AND THEN
OLDER ADULTS WERE NOT SEPARATED
OUT WHEN WE LOOKED AT DIETARY
PATTERNS CONSUMED BY ADULTS AND
OLDER ADULTS THEY WERE INCLUDED.
WE DIDN'T LOOK AT THEM AS A
SEPARATE GROUP MOSTLY BECAUSE
THERE WASN'T A LOT OF RESEARCH
IN THAT AREA.
SO THE NEXT GROUP ARE DIETARY
PATTERNS ASSOCIATED WITH
UNFAVORABLE HEALTH OUTCOMES.
WE HAD THREE OF THESE.
TWO WERE IN CHILDREN AND
ADOLESCENTS AND ONE IN ADULTS
AND OLDER ADULTS.
THE DIETARY PATTERNS LAD HIGHER
INTAKES OF SUGARY DRINKS, SUGARY
SWEETENED FOODS, USUALLY
PROCESSED MEAT OR RED MEAT WERE
SOME OF THE COMPONENTS THAT WE
FOUND IN THESE DIETARY PATTERNS
THOSE CONSUMED BY CHILDREN AND
ADOLESCENTS AND UNFAVORABLE
GROWTH PATTERNS AND HIGHER
ADIPOSITY AND HIGHER RISK OF
EEFBT -- OBESITY AND DIETARY
PATTERNS AND THERE WERE VARYING
AMOUNTS OF ULTRAPROCESSED FOODS
AND THE LAST CONCLUSION
STATEMENT IS PERTY MUCH THE SAME
AS THE CHILDREN, DIETARY PATTERS
CONSUMED BY ADULTS AND OLDER
ADULTS WITH VARIATION -- VARYING
AMOUNTS OF THESE FOODS AND ALL
THREE THE EVIDENT WAS GRADE ID
AS LIMITED.
THIS IS WHERE THERE WAS NO
ASSOCIATION OR GRADE NOT
ASSIGNABLE.
ONE SHOWED NO ASSOCIATION
BETWEEN DIETARY PATTERNS DURING
PREGNANCY AND RISK OF PRETERM
BIRTH.
THIS WAS BASED ON EVIDENCE
GRADED AS LIMITED.
THEN WE HAD A SERIES OF
CONCLUSION STATEMENTS THAT COULD
NOT BE DRAWN IN PARTICULAR LIFE
STAGES I MENTIONED PREVIOUSLY.
IN INFANTS AND YOUNG CHILDREN UP
TO 24 MONTHS OF AGE IS THERE
WERE TWO CONCLUSION STATEMENTS A
GRADE WAS NOT ASSIGNABLE AND
THEY HAD TO DO WITH DIETARY
PATTERNS AND GROWTH ADIPOSITY
AND RISK OF OBESITY AND DIETARY
PATTERNS WITH VARYING AMOUNTS OF
FOOD AND ADIPOSITY AND RISK
OBESITY AND IN CHILDREN THERE
WAS DIETARY PATTERNS CONSUMEDED
AND RISK OF TYPE II DIABETES.
IN PREGNANT INDIVIDUALS THERE
WERE FOR CONCLUSION STATEMENTS
THAT A GRADE WAS NOT ASSIGNABLE
AND THOSE ARE DIETARY PATTERNS
CONSUMED DURING PREGNANCY AND
INADEQUATE GESTATIONAL GAIN AND
PROCESSED FOOD AND DIETARY
PATTERNS CONSUMED DURING
PREGNANCY AND HYPERTENSIVE
DISORDERS OF PREGNANCY AND THEN
DIETARY PATTERNS CONSUMED DURING
PREGNANCY AND LARGE FOR
GESTATIONAL AGE AND MACROSONIA
AND THERE WERE TWO GRADES NOT
ASSIGNABLE, CONSUMED DURING
POSTPARTUM AND POSTPARTUM WEIGHT
CHILDREN AND PATTERNS WITH
VARYING AMOUNTS OF AULTRA
PROCESSED FOODS.
THE GRADE NOT ASSIGN BE WAS DUE
TO RESEARCH WE COULD NOT FIND A
BODY OF RESEARCH THAT EXAMPLE
EXAMINED THESE OR HAD
HETEROGENEITY AND WITH THAT I'LL
HAND IT TO ED.
>> THANK YOU.
>> THE FIRST WAS DIETARY PATTERN
AND RISK OF CARDIOVASCULAR
DISEASE.
SAMEERA NICELY INTRODUCED LEATH
EQUITY LENS AND THE COMMITTEE
LOOKED AT THE RELATIONSHIP
BETWEEN DIETARY PATTERNS AND
RISK OF CARDIOVASCULAR DISEASE.
THIS WAS UPDATING CONCLUSIONS
FROM THE 2015 COMMITTEE AS A
REPORT.
THE 2020 COMMITTEE GRADED THE
STRENGTH OF EVIDENCE UNDERLYING
THIS CONCLUSION STATEMENT AS
STRONG.
THERE WAS AN ASSOCIATION OF
HEALTHY DIETARY PATTERN AND
LOWER RISK OF CARDIOVASCULAR
DISEASE.
BECAUSE THE REVIEW IS BASED ON
LARGE BODY OF EVIDENCE GRADED AS
STRONG, THE COMMITTEE CHOSE TO
APPLY A HEALTH EQUITY LENS TO
THIS REVIEW.
AND ENROLLED THE PARTICIPANTS
THAT HAD GREATER RACIAL AND
ETHNIC AND SOCIO ECONOMIC TI.
-- DIVERSITY.
MOST DID NOT INCLUDE COMPARABLE
MEASURES OF SOCIO ECONOMIC
POSITION CRITERIA FOR DIVERSITY
INCLUDING RACE, ETHNICITY AS
WELL AS OTHER SOCIO ECONOMIC
MEASURES WHERE APPLICABLE.
THE COMMITTEE CLASSIFIED STUDIES
WITH PARTICIPANTS OF LESS THAN
OR EQUAL PERCENT NON-HISPANIC
WHITES AS INCLUDING SIGNIFICANT
POPULATION DIVERSITY.
SO WHEN STUDIES THAT HAD LESS
THAN OR EQUAL TO 40%
NON-HISPANIC WHITES WERE
CONSIDERED AS DIVERSE
POPULATIONS.
APPLYING THE CRITERIA THE
ANALYSIS CONFIRMED THE FINDINGS,
THIS IS OF HEALTH AND DIETARY
PATTERNS AND CARDIOVASCULAR
DISEASE WERE CONSISTENT IN THE
SUBSET OF STUDIES WITH GREATER
RACIAL AND ETHNIC AND SOCIO
ECONOMIC DIVERSITY.
THIS SLIDE DISCUSSES THE DIETARY
PATTERNS AND HEALTH OUTCOMES.
THE COMMITTEE INTEGRATED THE
CONCLUSION STATEMENTS FOR
DIETARY PATTERNS ACROSS HEALTH
OUTCOMES AS PART OF THAT THERE
WERE CHANGES TO THE CONCLUSION
STATEMENT AND GRADES THAT
OCCURRED SINCE THE ORIGINAL OR
PREVIOUS REVIEWS OF THE TOPICS
THAT HAD BEEN CONDUCTED.
SO THE TABLE YOU CAN SEE THE TOP
PART OF THE SLIDE SUMMARIZES
WHERE CONCLUSIONS WERE
DEVELOPED.
THE EVIDENCE UNDERLYING THE
CONCLUSIONS AND NOTE WHERE THE
STRENGTH OF EVIDENCE CHANGED
SINCE PREVIOUS REPORTS WERE
CONDUCTED.
YOU CAN SEE FOR ADULTS AND OLDER
ADULTS, ALMOST ALL CONCLUSIONS
ARE COMBGRADES AS STRONG OR MODE
AND THE STRENGTH OF EVIDENCE WAS
UPGRADED FROM LIMITED TO
MODERATE OR MODERATE TO STRONG.
THESE INCLUDE DIETARY PATTERNS
AND TYPE 2 DIABETES UPGRADED
FROM MODERATE TO STRONG AND
COGNITIVE FUNCTION AND DIETARY
PATTERNS WAS UPGRADED FROM
LIMITED TO MODERATE.
FOR CHILDREN AND ADOLESCENTS,
MOST CONCLUSIONS ARE GRADED AS
MODERATE OR STRONG.
FOR ONE CONCLUSION THE STRENGTH
OF EVIDENCE WAS UPGRADED.
THIS IS FROM LIMITED TO MODERATE
AND THIS WAS FOR DIETARY
PATTERNS AND CARDIOVASCULAR
DISEASE.
FOR INFANTS AND YOUNG CHILDREN,
UNFORTUNATELY NO CONCLUSIONS
WERE DEVELOPED DUE TO
INSUFFICIENT EVIDENCE.
THIS IS ONE GROUP WHERE THE
EVIDENCE IS LACKING CURRENTLY.
DURING PREGNANCY, A FEW
CONCLUSIONS WERE DEVELOPED DUE
TO INSUFFICIENT EFFORTS AND
STRENGTH OF EVIDENCE WAS GROUND
GRADED.
SO FROM LIMITED TO GREAT NOT
ASSIGNABLE OR INDICATED NO
ASSOCIATIONS FOUND.
DURING POSTS PARTUM NO
CONCLUSIONS WERE DEVELOPED DUE
TO INSUFFICIENT EVIDENCE.
AND SOME WERE ADDED OR REMOVED
BASED ON THE EVIDENCE SO THIS
SHOWS SOME EXAMPLES.
SEVERAL DIETARY PATTERNS WERE
GRADED TO INCLUDE HIGHER UPTAKES
OF LEGUMESING , LEGUMES AND
PLEATS AND --
LEGUMES, BEANS AND NUTS AND THE
COMMITTEE CAREFULLY CONSIDERED
THE CONCLUSIONS THEY DREW FROM
THE SYSTEMATIC REVIEW WITH
MULTIPLE LIFE STAGES AND HEALTH
OUTCOMES AND FOUND DIETARY
PATTERN EMERGED CONSISTENT
RELATED TO BENEFICIAL HEALTH.
THE HEALTHY DIETARY PATTERN FOR
INDIVIDUALS AGES 2 AND OLDER IS
CHARACTERIZED BY DIETS THAT ARE
HIGHER IN VEGETABLES, FRUITS,
LEGUMES, NUTS, WHOLE GRAINS,
FISH, SEAFOOD AND VEGETABLE OILS
HIGHER IN UNSATURATED FAT AND
LOWER IN RED AND PROCESSED
MEATS, REFINED GRAINS AND
SATURATED FAT AND SUGARS.
SOME HEALTHY DIETARY PATTERNS
ALSO INCLUDE CONSUMPTION OF LOW
OR NON-FAT DAIRY AND FOODS LOWER
IN SODIUM AS NOTED IN SPECIFIC
SYSTEMATIC REVIEW CONCLUSION
STATEMENTS.
THIS AND THE FOLLOWING SLIDE HAD
GUIDANCE TO THE DEPARTMENTS AND
MOSTLY READING FROM THE SLIDES
I'LL GO THROUGH.
FIRST IS EMPHASIZE CONSUMPTION
OF VEGETABLES, FRUITS, LEGUMES
INCLUDING BEANS, PEAS AND
LENTILS, WHOLE GRAINS, NUTS AND
FISH OR SEAFOOD.
AND CONTINUE TO EMPHASIZE
CONSUMPTION OF LOW FAT OR
NON-FAT DAIRY AND UNSATURATED
FATS.
LIMIT CONSUMPTION OF RED OR
PROCESSED MEATS, REFINED GRAINS,
FOODS HIGH IN SATURATED FAT AND
SALTY SAVORY SNACKS.
AND CONTINUE TO LIMIT FOODS HIGH
IN SUGARS AND SWEETENED
BEVERAGES AND FOODS.
INCLUDING MORE NEWT REVENT DENSE
PLANT-BASED MEAL AND DIETARY
OPTIONS.
ENCOURAGE CONSUMPTION OF HEALTHY
DIETARY PATTERNS AND MAINTAIN
EXISTING GUIDANCE THAT
EMPHASIZES INTAKES OF IRON,
FOLATE, FOLIC ACID, IODINE AND
CHOLINE AMONG PREGNANT AND
POSTPARTUM PERSONS.
SO THEY WERE ASSOCIATED WITH
GESTATIONAL GAIN AND DIABETES
AND SMALL FOR GESTATIONAL AGE IN
INFANTS.
THOSE WERE THE BASIS FOR THE
RECOMMENDATION.
AND FINALLY, ENCOURAGE
CONSUMPTION OF HEALTHY DIETARY
PATTERNS AT ALL STAGES OF LIFE
AND FOR DIVERSE POPULATIONS.
THANK YOU.
I'LL TAKE DISCUSSION TIME.
>> THANK YOU, ED AND THANK YOU,
DEANNA FOR STARTING OFF THE
DISCUSSION ON DIETARY PATTERNS
PARTICULARLY AS WE HAD OUR PRIOR
DISCUSSION EMPHASIZING THE
IMPORTANCE OF INTEGRATING THE
SYSTEMATIC REVIEWS WITH THE DATA
ANALYSIS.
WITH THAT I'LL OPEN UP TO THE
DISCUSSION QUESTIONS FROM THE
TEAM.
>> GREAT PRESENTATION.
IT'S SUCH A FUN TOPIC TO
DISCUSS.
AT THE BEGINNING OF THE YEAR
IT'S FRUSTRATING TO USE DIETARY
PATTERNS AS A TERM.
BECAUSE I THINK THE PUBLIC
PERCEIVES OR LOOKS AT THIS AS
MEDITERRANEAN AND KETO AND OTHER
PATTERNS AND IT'S CONFUSING BY
FOLLOWING UP WHAT WE MEAN IS
MEDITERRANEAN OR LOW-FAT BUT
IT'S STUNNING THE SAME GROUP
THAT PROPOSED TO GET MORE OF AND
LESS OF.
DOES IT REALLY HAVE A NAME?
SO THIS IS A PRETTY CHALLENGING
AREA AND IT'S GOING TO COME UP
LATER IN THE DISCUSSION OF 75
MINUTES BLOCKED OFF FOR IT.
I LOOK FORWARD TO THAT
DISCUSSION BUT MY FIRST COMMENT
WILL BE FOR THE PUBLIC LISTENING
JUST HOW CHALLENGING THAT TOPIC
IS TO SUBJECT WE HAVE MOVED FROM
NUTRIENTS TO FOODS TO PATTERNS
AND PATTERNS IS MORE INCLUSIVE,
ALLOWS MORE FLEXIBILITY AND
CREATES A WHOLE OTHER LEVEL OF
CONFUSION WHEN YOU'RE NOTE BEING
REALLY SPECIFIC ABOUT WHICH
PATTERN IT IS.
SO I THINK THIS WILL CONTINUE TO
BE A GREAT OPPORTUNITY AND
SOMEWHAT OF AN OPEN CHALLENGE TO
COMMUNICATE TO THE PUBLIC AND
HOW TO IMPLEMENT THAT AND LOOK
FORWARD TO THE DISCUSSION LATER
TODAY OF THE SAME TOPIC.
>> THANKS, CHRISTOPHER.
I THINK WHEN YOU LOOK ACROSS THE
DIETARY PATTERNS THOUGH, THOUGH
THEY HAVE DIFFERENT NAMES AS YOU
MENTIONED THERE'S CORE FOODS
THAT KEEP POPPING UP AGAIN AND
AGAIN.
THOSE ARE REALLY STRONG AND
YOU'LL SEE THAT REPRESENTED
LATER WHEN WE TALK ABOUT THE
INTEGRATION.
THEN YOU CAN HAVE DIFFERENT
FLEXIBILITIES AS YOU MENTIONED.
DO YOU EAT MEAT OR NOT EAT MEAT?
SOME WILL COME UP LATER.
>> THANK YOU FOR A WONDERFUL
PRESENTATION.
I HAD A COUPLE QUESTIONS WITH
ADVICE TO THE DEPARTMENT AND
ENCOURAGING LOW FAT AND NON-FAT
DAIRY AND LIMIT SATURATED FAT.
I WAS WONDERING IF THAT IS A
COMBINED STATEMENT OR IF THERE'S
SOMETHING VERY SPECIFIC TO THE
DAIRY YOU WANTED TO POINT OUT?
THAT'S ONE OF THE QUESTIONS.
WHEN WE TALK ABOUT BEVERAGES
TOMORROW YOU'LL HEAR MORE ABOUT
DAIRY CONSUMPTION.
WE KIND OF WENT ALONG WITH THAT
ADVICE AND WHAT WE SAW IN THE
DIETARY PATTERNS AS WELL.
THE ADVICE FOR CHILDREN, THIS
WASN'T A WHOLE LOT THERE.
THERE WAS MORE IN THE BEVERAGES
GROUP.
AND CHRISTOPHER WILL TALK ABOUT
DAIRY BUT IN ADULTS THE
SATURATED FAT CONTENT.
>> THANK YOU.
AND MAYBE THAT'S WHERE MY OTHER
COMMENT WAS WHICH IS ARE WE
GOING TO SPECIFY AGE GROUP FOR
THE RECOMMENDATIONS BECAUSE IT
MAY NOT BE APPLICABLE ACROSS THE
LIFE STAGE.
THANK YOU.
>> I WANT TO BUILD ON THAT
COMMENT, ALLINE BECAUSE THIS IS
FASCINATING AND PRETTY UNIQUE
WHEN IT CAME UP IN THE PATTERNS
FOR THE CARDIOVASCULAR DISEASE
FOR THE FIRST TIME WE HAD ENOUGH
STRONG EVIDENCE TO LOOK AT
HEALTH EQUITY ISSUES.
WHEN WE SEPARATED OUT
POPULATIONS OF DIFFERENT RACE
ETHNICITY AND SOCIO ECONOMIC
POSITION, ONE OF THE INTERESTING
THINGS THAT CAME UP WAS THE
DAIRY GROUP WAS LESS CONSISTENT
THAN IT HAD BEEN OVER ALL-.
SO THERE WERE FEWER TIMES WHEN
DAIRY SHOWED UP NOT JUST LOW FAT
OR NON FAT OR SATURATED FAT BUT
AS A CATEGORY SHOWED UP LESS
CONSISTENTLY THAN IT HAD FOR THE
REG VEGGIES AND LEGUMES AND
BEANS AND PEAS AND WHAT CAME UP
FOR CULTURAL DIVERSITY IS THE
PREVALENCE OF LACTOSE IN
TOLERANCE AROUND THE WORLD.
YOU REALLY NEED TO HAVE DAIRY AS
PART OF THAT.
AND WE FOUND IN SOME MUCH THOSE
POPULATIONS, NO, THAT ACTUALLY
WASN'T PART OF THE PATTERN.
IT WASN'T AS CONSISTENT AS OTHER
PLACES BUT IT COULD BE.
THERE'S POPULATIONS WHERE IT WAS
PART OF THE PATTERN.
IT'S INTERESTING AND IT'S QUITE
SUBTLE BUT IT'S REALLY IMPORTANT
THAT THE DAIRY CATEGORY GOT
MOVED OUT OF THIS IS PART OF THE
PATTERN TOO AND COULD BE PART OF
THE PATTERN.
THE REST OF THAT FRAYED WAS IT
WASN'T ALWAYS PART OF THE
PATTERN WHEN IT WAS SOMETHING
LIKE A RACIAL GROUP THAT MIGHT
HAVE BEEN EXPERIENCING LACTOSE
IN TOLERANCE AND DOESN'T HAVE TO
BE THERE.
I DON'T KNOW IF ANYBODY WANTS TO
BUILD ON THAT.
THERE'S AN INCREDIBLE
OPPORTUNITY WE HAD SINCE WE HAD
ENOUGH DATA FOR A STRONG
CONCLUSION AND TO GO BEYOND
THAT.
AND TO LOOK AT THAT DIFFERENT
PERSPECTIVE.
THANKS FOR LETTING ME SHARE
THAT.
>> AND I'LL REITERATE WE DID
FIND DAIRY FOR CERTAIN
POPULATIONS.
THAT WAS IN THERE.
I THINK ONE OF THE ISSUES THAT
WE FOUND IS A LOT OF TIMES WHEN
DAIRY WITH US IDENTIFY WE DIDN'T
DISTINGUISH BETWEEN THE FAT
CONTENT OF THE DAIRY AND
SOMETIMES GO IN DIFFERENT
DIRECTIONS WHICH MADE IT HARD TO
COME UP WITH A CONSISTENT
RECOMMENDATION.
>> THIS RELATED TO ULTRA
PROCESSED FOODS.
WE DID HAVE THIS QUESTION.
CAN YOU DESCRIBE THE LIMITATION
OF THE DATA.
IT WAS FRUSTRATING.
THERE WAS A LOT OF PUBLIC
COMMENT WE RECEIVED ON THIS
PARTICULAR QUESTION.
I WAS WONDERING IF YOU CAN TALK
ABOUT THAT AND IF YOU HAVE
SPECIFIC RESEARCH
RECOMMENDATIONS REGARDING THIS
QUESTION.
LIKE FOR FUTURE COMMITTEES JUST
TO CONSIDER FOR THE RESEARCH
COMMITTEE IN GENERAL SO THEIR
BODY OF EVIDENCE CAN BE
CONSIDERED BY FUTURE COMMITTEES.
>> SO, WHEN WE STARTED THAT
SYSTEMATIC REVIEW, ONE OF THE
ISSUES WAS HOW DO YOU CLASSIFY
ULTRA PROCESSED FOODS BECAUSE
THERE'S SEVERAL CLASSIFICATION
SCHEMES RIGHT NOW.
KNNOVA IS THE MOST WELL KNOWN B
THERE ARE OTHERS AND WANTED TO
BE MORE INCLUSIVE AND LET THE
AUTHORS DETERMINE WHAT IS MEANT
BY ULTRA PROCESSED FOODS AND HAD
OTHER FOODS SHOW UP BUT IT WAS
HARD TO COME UP WITH A SUCCINCT
DEFINITION FOR ULTRA PROCESSED
FOODS AND THAT'S NOT AVAILABLE
IN THE LITERATURE NOW THOUGH
SEVERAL GROUPS ARE WORKING
TOWARDS THAT RIGHT NOW.
SO I THINK UNTIL WE GET A BETTER
DEFINITION FOR WHAT WE MEAN AS
ULTRA PROCESSED FOODS, IT'S
GOING TO BE DIFFICULT TO LOOK AT
THIS.
THE OTHER ISSUE WAS A LOT OF THE
STUDIES WE REVIEWED FROM OTHER
COUNTRIES AND WHAT WE HAVE FROM
ULTRA PROCESSED FOODS MAY BE
DIFFERENT FROM WHAT YOU FIND
HERE.
THERE ARE SEVERAL ISSUES
ASSOCIATED WITH THAT.
ED, I DON'T KNOW IF YOU WANTED
TO SAY SOMETHING MORE ABOUT
THAT.
>> I THINK YOU COVERED IT WELL.
IT'S OBVIOUSLY AN IMPORTANT
ISSUE BUT IT'S MORE A QUESTION
OF HOW IT'S BEING STUDIED AND
IT'S A RELATIVELY NEW AREA OF
RESEARCH ALL THE FOODS WOULD NOT
BE CONSIDERED HEALTHY FOODS BY
STANDARD DEFINITION AND WE DO
MENTION NO SUGAR AND SWEETENED
BEVERAGES, ITEMS LIKE THAT
LIKELY CONSIDERED ULTRA
PROCESSED FOODS INDIRECTLY
BECAUSE PART OF THE PATTERN
RATIONALE IS NOT JUST WHAT
YOU'RE EATING BUT WHAT YOU'RE
NOT EATING.
I THINK IT KIND OF COVERS ULTRA
PROCESSED FOODS INDIRECTLY BUT
SOMETHING AS MORE RESEARCH IS
COMING OUT IN THE FUTURE WE'LL
BE ABLE TO MAKE MORE DIRECT
STATEMENTS REGARDING IT.
>> SARAH.
>> CAN CHRISTOPHER, DID YOU WANT
TO FOLLOW UP ON THE TOPIC OF
ULTRA PROCESSED FOODS BECAUSE I
HAVE A QUESTION ON A DIFFERENT
TOPIC.
>> I DID WANT TO FOLLOW UP ON
ULTRA PROCESSED FOODS.
WE HAD AN OPPORTUNITY TO WORK ON
AN AMERICAN HEART ASSOCIATION
PAPER THAT UNFORTUNATELY WON'T
COME OUT FOR MONTHS SO WON'T ADD
TO THIS DIRECTLY BUT THE PUBLIC
IS INTERESTED IN THIS BECAUSE
IT'S ALL OVER THE MEDIA.
IT SEEMS LIKE SUCH A TIMELY
OPPORTUNITY TO ADDRESS THIS
GIVEN WE'RE ADVISING THE DIETARY
GUIDELINES FOR AMERICANS AND
MOST THE PUBLICATIONS ARE
OBSERVATIONAL STUDIES,
PROSPECTIVE COHORT STUDIES FROM
DATA FROM 30 AND 40 YEARS AGO.
WE HAVE TWO ISSUES.
ONE IS WE DIDN'T HAVE THE LEVEL
OF ULTRA PROCESSED FOODS 20, 30
YEARS AGO SO THEY WEREN'T THERE.
AND THE SECOND ONE IS THE MOST
CLEARLY DEFINITION IS NOVA.
IT'S NOT AS MUCH AS NUTRIENTS AS
THE PURPOSE OF THE INGREDIENTED
AND THE MAIN IS COSMETIC
ADDITIVES AND THE OTHER OF NO OR
RARE CULINARY USED ONLY IN
INDUSTRIAL SETTINGS.
YOU WOULDN'T FIND IT IN A RE
RESTAURANT OR AT HOME.
IT'S AN EXTENSIVE LIST.
IT'S SO EXTENSIVE NOBODY'S HAD
TIME TO LOOK AT EACH ADDITIVES
ONE AT A TIME.
THEY'RE ALL GROUPED TOGETHER.
THEY'RE NOT IN THE DATA SETS.
AS PEOPLE MOVE FORWARD IN
STUDIES, THEY'RE LOOKING WHAT IS
IN THE FOOD FREQUENCY
QUESTIONNAIRE DATA COLLECTED AND
ASSUMING THE ULTRA PROCESS OF
ONES ARE IN THIS GROUP AND THIS
GROUP BUT THERE'S A HUGE
LIMITATION IN THE ASSESSMENT AND
CONCLUSIONS YOU CAN DRAW.
UNFORTUNATELY AS MUCH AS THE
PUBLIC IS SEEING THIS IN THE
HEADLINES AND UNTIL WE HAVE
BETTER TOOLS FOR DEFINING IT BUT
FINDING THE FOODS WE KNOW WE
HAVE THE COSMETIC ADDITIVES.
THAT'S A LONG WAY OFF.
WE CAN MAKE PRACTICAL
RECOMMENDATIONS AT THE THIS IS
TOO I AM -- TIME BUT THERE'S
DIFFICULTIES WITH ASSESSMENT IS
WOULD BE MY COMMENT.
>> I THINK YOU DID A NICE JOB
LAYING OUT THE CONCLUSION
STATEMENT WE REACHED.
>> SO MY QUESTION TO THE
SUBCOMMITTEE IS DRIVEN BY YOUR
SLIDES WHERE YOU SUMMARIZED ALL
THE SYSTEMATIC REVIEWS AND AGE
GROUPS WHERE EVIDENCE WAS GRADED
AS VERY STRONG.
YOU ALSO OUTLINED SYSTEMATIC
REVIEWS AROUND LIFE STAGE WHERE
THERE WASN'T DATA TO DRAW
CONCLUSIONS FROM.
AS WE MOVE FORWARD AND AS WE
GIVE ADVICE, WE ADD A LOT OF
THINGS THAT WE WOULD REALLY
RECOMMEND FOR FUTURE COMMITTEES
BUT WE TEND NOT TO SAY WHAT WE
WOULD TAKE OFF.
SO BASED ON ALL THESE REVIEWS,
ARE THERE TOPICS THE
SUBCOMMITTEE BELIEVES MAY NOT BE
NECESSARY TO PRIORITIZE IN
FUTURE COMMITTEES WHILE WE FOCUS
ON OTHER QUESTIONS?
>> I CAN GIVE SUGGESTIONS AND
OTHERS CAN CHIME IN.
WHAT WE DID ON CARDIOVASCULAR
DISEASE AND THE FACT IT'S BEEN
STRONG FOR SO MANY ITERATIONS, I
THINK THAT ONE MAY BE A QUICK
SCAN TO SEE IF ANYTHING NEW IS
HAPPENING IN THE FIELD SOW MAKE
SURE YOU'RE NOT MISSING A NEW
DEVELOPMENT THAT'S LAHAPPENED.
THE TYPE II DIABETES AND DIETARY
PATTERNS GOT MOVED TO STRONG.
I THINK I WOULD KEEP THAT ON
THERE FOR ANOTHER YEAR AND
ANOTHER ITERATION.
I THINK SOME OF THE -- YOU COULD
LOOK AT SOME OF THE CANCER
ASSOCIATIONS ARE MODERATE.
YOU COULD MAYBE SKIP A YEAR,
MAYBE NOT WITH COLORECTAL CANCER
GIVEN TRENDS WE'RE SEEING.
PRIORITIZING THE CHILDREN AND
PREGNANT INDIVIDUALS AND
POSTPARTUM EVEN IN WHAT I
MENTIONED.
SO FOR CBD WITH CHILDREN WE JUST
UPGRADED IT TO MODERATE.
I REALLY FEEL THAT NEEDS TO BE
LOOKED AT AGAIN IN PREGNANT AND
POSTPARTUM WOMEN.
THOSE ARE WHAT I WOULD CONSIDER.
UNLESS WE HAVE A BETTER
DEFINITION OF ULTRA PROCESSED
FOODS WE MIGHT TABLE THAT ONE.
THOSE ARE MY INITIAL THOUGHTS.
BUT OTHER MEMBERS OF THE
SUBCOMMITTEE FEEL FREE TO JUMP
IN.
DIDI.
>> I AGREED WITH YOU, DEANNA
RESPECTFULLY UNTIL THE ULTRA
PROFES
PROCESSED FOOD COMMENTS IN FIVE
YEARS THAT GOES AWAY AND WE'LL
HAVE MORE CLINICAL EXPERIMENTAL
AND EVIDENCE.
THE DEFINITION FOR HEALTH
OUTCOME IT'S FOR EXCLUSIVELY
DELINEATING TECHNIQUES.
THE INTENT IS WHAT IT IS.
FOR THE NEXT FIVE YEARS OF THE
RESEARCH WILL EXPLODE.
IT WILL BE MORE OF A PRIORITY.
AS WE MOVE TOWARDS A MORE
ACCEPTABLE DEFINITION IS ONE IS
NEEDED OR ONE THAT COULD BE MORE
EASILY COMMUNICATED IF THAT'S
NECESSARY IN THE END.
AND WE FELT IT WAS MORE THE
VOLUME OF LITERATURE BEING
SPARSE THAN THE DEFINITION ALONE
EXPLAINING THAT.
WE RAN INTO THAT SAME ISSUE WITH
ALL THE PATTERNS WE LOOKED AT
BEING VAGUE OR NOT QUANTITATIVE.
IN FIVE YEARS, HOPEFULLY THIS
ISN'T PUNTED AGAIN FOR ANOTHER
FIVE BUT AND I AGREE WITH ALL
THE OTHER POINTS YOU RAISED.
>> MORE TRIAL DATA WOULD BE
HELPFUL BECAUSE WE DIDN'T SEE
MUCH TRIAL DATA IN WHAT WE
LOOKED AT THIS ROUND.
GOOD COMMENTS.
SAMEERA.
>> SO I THINK THE FUTURE
COMMITTEES SHOULD CONSIDER OLDER
ADULTS OR CONDITIONS THAT
SPECIFICALLY AFFECT THEM.
THIS TIME AROUND WE WERE NOT
ABLE TO PRIORITIZE SARCOPENIA OR
FRAILTY BECAUSE WE DIDN'T HAVE
ENOUGH STUDIES.
THOUGH I UNDERSTAND SARCOPENIA
NEEDS A CLINICAL DIAGNOSIS, I DO
THINK THE FUTURE COMMITTEES
SHOULD THINK OF GRIP STRENGTH
AND DISABILITY AS OUTCOMES AND
TRY TO ANSWER QUESTIONS OF
DIETARY PATTERNS WITH
AGE-RELATED OUTCOMES.
>> VERY GOOD POINT.
>> I WANT TO MENTION WHAT YOU
SAID AROUND THE LITERATURE AND
SPACE IS GOING TO CONTINUE TO
GROW AND I THINK WE NEED TO KEEP
A LENS ON NOT JUST WHAT NOT TO
EAT BUT WHAT PEOPLE SHOULD BE
EATING.
AS THE LITERATURE GROWS WE'LL
SEE SOME EVIDENCE AND IF WE'RE
GOING TO MAKE SOME SHIFTS AROUND
THE TYPES OR THE AMOUNTS OF
ULTRA PROCESSES FOODS THAT ARE
BEING CONSUMED WE ALSO KNOW WHEN
THOSE SHIFTS HAPPEN, WHAT PEOPLE
ARE LIKELY TO REPLACE THEM WITH.
WE KNOW FROM OTHER NUTRIENTS OF
CONCERN FROM OVER CONSUMPTION
THERE'S A REPLACEMENTS AND
DISPLACEMENT ISSUE WE NEED TO
THINK ABOUT SO THE AMERICAN
PEOPLE CAN HAVE THINGS TO DO AND
NOT JUST THINGS NOT TO DO.
>> ANY OTHER COMMENTS?
IF THERE ARE NO OTHER COMMENTS,
DEANNA AND ED THANK YOU OFF AND
TO THE SUBCOMMITTEE AND STAFF.
I KNOW WE'LL BE HEARING MORE
TOMORROW SO THANK YOU VERY MUCH.
THIS IS REALLY INTERESTING.
SO, OUR NEXT SPEAKER IS GO TO BE
CHRIS TAYLOR WHO IS GOING TO BE
REVIEWING THE THREE FACTORS THAT
RELATE TO FOOD PATTERN
MODELLING.
INSTEAD OF ITEMIZING EACH ONE,
CHRIS, I'LL LET YOU TAKE IT AWAY
BECAUSE YOU'LL BE THE BEST TO
EXPLAIN HOW EACH OF THESE ARE
ITERATIVE AND RESULT IN WHO WILL
BE A GREAT DISCUSSION THIS
AFTERNOON.
THANK YOU, TAKE IT AWAY.
>> TO CHERYL'S COMMENT AROUND
WHAT HAPPENS WHEN YOU TAKE
SOMETHING OUT AND WHAT THE
SUBSTITUTION ENDS UP BEING,
ETCETERA.
SO IT GIVES US A CHANCE TO TALK
THROUGH THE STEPS WE HAD FOR THE
FOOD PATTERN MODELLING ANALYSIS
AND HOW WE WENT THROUGH WITH OUR
INCREMENTAL PROCESS TO GET TO
THAT PHASE.
AGAIN, THIS WAS A MASSIVE
UNDERTAKING BY OUR SUBCOMMITTEE
AND STAFF TO SUPPORT US THINKING
ABOUT IT AS A PERSON WHO USES
THIS DATA ON A REGULAR BASIS.
WE'RE TALKING ABOUT NUMEROUS
PUBLICATIONS WORTH OF ANALYSES
DONE AND DESCRIBED OVER THE LAST
SEVERAL PUBLIC MEETINGS.
AND SYSTEMATIC REVIEWS.
THE CURRENT REVIEWS ARE NOT
ALIGNED WITH DIETARY
RECOMMENDATIONS.
WHEN WE LOOK AT THE SYSTEMATIC
REVIEWS THEY'RE HIGHER IN SOME
COMPONENTS AND LOWER IN OTHERS.
IT DOESN'T MEAN THE DIETARY
PATTERNS TRANSLATE INTO A FULL
AND COMPLETE NUTRIENT PROFILE
AND DIETARY PATTERN RECOMMENDED
WITHIN THE DIETARY GUIDELINES.
SO THIS PROCESS AND TALKING
ABOUT OUR NUTRIENT NEEDS AND
OVERCOME THE THEMES WITH DATA
ANALYSIS AND PRESENTATIONS TO
REALLY HAVE THAT FOUNDATIONAL
DIETARY PATTERN THAT WILL ALLOW
US TO MEET NUTRIENT NEEDS WITHIN
OUR ENERGY RECOMMENDATIONS.
THIS IS A PROCESS FOR FOOD
PATTERN REMODELLING AND THESE
SERVE AS THE ANCHOR FOR EACH OF
THE CHAPTERS TO DEMONSTRATE THE
WORK WE'VE DONE AND STARTED WITH
THE NUTRIENT PROFILE DEVELOPMENT
AND THEN ANALYZED HYPOTHETICAL
MODIFICATIONS TO FOOD GROUPS AND
SUB GROUPS AND/OR DIETARY
PATTERNS AND THIRD, SYNTHESIZE
THE RESULTS AND DRAFTED A
MODIFIED DIETARY PATTERN.
SO TODAY'S CHAPTER OVERVIEW
WE'LL COVER THE FIRST THREE
STEPS OVER THE COMPONENTS WHICH
WILL HELP US ANSWER THIS OVER
ARCHING QUESTION AT THE END OF
CONSIDERATION EACH STAGE OF LIFE
SHOULD CHANGES BE MADE TO THE
U.S. DIETARY PATTERNS AND SHOULD
ADDITIONAL DIETARY PATTERNS BE
DEVELOPED.
SO HERE WE'RE GOING TO START
WITH CHAPTER 9 WHICH IS THE
NUTRIENT PROFILE DEVELOPMENT.
CHAPTER 9 HAS THE APPROACHES WE
TOOK TO CARRY THIS OUT.
THIS BECOMES OUR FUNDAMENTAL
PIECE IN HOW WE DEVELOP THE
DIETARY PATTERNS IN THE NUTRIENT
PROFILES THAT THEN ALLOW US TO
TEST EACH ONE OF THE DIFFERENT
FOOD GROUPS AND DEVELOP THE
PATTERN ITSELF.
THESE ARE THE APPROACHES WE USED
AS A COMMITTEE TO REALLY FOCUS
ON FOODS, NUTRIENT FOODS AND
BEVERAGES TO CONTRIBUTE TO THE
NUTRIENT PROFILE CALCULATIONS
AND WAY WAY -- A WAY TO EXPLORE
IF NUTRIENT DENSITY SHOULD BE
INCLUDED FROM THE NUTRIENT
PROFILE.
WE COMBINED THEM WITH IN
ESTIMATED PROFILE AND DEVELOP
PATTERNS THAT BALANCE THE NEED
FOR NUTRITIONAL GOALS FOR
ADEQUACY AND MODERATION.
HOW DO WE TALK ABOUT THAT
POTENTIAL SUBSTITUTION?
ADDITIONALLY RECOMMENDING
NUTRIENT DENSE VERSIONS WITH THE
LEAST AMOUNT OF ADDED SUGAR AND
FAT AND SODIUM.
HOW DO WE CREATE THE PROFILE
THAT REPRESENTS THESE FOODS?
AND WHETHER THEY CONTRIBUTE TO
NUTRIENT PROFILES DUE TO
PRESENCE OF ADDED SUGAR OR FAT
OR SODIUM SHOULD BE INCLUDED
FROM CONTRIBUTING.
SO FOR EXAMPLE, LOWER FAT OR
REDUCED SUGAR ICE CREAM COULD BE
USED IN DEVELOPING THE PROFILE
FOR DAIRY AND FORTIFIED SOY BUT
WOULD STILL CONTAIN ADDED SUGAR
AND SATURATED FAT AND BE HIGHER
IN CALORIES COMPARED TO OTHERS
IN THE FOOD GROUP.
ALTERNATIVELY, ICE CREAM COULD
BE INCLUDED FROM THE DEVELOPMENT
OF THE NUTRIENT PROFILE ALL
TOGETHER.
THE ADDITIONAL ASPECT IS WITH
THE HEALTH EQUITY LENS DEVELOP
PROFILES FROM THE TOTAL
POPULATION LEVEL.
LOOKING AT THE CONSUMPTION OF
FOODS AND BEVERAGES BASED ON
NHANES CONSUMPTION DATA AND THAT
PROPORTIONAL CONTRIBUTION ALLOWS
US TO UNDERSTAND WHAT FOODS AND
BEVERAGES ARE COMMONLY CONSUMED
AND HAVE A POPULATION-BASED
PROFILE THAT REPRESENTS THAT
TOTAL POPULATION AND THERE'S A
LIFE STAGE APPROACH FOR THE
NUTRIENT PROFILES WITH THE
PROPORTIONAL CONSUMPTION WITH
AGE GROUPS AND WITH THE STRATEGY
ON HEALTH EQUITY AND LOOKING AT
THAT PERSPECTIVE THEN WANTED TO
ASK THE QUESTION AND DEVELOPING
NUTRIENT PROFILES FOR POPULATION
GROUPS RACE OR ETHNICITY OR
FEDERAL PROGRAM ELIGIBILITY AND
WOULD THEY BE DIFFERENT THAN
USED FOR A TOTAL POPULATION
ANALYSIS?
THIS ALLOWED US TO EVALUATE THE
GENERALIZABILITY OF A SINGLE
U.S. POPULATION NUTRIENT PROFILE
OR IF POPULATION GROUPS WOULD BE
NECESSARY OR HELPFUL.
AND SCIENTIFIC QUESTIONS WE'RE
ANSWERING WITHIN THE FOOD
PATTERN MODELLING ANALYSIS.
SHOULD FOODS AND BEVERAGES WITH
LOWER NUTRIENT DENSITY REPRESENT
FOODS AND THE NUTRIENT PROFILES
FOR EACH FOOD GROUP AND SUB
GROUP IN MODELLING THE USDA
340E8D MODELLING PATTERNS AND
THE DIFFERENCE BETWEEN THE
NUTRIENT PROFILES CALCULATED
WITH DIETARY INTAKES WITH THE
TOTAL POPULATION OR POPULATION
GROUPS?
AND WITH LOTS OF DATA AND
CONTINUING TO EVALUATE WHAT
TYPES OF CHANGES MIGHT HAPPEN
LOOK AGING -- LOOKING AT THE
TOTAL POPULATION CONSUMPTION
STARTING WITH THE HEALTHY
U.S. STYLE DIETARY PATTERN THAT
HAS AN AND LOOKING AT FOODS
NUTRIENT DENSE IN OUR ANALYSIS
INCLUDING DESERTS, CANDIES OR
OTHER SWEETS FROM THE NUTRIENT
PROFILE HAD MINIMAL OR LITTLE OR
NO CHANGE WITH MOST THE FOOD
GROUPS AND SUB GROUPS BUT SAW
DIFFERENCES IN THE CATEGORIES OF
FOODS THAT HAD IMPLICATIONS FOR
DAIRY AND FORTIFIED SOY
ALTERNATIVES AND ALSO FOR GRAINS
WOULD BE ADDRESSING SAY ICE
CREAM OR GRAIN-BASED DESERTS
THAT MAY BE HIGHER IN SATURATED
FAT AND ADDED SUGAR.
SO WE HAD NEGLIGIBLE CHANGES IN
THE NUTRIENT PROFILES ASPECT.
WHEN YOU'RE USING NUTRIENT DENSE
FOODS TO CAPTURE THE PROFILES
THEY'LL HAVE LIMITED SUGAR AND
SATURATED FAT SO WE WOULDN'T
EXPECT TO SEE LARGE DIFFERENCES
IN THE NUTRIENT PROFILES
ESPECIALLY WITHIN THE FOOD GROUP
THEMSELVES BUT ALLOWED US TO
TIGHTEN UP THE PROFILES MORE AND
IDENTIFY WHEN WE ARE FOLLOWING
THE RECOMMENDATIONS FOR LESS
INTAKES OF SATURATED FAT AND
SUGAR AND THE REMOVAL OF SOME OF
THE FOODS LESS NUTRIENT DENSE
WOULD ALLOW US TO GET A SLIGHTLY
TIGHTER NUTRIENT PROFILE
ESPECIALLY WHEN TRYING TO MEET
NEEDS WITHIN CALORIE GOALS AND
LINK THAT BACK TO OUR DATA
ANALYSIS FINDINGS AROUND THE
RATES OF OBESITY IN THE U.S. SO
ENERGY BALANCE WOULD BE AN
IMPORTANT CONSIDERATION.
AND CAPTURE THE NUTRIENT FRO --
PROFILES BY RACE AND ETHNICITY
AND SOCIO ECONOMIC POSITION IN
NHANES USING INCOME MEASURES
FROM FEDERAL ASSISTANCE
USABILITY AND THIS ANALYSIS WAS
SET TO FOCUS ON THE SEVERAL
STEPS THAT TOOK INTO ACCOUNT THE
VARIATION IN DIETARY INTAKE
BECOMING OPPORTUNITIES FOR THE
FUTURE.
AND THERE'S INDIVIDUAL
POPULATION GROUPS TO AVOID THE
POSSIBILITY OF EXACERBATING
INADEQUACIES AMONG NUTRIENT OF
CONCERNS.
THE NUTRIENT PROFILES DIDN'T
CHANGE AND WEREN'T TOO DIFFERENT
SO MOVING FORWARD WITH A SINGLE
PROFILE WAS GOING TO TO BE A
VIABLE AND USEFUL OPTION BUT WE
THEN WANTED TO BE ABLE TO CHECK
AFTER THE FACT WHEN WE DO OUR
PROFILE STEPS LATER WHICH WE'LL
TALK ABOUT IN CHAPTER 10, TO
DETERMINE DID IT CREATE
ADDITIONAL GAPS THAT MIGHT BE
UNINTENDED FROM USING A TOTAL
U.S. POPULATION PROFILE.
OUR DRAFT FUTURE DIRECTION FROM
THE WORK LOOKING AT WAYS TO
ADVANCE FOOD PATTERN MODELLING
BY ALIGNING THE NUTRIENT PROFILE
WITH THE MAJORITY CONSUMPTION
FROM NUTRIENT DENSE SOURCE.
WE'RE TRYING TO DEVELOP WHAT
INDIVIDUALS ARE CONSUMING AND
IDENTIFYING THE PATTERNS AND
USING THAT TO CALCULATE THE
NUTRIENT PROFILE BUT THEN
TESTING THE GENERALIZABILITY
FROM THE TOTAL POPULATION INTO A
MORE DIVERSE U.S. POPULATION.
WHAT ARE THINGS WE NEED TO
ACCOMPLISH THIS AND FUTURE
DIRECTIONS.
ONE, DO WE HAVE A HIGHLY
VALUABLE WITH WHAT THE AMERICAN
DATABASES WE TALKED ABOUT THE
IMPORTANCE OF NHANES AND DIETARY
INTAKE DATA AND WHAT IT PROVIDES
FOR US IN TERMS OF KEEPING A
FINGER ON THE PULSE OF THE
U.S. DIETARY INTAKE.
BUT AT THE SAME TIME, OUR FOOD
SUPPLY IS CHANGE IING RAPIDLY A
THE QUALITY OF DATA WE EXPECT
FROM THE DATABASE BUT BEING ABLE
TO STAY NIMBLE MEANS WE'LL NEED
MORE RESOURCES NECESSARY TO KEEP
US WITH THE MARKET TRENDS BUT
ALSO PROVIDE US WITH THE QUALITY
OF DATA AND THE BREADTH OF DATA
WE HAVE WITHIN THESE.
MANY OF THESE EFFORTS ARE
ONGOING BUT IT IS A CONTINUAL
CHALLENGE WHICH WE'LL TALK ABOUT
A LITTLE BIT MORE IN CHAPTER 10
AND NUTRIENT PROFILE
CALCULATION, EVERY TIME YOU GO
IN AND START THE PROCESS THERE
ARE ALWAYS A FEW THINGS YOU
LEARN AND IDENTIFY, A FEW WAYS
WE CAN DO THINGS SLIGHTLY
DIFFERENTLY.
ONE OF THOSE WAS ADDRESSING
LABELLING MIXED DISHES.
HOW DO MIXED DISHES FIT WITHIN
THE PROFESSION?
THEY'RE DISAGGREGATED INTO THEIR
INDIVIDUAL INGREDIENTS BUT ALSO
INGREDIENTS WITHIN MIXED DISHES
THAT DON'T COUNT TOWARDS FOOD
GROUPS SUCH AS SAUCES AND
CONDIMENT S AND THINGS LIKE THA.
IT'S A WAY TO GRAPPLE WITH THE
HEALTH EQUITY LENS AND CULTURAL
FOOD WAYS AND HOW IT CARRIES
FORWARD AND ALSO IMPLICATIONS
FOR ENRICHMENT AND FORTIFYING OF
FOODS WITHIN NUTRIENT PROFILES
BECAUSE WE'RE LOOKING AT A
DATABASE TRYING TO ASSESS A
POINT ESTIMATE FOR A FOOD THAT
DOES REPRESENT THE BROADER
REPRESENTATION OF FOODS AND
BEVERAGES IN THE FOOD SUPPLY.
SO THERE WILL BE DIFFERENCES IN
FORTIFICATION AND ENRICHMENT
ACROSS VARIOUS FOOD PRODUCTS,
GRAINS, ALSO WITHIN OUR
FORTIFIED DAIRY ALTERNATIVES.
SO BEING ABLE TO CAPTURE
INFORMATION AROUND ENRICHMENT
AND FORTIFICATION BECOMES AN
IMPORTANT FACTOR IN TRACKING THE
FOODS AND BEVERAGES.
SO, THIS CHAPTER THEN DESCRIBES
HOW WE DEVELOPED THE NUTRIENT
PROFILES WE'LL USE.
THIS REVISED NUTRIENT PROFILE
WITH THE EXCLUDED DESERTS,
CANDIES AND SWEETS ARE
GENERALIZABLE TO INDIVIDUAL
POPULATION GROUPS AND ALIGNED
WITH THE GOAL OF THE MODEL
NUTRIENT DENSE FOODS AND THE
REVISED NUTRIENT PROFILES USED
IN ANALYSES DESCRIBED IN CHAPTER
10 AND SERVICE THE FOUNDATION
FOR THE HYPOTHETICAL
MODIFICATION ANALYSES.
SO, AT THIS TAKE I WILL INVITE
THE COMMITTEE TO TURN ON THEIR
CAMERAS AND DISCUSS.
COMMENTS AND DISCUSSION.
>> THANK YOU, CHRIS AND THANK
YOU TO THE STAFF AND TO THE
STEAM.
THIS IS GREAT, GREAT WORK.
I THINK LAYING IT OUT THIS WAY
WILL HELP THE EVOLUTION OF THE
DECISIONS OF THE GROUP.
QUESTIONS FOR CHRIS ON THIS?
CHRIS, I THINK EVERYONE IS
WAITED WITH BATED BREATH FOR
CHAPTER 10 AND LET'S GO TO THAT
AND WE'LL DO QUESTIONS THEN.
KEEP 'EM GOING.
>> OKAY.
TRANSITIONING BACK.
MOVING ON TO CHAPTER 10 THE FOOD
GROUP ANALYSIS AND THIS IS OUR
OPPORTUNITY WITHIN THE ANALYSIS
TO REALLY LOOK AT THE INDIVIDUAL
FOOD GROUPS LOOKING AT THE
SUBGROUPS WE HAVE THAT MAKE UP
THIS DIETARY PATTERN AND ALLOWS
US TO TURN ALL THE LEVERS AND
SEE WHAT HAPPENS IF WE HAVE MORE
OR LESS OF SOME ITEMS.
SOME IMPLICATIONS.
WE'VE HAD A LOT OF PUBLIC
COMMENT AND FEEDBACK AROUND
SPACES OF CONSUMING MORE OR LESS
OF CERTAIN THINGS WITHIN THE
DIETARY PATTERNS SYSTEMATIC
REVIEW WE JUST HEARD ABOUT.
THERE WAS A CONSIDERATION
DISCUSSION AROUND CONSUMING MORE
OR LESS OF CERTAIN THINGS.
WHAT DO WE DO WITH SUBSTITUTION?
SO THIS REALLY ALLOWS US TO LOOK
AT EACH ONE OF THE INDIVIDUAL
SECTIONS AND WHAT HAPPENS WHEN
WE PULL THE LEVERS AND WHAT IS
THE IMPLICATION OF THAT FOR
NUTRIENT INTAKES AND REALLY HOW
THIS ADDRESSES DIETS OF PUBLIC
HEALTH INTEREST.
SO WE'RE GOING TO START WITH THE
FOOD GROUPS AT THE TOP AND THEN
WE'LL CONTINUE ON TO EXPLORATORY
ANALYSES AROUND REMOVING
ANIMAL-BASED FOODS AND OTHER
GROUPS AND IT WILL ALLOW US TO
COMPARE THOSE TO OUR POPULATION
GROUPS AND DETERMINE IF THERE
WERE ANY UNEXPECTED CHALLENGES
THAT MIGHT OCCUR WITHIN THE
POPULATION GROUPS THEMSELVES.
THERE WERE PATTERNS THAT MET
NUTRITIONAL GOALS WITH FEW
EXCEPTIONS.
THESE PATTERNS, THESE USDA
DIETARY PATTERNS THAT CREATED
THE CORNERSTONE OF THE WORK THAT
WE'RE CONDUCTING AND PRESENTING
HERE WHERE THE HEALTHY DIETARY
GUIDE AN AND VEGETARIAN PATTERN
AND MEDITERRANEAN STYLE PATTERN.
CHAPTER 10 EXPLORE THE
IMPLICATIONS IN MEETING GOALS.
IF WE SHIFT THE QUANTITIES OF
FOOD GROUPS AND SUB GROUPS
MOSTLY TESTING ON THE 2020
U.S. STYLE OR HUSS PATTERN IF
FLEXIBILITIES SHOULD BE MADE TO
THE EXISTING PATTERNS OR NED NEW
DIETARY PATTERNS TO ADDRESS
DIFFERENT EATING STYLES.
GROUPS ARE ALIGNED ON KEY
NUTRIENT CONTENT.
SO, WHEN WE MAKESHIFTS WITHIN
THESE FOOD GROUPS AND SUB
GROUPS, THEY'RE GOING TO BE
SUBSEQUENT NUTRIENT CHANGES
WITHIN THAT.
WHEN DIETARY CHANGES ARE
PROPOSED THERE'S AN IMPLICATION
ON THE NUTRIENT CONTENT OF THE
DIET AND THE ROLE OF
SUBSTITUTION BECOMES JUST AS
IMPORTANT AS THE REMOVAL OR
ADDITION IN THE DIETARY PATTERN
AND LOOK AT THE INDIVIDUAL
GROUPS AS EACH FOOD GROUP AND
SUBGROUP AS INDIVIDUAL GROUPS
AND SEE FURTHER AND SEE HOW WE
USED THEM TO ASSESS THE CHANGE.
A COUPLE TERMS TO BE CLEAR WHEN
WE TALK ABOUT MODIFICATIONS
VERSUS FLEXIBILITIES VERSUS.
DIETARY PATTERN MODIFICATIONS
THE COMMITTEE OPERATIONALIZED
THE TERM MODIFICATIONS AS ANY
PROPOSED CHANGE TO THE FOOD
GROUP OR SUBGROUP QUANTITIES
THAT SHOW UP IN THE PATTERN.
HOW MANY CUP EQUIVALENTS ARE
NEEDED PER DAY.
IF WE MADE A CHANGE TO ONE OF
THE FOOD GROUPS IT WOULD BE A
MODIFICATION TO THE PATTERN THAT
WOULD EXIST ACROSS ALL SEX
GROUPS DEPENDING CHANGES WE
PROVIDE.
THE PATTERN FLEXIBILITIES WERE
OPERATIONALIZED AS NARRATIVE
ADVICE FOR NUTRIENT NEEDS
OUTSIDE THE QUANTITATIVE
RECOMMENDATIONS.
WHAT KINDS OF FLEXIBILITIES
MIGHT THERE BE WITHIN FOOD
GROUPS AND HOW FOOD GROUPS MIGHT
BE USED DIFFERENTLY WITHIN A
FOOD GROUP TO STILL MEET THE
NUTRIENT GOALS BUT CREATE
OPPORTUNITIES FOR INDIVIDUALS
ACROSS DIFFERENT CULTURAL FOOD
WAYS, DIETARY PREFERENCES,
INTOLERANCES, AVOIDANCES TO
THEIR OWN PATH TO MEETING THE
DIETARY PATTERN.
AND THE FINAL TERM IS DIETARY
PATTERN VARIATIONS THE CREATION
OF A NEW DIETARY PATTERN.
BUT ULTIMATELY THE COMMITTEE
DOES NOT PROPOSE THE ADDICTION
OF ANY NEW DIETARY PRAT --
PATTERNS AND WILL ROUND OUT OUR
DISCUSSIONS.
THE COMMITTEE STARTED WITH THE
U.S. 2020 HEALTHY STYLE PATTERN
EVALUATED BY PREVIOUS
COMMITTEES.
AND IS A FAIRLY NUTRIENT DENSE
PATTERN FOLLOWING THE DIETARY
GUIDANCE.
WHAT THIS ALLOWS US TO DO IS
TAKE A UNIQUE OPPORTUNITY TO
LOOK AT WHAT-IF SCENARIOS AND
BUILD ON CURRENT DIETARY
GUIDELINES BUT TO EXPLORE
MODIFICATIONS AND FLEXIBILITIES
THAT COULD BE INTRODUCED IN AND
BETWEEN FOOD GROUPS TO ENHANCE
DIETARY GUIDANCE FOR
INDIVIDUALS.
THIS GIVES US A CHANCE TO BRING
THIS HEALTH EQUITY LENS TO
EXPLORE DIFFERENT COMBINATIONS
OF FOODS WITHIN FOOD GROUPS AND
SUBGROUPS TO MAXIMIZE THE
CAPACITY FOR HEALTHY DIETARY
PATTERNS AND TO ADDRESS
INDIVIDUAL DIFFERENCES WHILE
OPTIMIZING HEALTH.
THIS REALLY GAVE US AN
OPPORTUNITY TO INTEGRATE
SYSTEMATIC REVIEW THROUGH THE
HEALTH EQUITY LENS AND ASSESS
GROUPS TO MAXIMIZE THE CAPACITY
FOR OPPORTUNITIES.
FOOD PATTERN ANALYSES IN LOOKING
AT THE HYPOTHETICAL CHANGES TO
THE DIETARY PATTERNS ONE THE
FOOD GROUPS AND SUB GROUPS AND
EXPLORATORY ANALYSES WHEN
DETERMINING THE DEGREE TO WHICH
NUTRITIONAL GOALS MAY BE MET
AFTER THE REMOVAL OF FOOD GROUPS
OR SUBGROUPS.
LOOKING AT THE IMPLICATIONS FOR
FORTIFIED SOY ALTERNATIVE FOOD
GROUP QUANTITIES AND INTAKES
WHEN FOOD AND BEVERAGE SOURCES
ARE REPLACED WITH NON-DAIRY
ALTERNATIVES AND INTAKES WHEN
MODIFYING THE FOOD GROUPS
QUANTITIES.
THE IMPLICATIONS WHEN MODIFYING
THE VEGETABLE QUANTITIES WITHIN
THE HUSS AND MODIFYING THE GRAIN
GROUPS AND IMPLICATIONS FOR
NUTRIENT INTAKES WHEN STAPLE
GRAINS ARE EMPHASIZED OR WHEN
THE GRAIN GROUP IS REPLACED WITH
OTHER STABLE CARBOHYDRATES?
AND IMPLICATIONS FOR QUANTITIES
OR THE HEALTHY VEGETARIAN
DIETARY PATTERN AS WELL AS THE
IMPLICATIONS FOR NUTRIENT
INTAKES WHEN I PROPORTION ANIMAL
BASED PROTEIN AND ARE DECREASED
AND PLANT-BASED FOODS ARE
INCREASED AND WHAT QUANTITIES OF
FOODS AND BEVERAGES CAN BE
ACCOMMODATED IN THE U.S. DIETARY
PATTERNS WHILE MEETING NUTRIENT
GOALS WITHIN CALORIE LEVELS?
THEN TWO EXPLORATORY QUESTIONS
CAN NUTRIENT GOALS BE MET WHEN
AND ANIMAL SOURCES HAVE BEEN
REMOVED FOR AGES 2 YEARS AND
OLDER AND CAN NUTRIENT GOALS BE
MET WHEN CARBOHYDRATE REDUCED
BASED IN THE HUSS AND THIS WILL
LOOK AT THE ITEMS ARE REMOVED TO
LOOK AT WHAT REPLACEMENT FOODS
ARE NEEDED TO REPLACE THE
NUTRITIONAL GAPS THAT EMERGE.
STARTED POINT FOR THE EVALUATING
WHAT TO DO TO EXPLORE
MODIFICATIONS AND FLEXIBILITIES
INTRODUCED TO ENHANCE GUIDANCE
FOR INDIVIDUALS.
THE INTEGRATION OF DIFFERENT
FOODS AND BEVERAGES AND MAXIMIZE
FLEXIBILITIES OF THE HEALTHY
DIETARY PATTERNS WHILE
OPTIMIZING HEALTH.
THE COMMITTEE EXAMINED FOOD
GROUP INDEPENDENTLY TO NOT
INTRODUCE BIAS IN FOOD PATTERN
MODELLING.
FIRST THE ANALYSES EMPHASIZED
THE IMPORTANCE OF VARIETIES FOR
MEETING NUTRITIONAL GOALS.
AGAIN, THE FOOD GROUPS AND
SUBGROUPS ARE LINKED ON SIMILAR
NUTRITIONAL COMPOSITION.
AS WE LOOK AT POTENTIAL
REDUCTION OR REMOVAL OF FOOD
GROUPS, YOU'LL THEN SEE THE
NUTRIENTS THAT YOU DON'T CONSUME
WITHIN ZERO.
WHEN YOU REMOVE FOODS AND FOOD
GROUPS YOU'RE REMOVING
NUTRIENTS.
AND WHAT WITH FOUND WAS THE
PATTERN AS PREVIOUSLY NOTED AND
WHAT THE MODIFICATIONS WE LOOKED
AT IN DIFFERENT WAYS NUTRIENT
GOALS CAN BE MET THROUGH A
HEALTHY DIETARY PATTERN.
BUT NUTRIENT DENSITY BECOMES A
REALLY IMPORTANT FACTOR
ESPECIALLY IN THE LOWER CALORIE
LEVELS WHEN THERE'S A LOT LESS
WIGGLE ROOM WITHIN THE FOODS
THAT CAN BE CONSUMED BEFORE
CALORIES BEGIN TO ADD UP.
SO YOU'RE TRYING TO MAXIMIZE
NUTRIENT NEEDS WITHIN A LIMITED
AMOUNT OF CALORIES.
IT THEN BRINGS US TO THE KEY
FACTORS OR KEY PIECES FROM THE
ANALYSES THAT WE FOUND.
THERE'S A VARIETY OF CALORIE
LEVEL AND WE'RE LOOKING AT A
NUTRIENT PROFILE OF NUTRIENT
DENSE FOODS ACROSS THE WEIGHTED
VALUE BASED ON WHAT THE
CONSUMPTION IS.
AND LESS PLASTIC TO HAVE A WIDER
RANGE OF CALORIE LEVELS.
YOU CAN STILL MAKE
NUTRIENT-DENSE CHOICES WITHIN A
FOOD GROUP AND SUBGROUP BUT FOR
FOODS WITH A HIGHER CALORIE
LEVEL WITH THE FOOD IT MEANS
EXTRA CALORIES THAT EXIST THAT
WOULD BE CALORIES FOR OTHER U
GROUPS THAT BECOME LESS PRECISE
AND THOSE WITH A CALORIE LEVEL
WITHIN FOOD GROUPS AND SUBGROUPS
PROVIDES A CHALLENGE TO CREATE A
NUMBER THAT SAYS THIS IS HOW
MANY CALORIES IS LEFT OVER WITH
NUTRIENT DENSE FOOD CHOICES.
SO IS FOOD PATTERN MODELLING IS
AN IMPORTANT TOOL FOR DIETS OF
INTEREST AND TO HELP INFORM
FUTURE DIRECTIONS SUCH AS
ADDITIONAL DIETARY IN TAKE DATA
AND PRIORITIYIES FOR REPLACEMEN
FOODS WHEN NUTRIENTS MAY BE
REMOVED AND IDENTIFIED WITHIN
THE QUESTIONS WHEN YOU REMOVE
INDIVIDUAL FOOD GROUPS, THE
NUTRIENTS THAT GO WITH THEM MAY
DISSIPATE.
SO IT BECOMES IMPORTANT TO HAVE
THE EVIDENCE TO DESCRIBE WHAT
THE REPLACEMENT WOULD BE AND
BASED ON NUTRITIONAL GAPS.
IT'S WORK REMINDING THAT THESE
ARE MODIFICATIONS TO BE MODELLED
WITHIN THE PATTERNS.
WE SAW THE CURRENT INTAKES
GENERALLY DO NOT ALIGN WITH
THESE PATTERNS.
THEREFORE THE DIRECTION OF THE
MODIFICATION PLAY NOT APPLY TO
THE DIRECTION NEEDED TO IMPROVE
DIETARY INTAKE.
LIKEWISE, THERE'S NO
MODIFICATION.
WHEN THERE'S NO MODIFICATION
DIETARY INTAKES PLAY -- MAY
NEED TO CHANGE AND LOOKING AT
THE SYSTEMATIC REVIEW EVIDENCE
MAY INDICATE HIGHER OR LOWER
INTAKES BUT MAY NOT BE FULLY
ALIGNED WITH THE DIETARY
PATTERN.
SO THIS OUR CHANCE TO REALLY
LOOK AT THE DIETARY PATTERNS
THEMSELVES, BRING IN THE
SYSTEMATIC REVIEW EVIDENCE TO
HELP IDENTIFY AREAS WHERE
CHANGES OR MODIFICATIONS WOULD
BE IMPLEMENTED AND WHAT THEY
WOULD BE.
IN THIS CASE WE SAW THE BEANS,
PEAS AND LENTILS WAS A RECURRING
THEME THROUGH THE DIETARY
PATTERNS ACROSS THE DIFFERENT
HEALTH OUTCOMES AS WELL AS
REDUCING INTAKES OF RED AND
PROCESSED MEAT FROM THE
SYSTEMATIC REVIEW EVIDENCE AND
LOOKING AT THE DATA INCREASING
ENERGY FROM BEANS, PEAS AND
LENTILS MODIFICATION WHEN WE
INCREASE THE PROPORTION OF
BEANS, PEAS AND LENTILS FROM THE
TOP PORTION, INCREASING BEANS,
PEAS AND LENTILS INCREASED THE
CALORIE LEVELS OFFSET BY A
DECREASE IN STARCHY VEGETABLE AS
THE CHANGE ADDRESSED NUTRIENT
NEEDS AS WELL AS THE CALORIE
LEVELS THEMSELVES.
PREVIOUS COMMITTEE HAD TO
ADDRESS A HIGHER A.I. FOR
POTASSIUM AND STARCHY VEG --
VEGETABLES AND SINCE IT WAS
RELEASED THE A.I. FOR POTASSIUM
HAS BEEN DECREASED.
SO STARCHY VEGETABLES WERE THE
HIGHER LEVEL OF VEGETABLES
WITHIN THE GROUP AND WITH THE
INCREASE TO MEAT THE POTASSIUM
GROUP NOW LOWER WE'RE ABLE TO
LOOK AT IT WITH STARCHY
VEGETABLE TO MAINTAIN OUR
VEGETABLE RECOMMENDATIONS BUT
LOOK AT A SHIFT IN IMPROVING
SOME NUTRIENT OUTCOMES AND
POTENTIAL HEALTH OUTCOMES FROM
SYSTEMATIC REVIEWS IN THE
PATTERN.
AND AS WELL THE VARIATION IN
ENERGY AMONG ENERGY-DENSE FOODS
AS I MENTIONED CREATED A
CHALLENGE IN IDENTIFYING WHAT
THE POTENTIAL CALORIE LEVELS
MIGHT BE.
SO OUR DRAFT RECOMMENDATION WAS
TO REMOVE THE CALORIES FOR OTHER
USES AND TO CONTINUE TO PROMOTE
CONSUMPTION OF NUTRIENT-DENSE
FOODS TO MEET THE DIETARY
PATTERN.
AND THE ANALYSES JUST PRESENTED
RELIED ON A SINGLE
POPULATION-BASED NUTRIENT
PROFILE THAT WAS REFLECTING THE
PROPORTIONAL INTAKES OF THE
TOTAL POPULATION.
IN A SECOND STEP WE APPLIED THE
INDIVIDUAL POPULATION NUTRIENT
PROFILES AND THERE WERE NO
DIFFERENCES IN THE FEW NUT
RENT -- NUTRIENTS THAT WELL
NUTRITIONAL GOALS WE WERE ABLE
TO ASSESS THEM BY RACE OR
ETHNICITY OR INCOME AND FEDERAL
NUTRITION PROGRAM PARTICIPATION
MIGHT GIVE US DIFFERENT OUTCOMES
BUT WE HAD FAIRLY CONSISTENT
FINDINGS THE PROFILES.
AS WE LOOK AT THE FUTURE
DIRECTIONS OF THESE FOOD PATTERN
MODELLING EXERCISES AND LOOKING
AGENTS THE DIFFERENT FOOD
GROUPS, CONTINUING TO EXPLORE
THE REPRESENTATION OF POPULATION
GROUPS WITHIN THE U.S. USING
FOOD PATTERN MODELLING WILL BE A
USEFUL ADDITION TO IDENTIFYING
WHAT FOODS AND BEVERAGES WITHIN
FOOD GROUPS AND SUBGROUPS WILL
HELP MEET NUTRIENT GOALS WITHIN
VARIOUS POPULATIONS WITHIN THE
U.S.
AND CONTINUING ADVANCING THE
FOOD PATTERN MODELLING
METHODOLOGY TO INCORPORATE BIO
AVAILABILITY AND ACCESSIBILITY
WAS ANOTHER CONCERN WE DISCUSSED
IN TERMS OF NUTRITIONAL
COMPOSITION WITHIN THE FOOD
DATABASES THAT TELL US HOW MUCH
OF A NUTRIENT EXIST BUT MANY
FACTORS THAT DICTATE BIO
AVAILABILITY AND ACCESSIBILITY
BEYOND THE SCOPE OF WHAT THE
DATABASES CAN PROVIDE SO MORE
RESEARCH IS NEEDED IN THAT SPACE
TO UNDERSTAND AND ASSESS THE
IMPLICATIONS OF DIFFERENT
SOURCES OF NUTRIENTS AND HOW
THAT MAY PLAY IN THE DIETARY
PATTERN AND NUTRITIONAL
ADEQUACY.
THIS HELPS US TO DEPLOY PROFILES
WITHIN THE GROUPS AND
MODIFICATIONS TO BE MADE WITHIN
THE HUSS 2020 DIETARY PATTERN
AND THE EYE TOWARDS MEETING
NUTRITIONAL GOALS THE LIFE
STAGES, AGE AND SEX GROUPS AND
PATTERN MET THE GOALS WITH FEW
EXCEPTIONS.
DIET SIMULATIONS WILL BE IN THE
NEXT CHAPTERS.
>> WHY DON'T WE STOP HERE,
CHRIS, AND HAVE DISCUSSION.
THE DISCUSSION LENDS ITSELF TO
CHAPTERS 9 AND 10 AND THANK YOU
VERY MUCH FOR CLEARLY OUT LINING
THE PROCESS IT'S INCREDIBLY
HELPFUL TO US BECAUSE IT'S AN
AREA WE'RE MOST FAMILIAR WITH.
LET'S OPEN UP THE QUESTIONS.
>> YOU TALKED ABOUT THE LACK OF
WIGGLE ROOM IN THE LOWER CALORIE
RANGES.
I'M WONDERING WHAT YOU THINK
THIS MEANS FOR GUIDANCE AND
DIRECTS TOWARDS INDIVIDUALS IN
POPULATION AND ACROSS THE
POPULATION AND THINKING OF
CHILDREN UP TO 24 MONTHS, YOUNG
CHILDREN AND WHAT IS YOUR SENSE
OF WHAT YOUR FINDINGS MEAN FOR
GUIDANCE AROUND NUTRIENT-DENSE
CHOICES?
>> I THINK PARTIALLY IT'S A
JUXTAPOSITION BETWEEN WHERE WE
NEED TO BE AND THE DIETARY OR
DATA ANALYSIS JUST SHOWS WHERE
OUR CURRENT CONSUMPTIONS ARE.
WITH THE RATES OF OBESITY AND
CROSS POPULATION GROUPS THE
BALANCE OF MEETING OUR NUTRIENT
NEEDS WITHIN CALORIE LEVELS
BECOMES A CONSIDERABLE TUG AND
PULL.
I KNOW I MENTIONED THIS IN ONE
OF OUR PREVIOUS PUBLIC MEETINGS
THAT THIS IS KIND OF OUR LOWEST
CALORIE LEVEL WITHIN THE AGE SEX
GROUPS THAT ADDRESS THE EER, THE
AMOUNT OF ENERGY NEEDED WITHIN
THE GROUPS FOR SEDENTARY
INDIVIDUALS.
ONCE AGAIN, WE'RE GENERALLY
SEDENTARY AS A POPULATION SO
INCREASING PHYSICAL ACTIVITY
ADDS INTO FLEXIBILITY WITHIN THE
DIET FOR HIGHER CALORIE LEVELS.
SO YOU KIND OF HAVE THAT PIECE
BUT IT ALSO REALLY FOCUSES ON
THE NEED FOR NUTRIENT DENSE
LOWER SATURATED FAT, LOWER ADDED
SUGAR, LOWER SODIUM FOODS
AVAILABLE AND LINKS BACK TO OUR
PREVIOUS CONVERSATIONS WE'VE HAD
TODAY AROUND HOW DO WE GET TO
BEING ABLE TO HAVE DIETARY
PATTERNS THAT MINIMIZE THE
ADDITIONAL CALORIES AND GIVE US
THE PUNCH OF NUTRIENTS WE NEED
TO MEET THIS WIDE ARRAY OF
NUTRIENTS WE HAVE FOR OUR DRIs
TO OPTIMIZE AND PROMOTE HEALTH
AND THEN YOUR QUESTION PROMOTE
GROWTH AND DEVELOPMENT AND SETS
THE YOUNG CHILDREN ON A
HEALTHIER PATH TO ADULTHOOD.
>> CHRISTOPHER.
>> MIND BLOWING.
JUST ALWAYS DAZZLING WHEN YOU
PRESENT.
JUST AMAZING.
I'M STILL GOING TO VOICE WHAT I
HAD AN ISSUE WITH SINCE THE
BEGINNING ABOUT SOME OF THE
QUESTIONS AND EXPLORATORY
QUESTION 7 AND 8 ESPECIALLY
BUILDING ON ABOUT WHAT WAS JUST
SAID, THE CALORIES AND NUTRIENTS
AND NOT ENOUGH ROOM FOR EVEN A
COOKIE BUT HOW MUCH WE NEED
VARIETY TO MEET ALL THE NUTRIENT
NEEDS.
SO I WOULD STRONGLY SUGGEST
MOVING FORWARD FOR QUESTION 7
AND 8 THAT THEY NOT BE MOVED
FORWARD AS THE QUESTIONS THEY
ARE ARE BOTH ADDRESS MEETING THE
NEEDS THE FOODS WITHOUT
REPLACING AND IT'S AN
IMPOSSIBLE.
HERE'S A STARTING POINT.
IF WE WERE GOING TO ARE MOVE OR
REDUCE THESE FOODS, WE'D NEED A
SECOND STEP WHICH IS DAUNTING.
WHAT WOULD YOU REPLACE THEM WITH
AND THERE'S HUNDREDS OF WAYS TO
REPLACE THEM BUT WON'T COME TO
CONCLUSION KNOWING IN OTHER
PATTERNS WE NEED ALL THE FOODS
TO MEET ALL THE NUTRIENTS.
I THINK THE MESSAGING OF THAT OF
WHAT NUTRIENTS IS MISSING AND
I'M CLEARLY VERY SPECIFICALLY
INTERESTED IN TAKING THE HEALTHY
VEGETARIAN AND HEALTHY PATTERN
AND REMOVING THE ANIMAL SOURCES
OF FOOD.
YES, THAT WOULD RESULT IN
NUTRIENT DEFICIENCIES BUT THE
ANSWER TO THAT QUESTION SHOULD
BE AFTER REPLACING THEM WITH
SOMETHING, WOULD THEY STILL BE
MISSING?
I'D STRONGLY EMPHASIZE WE WORD
THOSE 7 AND 8 QUESTIONS
CAUTIOUSLY MOVING FORWARD.
THANK YOU.
>> WE HAD REVISED THE WORDING OF
THOSE QUESTIONS AS WE MOVED IN
AND STARTED TO WRITE THE
PROTOCOLS BECAUSE THE GAP WE HAD
IN THE SCIENCE FOR REMOVING OF
ANIMAL AND THE INDIVIDUALS MAY
AVOID ANIMAL PRODUCTS FOR A
VARIETY OF REASONS, ONE IS
HEALTH, RELIGIOUS, ETHICAL,
SOCIAL MEDIA, WHATEVER THE
REASON MAY BE AND WHAT THEY EAT
IN REPLACE OF THAT ISN'T ALWAYS
BASED OWN HEALTH OR REPLACEMENT
DECISION AS AN EXCLUSION.
FOR US TO MAKE ASSUMPTIONS
AROUND WHAT SHOULD GO BACK IN
WAS LESS SCIENTIFIC.
WE NEEDED TO IDENTIFY WHAT
HAPPENS WHEN THE CHANGES
OCCURRED AND REMOVAL OCCURRED
AND THE GAPS AND HELPS INFORM IF
THE FUTURE, IF THIS GOES AWAY,
WHAT RESEARCH CAN BE DONE TO
DESCRIBE WHAT THOSE REPLACEMENTS
WOULD BE.
BECAUSE IF YOU ARE REPLACE THEM
WITH PLANT BASED THAT DON'T
REFILL THE COMPONENTS IT DOESN'T
REPLACE.
>> THIS IS MORE OF A
PHILOSOPHICAL QUESTION BUT YOU
WANT TO CONTINUE ON
CHRISTOPHER'S COMMENT.
I DO WANT DO SAY I WOULD ARGUE
THE LOW CALORIES LEVEL LEVELS
PERTAIN TO OLDER ADULTS AND
LITTLE FOCUS HAS BEEN OUT ON THE
AGE GROUP AS WELL.
YOU POINTED OUT THERE'S NOT MUCH
WIGGLE ROOM IN THE LOWER CALORIE
INTAKES BUT YOU REITERATED WHAT
HEATHER PRESENTED AT THE
BEGINNING OF THE DAY THAT THE
AMERICAN POPULATION IS NOWHERE
NEAR WHERE WE SHOULD BE.
THERE'S A HUGE GAP BETWEEN THIS
HYPOTHETICAL IDEAL PATTERN WITH
LITTLE WIGGLE ROOM AND WHAT THEY
ACTUALLY EAT
IT.
IT'S EASY TO DEMONIZE CERTAIN
FOOD GROUPS BUT EVERYTHING IN
MODERATION, RIGHT?
I FEEL LIKE THIS BIG GAP BETWEEN
WHAT PEOPLE EAT AND WHAT WE'RE
SAYING PEOPLE SHOULD EAT, IF WE
KEEP SAYING IT, YOU'LL HAVE TO
EAT AN ENTIRE PATTERN AND CHERYL
YOU SAID IT EARLIER, IF YOU TELL
PEOPLE WHAT THEY OUGHT NOT TO DO
AND WHAT CAN WE SAY IN REGARDS
TO ADVICE TO THE DEPARTMENT OR
SOMETHING IN THAT DIRECTION.
>> AS I WAS LISTENING TO
QUESTIONS EARLIER, THERE'S
DIFFERENT FACTORS PLAYING IN
MAKING THE HEALTHIER OPTION
EASIER.
IT'S OUR FOOD SUPPLY, IT'S THE
ENVIRONMENT IT'S THE TRANSITIONS
THAT HAPPEN ACROSS THE SPECTRUM
OF OUR CONVERSATIONS AROUND HOW
WE GET FOOD FROM FARM TO FORK
AND WHAT GETS ON THE FORK OF THE
INDIVIDUAL AND ALL THE STEPS
THERE MAKING INCREMENTAL STEPS
TO WHERE WE ARE TO WHERE WE WANT
TO BE AND MEETING THE
NUTRITIONAL GOALS USING THAT TO
INFORM OR CHOICES AND POLICIES
AND PROGRAMS AND RESEARCH,
ETCETERA.
>> SO, I'M KIND OF FOLLOWING UP
ON WHAT SARAH AND CHRISTOPHER
SAID AND IT'S AN OPPORTUNITY FOR
FOOD COMPANIES TO MAKE AVAILABLE
THE TYPES OF FOODS THAT WE'RE
PROMOTING IN THE DIETARY
GUIDELINES.
CURRENTLY, YOU GO INTO SOME
STORES OR VENDING MACHINES AND
YOU CAN'T FIND ANYTHING.
EVERYTHING WOULD BE IN THE GROUP
WE'RE TAKING OUT.
SO, I THINK IT'S IMPORTANT FOR
US TO KIND OF GIVE THAT THROUGH
OUT CHALLENGE TO FOOD COMPANIES
TO DO EXACTLY WHAT YOU SAID BUT
HOW DO YOU MAKE IT CONVENIENT
AND ABLE TO COMPETE SO YOU CAN
DO THAT ONE TO ONE REPLACEMENT
THAT CHERYL WAS TALKING ABOUT
EARLIER.
YOU CAN'T DO THE ONE TO ONE
REPLACEMENTS IF YOU DON'T HAVE
SOMETHING TO REPLACE IT WITH.
>> THAT GOES BACK TO DIET AND
CHRONIC DISEASE AND TRYING TO
SOLVE THE CHRONIC DISEASE
WITHOUT THE DIETARY COMPONENT IN
THE POLICY AND THE POLICIES THAT
WE MAKE AND CHANGES THAT WE MAKE
AND POLICIES AND EVERYTHING ELSE
ON THIS SIGHT IMPACT THE LATTER.
IT'S DIFFICULT TO COMBAT THE
OUTCOME WITHOUT ADDRESSING THE
CAUSE.
SO THESE BECOME REALLY THE
FOUNDATIONAL PIECES WE NEED TO
SAY, THIS IS WHERE WE NEED TO BE
AND WHERE WE'RE AT AND IF THIS
IS HOW WE'RE GOING TO MEET
NUTRITIONAL ADEQUACY AND AT THE
SAME TIME SO MUCH OF THE
CONVERSATION IS DON'T EAT THIS
OR THAT OR YOU SHOULD NEVER EAT
THESE AND WHEN WE HEAR THOSE
SUGGESTIONS AROUND DON'T EAT
THIS OR DON'T EAT THAT, WE'RE
TAKING THE NUTRIENTS OUT AT THE
SAME TIME AS WE'RE TAKING THE
FOODS OUT.
AND WHAT WE PUT BACK IN BECAUSE
JUST AS IMPORTANT AS WHAT WE
TAKE OUT.
SO, THIS REALLY GIVES US A
FRAMEWORK TO ASSESS THAT BALANCE
AND WE'RE GOING TO TAKE OUT MORE
REFINED GRAINS LIKE YEAR OVER
CONSUMING FROM OUR DATA
ANALYSIS.
THESE ARE THE WHOLE GRAINS THAT
WE CAN PUT BACK IN.
SO IT GIVES US A SUBSTITUTION
PROCESS TO HELP US IDENTIFY
THINGS THAT WE SHOULD BE EATING
LESS OF AND THINGS WE SHOULD BE
EATING MORE OF AND NOW HAVE A
PATTERN TO HELP US DO THAT.
>> THIS HAS BEEN A FANTASTIC
DISCUSSION AND WITH THIS I'M
GOING TO ASK YOU TALK ABOUT
SOMETHING VERY EXCITING, NO
OTHER COMMITTEE HAS HAD THE
PLEASURE OF WORKING WITHDIET
SIMULATION SO TAKE IT AWAY.
-- WITH DIET SIMULATION.
>> ONE DEEPER STEP OF THE
NERDERY WE HAVE HERE BUT IT'S SO
EXCITING AND SO INNOVATIVE AND
CHAPTER 10 WALKS THROUGH THE
DIET SIMULATIONS , THE NEW
EDITION USED.
HOW DOES THIS FIT WITHIN OUR
WORK OF THE GROUP?
SO I PRESENTED THE MODIFIED
DIETARY PATTERN AT THE END OF
CHAPTER 10 AND CARRY FORWARD TO
EVALUATE AND FINE TUNE THE
PATTERNS THROUGH DIET
SIMULATIONS.
THAT'S OUR THIRD STEP WITHIN THE
PROCESS.
THIS CHAPTER DEFINES THE FIRST
USE OF SIMULATION ANALYSIS BY
THE COMMITTEE TO GENERATE AND
ASSESS RANDOMLY GENERATE AND
ASSESS THOUSANDS OF DIETARY
INTAKES OR DAYS OF DIETS THAT
MEET THE PROPOSED SUBGROUP
AMOUNTS WITH COMBINATIONS OF
FOODS AND BEVERAGESES AWAY --
BEVERAGES AS A WAY TO TEST TO
MEET THE FOOD GROUP AND SUB
GROUPS.
IT'S OUR CHANCE TO TEST THE
PATTERNS IN THE WILD INSTEAD OF
JUST BASED ON THE NUTRIENT-DENSE
REPRESENTATIVE FOODS BUT TO
SIMULATE DIETS FROM THE
COLLECTION OF THIS FOODS AND
BEVERAGES IN THE WHAT WE EAT IN
AMERICA DATABASE AND HOW IT
MEETS OUR NEW -- NUTRITIONAL
GOALS AND ONE THING WE ADDED
BEYOND THE FOODS AND BEVERAGES
CONSUMED BY THE U.S. POPULATION,
A PILOT WAS UNDERTAKEN HERE ALSO
TO SIMULATE FOODS IDENTIFIED AS
INCLUDED IN SELECT AMERICAN
INDIAN AND ALASKAN NATIVE DIETS.
SO THIS PROVIDED AN OPPORTUNITY
TO CONSIDER A WIDER SELECTION OF
GROUPS FROM DIVERSE GROUPS AND
ENVIRONMENTS AS A FIRST STEP IN
MANY TO COME IS THE DEPARTMENTS
CAN USE TO TAKE ON DIFFERENT
FOODS AND BEVERAGES THAT MAKE UP
THE GROUPS AND SEE HOW THE
PATTERNS OR RELATED TO NUTRIENT
ADEQUACY.
SO THE SIMULATED DIETS THAT MET
THE MODIFIED 2020 HUSS WERE
EVALUATED FOR CHANGES IN THE
AMOUNTS OF LOWER NUTRIENT DENSE
DEFINED AS FOODS HIGHER IN ADDED
SUGAR, SATURATED FATS AND
SODIUM.
SO WE LOOKED AT DIFFERENT
AMOUNTS OF NUTRIENT DENSE FOODS
WITHIN THE SIMULATIONS
THEMSELVES.
OUR SCIENTIFIC QUESTION, DO
SIMULATED DIETS THAT MEET THE
UPDATED USDA DIETARY PATTERNS
REFLECTION DIETARY INTAKES
ACHIEVE NUTRIENT ADEQUACY?
SO OUR FINDINGS, DRUM ROLL --
WHAT WE FIND IS THEY WORKED WELL
WITH MEETING NUTRIENT DENSE
FOODS AND SIMULATING FOODS
CONSUMED IN THE U.S. AND AS
INCLUDED IN NATIVE AMERICAN AND
ALASKAN NATIVE DIETS GENERALLY
MEET REQUIREMENTS.
THIS IS A BIG HOORAY AND WE
LOOKED AT THE PATTERNS AND
DETERMINED WHAT HAPPENED WHEN WE
MADE TWEAKS AND CHANGES INFORMED
BY SYSTEMATIC REVIEWS AND PUT
THIS IN THE REAL WORLD SITUATION
WITH SIMULATION AND DIETARY
INTAKE FOR AGE AND SEX GROUPS
AND MET NUTRIENT GOALS AND
LOOKING AT THEM IN WHAT WE EAT
IN AMERICA FOOD GROUPS OR WHAT
WE EAT IN AMERICA DATABASE,
SIMULATING THOSE DIETS MET
NUTRIENT GOALS WITH FEW
EXTENSIONS.
THE ASSESSMENT WITH VARIED
AMOUNT OF NUTRIENT FOODS AND
BEVERAGES WERE MORE LIKELY TO
MEET ADDED SUGAR AND SATURATED
FAT AND ALSO SO IN SODIUM WHEN
WE RESTRICTED FOODS THAT WERE
LOWER IN NUTRIENT DENSITY THAT
WERE HIGHER IN SATURATED FAT AND
SODIUM AND DECREASED THE
PROPORTIONALITY OF THOSE FOODS
TO BE INCLUDED.
AND WITH OUR INITIAL RUN WE DID
NOT INCLUDE SODIUM AND LOOKED AT
SODIUM BEING ACROSS FOODS WITHIN
THE DATABASES.
AND THE FOOD SUPPLY BUT WE DID
IN THE SECOND ROUND LOOKED AT
RESTRICTING THOSE WITH GREATER
THAN 15% OF THE DAILY VALUE EVEN
WITH THE HIGHEST RESTRICTION
LEVEL OF SODIUM AND LOOK AT
RESTRICTION OF LESS NUTRIENT
DENSE FOODS AND THEY WERE MORE
LIKELY TO MEET NOT ONLY THE
NUTRIENT PROFILE BUT ALSO
SATURATED FAT AND SUGAR GOALS
BUT SODIUM WAS STILL ABOVE FOR
MOST THE SIMULATED DIETS.
AS A FACTOR OF ALL THESE WE DID
NOT FURTHER REFINE THE 2020
MODIFIED HUSS AS A RESULT OF THE
SIMULATIONS.
SO, OUR FUTURE DIRECTIONS WITHIN
THE SPACE, IT WAS EXCITING THE
STAFF WERE AMAZING IN HELPING US
GET ALL THIS DATA, FACILITATE
WORKING WITH THE CONTRACTOR TO
DEVELOP AND SET UP THE
INORDINATE AMOUNT OF DECISIONS
OF WHAT TO INCLUDE AND RUN IT
THROUGH AS PART OF OUR
SCIENTIFIC GUIDELINE PROCESS AND
DATA AND LOOK TO SPECIALLY
EXPAND SIMULATION METHODS TO
ADDRESS SOME COMPLEXITIES IN
DIETARY INTAKE DATA, INDIVIDUAL
RECIPES WERE NOT INCLUDED BUT
ALL THE FOODS AND BEVERAGES
EXISTED AS INDIVIDUAL
INGREDIENTS IN THE DATABASE SO
LOOKING AT DIFFERENT WAYS THESE
CAN BE EXPLORED.
AND ALSO FUTURE DIRECTIONS TO
LOOK AT THE REPRESENTATION OF
DIETARY INTAKES OF DIFFERENT
POPULATION GROUPS IN DATA
SOURCES TO BE USED IN
SIMULATION.
SO MANY DIFFERENT FUTURE
DIRECTIONS WITHIN THIS AND OUR
KEY RECOMMENDATIONS HERE ARE
AROUND REFINING THAT DIETARY
SIMULATION METHODOLOGY.
WE HAD TREMENDOUS SUCCESS IN
UTILIZING THIS TO ACHIEVE THE
NUTRIENT GOALS FROM A LENS OF
LOOKING AT THE BROADER FOOD
CHOICES THAT WOULD BE AVAILABLE
WITHIN WHAT WE EAT IN AMERICA
RATHER THAN JUST BASED ON THE
NUTRIENT-DENSE REPRESENTATIVE
FOODS BUT THERE ARE SEVERAL WAYS
AND DECISIONS AROUND THE CUT
POINTS FOR SODIUM FOR SATURATED
FAT OR ADDED SHUGAR AND HOW WE
DEFINED THOSE IN HIGHER OR LOWER
DENSITY MODIFIED AND WAYS TO
EXPAND METHODS OF SIMULATION AND
LOOK AT DIFFERENT POPULATIONS
AND HOW THAT MAY LEAD TO WAYS TO
EVALUATE AND GENERALIZABILITY
AND INCREASE REPRESENTATION OF
DIETARY INTAKES.
SO THE COMMITTEE STRONGLY
RECOMMENDS INCREASING
REPRESENTATION OF DIETARY
INTAKES AT DIFFERENT PONG GROUPS
FOR THE COLLECTION OF DIETARY
INTAKE DATA FROM UNDER
REPRESENTED POPULATIONS AN
REPRESENTATION OF FOODS FROM
DIFFERENT FOOD WAYS AND
NUTRITION COMPOSITION DATABASES
ALLOWING FOR A WIDER BREADTH OF
FOODS TO BE INCLUDED WITHIN THE
SIMULATIONS TO TEST DIFFERENT
CULTURAL FOOD WAYS AND
CONSUMPTION PATTERNS.
CHAPTER 11 GETS TO THE HEART OF
HOW WE CAN TEST THE MODIFIED
2020 HUSS WITH A WIDER SELECTION
OF FOODS AND BEVERAGES THROUGH
DIET SIMULATIONS AND LOOKING AT
WHAT HAPPENED ACROSS MULTIPLE
DAYS AND SIMULATING WEEKS OF
INTAKES OF DIETS ACROSS AGE-SEX
GROUPS THROUGH NUTRIENT-DENSE
FOODS.
WE GOT THE GREATEST LIKELIHOOD
TO MEET NUTRITIONAL GOALS AND
LOOK AT INTEGRATION OF EVIDENCE
ACROSS REVIEWS AND FOOD PATTERN
MODELLING AND DATA ANALYSIS TO
ANSWER THE OVER ARCHING QUESTION
OF SHOULD MODIFICATIONS BE MADE
TO THE EXISTING USDA DIETARY
PATTERN AND ARE NEW PATTERNS
NEEDED.
DISCUSSION?
>> QUESTIONS FOR CHRIS REGARDING
THE DIET SIMULATION?
I'LL START.
I WANT TO THANK THE SUBCOMMITTEE
AND CALL OUT TO THE STAFF WHO
EXPLORED NEW TECHNOLOGIES AND
STRATEGIES AND APPROACHES.
IT WAS REALLY EXCITING A NEW
INITIATIVE FOR THE COMMITTEE.
SO CHRIS, I WANT TO ASK YOU A
QUESTION ABOUT THE SODIUM
BECAUSE I THINK THE SODIUM
SHINES A SPOTLIGHT ON WHAT A LOT
OF THE CONVERSATION TODAY HAS
BEEN AROUND.
YOU COULDN'T DO IT IS WHAT I
HEARD.
WHAT ARE YOUR THOUGHTS ABOUT IT
AND WHAT DO WE RECOMMEND TO THE
FEDERAL AGENCIES BASED ON THE
FINDINGS OF THESE DIET
SIMULATIONS?
>> IT WAS A TOPIC OF OUR
CONVERSATION AT THE SIXTH PUBLIC
MEETING LOOKING AT THE FOOD
SUPPLY.
THE FOOD SUPPLY IS BASICALLY
LOADED WITH SODIUM.
SO MATTER WHERE YOU TURN, IT'S
IN ALL THE FOOD GROUPS AND SUB
GROUPS WHICH MEANS THIS GOES
BEYOND PERSONAL CHOICE.
THIS GOES BEYOND FOOD SELECTION.
THIS GOES TO THE FOODS AVAILABLE
FOR CONSUMPTION IN THE U.S. AND
SOMETHING HAS TO CHANGE AT A
HIGHER LEVEL THAN INDIVIDUAL
CHOICE TO BE ABLE TO ACHIEVE THE
CERR FOR SODIUM.
>> I THINK CHERYL HAS MORE TO
ADD.
>> THANK YOU FOR THE WORK IN THE
SPACE AND MAKING IT CLEAR ON THE
OTHER ASPECTS OF THE DATA
ANALYSIS BECAUSE THE STORY IS
MORE COMPLETE WHEN WE LOOK AT
THE PRESENTATIONS YOU JUST MADE.
AND I THINK SARAH'S QUESTION
REINFORCES IN MY MIND THE
IMPORTANCE OF A FOOD SUPPLY.
THE FOOD SUPPLY THAT INDIVIDUALS
INTERACT WITH IS INCREDIBLY
IMPORTANT.
SINCE 2010, THE GUIDANCE FROM
AUTHORITATIVE PUBLIC HEALTH,
SCIENTIFIC, MEDICAL AGENCIES HAS
REALLY BEEN LET'S GET TO A FOOD
SUPPLY THAT ALLOWS FOR AMERICANS
TO BE ABLE TO DO THIS
PARTICULARLY AROUND SODIUM.
AND WE'VE SEEN RECENT MOVEMENT
AROUND THE VOLUNTARY APPROACH
FROM THE FDA WHERE COMPANIES ARE
BEING ASKED TO GRADUALLY REDUCE
SODIUM IN THE FOOD SUPPLY AND
SEE HOW WE'RE PROGRESSING AND
USE NHANES AND OTHER MONITORING
SOURCES AND SARAH TO YOUR
QUESTION I WANTED TO ADD TO WHAT
CHRIS SAID, PERHAPS THAT
CONVERSATION WILL BE EXTENDED
BASED ON THE WORK THAT WE SEE
HERE AND SO AGAIN JUST CHEERS
FOR REALLY HELPING US TO SEE THE
PICTURE IN A MORE COMPLETE WAY.
>> DIDI.
>> THANK YOU, I COULDN'T AGREE
MORE WITH YOUR CONCLUSION.
IT COMES DOWN TO THE SUPPLY.
AND IF SODIUM'S UP WITH THING WE
CAN IMPROVE, THAT WOULD BE
FANTAS
FANTASTIC.
IT'S ACROSS SO MANY FOODS EVEN
IT WAS A MODERATE JUDGMENT IT --
MODERATE IMPROVEMENT AND THERE'S
AND IF YOU FOLLOW THE PATTERNS
WITH THE TYPICAL CHOICES WHAT DO
YOU GET?
ALL THIS OPTIMIZATION AROUND
BENEFICIAL DON'TS OF DIET AND
NUTRIENTS OF PUBLIC HEALTH
CONCERN, SALT, SUGAR, SATURATED
FAT AGAIN AND AGAIN ALL WENT
THROUGH THE ROOF.
FOLLOWING THE GUIDELINES AND
MORE REAL WORLD VISION WE'RE NOT
TYPICALLY EXPOSED TO DERAILS A
LOT OF THE PROGRESS THE
GUIDELINES IN IT'S OPTIMAL FORM
ARE MEANT TO HAVE.
WITH THE DATA ANALYSIS
PRESENTATION WE SEE EVERYONE IS
SO FAR OFF FROM FOLLOWING THE
GUIDELINES BUT IN OUR SYNTHESIS
AND MODELLING, EVEN IF THEY DID,
THE TYPICAL VERSIONS OF THE
FOODS WE'RE EXPOSED TO ARE
DERAILING THE PROGRESS THAT
WOULD HAVE BEEN MADE BY
FOLLOWING THE RECOMMENDATIONS
FOR ALL THE INDIVIDUAL FOOD
GROUPS.
SO I REALLY LIKE PUTTING THIS
ALL TOGETHER AND IN SO MANY W
WAYS.
SODIUM IS NOT A BEHAVIOR IT'S A
SUPPLY AND I HOPE IT'S
MOTIVATION FOR THOSE THAT HAVE
THE POWER TO IMPLEMENT WHAT THE
SCIENCE IS REPEATEDLY SHOWING TO
DO SO, SO THANKS, CHRIS.
>> GREAT COMMENTS CHERYL AND
DIDI.
OTHER QUESTIONS FOR CHRIS?
CHRISTOPHER.
>> HERE'S AN IDEA FOR MODELLING.
WE HAVE THE CHALLENGE OF WHOLE
GRAINS AND REFINED GRAINS IN
DIFFERENT DIRECTION.
AMERICANS EAT A LOT OF BREAD.
YOU NEED SODIUM TO MAKE BREAD.
I DON'T THINK YOU CAN MAKE BREAD
WITHOUT SOME AMOUNT OF SALT BUT
IT WOULD BE FASCINATING TO COULD
YOU SWITCH FROM REFINED TO WHOLE
NOT JUST 50/50.
WHAT KIND OF 40/60 AND DIFFERENT
SWITCHES CAN YOU MAKE?
DO WE HAVE TO STOP EATING BREAD
WHETHER FAZE IT'S REFINED OR
WHOLE GRAIN BECAUSE SO MUCH IS
IN THERE NOT TO MAKE US HUNGRY
OR THIRSTY FOR IT BUT A REQUIRED
COMPONENT AND COULD BE A
FASCINATING INTEGRATION OF
SODIUM AND BREAD VERSUS VEGGIES
AND BEANS, PEAS AND LENTILS.
>> SO WHEN WE DO MODEL IT, WE'RE
MODELLING THE 50% REFINED GRAIN
AND 50% WHOLE.
IT'S MUCH GREATER THAN THE USUAL
U.S. INTAKE AND HIGHER SODIUM
AND IT WILL BE OFF THE LORE
SODIUM FOODS AND COMBINATION OF
REFINED GRAIN VERSUS WHOLE
GRAIN.
SO PART OF THAT IS UNINTENDED,
BE
BAKES IN AND A -- IT GETS TO THE
COMBINATION OF A POPULATION
LEVEL THE MAGNITUDE OF
CONSUMPTION BECAUSE YOU CAN MAKE
SMALL CHANGES IN SOMETHING
CONSUMED A LOT TO HAVE AN
IMPACT, DIDI WAS SAYING AND LOOK
AT SOME FOODS WITH A LOT OF
SODIUM Y'ALL NEED TO HAVE A LOT
OF SODIUM CONSUMED LESS.
YOU CAN MAKE BIG CHANGES IN SOME
GROUPS AND LESSER IMPACTS AND
SMALL CHANGES IN BROADER
CONSUMPTION GROUPS.
CHERYL.
>> I JUST WANTED TO GO BACK TO
CHRISTOPHER'S POINT BECAUSE WHAT
I DIDN'T MENTION IN MY LAST
COMMENT WAS THAT A LOT OF THE
GUIDANCE THAT'S BEEN NOW SINCE
THE DIETARY GUIDELINES OF 2015
AS WELL AS PRIOR WORK AT THE
NATIONAL ACADEMIES UN2010 HINGES
ON SODIUM AS SAFE STATUS.
YOUR POINT BRINGS UP THE ISSUE
THAT WHEN SODIUM MAINTAINS THIS
STATS IT WOULD BE USED
GRATUITOUSLY AND THE CATEGORY
WEIGHTED APPROACH THAT CHRIS
JUST MENTIONED DIDN'T HAVE TO BE
TAKEN INTO ACCOUNT.
AND SO THE FOOD SUPPLY ISSUE IS
GOING TO NECESSITATE SOME POLICY
SHIFT WHERE THOSE CONTRIBUTING
IN FOODS WHETHER BAKING OR
PICKLING OR USING THINGS FOR
LEMONADE OR OTHER CHEMICAL AND
NECESSARY MEANS STOP AND SAY ARE
WE USING THE AMOUNT OF SODIUM
APPROPRIATE AND SO WHEN WE TALK
ABOUT WHERE WE GO NEXT AND
CAPTURIZATION AS A LOW-HANGING
FRUIT IT FORCES FOOD
MANUFACTURING TO PAUSE AND THOSE
WHO MAKE POLICY TO PAUSE AND TO
SAY IS THIS GENERALLY REGARDED
AS SAFE GIVEN IMPLICATIONS THAT
SODIUM IN HEALTH AND WHAT WE SEE
PLAY OUT IN OUR MODELLING
EXERCISES AND THE AUTHORITATIVE
FINDINGS FROM PUBLIC HEALTH AND
MEDICAL AND NUTRITION AGENCIES.
>> AND JUST THINKING ABOUT THE
POTENTIAL FOR THE NEXT
COMMITTEE.
ONE OF THE THINGS THAT IN
ADDITION TO THE OVER ALL
U.S. POPULATION YOU'RE ABLE TO
TAKE AMERICAN INDIAN AND ALASKAN
NATIVE DIETS AND IN THE FACE OF
LACK OF DATA THAT WAS AVAILABLE.
I GUESS WHAT KIND OF
RECOMMENDATIONS CAN YOU MAKE
ABOUT THE TYPES OF DATA WE NEED
GOING FORWARD IF WE THINK ABOUT
THE CULTURALLY INCLUSIVE
POTENTIAL METHODOLOGY AND WHAT
IS THE POTENTIAL OF EXPANDING
THIS BECAUSE THERE'S PROBABLY A
LOT OF GROUPS WE DON'T HAVE DATA
FOR.
DO YOU THINK IT'S EVEN POSSIBLE
FOR US TO DO AND IF SO WHAT KIND
OF DATA WILL WE NEED WE SHOULD
BE THINKING ABOUT TO MAKE THIS
HAPPEN?
THAT'S WHY DIET SIMULATION AND
THE FULL DATABASE OF ALL THE
FOODS WE EAT IN AMERICA ALLOWED
TO DO THE TOTAL POPULATION AND
FOOD CONSUMPTION AS A WAY TO
TEST SIMULATIONS AND TWO PIECES
THAT NEED TO BE IN PLACE TO
CARRY THOSE STEPS FORWARD IS THE
UNDERSTANDING, THE KNOWLEDGE OF
WHAT FOODS AND BEVERAGES NEED TO
BE INCLUDED.
SO THE RESEARCH THAT REALLY
DEFINES OR IN THIS CASE WHAT WE
HAD AS THE EXPERTISE OF
INDIVIDUALS WITH THE LIVED
EXPERIENCE THAT COULD LOOK AT
THE LIST OF FOODS AND SAY THESE
ARE THE FOODS CENTRAL.
THESE ARE THE FOODS THAT ARE
SOMETIMES INCLUDED AND THESE ARE
THE FOODS THAT WERE NEVER
CONSUMED WITHIN THE CULTURAL
FOOD WAY.
SO, FIRST BEING ABLE TO IDENTIFY
WHAT THE FOODS AND BEVERAGES ARE
AND THEN DO THOSE EXIST WITHIN
OUR DATABASE?
BECAUSE IF WE IDENTIFY THERE ARE
CERTAIN TYPES OF WILD STRAWBERRY
AND WHAT WAS USED IN ITS PLACE,
THAT SORT OF THING.
WHAT ARE FOODS THAT NEED TO BE
ASSESSED, NEED TO BE INCLUDED
AND IS THERE THE NUTRIENT DATA
FOR THOSE FOODS SO YOU HAVE THE
TWO PIECES YOU NEED TO BE ABLE
TO CARRY THAT OUT.
BECAUSE AFTER THAT YOU'VE GOT
THE LIST OF FOODS AND THE
NUTRITIONAL COMPOSITION AND GET
TO DETERMINE WHAT FOODS GET
ADDED IN AND PROPORTIONALLY
BASED ON ALWAYS CONSUMED OR
SOMETIMES PART OF THE CULTURE.
BUT THAT BECOMES INDIVIDUALIZED
FOR EACH POPULATION GROUP THAT'S
BEING ASSESSED.
IT GAVE US A WAY TO START WITH
THIS BUT GIVES A FRAMEWORK TO
THEN CARRY FORWARD FOR THE
POPULATION GROUP AND CARRY A NEW
BATTERY OF FOOD LIST AND
COMPOSITION AND FROM THAT THE
HOURS AND DAYS IT TAKES TO
GENERATE THE OUTCOMES TO BECOME
PROCESS OPPOSED TO DATA
SOURCING.
>> THANK YOU FOR A GREAT
PRESENTATION AND SO MANY GREAT
COMMENTS.
WE HEARD A LOT ABOUT SODIUM SO I
WANTED ECHO A LITTLE BIT OF WHAT
DIDI WAS FOCUSSING ON BECAUSE
WHILE SODIUM IS VERY CLEAR THAT
THE FOOD SUPPLY IS NOT PROVIDING
US WITH WHAT WE NEED IS TRUE FOR
OTHERS.
AND THE FACT THE FOOD SUPPLY HAS
PRODUCTS WHERE THE CONSUMER MAY
THINK IT'S LOW IN SODIUM YET
HIGH IN SATURATED FAT OR SUGAR
AND THEN THEY'RE CONFUSED
BECAUSE THEY ARE MADE THE CHOICE
OF THE SODIUM THEY'RE SUPPOSED
TO HAVE.
AND THAT MAKES IT COMPLICATED
FOR SOMEBODY MAKING THE CHOICE
ON WHAT IS THE BEST OR I LOVE
THE SODIUM STORY IT'S A KEY
STUDY IN MY MIND AND WE NEED TO
BE AWARE IT'S TRUE FOR A LOT OF
OTHER FOOD SUPPLIES AROUND US
FOR THE AMERICAN POPULATION.
>> ABSOLUTELY.
AND ESSENTIALLY WITHOUT THE
NUTRIENT DENSE CHOICES, THE
SATURATED FAT AND ADDED SHUGUGA
AND CALORIES WERE ALL HIGHER.
IT ISN'T JUST ONE DIMENSIONAL.
WE'RE ALWAYS LOOKING FOR A ONE
DIMENSIONAL ANSWER AND NUTRITION
IS FAR MORE COMPLICATED THAN A
SINGLE NUTRIENT AT THE TIME.
AND SOMETIMES WE'RE TRYING TO
MAKE A LOT OF DECISIONS ON
TRYING TO ADDRESS ONE PROBLEM
AND WHEN YOU ADDRESS ONE PROBLEM
IT MAY LEAD TO CHALLENGES IN
OTHER SPACES.
THIS IS WHERE THE INTENT AND
CARRY-THROUGH OF POLICY IS
IMPORTANT.
IF EVERYONE REMOVES SODIUM AND
PUTS SOMETHING ELSE IN, WHAT IS
THAT SOMETHING ELSE IN THAT THEN
CREATES THE BALANCE OR CHANGE?
EVERYTHING IS LOW SODIUM AND
LOOKED AT THIS FROM THE FAT FROM
PRODUCTS THEY JUST PUT SUGAR
BACK IN TO GET THE SAME FEEL.
SO REMOVING FAT WAS GREAT BUT
REPLACING IT WITH SUGAR CREATED
A DIFFERENT PROBLEM OPPOSED TO
CREATING THE SAME PROBLEM.
SO A BROADER LOOK ACROSS CHANGES
IN OUR FOOD SUPPLY.
IF YOU TAKE SOMETHING OUT YOU
HAVE TO PUT SOMETHING ELSE BACK
IN FITS ACROSS ALL THE DIFFERENT
DECISION MAKING PROCESSES.
CAROL.
>> GOING BACK TO YOUR PREVIOUS
COMMENT ON THE INFORMATION AND
WE HEARD ABOUT FOOD WASTE.
WE HEARD ABOUT ACCULTURATION.
WE HAVE LITTLE UNDERSTANDING OF
HOW ACCULTURATION AFFECTS
DIFFERENT LIFE STAGES AND HOW
THAT AFFECTS THE FOOD CHOICES
WE'RE MAKING.
SO WE HAVE THE WHOLE CONTINUUM
WE NEED TO CONSIDER AS WE THINK
ABOUT REPLACING FOODS AND MOVING
THIS FORWARD.
SO THAT'S ANOTHER AREA WE NEED
TO FOCUS ON GETTING MORE
INFORMATION ABOUT IS HOW DO
THESE CHANGES AND WHAT CHANGES
HAPPEN FIRST WITH ACCULTURATION.
>> ANGELA.
>> IT MAKES ME THINK HOW LIKE
WE'RE IN OUR OWN BUBBLE AND
THINKING ABOUT THE DIETARY
GUIDELINES OR RECOMMENDATIONS
BEING PUT INTO PLACE GLOBALLY OR
CERTAIN COUNTRIES THAT MAKE
EFFORTS TO REDUCE SODIUM IN THE
FOOD SUPPLY.
I KNOW DIETARY GUIDELINES OR
THINKING ABOUT ANY RELATIONSHIP
OR INTERACTION WITH ROOM
CHRISTINA THAT TALKED ABOUT THE
LATIN AMERICAN COUNTRIES AND
RECOMMENDATIONS.
I'M WONDERING IF WE THINK ABOUT
CONNECTING AS THE WORK HAPPENS
HOW WE CAN SHARE LESSONS LEARNED
WITH OTHER PLACES.
ONE IS THE NUTRIENT DATABASES.
AND WE LIVE IN A GLOBAL SOCIETY.
SOME OF THOSE FOOD WHERE YOU
HAVE INFORMATION ABOUT THANK YOU
NUTRIENTS OR VALUABLE IN THE
CONTEXT AND THINKING ABOUT
EFFORTS THAT HAVE RESPONSE TO
DIETARY GUIDANCE WILL BE HELPFUL
IN THIS CONTEXT.
I'M WONDERING IF ONE
RECOMMENDATION WOULD BE TO BE
ABLE TO LOOK AT A BIGGER PICTURE
OF WHAT'S AVAILABLE AND WHAT
INTERVENTION AND EFFORTS OF
FEDERAL POLICY HAVE BEEN PUT IN
PLACE.
>> THE INFORMATION ON THE DATA
SOURCE AS WELL AS THE
PARTNERSHIPS AND COMMUNICATIONS
BACK AND FORTH IN TERMS OF HOW
FAR IT INFLUENCES THE NUTRIENT
DATABASE SIDE OF THINGS.
OUR DUDE SIMULATION PROCESS WAS
MIRRORED ACROSS A COUPLE OTHER
NATIONAL APPROACHES IN THE WAYS
THEY'VE DONE IT BUT IT'S THE
FIRST TIME THEY'VE TAKEN A
DIFFERENT APPROACH AND ASPECTS
THEY ARE LAD AND CREATING A WAY
TO HELP REFINE ASSESSING THE
ACTUAL DIETARY GUIDANCE WITHIN
THE PATTERNS CREATED.
A LOT OF THE NATIONAL
COMMUNICATIONS WILL BE HELPFUL
NOT ONLY IN HOW WE'RE INFORMING
IN TERMS OF RECOMMENDATIONS BUT
ALSO WHAT OTHER RECOMMENDATIONS
AND DATABASES EXIST THAT CAN
INFORM THE WORK HAPPENING HERE.
ABSOLUTELY.
>> GREAT, GREAT DISCUSSION.
ANY OTHER COMMENTS OR QUESTIONS
FOR CHRIS?
WELL, CHRIS, KUDOS TO YOU AND TO
THE SUBCOMMITTEE AND TO THE
STAFF FOR THEIR AMAZING, AMAZING
WORK.
THIS HAS BEEN VERY INFORMATIVE.
OKAY.
WE'RE GOING TO TAKE A BREAK
HERE.
WE ARE GOING TO MEET BACK AT
3:45 SO COMMITTEE MEMBERS WHEN
WE COME BACK AT 3:45 WE'LL KEEP
OUR CAMERAS ON BECAUSE IT'S
GOING TO BE A DISCUSSION.
AND WE REALLY WANT A LOT OF
INTERACTION.
SO GET HYDRATED, BE READY TO
CHAT.
THANK YOU AGAIN EVERYBODY FOR AN
AMAZING DISCUSSION SO FAR.
SO TEAM WE'RE COMING THE END OF
OUR 22-MONTH LONG JOURNEY.
AND BEFORE I START THIS, I WANT
TO SAY A THANKS TO EACH AND
EVERY ONE OF YOU AND MEAN THE
COMMITTEE AND STAFF.
EACH AND EVERY ONE OF YOU ARE
KNOWLEDGEABLE AND THOUGHTFUL AND
ENGAGE AND THE REASON WE'RE AT
THIS STAGE IS BECAUSE OF EACH
AND EVERY ONE OF YOU SO THANK
YOU.
NOW WE'LL HAVE A DISCUSSION.
WE'LL PUT A LOT OF WHAT WE HEARD
TODAY TOGETHER I'M GOING TO
GROUND US WITH WHERE WE ARE AND
WHERE WE NEED TO GO AND STOP
THROUGHOUT THE PRESENTATION FOR
INPUT AND DISCUSSION.
REMEMBER, THIS IS OUR REPORT.
I KNOW THERE'S NOBODY HERE WHO
IS SHY.
WE WANT TO HEAR FROM ALL OF YOU
TO BE YOU BECAUSE THIS IS OUR
FINAL REPORT.
SO WE HAVE BEEN HEARING FROM
SOME OF THE SUBCOMMITTEES ABOUT
THE CHAPTERS AND PARTICULARLY
THE D SECTION THAT PROVIDED
ADVICE TO THE DEPARTMENTS
RELATED TO A TOPIC AREA.
SO, WHAT WE'RE GOING TO TALK
ABOUT FOR THE REST OF THE DAY IS
INTEGRATING ACROSS THE CHAPTERS
AND PROVIDING OVERARCHING ADVICE
TO THE DEPARTMENTS.
IN ADDITION TO THE ADVICE THAT
HAS ALREADY BEEN PRESENTED AND
MORE WILL BE PRESENTED TOMORROW.
SO WE'RE GOING TO BUILD ON THE
FOOD PATTERN MODELLING FOR
CHAPTERS 9-11 AND THE SYSTEMATIC
REVIEW WORK.
DEANNA AND ED STARTED THAT AND
WE'LL HEAR TOMORROW FROM OTHER
MEMBERS OF THE COMMITTEE AND 5D
VICE CURABILITILY IN THE 2020
EDITION OF THE DIETARY
GUIDELINES.
THIS IS OUR CHARGE TODAY.
SO OUR JOURNEY IS TO ANSWER
AARON OVER ARCHING QUESTION ON
PROPOSED DIETARY PATTERNS.
SO CONSIDERING EACH LIFE STAGE,
THE CHANGES BEING MADE TO THE
CURRENT USDA PATTERN AND HEALTHY
STYLE SOME REFER TO AS HUSS.
THE HEALTHY MEDITERRANEAN STYLE
AND/OR THE HEALTHY VEGETARIAN
AND SHOULD ADDITIONAL DIETARY
PATTERNS BE DEVELOPED OR
PROPOSED BASED ON OUR COLLECTIVE
WORK, SYSTEMATIC REVIEWS, DATA
ANALYSIS AND/OR FOOD PATTERN
MODELLING.
AND HERE SOME EXAMPLES OF HOW WE
COULD PROPOSE CHANGES TO THE
DIETARY PATTERN.
I'LL GIVE YOU A MOMENT BEFORE WE
GO TO THE NEXT SLIDE.
SO AS CHRIS PRESENTED IN THE
SESSION BEFORE THE BREAK, THE
PROPOSED MODIFICATIONS THAT WERE
DESCRIBED THROUGH THE FOOD
PATTERN MODELLING EXERCISES AND
INFORMED DID I SYSTEMATIC REVIEW
AND DATA ANALYSIS BY THE DIET
SIMULATIONS AND THESE ARE ALL
GOING TO BE DESCRIBED IN GREAT
DETAIL IN CHAPTER 10.
THERE WAS A PROPOSAL TO INCREASE
BEANS, PEAS AND LENTILS WITHIN
THE VEGETABLE GROUP FOR THESE
CALORIE LEVELS AND TO
ACCOMMODATE THE INCREASE IN THE
CALORIES WITH THE INCREASE OF
BEANS, PEAS AND LENTILS OR OTHER
NUTRIENTS OF CONCERN THAT WOULD
BE IMPROVED THERE HAVE TO BE A
PLACE FOR CALORIES TO BE REDUCED
AND SO THERE WAS A DECISION MADE
TO REDUCE THE STARCHY VEGETABLE
AND REDUCE THE PROTEIN FOOD
SPECIFICALLY IN THE MEAT,
POULTRY AND EGGS.
AND CHRIS, IF I SAID ANYTHING
WRONG, THIS IS YOUR TIME TO
CORRECT ME BUT I WANT TO PAUSE
THERE AND JUST GET CONSENSUS
FROM THE COMMITTEE THAT WE'RE
OKAY WITH THIS.
>> THIS FROM THE EVIDENT OF
REDUCE RED MEAT.
>> THANK YOU, CHRIS.
AND AS CHRIS DISCUSSED PROPOSED
TO ELIMINATE THE LIMIT ON
CALORIES FOR OTHER USES GIVEN
THE VARIABILITY AND THE CALORIE
CONTENT OF THE FOODS CONSIDERED
IN THE FOOD PATTERN MODELLING.
AGAIN, CHRIS, IF I SAID ANYTHING
WRONG, JUST JUMP IN.
OKAY, ANY CONCERNS WITH THIS?
I HAVE A COUPLE THUMBS UP AND
NODS.
WE HEARD SOME OF THIS TODAY AND
DISCUSSED IT THROUGH OUR
PREVIOUS MEETING.
DEANNA EMPHASIZED IT IN HER
PRESENTATION AND HEALTHY DIETARY
PATTERNS HAVE SIMILAR CORE
ELEMENTS REGARDLESS OF THE LABEL
USED OR THE NAME THE DIETARY
PATTERN IS CALLED.
SO WHEN WE TALK ABOUT THE
DIETARY PATTERN, WE'RE TALKING
ABOUT THE HEALTHY U.S. STYLE,
HEALTHY VEGETARIAN, HEALTHY
MEDITERRANEAN DIETARY PATTERN AS
WELL AS OTHER HEALTHY DIETARY
PATTERNS NOT CONSIDERED HERE,
THEY ARE ALL HAVE SIMILAR CORE
ELEMENTS SUPPORTED BY THE
SYSTEMATIC REVIEWS.
SO WE WOULD LIKE TO CONCLUDE
THAT THIS COMMITTEE PROPOSES
EMPHASIZING THE CORE ELEMENTS
WITHIN THE HEALTHY DIETARY
PATTERN AND PART OF THIS OVER
ALL VIEWING THROUGH THE HEALTH
EQUITY LENS, HIGHLIGHTING THE
FLEXIBILITIES WITHIN THE CORE
ELEMENTS, ACKNOWLEDGING ACROSS
THE UNITED STATES OUR GOAL IS TO
ACHIEVE A HEALTHY DIETARY
PATTERN DESPITE OUR DIVERSE
BACKGROUNDS AND FOOD WASTE.
I BELIEVE EARLIER TODAY DIDI
MADE A POINT THAT ANY
MODIFICATIONS, ANY CHANGES LET'S
MAKE SURE THAT ALL IMPROVEMENTS
RISE UP FOR ALL AND NO ONE'S
LEFT BEHIND.
SO, ANY COMMENTS, REACTIONS,
QUESTIONS ON THE CONCLUSION
STATEMENT?
WOW.
OKAY.
THIS IS GOING TO BE GREAT.
WHAT DOES THAT MEAN?
THE GOAL IS TO CAPTURE DIETARY
PATTERNS IN AN INCLUSIVE
FLEXIBLE DIETARY PATTERN.
TO OPERATIONALIZE THAT, THIS
COMMITTEE IS PROPOSING THAT
INSTEAD OF THE CURRENT HEALTHY
STYLES, DIETARY PATTERN PLUS THE
HEALTHY VEGETARIAN, PLUS THE
HEALTHY MEDITERRANEAN WE JUST
HAVE ONE, HEALTHY U.S. STYLE
DIETARY PATTERN TO HAVE BUILT-IN
FLEXIBILITIES TO ADDRESS THE
NEEDS OF THE ENTIRE U.S. POMS.
I'M GOING TO PAUSE THERE AND
HAVE REACTION.
OKAY.
I'VE GOT MY FIRST THUMBS DOWN.
I'M GOING TO START WITH
CHRISTINA AND THEN GO WITH
CHRISTOPHER.
>> FROM EVERYTHING CHRIS TRIED
TO EXPLAIN TO US, IS THIS EVEN
POSSIBLE?
>> IT IS POSSIBLE.
>> THERE WERE SPECIFIC
ASSOCIATIONS WITH ANIMAL
PROTEINS.
MAYBE I NEED MORE EXPLANATION,
SORRY, IF I MISSED THIS.
>> NO, NO, THIS IS WHY WE'RE
DISCUSSING AND DO YOU WANT IT
TALK ABOUT THE FOOD PATTERN
MODELLING BECAUSE IT WOULD HELP
ANSWER THE QUESTION?
>> THE ANALYSES WE DID WE HAD TO
CONSOLIDATE DOWN TO CONCLUSIONS
FROM TODAY.
WE LOOKED AT WHAT HAPPENED
WITHIN THE FOOD GROUPS AND
CREATING GUIDANCE AROUND
PARTICULAR FOOD GROUPS AND SUB
GROUPS BUT WITHIN THAT WE
EVALUATED WHAT THE IMPLICATIONS
WERE OF SHIFTING WITHIN THE FOOD
GROUPS AND SUB GROUPS WITHIN THE
FOOD GROUPS AND WHAT IT PROVIDES
IS AN OPPORTUNITY TO SAY HERE
ARE FLEXIBILITIES YOU HAVE
AROUND WHAT TYPE OF VEGETABLES
AND GETTING ALL YOUR VEGETABLES
FROM ONE VEGETABLE AND SAYING
HERE'S THE BREADTH OF THOSE AND
IF YOU'D LIKE MORE BEANS, PEAS
AND LENTILS HERE'S THE
FLEXIBILITIES WITHIN THAT AND
WHAT THE NUTRIENT PROFILES ARE
TO DO THAT WITHIN THE SCOPE OF
THE HUSS PATTERN.
INSTEAD OF SAYING, WELL, I
DECIDED I'M NOT GOING TO EAT ANY
VEGETABLE SO I'M GOING TO EAT
THESE THINGS IT ALLOWS US TO
LOOK AT FLEXIBILITIES WITHIN THE
FOOD GROUPS AND SAY I WANT TO
EAT MORE PLANT-BASED PROTEINS,
BEANS, PEAS AND LENTILS AND WHAT
IMPLICATIONS DOES THAT HAVE AND
NOW I HAVE I AWAY TO DO THAT
WITHIN THE PATTERN IN THE SCOPE.
IT ALLOWS US TO PUT THE
FLEXIBILITIES OPTION WITHIN THE
DIETARY PATTERN THAT WASN'T
INHERENTLY THERE BEFORE.
>> YOU'LL SEE WHERE THE
FLEXIBILITIES GET BUILT IN.
BUT A GREAT QUESTION.
OKAY, CHRIS FER.
>> THERE'S HAD I'LL SAY AS A
PUBLIC HEALTH NUTRITIONIST I'VE
BEEN THRILLED EVER SINCE THREE
PATTERNS WERE INTRODUCED.
I CAN'T TELL YOU HOW OFTEN I
SUGGESTED MEDITERRANEAN AND
VEGETARIAN, THERE'S LOTS OF WAYS
OF DOING THIS.
IF THERE WERE ONE PAGE SIMILAR
TO THE UPS AND DOWN ARROWS IT
DOESN'T SUGGEST -- IT SUGGESTS
LITTLE FLEXIBILITY.
IT SUGGESTS THIS MANY SERVINGS
OF MEAT OR WHATEVER.
MAYBE I DON'T UNDERSTAND WHAT
THE NEXT ITERATION IS GOING TO
LOOK LIKE AND IN AN H.A. PAPER
BEING CITED IN OUR COMMITTEE
REPORT BUT WE REALLY HAD A LOT
OF FUN LOOKING AT ALL THE THINGS
TO EMPHASIZE, ALLOW TO INCLUDE,
SUGGEST TO LIMIT AND TO
ABSOLUTELY AVOID ACROSS A RANGE
OF DIETARY PATTERNS AND IN THAT
PARTICULAR PAPER WE SAID THERE'S
AT LEAST FOUR PATTERNS.
THIS IS SPECIFIC TO AMERICAN
HEART AND CARDIOVASCULAR DISEASE
BUT AS WE'VE SEEN, IT'S PRETTY
MUCH THE SAME PATTERN FOR HEART,
DIABETES, CANCER, ETCETERA AND
WE VERY MUCH CONCLUDED DASH,
MEDITERRANEAN AND PES CA PES CA
TARIAN AND THEY WOULD PROVIDE
THE BASIS FOR A HEART HEALTHY
DIET AND THE CONCLUSION, THE
MESSAGING OF MANY DIFFERENT
PATTERNS AND IT'S BEEN VERY
PRACTICAL FOR ME AS A NUTRITION
SCIENTIST AND SOMEHOW THIS
DIRECTION IS TERRIFYING ME.
>> POINT TAKEN.
WE'LL HEAR MORE OPINIONS.
DEANNA.
>> CHRISTOPHER, I DON'T
UNDERSTAND WHERE YOU'RE COMING
FROM BECAUSE THAT'S MORE WHERE I
WAS AT THE BEGINNING.
I THINK NOW WHAT I'M SEEING IS
THIS IS KIND OF THE SCIENCE
UNDERLYING THE VAGUE PATTERNS
AND THE TRANSLATION OF IT, HOW
IT GOES OUT IS ANOTHER THING AND
FOR THE CONSUMER SIDE, WE'RE
REALLY GOING TO HAVE TO FOCUS ON
HOW YOU TRANSLATE THIS BECAUSE
THEY'RE NOT GOING TO BE ABLE TO
NECESSARILY SUBSTITUTE JUST BY
LOOKING AT IT.
HAVE TRANSLATION OF IT INTO
PUBLIC HEALTH ASPECT.
SO THAT'S KIND OF WHERE I'M COME
COMING FROM AND WE'LL SEE LATER
THERE'S INTERESTING
RECOMMENDATIONS KIND OF
ASSOCIATED WITH IMPLEMENTATION
OF THIS IN TRANSLATION.
>> THANK YOU FOR DIFFERENTIATING
BETWEEN THE RECOMMENDATION AND
IMPLEMENTATION AND WHAT NEEDS TO
BE DONE IN BETWEEN THAT.
>> I THINK WHAT I WAS THINKING
OF WHAT IS THE ROLE OF THE
COMMITTEE IN MAKING
RECOMMENDATIONS REGARDING AND
EVERY GROUP SORT OF SEES THIS AS
A POSSIBILITY WITHIN THE PATTERN
THAT THEY ARE EAT.
I MEAN THE DIFFICULTY OF HAVING
THE PATTERNS IN THE PUBLIC
COMMENT AS WELL AS OTHER
SETTINGS IF PEOPLE DON'T IF THE
THREE LABELS DON'T RESONATE WITH
PEOPLE, THEN ESSENTIALLY THEY
DON'T SEE THEMSELVES IN THOSE
PATTERNS SO I THINK PART OF IT
IS TO COMMUNICATE AND FOR US AS
A COMMITTEE TO MAKE SOME
RECOMMENDATIONS ABOUT WHAT MIGHT
NEED TO BE IN PLACE FOR
IMPLEMENTATION TO ENSURE THAT
ALL AMERICANS SEE THIS HEALTHY
U.S. PATTERN AS WAYS THAT THEY
CAN USE IT IN THE
RECOMMENDATIONS.
I THINK THE IDEA OF SEEING A
HEALTHY U.S. PATTERN I HOPE WE
MAKE A RECOMMENDATION WE STRESS
THE U.S. IS PRETTY DIVERSE.
AND A HEALTHY DIETARY PATTERN
FOR U.S. CAPTURES THE DIVERSITY
THAT IS INCLUDED IN THAT.
AND I KNOW WE HEAR THAT FROM A
NUTRITION EDUCATION STANDPOINT
EVEN WITH SOME EDUCATORS THE
DIETARY GITE LINES PLAINLY IN
TRANSLATION OF IT THEY FEEL IT
DOESN'T ALWAYS REZ -- RESONATE
WITH THE CULTURES THEY WORK
WITH.
>> HEATHER.
>> I WAS THINKING ALONG THE SAME
LINES AS ANGELA.
I LIKE THE PROPOSED IDEA TO MAKE
THERE ONE HUSS PATTERN I FEEL
THE IDEA OF A MEDITERRANEAN
PATTERN JUST FOCUSSED ON FOODS
FROM A CERTAIN REGION THEIR
WORLD MAKE PEOPLE WHO HAVE
HERITAGE AND CULTURES FROM OTHER
PLACES FEEL NOT REPRESENTED.
BECAUSE IT'S CALLING OUT THIS
CERTAIN AREA AND I FEEL THAT
LEADS US WITH THIS GAP AND IF WE
JUST HAVE ONE PATTERN AND THEN
WE CAN TRANSLATE HOW FOODS FROM
ALL OVER CAN FIT IN THAT PATTERN
AND NOT JUST CULTURAL BUT ALSO
OTHER DIETARY THINGS,
ADJUSTMENTS THAT NEED TO BE MADE
LIKE FOR VARIOUS REASONS FOR
HEALTH OR FOR PREFERENCES ALL OF
THOSE PATTERNS ALL THOSE WAYS OF
EATING CAN FIT INTO THE HUSS
PATTERN WITH DIFFERENT KINDS OF
ADJUSTMENTS.
I FEEL THIS IS A GREAT WAY BUT
9th TO BE GOING IN TO BE HAND IN
HAND WITH THE TRANSLATION OF HOW
THIS WORKS.
>> DIDI.
>> I'VE BEEN LOOKING FORWARD TO
THIS DISCUSSION AND CHRISTOPHER,
I'VE BEEN BACK AND FORTH ALONG
THE LINES YOUR CONCERNS ARE
RAISING WITH WHAT SEEMS LIKE THE
LOSS OF SOLID DIETARY PATTERNS
BUT I THINK IN THE WAY I'VE COME
TO APPRECIATE A SINGLE HUSS IF I
CAN ADVOCATE FOR THAT IS THAT
IT'S MORE SO ABSORBED THE
BENEFITS OF THE OTHER PATTERNS
RATHER THAN ELIMINATED THEM.
IN A LOT OF OUR MODELLING WE
RECOGNIZE HOW SIMILAR THE HUSS
BASE PATTERN IF YOU WILL THE
TABLE WE SAW AND THE AMERICANED
WERE SIMILAR AND ALMOST SEEMED A
LITTLE BIT REDUNDANT AND THE
VEGETARIAN PATTERN CAN BE
ACHIEVED IN SO MANY WAYS RATHER
THAN THE PATTERN IN THE LAST
ROUND.
BY OBSERVE BEING VEGETARIAN AND
VARIOUS ITERATIONS IN WHICH IT
IS CONSUMED WITHIN THE U.S. AND
ALSO THE GRADIENT FROM WHERE THE
HUSS IS NOW TO SOMETHING THAT
LOOKS VEGETARIAN SO INCREASINGLY
PLANT FORWARD WITHOUT BEING
NECESSARILY ALL THE WAY INTO ONE
PATTERN I THIRN IS ALSO A
FLEXIBILITY THAT WILL BE REALLY
NOVEL BECAUSE WE CAN SHOW AS WE
DID WITH OUR MODELLING THAT YOU
KIND OF PRESERVE THE BENEFIT
WITH THE MODELLING INTO
INCREASINGLY VEG OR MEAT IF
THAT'S WHAT SOMEONE WANTED TO
DO.
THE OTHER POINT ABOUT TABLES
REFLECTING THE VARIATIONS, I
AGREE WITH.
I THINK WE NEED QUANTITATIVE
PATTERNS IF WE'RE PROPOSING
OPTIONS WE CAN OFFER SOME IN A
QUANTITATIVE WAY OR SOMETHING
PRESCRIPTIVE WOULD BE HELPFUL
RATHER THAN PLANT BASED OR
VEGETARIAN OR MEDITERRANEAN
LIKE.
HAVING THE TABLES THAT WE SAW
AND THAT WERE IN THE 2020
VERSION AND THAT WE ANALYZED
LIKE CRAZY FROM THE MODELLING
PERSPECTIVE TO BE ABLE TO LAY
OUT QUANTITIES OF THE DIFFERENT
PATTERNS WE SUGGEST COULD BE
VARIATIONS OF THE MAIN HUSS
WOULD BE REALLY IMPORTANT TO
INCLUDE.
BECAUSE THE TRANSLATION WILL BE
OUT OF OUR CONTROL AND IF WE DO
VALUE THE QUANTITIES THAT HAVE
BEEN IN PREVIOUS VEG AND
MEDITERRANEAN PATTERN AND NOW
INCORPORATING INTO FLEXIBILITIES
OF THIS PATTERN WE SHOULD PUT
THOSE GUARDRAILS IN OUR REPORT
BUT AS A SINGLE HUSS IT MAKES IT
FLEXIBLE.
IT DOESN'T LOSE OR X OUT PAST
COMMITTEE'S PATTERNS.
I THINK IT BRINGS THEM INTO THE
FOLD AND MAKING THEM MORE
PROMINENT OR AVAILABLE.
>> CHRISTINA.
>> CAN WE CHANGE THE NAME AND
SAY A FLEXIBLE HEALTHY --
>> WE CAN PROPOSE WHAT WE AS A
COMMITTEE WANT.
GO FOR IT.
>> FLEXIBLE HEALTHY DIETARY
PATTERN OR SOMETHING LIKE THAT.
>> AND PRESENT A PRO AND CON.
DIDI I AGREE WITH YOU WITH THE
UMBRELLA TERM FOR ALL THAT HAS
BEEN AND I WOULD CALL TWO
ITERATIONS AGO THE DIETARY
GUIDELINES THE FIRST TIME WE SAW
THE DASH STYLE PATTERNS WITH
THIS EMPHASIS ON THE SCIENCE
WHICH WAS WHERE THE
MEDITERRANEAN PATTERN WAS
DEFERRING AND THEN OTHER THINGS
HAD BEEN DONE AND JUMPING OFF
FROM THE MEDITERRANEAN PATTERN
IN VARIOUS WAYS BUT ALL
RELATIVELY SIMILAR.
SOME THING WITH DASH SODIUM AND
THEN OMNI AND THEN OMNI HEART
AND CARBON.
ALL THESE ITERATIONS BUT THEY
ALL CAME BACK TO THE ONE
PATTERN.
I REMEMBER HAVING A SIMILAR
REACTION WAIT ALL THOSE THINGS
ARE NOW GOING TO GET LUMPED
UNDER ONE UMBRELLA TERM.
AND THAT REMINDS ME OF THAT TIME
AND I THINK IT ALL WORKED OUT
OKAY.
I THINK IT WILL BE FINE TO USE
THIS NEW UMBRELLA TERM WHETHER
WE CALL IT THIS OR WHATEVER
CHRISTINA MIGHT HAVE IN MIND.
THE CHALLENGE WILL BE NOT LOSING
THE HISTORY OF IT AND REALLY
COMMUNICATING CLEARLY THIS ISN'T
SOME BRAND NEW THING TESTED AND
CALLED OUT IN THE LITERATURE
IT'S AN AMALGAMATION OF A LOT OF
SCIENCE OVER A LOT OF YEARS THAT
NOW PUTS US IN THE SPACE WHERE
WE CAN OFFER FLEXIBILITY UNDER
THIS UMBRELLA.
THE PIECE WHERE I WANT TO JUST
CONNECT US TO THAT I OFFER
CAUTION IS AROUND THE DRIs.
SO IT REMEMBERS IN OUR RECENT
DISCUSSIONS THAT WE ARE
RECOMMENDATIONING AND MAYBE
WE'LL DO IT THIS MORNING AS WELL
THE SUPPORT OF CONTINUED DRIs.
WHEN THE DRIs GET MADE THEY'RE
GOING TO NEED TO GO BACK THE
FULL SCOPE OF THE LITERATURE VIA
SYSTEMATIC REVIEW PROCESS OR
RELY ON AUTHORITATIVE BODIES
THAT HAVE DONE SYSTEMATIC REVIEW
TYPE THINGS.
THAT TRANSITION BEING ABLE TOO
PICK OUT THE PATTERNS OVER TIME
AND WHERE THE NUTRIENT LEVEL
FELL WITH REGARDS TO HEALTH FOR
SECT THE CDRRs AND OTHER
COMPONENTS OF THE DRIs WILL BE
INTERESTING IF THE STORY DIDN'T
GET TOLD CORRECTLY.
PERHAPS A COMPANION PIECE TO
CAPTURE THE HISTORY DIETARY
PATTERNS SINCE 1997 IT DATES
BACK TO THE MEDITERRANEAN BUT IN
THE U.S. THAT PARADIGM SHIFTING
EFFORT DASH OF 90s TO CAPTURE
U.S. RECOMMENDATIONS AND TEST
THEM IN A WAY THAT I THINK WE
ALL AGREE WAS STRONG AND MANY
WAYS DEFINITIVE AND YOU THINK WE
SHOULD GET THAT GOING.
CHRISTOPHER.
>> I WANT TO BE OPEN MINDED AND
THE TOPIC CAME UP NOT LOOKING AT
THE VEGETARIAN BUT LOOKING AT
THE MEDITERRANEAN AND SEEING HOW
MINIMALLY DIFFERENT IT WAS FROM
U.S. AND VEGETARIAN WAS
DIFFERENT.
I LOVE THE COMMENTS NO MATTER
HOW MUCH YOU HAVE YOU'LL BE
EXCLUDING SOMEONE.
I'VE BEEN PLACES WHERE THEY HAVE
A DOZEN OR TWO DOZEN BEAUTIFULLY
ARRANGED GORGEOUS LOOKING FOOD
AND LATIN AMERICAN AND INDO --
OTHER FOOD GROUPS AND SAY NOTICE
GIVEN THERE'S 24 WE CERTAINLY
COULDN'T HAVE HAD 2,400.
WE'RE JUST TRYING TO SHOW
EVERYBODY WE'RE TRYING TO SHOW
HOW BROAD AND FLEXIBLE THIS
COULD BE.
I WANT TO PUT IN A NOTE WHEN WE
DID THIS AMERICAN HEART
ASSOCIATION OF PATTERN THERE'S A
POINT WHERE YOU'VE GONE TOO FAR.
AT ONE POINT WHERE YOU SAY IT'S
VERY FLEXIBLE AND LOTS OF THINGS
CAN BE ACCOMMODATED, WE TRY TO
DO THAT ON A CONTINUUM AND AT
SOME POINT WHEN WE GOT TO LOW
FAT VEGAN IT DIDN'T WORK.
LOW-FAT VEGAN DOESN'T WORK.
IT'S MISSING OUT ON HEALTHY
UNSATURATED FATS.
WHEN YOU GO TO PALEO AND KETO IT
DOESN'T WORK.
WE COULD NOT COME UP WITH A WAY
TO MAKE THOSE FIT.
MY SUGGESTION IF WE SHOW HOW
FLEXIBLE IT IS WITH 24 PLATES
THAT WORK, WHICH I WOULD LOVE,
AND LOOK UNAPOLOGETICALLY
DELICIOUS AND SHOULD TALK ABOUT
THE FLAVORS BECAUSE WE NEED TO
BRING THE JOY AND PLEASURE BACK
TO FOOD AND INCLUDING NOT JUST
RESTRICT BEING AND THIS ISN'T
ANYTHING GOES.
YOU CAN'T MAKE ANY PATTERN WORK.
THERE'S SO THE PATTERNS THAT
DON'T WORK HERE.
AND A LOT OF THE PATTERNS
AMERICANS ARE TRYING RIGHT NOW
WHICH IS A CONCERN I HAVE, PAST
TO FA TTFATIMA.
>> THANK YOU.
I SOMETIMES STRUGGLE IN THESE
CONVERSATIONS AS THE PERSON THAT
REALLY SPENDS A LOT OF TIME WITH
PATIENTS AND WONDER IF OUR
LANGUAGE GETS ESOTERIC AND TOO
FAR FROM WHAT HAPPENS AT THE
LEVEL OF PATIENT OR PERSON THAT
REALLY WAS RECEIVING THE
INFORMATION.
AND TO MAKE SURE WHEN WE'RE
THINKING ABOUT AND IT'S
ACCESSIBLE IF YOU RECOGNIZE THE
AVERAGE PERSON REALLY HAS AN
EIGHTH GRADE EDUCATION HERE IN
THE UNITED STATES.
ALL OF US ON THE CALL ARE HIGHLY
EDUCATED WITH OUR MULTIPLE
DEGREES AND IF YOU LOOK AT ALL
OF OUR LOVELY LETTERS AND
CLASSIFICATIONS, WE ARE THE KIND
OF THE TOP ONE PERCENTERS IN
TERMS OF OUR EDUCATION AND THIS
GETS OUT OF THE LEVEL OF
PROCESSING WHEN WE START TALKING
ABOUT WHAT THE AVERAGE AMERICAN
IS GOING TO BE ABLE TO PROCESS
IN TERMS OF NUTRITION AND
NUTRITION STATUS.
WHEN THAT PERSON COMES IN TO SEE
ME THE 20 PATIENTS TOMORROW WILL
BE LIKE, DOC, WHAT AM I SUPPOSED
TO EAT WHATEVER PATTERN WE
DECIDE TO NAME IT OR HOW WE
DECIDE TO CLASSIFY IT.
WHETHER WE'RE VEGAN OR SOMEONE
WHO WILL EAT A HUSS OR HEALTHY
VEGETARIAN PATTERN, THEY ARE
JUST WANT TO KNOW, DOC, WHAT AM
I SUPPOSED TO EAT TO BE HEALTHY.
WE NEED TO BE THOUGHTFUL IN OUR
CONSIDERATIONS AND TEND TO WORK
WITH PATIENTS THAT WILL MAYBE
HIGHER DEMOGRAPHIC AND WE HAVE
TO THINK OF THOSE UNHOUSED OR
FROM A LOWER SOCIO ECONOMIC
POSITION.
I KNOW WE WORKED ON THE HEALTH
EQUITY PIECE BUT I DON'T THINK
WE'RE TALKING ABOUT THIS WHEN WE
MAKE THE CONSIDERATIONS AND
THINKING HOW WILL PEOPLE ACCESS
THIS INFORMATION IN A WAY TO
PROCESS AND UNDERSTAND.
I DON'T THINK THEY'LL UNDERSTAND
IT IN THE WAY WE'RE ASSESSING
THIS AND CAPTURING IT FOR THE
AMERICAN POPULATION.
I WANT US TO TAKE A STEP BACK
AND MAKE SURE WE ARE MAKING THIS
INFORMATION ACCESSIBLE TO AN
EIGHTH GRADE EDUCATION LEVEL.
THAT'S MY THOUGHT.
>> IT BRINGS UP SOMETHING DEANNA
RAISED ABOUT LOW LITERACY.
GREAT POINT.
CHRIS.
>> CHAPTER 10 REALLY HITS ON A
LOT OF THOSE IN TERMS OF WHAT
SPECIFIC FLEXIBILITIES WE WERE
LOOKING AT VERSUS TURNING THIS
INTO A WILD WEST ANYTHING YOU
WANT TO DO WITHIN THOSE.
WE'RE LOOKING AT THIS FROM AN
EVIDENCE BASED PERSPECTIVE ON
MEETING THE NUTRIENT
RECOMMENDATIONS BASED ON
SPECIFIC FLEXIBILITIES THAT DO
WORK AND SOME FLEXIBILITIES THAT
DON'T WORK AND CREATE NUTRIENT
GAPS.
6:SO, WE'RE REALLY LOOKING AT
THIS MORE FROM A DO THE THREE
PATTERNS BECOME ONE NOT CAN YOU
TAKE ANYTHING ANYTHING YOU WANT
TO EAT AND MAKE IT EVERYTHING
THAT COMES FROM THAT FOOD
CATEGORY.
AND NOW IS IT ABOUT THE
MEDITERRANEAN THAT MUCH
DIFFERENT FROM HUSS TO WHATEVER
IT MIGHT BECOME YOU REALLY NEED
TO HAVE TWO SEPARATE PATTERNS TO
SAY IF YOU WANT TO EAT A LITTLE
BIT MORE FISH, THAT'S OKAY OR
EAT MORE PLANT FORWARD AND EAT
VEGETARIAN YOU CAN DO THAT
WITHIN ONE PROFILE VERSUS
CREATING FLEXIBILITIES THAT
BECOME SO UNWIELDY YOU HAVE TO
FIGURE OUT HOW TO MAKE THE
DECISIONS.
>> WHAT WAS OPPOSED EARLIER
TODAY IS THAT OUR CHARGE IS TO
PROVIDE GUIDANCE TO THE
DEPARTMENTS.
AND THE DEPARTMENT WILL
TRANSLATE THAT INTO THE DIETARY
GUIDELINES FROM HEALTH CARE
PROVIDERS.
AND THOSE WILL TRANSLATE IT.
WHILE I TRULY AGREE WE NEED TO
HAVE ACCESSIBLE MESSAGES, I'M
NOT SURE IT'S AT THE LEVEL OF
OUR EXPERT REPORT AND HOW IT'S
SUPPOSED FOR IMPLEMENTED.
>> THANK YOU.
ANGELA.
>> IT MADE ME THINK ABOUT THE
DIRECT RECOMMENDATION IN OUR
REPORT OF WHO GOES OUT TO DO THE
EDUCATION AND AND YOU PUT A
MESSAGE IN THE HANDS OF PEOPLE
WITH BOOTS ON THE GROUND.
THEY'RE GOING TO TRANSLATE THAT
MESSAGE PARTICULARLY TO
PROFESSIONALS.
TO FATIMA'S POINT WE HAVE
PROGRAMS THE WIC EDUCATORS
ACROSS THE NATION.
THERE'S TONS OF PEOPLE AND
WONDERING IF WHAT WE NEED TO DO
IN OUR RECOMMENDATIONS WE NEED
TO MAKE SURE THAT THOSE PROGRAMS
EDUCATORS AND DIETITIANS, HEALTH
CARE PROVIDERS ARE INCLUDED IN
HOW THIS SHOULD BE TRANSLATED.
I'M EXCITED, IF I PUT MY
PRACTITIONER HAT ON, I THINK
ABOUT HOW EDUCATORS CAN REALLY
CAN TALK ABOUT THE FLEXIBILITIES
ACROSS DIFFERENT CULTURES,
ACROSS DIFFERENT CONTEXT BECAUSE
WE DO EDUCATE PEOPLE THAT ARE
UNHOUSED.
AND THINKING ABOUT JUST IN OUR
STATE AND PROBABLY REALLY BROAD
WHEN YOU LOOK ACROSS THE
COUNTRY.
I'M WONDERING IF WE COULD HAVE A
RECOMMENDATION TO ENGAGE THOSE
PRACTITIONERS IN THE TRANSLATION
OF THIS BECAUSE I'M CURIOUS, I
THINK PEOPLE WILL BE EXCITED AND
WOULD BE NICE TO HEAR MORE FROM
THE EDUCATOR WHO IS REALLY
WORKING TO TRANSLATE AND EDUCATE
THE PUBLIC.
>> THANK YOU, ANGELA.
>> THAT SUPPORTS WHAT FATIMA
SAID.
>> CAN YOU TALK ABOUT THE BOOK
ENDS OF THE FLEXIBLE PATTERN AND
WHERE DOES IT END?
I RECOGNIZE WE ARE NOT TALKING
THE VEGAN REMOVING ALL THE
CARBOHYDRATE AND MAKING IT MORE
NUTRIENT DENSE PLANS-BASED MAYBE
THE FLEXIBILITY OF A FISH IN A
VEGETARIAN PATTERN AND GOING TO
LACTO -- IS THAT HOW WE'RE
FOLDING ALL THESE PATTERNS INTO
ONE?
>> THAT'S A REALLY GOOD
QUESTION.
I DON'T THINK THERE'S BEEN
DISCUSSION YET ON WHAT THE BOOK
ENDS ARE.
I THINK THAT'S PART OF THE
REASON WE'RE HAVING THE
DISCUSSION NOW ABOUT THE BOOK
ENDS, YES.
CHRIS, WOULD YOU AGREE OR
HEATHER?
>> I THINK IT'S SET AROUND OUR
RECOMMENDATIONS FOR WHAT
FLEXIBILITIES REALLY FIT FROM
OUR DATA OUR ANALYSIS LOOKING AT
WHAT THINGS CAN WORK WITHIN THE
FLEXIBILITIES WITHIN THE MEETING
NUTRIENT GOALS AND GIVING
PARAMETERS BECAUSE WHEN WE
LOOKED AT IT, YOU CAN DO SOME
THINGS AND CAN REDUCE OR SHIFT
THINGS AND REPLACE ALMOST ALL
WITH ANOTHER AND THERE ARE OTHER
IMPLICATIONS.
FOR OTHERS YOU HAVE ONE OR TWO
AND NOW ALL OF A SUDDEN WHEN
YOU'RE STARTING TO EAT THIS
INSTEAD OF THIS IT CREATES A
DIFFERENT PROBLEM.
SO THERE'LL BE BUFFER ZONES
AROUND WHERE THOSE FLEXIBILITIES
HERE AND START HERE AND
MAKESHIFTS AROUND THERE BUT
BEING ABLE TO ALSO PROVIDE THE
QUANTIFICATION AS TO IF YOU
START TO DO THESE YOU'LL HAVE TO
REPLACE THE FOLATE OR PROTEIN OR
WHATEVER IT MAY.
.
AND THERE'S ACTUALLY A COUPLE
MORE CHANGES BEING PROPOSED THAT
I'M A LITTLE NERVOUS ABOUT
PRESENTING.
BUT HOLD THAT THOUGHT.
I THINK THAT WILL COME UP AGAIN.
>> ALL RIGHT WITHIN THE HUSS
PATTERN THERE'S SO MUCH
VARIABILITY THAT'S ENCOURAGED.
THAT'S KIND OF REPRESENTED LIKE
THINKING ABOUT THE PROTEIN FOODS
LIKE THERE'S MANY THAT FIT
THERE.
WE'RE ALREADY ENCOURAGING PEOPLE
TO EAT A VARIETY.
WE LOOKED AT SOME OF THE
VARIABILITY AND WHAT WE DO AND
ESPECIALLY AGAIN THINKING ABOUT
THE VEGETABLE GROUPS AND ALL
THOSE DIFFERENT SUB GROUPS AND
WHAT HAPPENS WHEN WE INCREASE OR
DECREASE THE DIFFERENT
QUANTITIES THERE.
WITH REGARD TO THOSE WHEN IT'S
RAUL ONE THING THERE COULD
BECOME NUTRIENT SHORTFALLS AND
WE'VE BEEN ABLE TO NAIL THOSE
DOWN SO PEOPLE HAVE MORE
KNOWLEDGE OF WHAT DOES HAPPEN
THERE.
IT HELPS PUT BOOK ENDS ON WHAT
THAT SHOULD BE IN PARTICULAR AND
WHAT FLEXIBILITIES THERE ARE
WITHIN THE GROUPS.
>> I SEE THE BOOK ENDS AS THE
NUTRIENT ADEQUACY BECAUSE IF IT
GOES OUTSIDE OF THAT IS WHEN
THINGS START TO BREAK DOWN.
THAT'S WHAT THE FOOD PATTERN
MODELLING DOES WAS SHOW US WHERE
THE GUARDRAILS ARE.
THESE ARE PATTERNS SO THERE'S
USUAL CONSUMPTION.
OVER A WEEK YOU MIGHT HAVE ONE
OR TWO DAYS THAT DON'T LOOK THE
SAME BUT OVER THE TOTALITY IT
KIND OF MEETS THOSE GOALS.
>> THANK YOU VERY MUCH, DEANNA.
THAT'S REALLY HELP.
.
OTHER QUESTIONS BEFORE WE PULL
UP THE SLIDES AND GO TO THE NEXT
PROPO
PROPOSALS.
GREAT.
MOVING ON THE ASSUMPTION OF A
MORE FLEXIBLE DIETARY PATTERN,
WE'RE PROPOSING TO FLIP IT TO
THE NUTS, SEEDS AND SOY PRODUCTS
ARE LISTED FIRST THEN SEAFOOD
AND THEN MEAT, POULTRY AND EGG.
I WANTED TO STOP THERE WITH
DIFFERENT DISCUSSIONS IN
DIFFERENT SUBCOMMITTEES ABOUT
THE INTERNAL ORDER WITHIN THOSE
FOOD/SUB GROUPS AND WANTED TO
SEE IF PEOPLE WERE COMFORTABLE
AND IF THERE WERE CHANGES WITHIN
THE GROUPS LISTED HERE BECAUSE
OF ANOTHER BIG CHANGE COMING UP.
I'VE GOT A THUMBS UP FROM
CHRISTINA AND QUESTION FROM
CHRISTOPHER.
>> I THINK IT MIGHT BE THE NEXT
SLIDE, REMOVING BEANS, PEAS AND
LENTILS TO PROTEIN.
IS THAT PART OF THE QUESTION?
>> NO, THAT'S NOT PART OF THE
QUESTION.
YOU MAY NOT HAVE THAT RIGHT BUT
NO, IT'S JUST WHAT WE'VE GOT ON
THE SCREEN NOW.
JUST SO WE CAN SEPARATE OUT.
>> OKAY.
THE BEST SOURCE THAT IS GLOBALLY
CONSUMED IS BEANS, PEAS AND
LENTILS NOT NUTS OR SEEDS.
>> OKAY.
SO YOU'RE OKAY WITH THIS ORDER?
>> YEAH.
SOMEHOW THE PLANT-BASED PROTEIN
SOURCES I'D GO FOR IF THERE'S
ONLY THREE CATEGORIES, THOSE
THREE RIGHT THERE ARE FINE.
>> ANYBODY ELSE HAVE DIFFICULTY
WITH THE ORDER?
>> WAIT.
ADD ONE.
FOR THE MEATS, POULTRY AND EGGS,
PART OF WHAT WE SAW IN ALL OF
OUR ANALYSES WERE THE RED MEATS
WHETHER THEY WERE PROCESSED OR
NOT WERE THE ONES TO REDUCE MORE
THAN THE POULTRY.
OR THE EGGS.
I WOULD HAVE PUT THEM VERY LAST.
I WOULD HAVE PUT MEATS LAST
WITHIN THE CATEGORY.
>> SO EGGS, POULTRY AND MEAT?
>> YEAH.
>> OKAY.
DOES ANYBODY HAVE OBJECTION TO
THAT?
CHRISTOPHER, SO I'M
UNDERSTANDING, THIS IS BEING
DRIVEN BY THE SYSTEMATIC REVIEW
EVIDENCE?
>> YES.
SO WHAT WE DID FOR SOURCES OF
SATURATED FAT, WHAT WE DID FOR
PATTERNS, IT WAS OFTEN WHAT YOU
NEEDED TO REDUCED RED MEATS
PROFES
PROCESSED OR UNPROCESSED.
>> GREAT.
ANYBODY ELSE HAVE COMMENTS OR
CONCERNS?
OB.
NEXT SLIDE, PLEASE.
SO THIS IS WHERE COMMUNICATION
IS GOING TO COME IN.
WE KNOW AS EVERYONE KNOWS WE'VE
HAD A GREAT DEAL OF DISCUSSION
AMONG THE COMMITTEE MEMBERS IN
OUR PUBLIC MEETINGS ABOUT WHERE
DO YOU HOUSE BEANS, PEAS AND
LENTILS?
THEGS BECOMES -- THIS BECOMES
CHALLENGING LOOKING AT THE
HEALTHY VEGETARIAN PATTERN WHERE
YOU HAVE BEANS, PEAS AND LENTILS
IN PROTEIN FOODS AND IN THE
U.S. STYLE IT'S ALL IN THE
VEGETABLE.
PLEASE NOTE, THERE ARE DIFFERENT
UNITS ASSOCIATED WITH THE
DIFFERENT FOOD GROUPS.
WHEN BEANS, PEAS AND LENTILS ARE
IN THE VEGETABLE GROUP, THOSE
ARE CUP EQUIVALENTS PER WEEK.
WHEN THEY'RE IN THE PROTEIN
FOODS, THEY'RE OUNCE EQUIVALENT
A WEEK.
AND PEOPLE WERE THINKING ABOUT
SUBSTITUTIONS.
BEANS, PEAS AND LENTILS BE TAKEN
FROM THE VEGETABLE GROUP AND
ENTIRELY HOUSED IN THE PROTEIN
FOODS AGAIN ALIGNED WITH THE
SYSTEMATIC EFFORTS TO ENCOURAGE
PLANT SOURCES AND IT WILL GO
FIRST THE NEXT NUTS AND SEEDS
THEN THE SEAFOOD, AND WE HAVE
ALREADY GOT EGGS, POULTRY AND
MEATS.
CHRISTOPHER, SEE HOW FAST THAT
HAPPENED.
NOW THE IMPLICATIONS OF THIS I
WANT TO DRAW YOUR ATTENTION TO.
IT LOOKS LIKE WE'RE RECOMMENDING
AMERICANS EAT LESS VEGETABLES
BECAUSE YOU'RE PULLING GROUPS
AND LOOKS LIKE WE NEED TO EAT
MORE PROTEIN FOODS.
THE MOST IMPORTANT THING IS
PEOPLE DON'T EAT ENOUGH
VEGETABLES ALREADY.
WE'RE THOUGHT SAYING PEOPLE NEED
TO EAT LESS IT'S JUST THE BEANS,
PEAS AND LENTILS PUT IN PROTEIN
FOODS POULD HAVE TO BE A STRONG
EMPHASIS ON HOW TO COMMUNICATE
THAT TO THE U.S. PUBLIC.
OKAY.
I'M GOING TO THROW IT OUT FOR
REACTION.
ANGELA.
>> I REALLY DON'T LIKE THIS.
I DON'T LIKE THE LABEL PROTEIN
FOODS BUT THE THING IS SEAS
CONFUSING BUT I KNOW THERE'S
BEEN FOCUS GROUPS IN OTHER
THINGS BECAUSE PEOPLE LIKE THE
IDEA.
IT WAS CHANGED FOR A REASON.
I THINK BEANS, PEAS AND LENTILS
SHOULD BE IN ITS OWN GROUP BUT
THAT'S ANOTHER -- GROUP THAT'S
BEANS, PEAS AND LENTILS BUT TO
ME IT'S ALMOST LIKE IN THE
TRANSLATION.
LET PEOPLE WE'RE TRYING TO FORCE
PEOPLE IN WE'RE GOING TO MOVE IT
AND FORCE PEOPLE PROTEIN FOODS.
MY PURPOSE WOULD BE A ZONE GROUP
BUT IT'S OKAY TO BE IN THE
VEGETABLES BECAUSE WE STILL HAVE
WANT TO REINFORCE THERE ARE
CULTURES THAT BEANS, PEAS AND
LENTILS AS VEGETABLES.
IT'S OKAY TO BE IN THE VEGETABLE
GROUP.
I ACTUALLY LIKE IT IN THE
VEGETABLE GROUP.
>> OKAY.
DEANNA.
>> A COUPLE THINGS.
ONE IS WE DEVELOPED A HISPANIC
FOOD PYRAMID AND BEANS WAS ITS
OWN CATEGORY.
NO ONE EATS OUNCE EQUIVALENTS OF
BEANS, PEAS AND LENTILS IT NEEDS
TO BE IN CUPS SOMEHOW.
>> DOES ANYONE PROPOSE BEANS,
PEAS AND LENTILS BE ITS OWN FOOD
GROUP?
WHAT ARE THE PROS AND CONS?
GO WANT TO PROPOSE IT?
I'M SEEING A LOT OF NODS.
OKAY.
ALLINE.
>> I'M HEARING ALL THE COMMENTS.
HAVING IT AS ANOTHER FOOD GROUP
MAY A -- I THINK SOY IS A LEGUME
TOO BUT SOY HAS ALWAYS BEEN
CONSIDERED AND PEANUTS BELONG
THERE BUT WE MAY NOT WANT TOO
MUCH BUT I WONDER IF WE'RE
CONSIDERING THAT NEW CATEGORY OF
LEGUMES BEING BEANS, PEAS AND
LENTILS AND WOULD SOY GET INTO
THAT SO THEN IT MAKES MORE SENSE
RATHER THAN THE NUTS AND SEEDS
CATEGORY.
THAT'S A GOOD POINT.
I THINK IT WILL BE A
RECOMMENDATION FOR FUTURE
COMMITTEES.
THAT'S VERY HELPFUL.
THANK YOU, ALLINE.
>> PART OF THE ISSUE IN AMERICAN
IS THERE'S DIFFERENT
PERSPECTIVES.
THAT ASIDE THIS CONVERSATION HAS
GIVEN ME ANOTHER IDEA OF PUTTING
THE PROTEIN FOODS NEXT TO
VEGETABLES, ADD A BEAN ACCOUNT
GY BUT HAVE DOTTED LINES.
NOT ONLY IS IT ITS OWN CATEGORY
BUT BLURZ INTO VEGETABLES BLURS
INTO PROTEINS.
YOU CAN SEE HOW IT MERITS ITS
OWN CATEGORY BUT KIND OF DOUBLE
COUNTS AS VEGETABLES AND
PROTEINS FOR SOME PEOPLE.
I WONDER IF THERE'S A WAY TO
GEOGRAPHICALLY REPRESENT THAT?
>> I HAVE AN OPPOSITE REACTION
TO INJURY THEM.
I LEAST IN THE HISPANIC CULTURE
IS SEEN AS A PROTEIN GROUP AND
IT'S COMBINED WITH RICE AND
THAT'S WHAT MANY PEOPLE CONSUME.
RICE AND BEANS AND THAT'S IT.
THEY DON'T HAVE A MEAT OR ANY
OTHER SOURCE OF PROTEIN.
THAT'S THE SOURCE OF PROTEIN.
IT MAY BE DIFFERENT IN DIFFERENT
CULTURES.
AND
>> WHAT RAZE THE VEGETABLE?
A LOT OF CULTURES USE ONE-POT
MALES AND IN THE BEANS AND RICE
WHAT WOULD BE CONSIDERED THE
VEGETABLE?
>> IT VARIES.
IT'S VERY DIFFERENT IN HISPANIC
CULTURES.
IT'S A BIG MELTING POD OF
DIFFERENT CULTURES.
THERE'S VEGGIES USED IN THE
COOKING, CILANTRO AND HERBS AND
CARROTS AND SO IT VARIES.
IT'S EMBEDDED WITHIN THE COOKING
OF THE BEANS, PEAS AND LENTILS.
SOME MAY HAVE SOME SORT OF
GREENS OR OTHERS MORE THE ORANGE
BUT I'M NOT AN EXPERT IN THE
DIFFERENT HISPANIC CULTURES.
>> TOMATOES ALSO THOUGH THEY'RE
TECHNICALLY A FRUIT.
>> THANK YOU.
>> THIS IS A GREAT DISCUSSION.
I'M A LITTLE BIT ON BOTH SIDES.
IT'S A TOUGH ONE.
BUT FROM A STRICTLY SCIENTIFIC
PERSPECTIVE I DON'T LIKE
DISTINGUISHING PROTEIN I MEAN
ANIMAL AND PLANT PROTEIN BECAUSE
PROBABLY THE HEALTH EFFECTS HAVE
LITTLE TO DO WITH THE PROTEIN
BUT WHAT COMES ALONG WITH IT OR
DOESN'T SO IT'S LIKE THE FIBE
ESH AND ALL THE NUTRIENTS THAT
ARE IMPORTANT.
SO PRETEEN IS REALLY NOT
IMPORTANT ISSUE FROM THAT
PERSPECTIVE BUT A LOT OF PEOPLE
FEEL PROTEIN IS IMPORTANT.
IT'S ONE OF THE FEW ITEMS PEOPLE
WERE EXCEEDING AND A LOT OF
PEOPLE THINK AT LEAST PEOPLE I
TALK TO YOU HAVE TO EAT MEAT AND
THAT'S WHERE YOU GET YOUR
PROTEIN.
I THINK A LOT OF PEOPLE DON'T
THINK OF BEANS AND PEAS AS
ACCOUNTING FOR PROTEIN.
I THINK THAT WOULD BE A
POTENTIAL ADVANTAGE OF INCLUDING
IT AS A PROTEIN FOOD.
AND FROM THE SCIENTIFIC AND
PRACTICAL PERSPECTIVE.
>> THANK YOU, ED.
SAMEERA.
>> ASIAN CULTURE WOULD CONSIDER
BEANS, PEAS AND LENTILS AS
PROTEIN.
IN VEGETARIAN DIETS IT'S THE
SOLE PROTEIN IF THEY DON'T EAT
EGG EITHER.
I WOULD BE OKAY MOVING IT TO THE
PROTEIN GROUP IF THAT'S
FEASIBLE.
>> DIDI.
>> ONE THING THAT SURPRISED ME
FROM OUR MODELLING WAS THE
AMOUNT OF PROTEIN IN THE DIET
COMES ONLY HALF FROM FROM THE
PROTEIN GROUP THAT A LOT OF THE
NUTRIENT PROTEIN COMES FROM ALL
THE OTHER GROUPS TOGETHER.
PUTTING MORE PROTEIN SOURCES IN
THE CATEGORY MAKES A LITTLE BIT
OF SENSE JUST TO HAVE IT MORE OF
MAIN PROTEIN SOURCES.
BEHAVIORALLY BECAUSE THE
CALCULUS AT THE END OF THE DAY
IS THE STATEMENT.
AND THERE'S MORE PROTEINS IN THE
PROTEIN CATEGORY THAT COULD HELP
OVERCOME THAT MISLABELLING OR
MISNOMER OR MISINFORMATION FROM
HAVING IT MORE PROMINENTLY NOT
JUST ALL THE MEAT LINE.
AND OFFERED FLEXIBILITY IN THE
SWAPS WHERE WE'D HAVE
INCREASINGLY PLANT BASED THAT'S
BEANS, PEAS AND LENTILS AT THE
EXPENSE OF OTHER MEAT PRODUCTS
NOT SO MUCH TO DISPLACE
VEGETA
VEGETABLES I APPRECIATE THE
CULTURE ASPECT OF ACTING MORE OF
A PROTEIN AND MENUS AND I SEE A
LOT OF PROS FOR IT BEING IN THE
PROTEIN UP IN TERMS OF
COMMUNICATION AND HELPING
EMPHASIZE PROTEIN COMES FROM
MORE THAN JUST ANIMAL PRODUCTS
BECAUSE RIGHT NOW THAT'S WHAT
MOST PEOPLE THINK.
YOU HAVE TO HAVE YOUR MEAT TO
GET PROTEINS AND FROM ALL THE
MODELLING WE SEE THAT'S SIMPLY
NOT THE CASE.
>> THANK YOU, DIDI FOR THAT
PERSPECTIVE.
HOLLIE.
>> I WANT TO REINFORCE HER
COMMENT FROM A BEHAVIORAL
PERSPECTIVE HAVING MORE PLANT
FORWARD IN THE PROTEIN WILL
ENCOURAGE CHOICE MORE OFTEN.
AND IT WILL GIVE MORE
FLEXIBILITY.
FROM A POOR SUBSTITUTION
PERSPECTIVE PLACING IT IN THAT
CATEGORY WILL HELP.
>> THANK YOU, HOLLIE.
ANDREA.
>> THIS IS REINFORCING WHAT THEY
BOTH SAID.
I AGREE AND I DO THINK THE
PERSPECTIVE -- I THINK IT'S
BETTER FOR ME OF PEOPLE SEEING
IT IN THE PROTEIN GROUP MAKES A
LOT MORE SENSE BECAUSE THEN
THEY'RE ABLE TO I THINK PEOPLE
THINK OF JUST MEAT, EGGS AND NO
THOSE SOURCES AND HAVING IT IN A
PROTEIN GROUP WOULD ENCOURAGE
EAT BEING MORE BEANS, PEAS AND
LENTILS.
>> I KNOW THIS SOMETHING YOU HAD
A STRONG REACTION TO.
HOW ARE YOU FEELING?
>> GOOD.
>> IT'S LOOK LIKE YOU'D HAVE TO
NOT MAKE IT A PROTEIN GROUP AND
WOULD HAVE TO HAVE A MEAT GROUP
AND BEANS GROUP.
I THINK PEOPLE DO EAT PROTEIN
AND FOCUS ON THE GROUP TO
CONSUME MORE PROTEIN AND I'M
CURIOUS IF YOU USE IT AS PROTEIN
OR WILL REALLY MAKE THE SHIFT.
I THINK THE NEXT COMMITTEE WILL
BE ABLE IT SEE IF THAT HAPPENS
AND THE DIFFERENT LABELLING.
>> GREAT, THANK YOU.
>> I THINK THIS HAS BEEN AN
AMAZING DISCUSSION LOOKING AT
THE SUBJECT THROUGH A HEALTH
EQUITY LENS.
WE COULDN'T HAVE HAD A RICHER
DISCUSSION.
THANK YOU VERY MUCH.
WE'RE NOW GOING TO GO TO SOME
MORE SLIDES.
THIS IS DRAFTED BY WHAT THE
COMMITTEE I THINK AND THIS HAS
COME UP IN THE DISCUSSION WE'RE
GOING TO NEED NARRATIVE ADVICE
AND TABLES AROUND FLEXIBILITIES
WITHIN THE CORE ELEMENTS.
SO THERE WAS A LOT OF REACTION
INITIALLY ABOUT WHAT ARE THE
BOOK ENDS AND THE FLEXIBILITIES
AND I THINK THAT AS WE EXPLORE
THIS THEY WILL BECOME I THINK
IDEAS WILL BUBBLE UP.
FOR EXAMPLE, VIS MENT-- CHRIS
MENTIONED THIS WITH THE FOOD
PATTERN MODELLING THERE WERE
TERRIFIC EXERCISES.
WHAT HAPPENS IF ALL THE
VEGETABLES COME FROM ONE
VEGETABLE SUBGROUP VERSUS WHAT
HAPPENS IF YOU INCREASE DARK
GREEN VEGETABLES?
WHILE WE SAW IMPROVEMENTS IN
NUTRIENT AND THERE WERE SOME
COMBINATIONS WHERE THERE WERE
NUTRIENT SHORTFALLS CORRECTLY
IDENTIFIED AS CONTAINED IN THE
CHAPTER, I THINK WE ALSO WERE
GUIDED BY THE SYSTEMATIC
REVIEWS.
I THINK THE FOOD PATTERN
MODELLING EXERCISES ALLOWS FOR
MORE CONSIDERATION AND
FLEXIBILITIES BEYOND WHAT WE
HAVE IN SOME OF THE SYSTEMATIC
REVIEWS BECAUSE THEY DID NOT
NECESSARILY GIVE US THE
GRANULARITY OF WHAT SPECIFIC
VEGETABLES OR THEY DIDN'T USE
THE CATEGORIES PER SE THAT WERE
USED IN THE HUSS.
AND INTAKE SHOULD BE AT LEAST
HALF WHOLE GRAIN AND
HIGHLIGHTING MORE SHIFT TOWARDS
MORE WHOLE GRAINS.
AND WE HEARD FROM THE SUBGROUP
AMOUNTS.
I THINK THIS HAS BEEN PRETTY
WELL DISCUSSED WITH THE BEANS,
PEAS AND LENTILS DISCUSSION.
SO WE'LL GO TO THE NEXT AND STOP
ME IF -- SO, THESE ARE THE
CURRENT GUIDELINES.
THIS IS THE 2020 COMMITTEE'S
REVIEW AND THE DIETARY
GUIDELINES 2020 HAVE FOUR
RECOMMENDATIONS.
FOLLOW A HEALTHY DIETARY PATTERN
AT EVERY LIFESTYLE AND CUSTOMIZE
AND ENJOY NUTRIENT DENSE FOODS
AND FOCUS ON NUTRIENT NEEDS AND
STAY WITHIN CALORIE LIMITS AND
LIMIT FOOTSDZ AND BEVERAGES
HIGHER IN ADDED SHUG RAR AND
SATURATED FAT AND SODIUM.
SO WE NOW WANT TO SHIFT GEARS A
BIT AND SAY OKAY, WHAT ARE OUR
RECOMMENDATIONS?
WHAT ARE OUR REACTIONS TO THESE
FOUR CURRENT GUIDELINES?
SO WE SO WE
HAVEFSO WE
HAVESO WE
HA
THE FOUR GUIDELINES WE NEED TO
TAKE THE GUIDELINE AND ADD 9th
MORE OF A SYSTEMS LEVEL NOT
INDIVIDUAL LEVEL ALSO TO
INCORPORATE THE HEALTH EQUITY
LENS AND WE ALSO AND THIS HAS
BEEN DISCUSSED MANY TIMES TODAY.
YOU CAN SAY WHAT TO EAT BUT YOU
NEED A GUIDELINE HOW TO
IMPLEMENT SO IT'S NOT JUST WHAT
BUT ALSO HOW.
I THINK WE PROBABLY NEED TO HAVE
SOME DISCUSSION TO BETTER REFINE
THEM.
SO I'M JUST GOING TO STOP THERE
AND HAVE SOME REACTION TO DRAFT
ADVICE.
THERE ARE MULTIPLE ONES SO YOU
THROWING IT OUT THERE AND
REACTION TO THESE TWO.
PARTICULARLY PEOPLE WHO HAVE
DISCUSSED THESE OVER THE COURSE
OF THE DAY.
YOU KNOW WHAT, I'M GOING TO ASK
DEANNA.
I KNOW YOU TALKED A LOT ABOUT
IMPLEMENTATION SCIENCE.
I WONDER IF YOU HAD A REACTION
TO PARTICULARLY THE SECOND ONE.
>> I WAS JUST GOING TO PUT MY
HAND UP ABOUT THAT.
I THINK KEY IS HOW WE IMPLEMENT
THEM.
THE GUIDELINES EVEN IF YOU LOOK
AT THE CONCLUSION STATEMENT THEY
HAVEN'T CHANGED A LOT.
WE MAKE TWEAKS HERE AND THERE
AND WHAT CHERYL ALWAYS SAY ABOUT
THE HCI AND SO HOW DO YOU DO
THAT AND PUTTING AN
IMPLEMENTATION BRINGING IN
LEARNINGS FROM IMPLEMENTATION
SCIENCE AND CONTRIBUTE TO IT
BECAUSE IT'S MORE THAN AN
INDIVIDUAL GOING OUT AND
PURCHASING FOOD.
AND WE HAVE TO HAVE AFFORDABLE
AND HAS TO BE AND THEY ARE HAVE
TO HAVE ACCESS TO HEALTHY FOODS.
I THINK THOSE ARE ALL WHERE WE
NEED TO GO NEXT WITH THIS.
>> GREAT, THANK YOU.
OTHER COMMENTS OR REACTIONS?
TO THE INDIVIDUAL WHO TOOK THE
SLIDES DOWN, DO YOU MIND PUTTING
THEM UP?
I THINK IT'S HELPFUL TO HAVE
THEM ON THE SCREEN.
THANK YOU VERY MUCH.
I APPRECIATE THAT.
ANY OTHER REACTIONS TO THIS ONE?
CHRISTINA.
>> WHEN YOU SAY AT A SYSTEMS
LEVEL, I WONDER IF YOU CAN BE
MORE SPECIFIC AND MAKE SURE THAT
ALL THE STAKEHOLDERS ARE CALLED
OUT HERE.
WE HAVE TALKED ABOUT THE
ENVIRONMENT.
BUT THAT HAS TO DO WITH MANY
STAKEHOLDERS HERE.
AND SO I THINK I LIKE THIS
APPROACH.
I REALLY LIKE IT.
I THINK WE SHOULD CALL OUT BUT I
LIKE THIS.
>> GREAT, CHRISTINA.
CHERYL.
>> YEAH, I'M NOT SURE IF THIS IS
HERE ALREADY AND MAYBE I CAN'T
SEE IT YET.
WHERE IN THIS IS THE DIRECTION
AROUND THE FOOD SUPPLY THAT
WE'VE BEEN ESSENTIALLY COMING
BACK TO ALL DAY?
>> THAT IS A GOOD POINT AND I
THINK YOU KNOW YOU RAISED A GOOD
QUESTION, CHERYL AND I'M JUST
GOING TO JUMP IN HERE.
MY APOLOGIES.
I THINK WHEN WE WERE TALKING
ABOUT THE SYSTEMS LEVEL WE WERE
THINKING MORE FROM THE
PERSPECTIVE OF THE HEALTH EQUITY
LENS.
LESS AT THE LEVEL OF THE FOOD
ENVIRONMENT AND FOOD SYSTEMS.
I THINK THESE RICH DISCUSSIONS
OF FOOD SYSTEMS HAVE BUBBLED UP
REALLY TODAY MORE THAN WE'VE
HEARD IN THE PAST.
SO I WOULD WELCOME A
RECOMMENDATION.
BECAUSE I DO NOT BELIEVE WE HAVE
ANY OTHER DRAFT ADVICE AROUND
THE FOOD SYSTEMS.
I'M THROWING IT OUT TO ANYBODY
AND EVERYBODY BECAUSE I THINK
CHERYL IS RAISING A REALLY GOOD
POINT.
>> I WONDER IF WE THINK ABOUT
THE CURRENT STRUCTURE OF THE
FIRST BOX HERE AT A GUIDELINE TO
INCORPORATE THE HEALTH EQUITY
LENS.
PERHAPS IT'S A GUIDELINE AT THE
SYSTEMS LEVEL TO IMPACT THE FOOD
SUPPLY.
AND WE USE SODIUM EARLIER AS A
BIT OF A CONVERSATION STARTER.
BUT WHAT MANY COMMITTEE MEMBERS
ALSO CONTRIBUTED WAS FOR
NUTRIENTS WE NEED TO THINK ABOUT
ARE THEY USED IN CAREFUL,
THOUGHTFUL WAYS WITHIN THE FOOD
SUPPLY SUCH THAT WHEN
RECOMMENDATIONS COME THROUGH
EVERY FIVE YEARS IT MAKES IT
EASIER FOR EVERYONE TO MEET THEM
BECAUSE AS WE SAW, PRETTY
CONSISTENTLY DOESN'T MATTER WHO
YOU ARE IN THE UNITED STATES OF
AMERICA, THE THREAT IS REAL FOR
US TO NOT GET THERE.
>> I LIKE THAT.
AT A GUIDELINE SYSTEMS LEVEL TO
IMPACT THE FOOD SUPPLY.
I LIKE THE CONCEPT.
THANK YOU, CHERYL.
AND THEN ARE YOU THINKING MAYBE
HAVING A SECOND ONE ABOUT THE
HEALTH EQUITY LENS?
>> YEAH, I WAS THINKING THAT AS
LONG AS PEOPLE ARE OKAY WITH IT
LEAVE THE HEALTH EQUITY LENS ONE
AND MAKE THE IMPLEMENTATION
SCIENCE ONE.
JUST IN EXPLICIT STATEMENT
AROUND THE FOOD SUPPLY IS
CHALLENGING.
IT NEEDS TO BE EASIER FOR US TO
BE ABLE TO DO WHAT WE'RE ASKED
TO DO.
>> GREAT, THANK YOU.
ANY OTHER REACTIONS TO THIS?
YES, JENNY.
>> THE OBVIOUS.
OUR COMMITTEE WAS TASKED TO LOOK
AT EVIDENCE ON THE HOWs.
BEHAVIORAL STRATEGIES AROUND
MANAGEMENT AND THE HOWS OF
FEEDING CHILDREN.
I WOULD JUST LIKE TO SEE FUTURE
GUIDELINES REFLECT BEHAVIORAL
SCIENCE AS WELL NUTRITIONAL
SCIENCE ON HOW TO ACHIEVE THE
GUIDELINES.
I THINK IT'S BEEN A GREAT
ADDITION.
>> UM, THANK YOU, JENNY.
I'M SORRY, I'M GOING THROUGH MY
NOTES BECAUSE I BELIEVE IT COMES
UP LATER BUT JUST IF YOU COULD
JUST HOLD THAT AND IF IT DOESN'T
COME UP, THEN WHY DON'T WE ADD
IT AND I KNOW WE'LL HAVE A RICH
CONVERSATION ABOUT THAT VERY I'M
IN THE CROSS-CUTTING THEMES
TOMORROW.
YEAH, GREAT, OKAY.
SO I'M GOING TO GO TO THE NEXT
ONE.
NEXT SLIDE, PLEASE.
WE HAVE FIVE ADDITIONAL
CONSIDERATIONS.
SO, ONE IS ABOUT HOW THE DIETARY
GUIDELINES CAN BE ADAPTED FOR
DIFFERENT CULTURAL DIETS.
CHRISTOPHER, I'M IMAGINING THE
WONDERFUL PHOTOGRAPHS OF THE
>> WHEN WE TALK ABOUT THE
FLEXIBILITIES AND PEOPLE TALKER
TALKING ABOUT THE TABLES, IT IS
2024. I MEAN, WE CAN LEND
LOCKETS BY MACHINES. WE CAN HAVE
PEOPLE'S HART BEAT TRANSMITTED
TO THEIR PERSONAL HEALTHCARE
PROVIDER. IT'S A TIME WHEN
THESE COULD -- I THINK THAT WE
SHOULD BE ADVOCATING FOR
LEVERAGING THE TECHNOLOGY AND
THE DATA SCIENCES TO REALLY
PROVIDE MORE ATTRACTIVE
GUIDANCE. I REALLY DO THINK THAT
STATIC, THE STATIC PAPER IS NOT
GOING TO BE THE WAY TO MOVE
FORWARD PARTICULARLY WHEN WE ARE
TALKING ABOUT BUILDING IN THE
FLEXIBILITIES WITHIN -- WHILE
BEING, MEETING NUTRIENT NEEDS.
WE ALSO HAD A LOT OF DISCUSSIONS
PARTICULARLY EARLY ON ABOUT THE
TERMINOLOGY AROUND THE LIFE
STAGES. AND A LOT OF THE CURRENT
GUIDANCE SAYS FOR THOSE ONE PLUS
YEARS OF AGE OR FOR THOSE TWO
PLUS YEARS OF AGE, IT REALLY
SPANS THE WHOLE LIFE CYCLE. SO I
CAN TELL YOU I DO NOT RELATE TO
WHAT A TWO-YEAR-OLD EATS. I
DON'T EVEN RELATE TO WHAT AN AN
LESS SENT EATS SO I PERSONAL --
ADOLESCENT EATS SO I FIND WHEN I
SEE GUIDANCE FOR TWO PLUS YEARS
IT IS SOMETIMES HARD TO FIND OUT
WHERE I FIT IN. SO THIS -- I'M
JUST PERSONALIZING IT HERE BUT
THIS IS BEING A DISCUSSION. AND
THE OTHER THING, THIS IS
PROBABLY A BIG ONE, BUT IT DID
COME UP IN OUR DISCUSSIONS. I DO
BELIEVE ANGELA, YOU RAISED IT.
THE FOCUS OF THE DIETARY
GUIDELINES, WE HAVE DISCUSSED
THIS IN OUR PUBLIC MEETING, IT
IS REALLY DISEASE REDUCTION. BUT
SHOULD THERE BE A SHIFT TO
REALLY LOOKING AT HOW DIET
PROMOTES GROWTH AND DEVELOPMENT
BUT ALSO PARTICULARLY WHEN YOU
START THINKING OF THE ENTIRE
LIFE CYCLE AND YOU GO INTO THE
OLDER ADULTS, IMPROVING HEALTH
SPAN, SO THOSE VERY DIFFERENT
QUESTIONS THAT WOULD BE ASKED.
SO I'M TURNING ALL THOSE FIVE
OUT GAVE YOU SOME CONTEXT AND
WOULD LOVE TO HAVE SOME REACTION
TO THEM. IT IS THE END OF THE
DAY. YES. THANK YOU.
>> I THINK -- I DO AGREE WITH
FOCUSING ON PROMOTING GROWTH AND
DEVELOPMENT AND IMPROVING THE
HEALTH SPAN. I DO LIKE THAT. BUT
I THINK CHRONIC DISEASE RISK
REDUCTION AMONG CHILDREN AND
ADOLESCENTS, I MEAN, WE DON'T
HAVE A GOOD EVIDENCE BASE FOR
THAT YET. I ALSO THINK IN
PREGNANCY, WE KNOW THAT LIKE
HYPERTENSIVE DISEASE AND
PREGNANCY IS INCREASING, SO I
THINK THAT THERE ARE OTHER
GROUPS WE NEED TO KEEP THE FOCUS
ON CHRONIC DISEASE RISK
REDUCTION.
>> THAT'S GREAT POINT. THANK
YOU. HOLLY, THEN DEE DEE.
>> I ALSO REALLY LIKE THE IDEA
OF FOCUS ON PROMOTION OF GROWTH
AND DEVELOPMENT IMPROVING THE
HEALTH SPAN SO I THINK THAT
WOULD BE A GREAT MOVEMENT
FORWARD AND I ALSO AGREE ABOUT
LEVERAGING TECHNOLOGIES. WE
NEED TO MOVE TO A MUCH DIFFERENT
PLACE AS COMPARED TO HAVING JUST
BROCHURES OR HA HANDOUTS ARE VEY
UNIDIMENSIONAL WAYS TO HELP
PEOPLE UNDERSTAND.
>> THANK YOU VERY MUCH. DEE DEE.
>> FOR THE LAST BOX, I DON'T SEE
THESE AS EITHER OR. I THINK THAT
ARE SO INCREDIBLY IMPORTANT TO
HIGHLIGHT BOTH. REDUCE CHRONIC
DISEASE FOCUS WHEN IT IS
SKYROCKETING WOULD SEEM LIKE
MESSED UP IN MY OPINION. AND SO
MANY CHRONIC DISEASES NOT ONLY
ARE THEY HIGHLY PREVALENT BUT
WERE MEANT TO HAVE GUIDELINES AS
WE DISCUSSED ALL ALONG, THAT ARE
GENERALIZABLE TO THE AVERAGE
AMERICAN AND WHEN HALF OR NOT
MORE HAVE A MAJOR CHRONIC
DISEASE IT WOULD BE REALLY
IMPORTANT FOR HEM TO BE ABLE TO
IDENTIFY WITH THE PATTERNS AND
WITH THE RECOMMENDATIONS. AND
NOT BE EXCLUSIVE TO THOSE WHO
EITHER ARE FREE OF CHRONIC
DISEASE OR MAYBE NOT WORRIED
ABOUT CHRONIC DISEASE. I KNOW
THAT IS NOT WHAT IT IS SAYING
BUT MAY COME ACROSS THAT WA WAY.
GROSS DEVELOPMENT AND HEALTH
SPAN ARE CLOSELY TIED IF NOT THE
FLIP SIDE HAVING CHRONIC DISEASE
HAVING A HEALTH SPAN. SO I THINK
THEY BOTH NEED TO BE PRIORITIES
AND DAMPING THE FOCUS ON FOCUS
ON CHRONIC DISEASE SEEMS LIKE
VERY BAD TIME TO DO THAT IN
TRAJECTORY OF U.S. HEALTH.
>> THANK YOU VERY MUCH, DEE DEE.
THAT'S GREAT.
>> I THINK I WOULD ECHO THAT. TO
ME PROMOTING GROWTH AND
DEVELOPMENT AND I IMPROVING THE
LIFE SPAN WOULD INCLUDE REDUCING
CHRONIC RISK IF YOU WILL. IF YOU
WANT TO PROMOTE. SO SOMEHOW TO
ME THERE ARE MORE LINKS THAN
THERE ARE SHOWN HERE. BUT I
WANTED TO MAKE A POINT ON
LEVERAGING TECHNOLOGIES AND
REINFORCE HOLLY'S FEEDBACK ON
THAT LINE. I THINK WE NEED TO
THINK ABOUT THOSE TECHNOLOGIES
TO DO THE WHAT AND THE HOW. SO
HELPING PEOPLE IDENTIFY WHAT THE
THEY NEED TO EAT WITHIN THE
CONFINE OF THEIR RESOURCES AND
HOW CAN THEY GET THERE.
>> THANK YOU. .
>> I WAS GOING TO MAKE THE SAME
POINT ESSENTIALLY AS DEE DEE
DID. I THINK -- I REALLY THINK
WE STILL NEED TO FOCUS A LOT ON
CHRONIC DISEASE. IT IS ALSO THE
PRACTICALLY SPEAKING THE EASIER
ONE TO STUDY, WHEN YOU START
TALKING ABOUT HEALTH SPAN,
USUALLY CHRONIC -- AVOIDANCE OF
CHRONIC DISEASE IS PART OF THE
DEFINITION. I THINK ONE ASPECT
OF THAT, THAT MIGHT BE USEFUL IS
THE COMMONALITY ACROSS A LOT OF
CHRONIC DISEASES. SO I THINK WE
LOOKED AT DIABETES, CARDS OWE
VASCULAR DISEASE, CANCER,
SEPARATELY, BUT I THINK IN
ACTUALITY, PROCESSES LIKE
INSULIN RESISTANCE AND
INFLAMMATION ARE UNDERLYING LIKE
THE LINK BETWEEN DIET AND
CHRONIC DISEASE SO THAT IS A
GOOD WAY TO THINK OF NOT THE
CHRONIC DISEASES INDIVIDUALLY
BUT THE UNDERLYING PROCESSES
THAT CONTRIBUTE TO A LOT OF THEM
AT THE SAME TIME.
>> GREAT POINT. THANK YOU.
>> SO I FEEL LIFE SPAN IS LENGTH
FINAL YOUR LOOF AND LIFE SPAN IS
NUMBER OF YEARS YOU LIVE YOUR
LIFE DISEASE FREE. I FEEL THAT
IS ANOTHER WAY OF SAYING
PREVENTION OF CHRONIC DISEASE
AND ED MENTION AD LOT OF CROPPIC
DISEASE HAVE A SIMILAR RISK
FACTOR. SO I DO LIKE THE LAST
BALANCE SHEET BREATH AS IS
IMPROVING THE HEALTH SPAN BUT
YES. IT MAY NOT -- ACADEMICS
MIGHT UNDERSTAND A BETTER
UNDERSTANDING FOR IT, MAY NOT
TRANSLATE WELL SO IT MIGHT BE
SOMETHING THAT WE MIGHT HAVE TO
GO BACK TO ACHRONIC DISEASE
VERSUS HEALTH SPAN BUT I DO
THINK IT GETS AT THE SAME
BASICALLY CONCEPT, REDUCING
CHRONIC DISEASE.
>> GREAT. THANK YOU. HEATHER.
>> I WAS THINKING A BIT MORE
ABOUT THE SECOND ONE HERE
LEVERAGING TECHNOLOGIES TO
PROVIDE MORE INTERACTIVE
GUIDANCE. I THINK THAT COULD BE
PARTICULARLY RELEVANT TO YOUTH
LIKE ADOLESCENTS AND ALSO KIND
OF CONSIDERING OUR DISCUSSIONS
ABOUT THE FOOD ENVIRONMENT. I
THINK FOR YOUTH THEY ARE IN SUCH
A DIGITAL SOCIAL ENVIRONMENT ALL
THE TIME AND WE REALLY DON'T --
WE ARE ALSO THINKING ABOUT HOW
WE WANT -- WE WOULD LIKE TO
PROMOTE CHANGES IN THE FOOD
SUPPLY BUT THEY ARE IN THE
DIGITAL ENVIRONMENT, I DON'T
FEEL LIKE THERE'S VERY MANY
CHECKS ON THE KIND OF MEDIA AND
PROMOTION OF A LOT OF FOODS WE
WANT TO LIMIT AND THEY ARE
EXPOSED TO THAT MARKETING
THROUGH. SO I FEEL LIKE WE COULD
DO A BETTER JOB LEVERAGING
TECHNOLOGY TO PROMOTE A MORE
HEALTHFUL SOCIAL ENVIRONMENT
AROUND FOOD IN PARTICULAR FOR
ADOLESCENTS. IF WE ARE NOT GOING
TO HAVE POLICIES THAT PROTECT
KIDS IN THAT ENVIRONMENT. SO I
THINK THAT IS A DUAL THING.
COULD WE DO MORE TO PROTECT KIDS
IN THAT SPACE? AND COULD WE DO
MORE TO PROMOTE MORE HEALTHFUL
FOODS ESPECIALLY FOR THAT REALLY
VULNERABLE AGE GROUP OF
ADOLESCENTS.
>> THANK YOU, HEATHER, FOR THAT
PERSPECTIVE. ANY MORE COMMENTS?
SO COULD WE PLEASE HAVE THE NEXT
SLIDE. I THINK WE HAVE HAD QUITE
A BIT OF DISCUSSION ABOUT FIRST
ONE, THE RECOMMENDATION TO SHIFT
TO NUTRIENT DENSE PLANT BASED
MEALS. WE ALSO TALKED ABOUT
GRAINS. AND REALLY STRENGTHENING
THE RECOMMENDATION, THE GRAINS
MOSTLY WHOLE GRAINS. NOW, I
THINK THROUGH THE FOOD PATTERN
MODELING, IT WAS REVEALED THAT
ONE OF THE CHALLENGES WITH THE
SHIFT FROM REFINED WHOLE GRAINS
IS NUTRIENTS THAT ARE FORTIFIED
IN REFINED GRAINS. WHAT I HAVE
HEARD -- WE HAVE HEARD IS WE
NEED TO SUPPORT AND ENCOURAGE
MANDATORY FOLATE FORTIFICATION
FOR EXAMPLE TO INCLUDE WHOLE
GRAINS. I THINK THERE WAS A
DISCUSSION THE INITIAL
FORTIFICATION PLAN, THEY JUST
WANTED PEOPLE TO CONSUME HIGHER
AMOUNTS OF FOLATE, PARTICULARLY
WOMEN IN THE PERICONCEPTTIVE
PHASE BUT NOW THAT IT IS WELL
RECEIVED AND SUCCESSFUL SHIFTING
WHAT THE FOODS ARE THAT ARE
FORTIFIED. ANY COMMENTS, I THINK
THIS IS SUMMARIZING A LOT OF THE
DISCUSSION WE HAD UP TO NOW. ANY
OTHER COMMENTS ON THAT? YES.
CAROL.
>> CHRIS, CORRECT ME IF THIS IS
NOT CORRECT BUT WHEN WE DID THE
FOOD PATTERN MODELING WE SAW AS
WE INCREASED WHOLE GRAIN, WE
WERE LOSING SOME OF THE IRON
ESPECIALLY FOR SOME VULNERABLE
GROUPS. I'M WONDERING IF WE
MIGHT WANT TO THINK ABOUT GOING
BEYOND FOLATE FORTIFICATION, TO
THE FULL ENRICHMENT PACKAGE THAT
WE TYPICALLY SEE IN REFINED
GRAINS SO THERE IS A GREATER
OPPORTUNITY TO RECOMMEND MORE
WHOLE GRAINS. CHRIS, I DON'T
KNOW IF YOU CAN FOLLOW-UP ON
THAT.
>> YEAH, THAT IS CORRECT. IT WAS
MORE THAN JUST FOLATE WITHIN
THAT AND THEN WHEN WE LOOKED AT
THE NUTRIENT PROFILE FOR WHOLE
GRAINS THE FORTIFIED WHOLE
GRAINS BREAKFAST CEREALS WERE
MOST COMMONLY MAKING UP THE
NUTRIENT PROFILE BECAUSE FOR THE
MOST PART IF PEOPLE WERE
CONSUMING BREAD LESS LIKELY
CONSUMING WHOLEWHEAT BREAD, IT
WAS COMING FROM BREAKFAST
CEREALS WHICH IS MORE LIKELY TO
BE ENRICHED. SO THE PROFILE IS A
LITTLE SKEWED THAT WHEN YOU ARE
LOOKING AT BREADS THE BRANDS
HAVE A TENDENCY TO BE REFINED
GRAIN BUT THE CEREALS MADE UP
THE WHOLE GRAIN SO THIS
TRANSITION WOULD MEAN IF YOU ARE
GOING TO MAKE A SWITCH FROM
REFINED GRAIN BREAD TO WHOLE
GRAIN BREAD, YOU ARE MORE LIKELY
TO INTRODUCE THE ISSUES THAT
CAROL WAS MENTIONING AROUND THE
FOLATE, THE IRON BECAUSE YOU ARE
NOT GOING TO SOMETHING MORE
LIKELY GOING TO BE -- HAVE LOTS
OF THINGS ADDED TO IT. IT WILL
BE A WHOLE GRAIN VERSION OF THAT
FOOD.
>> CRISS JUST SO I UNDERSTAND
THIS CORRECTLY, BECAUSE AS I WAS
SAYING IT I REMEMBERED IRON CAME
UP BUT WHAT WOULD BE THE
RECOMMENDATION?
>> SO THE RECOMMENDATION WOULD
BE FOR MATCHING THE NUTRIENT
PROFILE. FOR REFINED GRAINS TO
WHOLE GRAINS. SO LOOKING AT IF
IRON BECOMES A LIMITING FACTOR
YOU WANT TO MAKE SURE THAT IRON
IS IN THE WHOLE GRAINS AS WELL
AS IN THE REFINED GRAINS.
>> GREAT. THANK YOU VERY MUCH.
THANK YOU, CAROL, FOR POINTING
THAT OUT.
>> I HAD A DIFFERENT ONE.
>> PLEASE.
>> IN THE ENCOURAGE
RECOMMENDATIONS TO SHIFT TO
NUTRIENT DENSE PLANT BASED
MEALS, THIS IS KIND OF A -- IS
IT A TERMINOLOGY THING OF
ENCOURAGING PEOPLE WHO'S FROM
DATA ANALYSIS EATING LESS PLANT
BASED MEALS OR IS IT A
CONSENSUAL FRAMEWORK TO SAY THE
GUIDELINES WERE PROMOTING MORE
PLANT BASED? BECAUSE PLANT
BASED HAS A TENDENCY TO BE USED
AS A CODE WORD FOR VEGAN AS
OPPOSED TO EATING MORE PLANT
PROTEIN OR EATING MORE PLANT
PRODUCTS. BECAUSE IF YOU LOOK
AT THE RECOMMENDATIONS IN THE
HUSS, IT IS A FOUNDATION OF
GRAINS, FOUNDATION OF FRUITS AND
VEGETABLES WITH SOME MEAT
POULTRY AND EGGS AND DAIRY
PRODUCTS, SEAFOOD, WHICH DOESN'T
MEAN THAT IT IS VEGAN BUT IT IS
MOTHER PLANT-BASED. SO THE
TERMINOLOGY HERE IN TERMS OF
WHAT THAT -- LIKE WHAT IS THE
CONCEPT THAT WE ARE REALLY
TRYING TO -- AND THAT IS MY
QUESTION.
>> CHRIS YOU RAISED A REALLY
GOOD POINT. I KNOW THERE'S BEEN
A LOT OF DISCUSSION, BECAUSE
DIFFERENT WORDS AND DIFFERENT
TERMS HAVE DIFFERENT
CONNOTATION. I THINK THIS IS
WHERE A GOODIES CUSHION WOULD
COME OUT SO I'M HOPING THAT IS
WHAT IS GOING TO COME UP BUT YOU
RAISE AD REALLY GOOD POINT, I
DON'T THINK IT LANDED ON PERHAPS
THE PERFECT TERM YET SO HEATHER,
PLEASE.
>> I'M NOT A BIG FAN OF THE
FIRST ONE THERE TO ENCOURAGE
SHIFT TO PLANT BASED MEALS
BECAUSE I ALSO FEEL LIKE THIS IS
KIND OF DISREGARDING THE DAIRY
AND FORTIFIED SOY GROUP. WE KNOW
A LOOT OF -- ALSO NOT JUST
BECAUSE OF DAIRY BUT OUR ANIMAL
SOURCES OF MANY NUTRIENTS IN
GENERAL ARE MORE BIOAVAILABLE. I
THINK IN PARTICULAR FOR OUR
GROWING AGE GROUPS, ADOLESCENTS
AND KIDS, THEY ARE ALREADY NOT
HAVING ENOUGH FROM LIKE THE
DAIRY GROUP AND IT WAS SO
IMPORTANT FOR BONE HEALTH THAT
THEY ARE GETTING BIOAVAILABLE
SOURCES SO I FEEL THE WAY THAT
THAT IS WRITTEN THERE IS OLD
LIKE EMPHASIZING THOSE REALLY
IMPORTANT FOOD GROUPS FOR
NUTRIENTS THAT ARE ALREADY
UNDERCONSUMED.
>> GOOD POINTS. CHRISTOPHER.
>> ONE TERMINOLOGY. SORRY MY
INTERNET WENT OUT SO I'M PART
PHONE NOW AND PART HOT SPOTTING
OFF MY PHON PHONE. SO I HOPE THS
COMES THROUGH. I WOULD AGREE
PLANT BASED IN THE PAST WAS VERY
MUCH MORE INCLUSIVE. IT ISN'T
PLANT RESTRICTIVE OR PLANT
INCLUSIVE, THIS IS PLANT BASED.
THIS IS SHIFTING. A LOT OF
PEOPLE ARE USING PLANT BASED
INSTEAD OF VEGAN, VEGAN ALREADY
HAS BAD CONNOTATION AND NOW
PEOPLE ARE ANNE BRING THEY
SWITCHED THE WORD BUT KEPT THE
VEGAN THING BUT I THINK PLANT
FORWARD MAY WORK. I DON'T WANT
TO ANSWER THAT QUESTION NOW, WE
JUST SHOULD BE CAREFUL, THIS
COULD BE PLANT FOODS. MOTHER
NUTRIENT DENSE PLANT FOODS --
MORE NUTRIENT DENSE PLANT
SOURCED FOODS. THIS ALSO BRINGS
UP THE PLANT BASED MEATS, DAIRY,
THE FAKE THINGS. SO WE'LL HAVE
TO BE CAREFUL THERE. BUT TO
BUILD ON THE LAST POINT, MAYBE
IT NEEDS TO BE SPECIFIC BY AGE
GROUP. HEATHER, FOR THE ADULTS,
THE DAIRY, I DON'T THINK WOULD
BE AS IMPORTANT -- I DIDN'T
REALLY SEE THAT SHIFTING AWAY
FROM DAIRY BUT I TOTALLY
RECOGNIZE YOUR POINT FOR KIDS,
THAT THAT MIGHT CARRY ACROSS FOR
KIDS. MAYBE THIS NEEDS TO HAVE
ADULT BECAUSE WHEN WE GET TO
SATURATED FOOD SOURCES OF
SATURATED FATTED TOMORROW FOR
ADULTS IT WILL BE PRETTY CLEAR
TO SWITCH TO MORE PLANT SOURCED
FOODS. SO MAYBE SHIFT TO MORE,
NOT JUST A SHIFT TO -- AND YEAH,
THERE'S GOING TO BE A LOT OF
TERMINOLOGY QUESTIONS HAPPY PI
TO HELP IF I CAN BUT IT IS
CONFUSING AT THE MOMENT.
>> THANK YOU. AND I DO REALIZE
MEALS IS A VERY CONFUSING TERM,
THAT PROBABLY IS PART OF THE
CHALLENGE. ANGELA.
>> YEAH, I WAS WONDERING WHAT IS
THE SOURCE OF THIS, BECAUSE LIKE
WE HAVE CONCLUSION STATEMENTS
DOES THIS SUPPORT? I'M WONDERING
IF WE NEED A LEVEL OF
SPECIFICITY. BECAUSE I THINK
WHEN YOU SAY SHIFT, THAT MEANS
SHIFT AWAY FROM SOMETHING. IF WE
ARE TALKING ABOUT PLANT FOODS
THAT ALSO INCLUDES -- WE MAKE IT
PLANT FOODS AND NOT PLANT
PROTEINS THAT WOULD INCLUDE
VEGETABLES, GRAINS, LIKE -- SO
I'M WONDERING WHAT WAS THE
SOURCE THAT THIS ADVISE CAME
FROM? WHICH ARE WE TRYING TO
EMPHASIZE?
>> I THINK THESE ARE ALL REALLY
GOOD POINTS, I THINK WE REALLY
NEED TO GO BACK AND THINK THIS,
I THINK MORE IN LINE WITH THE
DISCUSSIONS THAT WE HAD EARLIER
ABOUT THE PROTEIN FOOD FOODS. AO
I'M ACTUALLY THINKING WE SHOULD
HOLD THIS AND MAYBE GO TO THE
WRAPSS. THEN IF WE HAVE TIME
CIRCLE BACK. DOES THAT SOUND
LIKE A GOOD IDEA? CRIST IFER,
DID YOU WANT TO SAY ANYTHING?
>> SOMEWHERE JUST TO ANSWER
LANGUAGE, THAT WAS CBD PATTERNS
AND SOURCES OF SATURATED FAT,
BOTH WHICH I'M ON. I'M NOT SURE
IF YOU WERE ON EITHER OF THOSE,
ANGELA.
>> THANK YOU, CHRISTOPHER.
HEATHER.
>> I JUST WANTED TO SAY ONE
QUICK THING ABOUT THE SECOND
POINT THERE ABOUT THE
RECOMMENDATION FOR THE GRAINS. I
COULD BE IN SUPPORT OF THAT BUT
I ALSO FEEL LIKE IF THAT IS
GOING TO HAPPEN THERE NEEDS TO
BE A LOT MORE EDUCATION AROUND
WHAT WHOLE GRAINS ARE, BECAUSE I
STILL FEEL LIKE PEOPLE ARE VERY
CONFUSED BY THAT. THERE IS -- WE
HAVE HAD THE RECOMMENDATION FOR
HAVING HALF FOR A WHILE. AND I
FEEL LIKE ONE OF THE GAPS THERE
IS JUST THAT PEOPLE DON'T KNOW
WHAT WHOLE GRAINS ARE.
>> GOOD POINT. THANK YOU. THE
OTHER WAS WHEN WE -- ADVICE TO
THE DEPARTMENTS IS TO EXERCISE
NUTRIENT DENSE OPTIONS. THESE
ARE FORMS WITHOUT ADDED SUGAR
SATURATED FAT AND SODIUM. I
THINK WE HAD A LOT OF DISCUSSION
ABOUT THE FOOD SUPPLY HIGH IN
SODIUM BECAUSE IT IS A DIET
SIMILAR RATIO -- SIMULATION. WE
GOT AND AD VICE HERE THAT WE
SUPPORT MAKING VOLUNTARY TARGETS
MANDATORY TO SUPPORT FOOD SUPPLY
LOWER IN SODIUM. WE ALSO HERE IS
WHERE WE EXPLAINED WHY WE
RECOMMENDED THAT MOST OF THE
CALORIES ARE NEEDED, MOST OF ALL
CALORIES ARE NEEDED TO FOOD
GROUP NEEDS EVEN WITH THE MOST
NUTRIENT DENSE OPTIONS. THEN THE
SECOND ONE IS VERY SIMILAR TO
THE CURRENT RECOMMENDATION WHICH
LIMIT FOOD AND BEVERAGES HIGH IN
ADDED SUGARS AND SATURATED FAT
AND LIMIT ENERGY DENSE FOOD AND
BEVERAGES THAT ARE LOW IN
NUTRIENTS OF CONCERN. SO I WOULD
LIKE TO HAVE SOME REACTION TO
THAT. CHRISTOPHER, YOUR HAND
SUP, I DON'T KNOW IF THAT IS A
LEGACY HAND OR NEW HAND. THANKS
ANY REACTION, CONCERN? OKAY. GO
TO NEXT, NEXT SLIDE, THANK YOU.
SO FOR JUST TO CONFIRM, THIS
COMMITTEE WHERE IS THE 2020
COMMITTEE DID HAVE ADVICE AROUND
THE TOPIC OF ALCOHOLIC BEVERAGES
AND HEALTH OUTCOMES. BECAUSE
HHS AND USDA ARE ADDRESSING
SCIENTIFIC REVIEWS ON THIS TOPIC
THIS INDEPENDENT OF THE WORK WE
ARE DOING, AND THEY ARE LISTED
HERE, WE MADE A DECISION NOT TO
CONSIDER REVIEWS ON THIS TOPIC
AN THEREFORE WE ARE NOT WEIGHING
IN. THE FINDINGS OF THOSE TWO
COMPLIMENTARY EFFORTS ARE
AVAILABLE BY END OF DECEMBER
2024, WHICH IS AFTER A REPORT
WILL BE SUBMITTED, SO WE ARE
GOING TO RECOMMEND THE
DEPARTMENTS CONSIDER THE
FINDINGS OF THE TWO INDEPENDENT
SCIENTIFIC REVIEWS WHEN
CONSIDERING THE NEXT EDITION OF
THE 2025, 2030 DIETARY
GUIDELINES. ANY CONCERNS ABOUT
THIS? GOOD. OKAY. WE ARE AT THE
LAST ONE. THERE WERE THROUGH
OUR CONVERSATIONPS SOME REAL
RECOMMENDATIONS ABOUT
NOMENCLATURE. THE EMPHASIS ON
CONDUCTING CONSUMER RESEARCH ON
FOOD GROUPS AN SUBGROUP NAMES.
AND THE FOOD MARKET, WHAT'S
AVAILABLE ON THE MARKET IS
EVOLVING VERY RAPIDLY. AND WHAT
MAY HAVE BEEN AN APPROPRIATE
TERM TO CONSUMERS IN THE PAST
MAY NOT BE RELEVANT NOW. SO ONE
AREA IS ON THE CONCEPT PROTEIN
FOODS. AND I THINK DEE DEE, YOU
RAISED THIS. FOODS AND OTHER
FOOD GROUPS ALSO CONTAIN PROTEIN
SO BIT OF A MISNOMER. THEN WE
ALSO THERE WAS SOME
CONSIDERATION ABOUT BEING UNDER
THE DAIRY CATEGORY, NOT
REFERRING TO LACTOSE FREE
OPTIONS AND FORTIFIED SOY MILK
AND YOGURT AS ALTERNATIVES
BECAUSE THEY ARE PART OF THAT
DAIRY GROUP. ALSO DETERMINE IF
DAIRY IS THE WEST TERM TO CAP --
BEST TERM TO CAPTURE THE
RECOMMENDED FOOD WITHIN THAT
GROUP TO INCLUDE MILK, SOY MILK
YOGURT, SOY YOGURT AN CHEESE.
FINALLY, THERE ARE MANY, MANY
VEGETABLES THAT FALL IN THE
OTHER VEGETABLE CATEGORY. SO WE
ARE RECOMMENDING THAT THERE BE
CONSUMER RESEARCH ON WHAT WOULD
BE A BETTER WAY OR IF THIS IS
THE RIGHT NOMENCLATURE, HOW I
SHOULD PHRASE IT, IS OTHER A
GOOD CATEGORY GIVEN THE VAST
NUMBERD ON THE BROAD NUMBER OF
VEGETABLES IN THAT CATEGORY,
INCLUDING SOME VERY POPULAR ON
ONES. ANY REACTION TO THAT?
ANGELA.
>> I THINK ALL OF THESE ARE
GOOD. I WAS WONDERING IF WE DO
RECOMMEND -- IF WE ARE MAKING
THE RECOMMENDATION THE BEANS
LENTILS O THE PROTEIN GROUP I
WILL ADD THAT TO ONE, ALSO ON
THE CLASSIFICATION.
>> THANK YOU, ANGELA. GREAT
POINT. CHRISTOPHER.
>> FOR PAPER TO CITED 2019
NUTRITION REVIEWINGS MADE A
HEATED MAD SHOWING ALL PLANT
FOODS HAVE 20 AMINO ACIDS
INCLUDING ALL NON-CERTAIN AMINO
ACIDS. HAVING TO CHUCK THAT IN
THIS HEAT MAP OF AMMINO ACIDS,
EVERYONE NEEDS TO BE BLOWN AWAY
THAT THEY ARE NOT MISSING. AS
FOR OTHER VEGETABLES MAYBE
ADDITIONAL VEGETABLES OR ALSO
VEGETABLES. THERE MUST BE
SOMETHING. COULD STILL KEEP
VEGETABLE BUS SAY ADDITIONAL --
BUT SAY ADDITIONAL VEGETABLES
MAYBE.
>> GREAT. ANGELA, WAS THAT A NEW
QUESTION? OKAY. NO PROBLEM.
ANYBODY ELSE HAVE ANY COMMENTS?
YEAH, ELLEN.
>> I THINK FOR THE LAST ONE WE
NEED TO PUT IT INTO CONTEXT OF
THE CATEGORY OF THE DARK GREEN
RED AND ORANGE AND --
(INDISCERNIBLE) BECAUSE I THINK
THAT SHIFT IT IS OTHER
CATEGORIES AS WELL.
>> VERY GOOD POINT, ELENE. THANK
YOU. OTHER QUESTIONS, COMMENTS?
OKAY. NEXT SLIDE WHICH IS THE
LAST SLIDE OF THE DAY. DOES
ANYONE HAVE ANYTHING THEY WANT
TO TISS DOES THAT WE HAVE NOT
DISCUSSED UP TO NOW? REMEMBERING
THAT WE DO HAVE A FUTURE
DIRECTIONS AND CROSS CUTTING
THEMES DISCUSSION TOMORROW, WE
ARE ALSO HOPING ALL OF YOU HAVE
TIME TO REST TONIGHT AND
TOMORROW YOU WILL HAVE TIME TO
SYNTHESIZE THIS AND HAVE A WHOLE
NEW SET OF GREAT RECOMMENDATIONS
AND ADVICE. ANYBODY HAVE ANY
FINAL WORDS THEY WOULD LIKE TO
SAY? IF THAT IS NOT -- IF THAT
IS THE CASE FIRST I WANT TO
THANK YOU. THIS WAS SUCH A RICH
DISCUSSION. I AM JUST
CONTINUALLY BLOWN AWAY HOW THIS
COMMITTEE CAN COME TOGETHER AND
REACH CONSENSUS IN SUCH AN
INFORMED AND COLLEGIAL WAY.
AMAZING, AMAZING TEAM. AND I'M
GOING TO HAND IT NOW OVER TO
JANET TO WRAP UP TODAY'S
MEETING.
>> YES. ECHOING WHAT YOU SAID,
SARA. THANK YOU SO MUCH FOR THAT
VERY THOUGHTFUL CONVERSATION AND
REPORTING AND OUT OF YOUR
COMMITTEE AND ALL THE WONDERFUL
WORK THAT YOU HAVE BEEN DOING.
SO JUST A NOTE, WE WILL
RECONVENE TOMORROW AT 11 A.M.
EASTERN TIME. I HOPE YOU HAVE A
WONDERFUL EVENING. WITH THAT I
WILL ADJOURN THE MEETING. THANK
YOU.