share interactive transcript request transcript/captions live captions
download
|
MyPlaylist
SPEAKER 1: Thank you so much. And welcome to Inside Cornell. For those of you who have not been to an Inside Cornell event before, this is something that is sponsored by Cornell University through a series of roundtable discussions here in Washington DC and New York City.
And we feature some of our most prominent professors speaking about policy issues that are current. And today we're here to talk about-- the professors are here to talk about the latest dietary guidelines.
Our moderator today-- we're thrilled to have Allison Aubrey of NPR. Allison is a 2013 James Beard Foundation Award nominee for her broadcast coverage of food and nutrition. And along with her colleagues on "The Salt," she is the winner of the 2012 James Beard Award for best food blog. So thanks for helping.
ALLISON AUBREY: So I am pleased to introduce to you Tom Brenna. He is a professor of human nutrition and food science at Cornell. And as many of you know, a member of the 2015 Dietary Guidelines Advisory Committee. What I am fascinated by in Dr. Brenna's bio is that he spends a lot of time in the laboratory doing basic research-- bench science kind of work.
He has done all kinds of fascinating studies using techniques such as isotope tracer techniques and molecular isotope ratio mass spectrometry. Is that right?
TOM BRENNA: You got it.
ALLISON AUBREY: To probe our metabolism, which seems like a far step away from deciding should you and I be eating lean meat every day. But Dr. Brenna will convince you that he is-- we will ask him how he connects those two worlds in bench science and translational science. Next, is Dr. David Just, who is the director of the Cornell Center for Behavioral Economics in child nutrition programs.
He really uses the tools of psychology and economics to figure out why we eat what we eat and what we might be able to do to nudge people to a healthier diet. So why don't we begin with three to five minutes. Dr. Brenna, give us the lay of the land of what you've been working on lately and your experience on the Dietary Guidelines Panel.
TOM BRENNA: Well, thanks very much, Allison. I guess I'll pick up the isotope ratio in mass spectrometry and answer that question. In, let's say, the first decade I was on the Cornell faculty, roughly the '90s, we did a lot of work on omega-3 fatty acids and that isotope ratio technique was used to look at the metabolism of omega-3s.
And, ultimately, from a translational point of view, in part, led many other groups around world to the FDAs permitting omega-3 fatty acids and long-chain fatty acids in infant formula, which was something that happened in 2001. And so many of those things do have very strong connections to translation.
Certainly, there are a number of recommendations of panels along these lines. So I do however tend to think more chemically about problems than many of my epidemiological colleagues. To say a few words about the Dietary Guidelines Advisory Committee just as a general ground rule-- the Dietary Guidelines Advisory Committee is now disbanded.
So I am free-- free to speak. That was one of the slides they gave us in our training session. It was disbanded. We can say anything. The advisory committee is indeed advisory. The Dietary Guidelines for Americans, DGA, is something that will be put together by the secretaries of health and human services and agriculture and presumably will be published towards the end of this year.
It will be informed by the 570- page report and also evidence that connects to that report. And the secretaries will decide what policy is and take other things into account-- the science that was addressed.
This year we took a bit of a different approach than has been taken in previous years. Previous years have focused on foods or have focused on nutrients. And I must say in criticisms of those previous years sometimes, people focus on foods. And I get asked why don't you talk more about the nutrients and vice versa.
This year the focus was on dietary patterns. So that's the whole diet that people consume. And the reason that I think that we chose to focus in that way is that there has been a tremendous amount of activity in the nutrition research community in overall dietary patterns. The idea is to learn when individuals eat by asking them-- by looking at the food frequency questionnaires and then taking that big data and consolidating it down to something like a score, an index, or using other kinds of techniques in order to extract information about what a healthy overall diet looks like.
So these overall dietary patterns are really not focused specifically on one food or another food, but on a whole dietary pattern. And then we can say things about healthy dietary patterns and what characteristics that they have in common. And that's much of what's been discussed in public since the report has appeared.
One of the points that I think has not been made well about our findings were that of dietary patterns based on previous dietary guidelines advisories work out to be pretty healthy. And it could have come out the other way. In other words, the Healthy Eating Index, which was based on either of the 2005 recommendations and the 2010 recommendations-- have been studied.
The data are out there. And the folks that are adhering to that to a greater degree seem to have more risk of chronic disease than those who adhere to those recommendations to a lower degree. That's comforting for me. I haven't been on a committee before. And I'm glad to see that [INAUDIBLE] other folks-- the same things that are, well, not counterproductive. Let's put it that way. So that's terrific.
I'll just make a few more comments about various things. You've all heard about the coffee story. Coffee was a food we looked at, but we were mostly looking at it in terms of safety and found out that it's quite safe at three to five cups a day. That's about one-- I won't use a brand name-- 20-ouncer.
So that's terrific. And we also urge caution that maybe half that is OK for pregnant women. The cholesterol story has been a lot in the news. And it has mostly implications for eggs and perhaps shellfish. And that-- boy, the previous recommendations date from before my time in nutrition. I started in nutrition in the Jimmy Carter Administration, I suppose. Not, I forgot, on Capitol Hill-- almost. I wasn't in the administration. I was an undergraduate at that time.
And I remember in the mid-80s asking a professor at Cornell who was a prominent cholesterol researcher who thought we ought to limit cholesterol intake from eggs-- used to talk about putting warning labels on egg crates-- Danger, Contains Cholesterol. But the data were, I think, not as strong from a dietary point of view. Back then there were compelling reasons from the biology to think that prudence erred on the side of lower intake. But I think data indicate now that that's-- that really is not the case.
And then a couple of other points and I will stop talking for a bit. This was the first dietary guidelines group that considered mental health. I said a few things about it before. But we considered dietary patterns. There was a burst of activity in the last five years on dietary patterns and things like depression-- age-related cognitive impairment-- an aging population.
That's an important thing. And I think we took some of our cue from studies that have shown that omega-3 fatty acids are, well, actually therapy for depression, for instance. The American Psychiatric Association considers the adjunctive therapy to primary therapy for those with major depressions. There is meta-analysis out there that show that. Practice guidelines on depression say that. It's cited in the report.
And the dietary patterns evidence, although quite young, is pointing in that direction. We didn't feature it in summaries. But we think this is a very important thing. Nutrition above the neck is important. And I think I'll stop there.
ALLISON AUBREY: Great, so David, you want to take over?
DAVID R. JUST: Sure. My focus is primarily on consumer behavior and how consumers might respond. A short way of saying it is they probably won't. So you think about most consumers. And we make something on the order of 200 to 300 food decisions a day.
And in most of the decisions, we're under some sort of stress or in meetings or we're pushing a shopping cart through a busy grocery store with a bunch of kids in tow. And we don't have much time to go to any decision. And what that means is we'll fall back on habits and other things like that.
So the vast majority of people in the moment they are making food decisions are, no matter what they learn about these guidelines are probably are going to ignore them at the time that they are making their decisions. And that's what history has taught about these guidelines when they come out. They have very little impact there at that moment.
That said, that doesn't mean it's a wasted exercise because they do-- it does make some sort of impression on the consumers. And not all decisions related to food are in-the-moment decisions. Some of those decisions are much more related to how we structure our choices-- whether we decidie to have-- what we put on our shopping lists.
We're actually sitting down and thinking about it and what we decide to have displayed in our home versus put into a shelf up high or down low. So there it can have some pretty big impact. Although it has to be just through the people who actually pay attention to it.
Now, how are people going to understand these guidelines as they come out? I guess there is two big keys to it. It all rests on the idea that most people really aren't going to pick up the 500 and some odd pages and read through them. What they are going to do is they are going to get their information through the press. And they are going to hear little snippets here and there. And there are two things that govern how people process that information.
The first of them is that people tend to be much more willing to add things to their diet to try to get healthy then they are to take things out of their diet. So they are much likely to say-- have heard something about the guidelines and say, hey, I need to get more fruits and vegetables into my diet.
I'll take a banana with my lunch today-- or something like that-- then they will to read the guidelines on maybe you should cut back a little bit on the meat consumption. I'll ignore that. That tends to be how people do things.
And that actually is not too far afield from other main principals that govern people's behavior when they are looking at this type of nutrition information. And that's that they fall prey to what we call confirmation bias.
So essentially what happens is if I hear this information and it says I'm doing something good, it confirms my belief. Take it wholeheartedly. And it might even increase that behavior. Whereas if I hear something where it says I'm doing something bad, I'm going to look really skeptically at that. I might take some time to examine whether I really believe those studies or not and look for good excuses to eliminate that information.
So people hear coffee is OK. They are going to drink more coffee and feel good about it. And people hear that maybe they should cut back on meat. They are going to think, well, maybe there is some flaws in those studies. It also twists and distorts the information in some interesting ways.
So, for example, alcohol consumption-- as I understand it-- please correct me if I misstate. As I understand it, it says moderate alcohol consumption is OK. But it does not encourage anybody to start drinking or to increase their consumption of alcohol in order to come into compliance with these guidelines.
I think the way people are going to filter this is alcohol consumption is OK and ignore the rest of it. And people who are drinking are going to feel good about it and are probably going to drink a little bit more. That said, I don't want to overstate the reaction because it's [INAUDIBLE] to be almost no response at the consumer level.
How will it actually affect people? Well, it's mainly going to affect people through institutions. So kids eating in the school lunchroom-- the guidelines filter their way down into the school lunch program. Those kids are going to have a major change in their diet.
Institutional feeding or workplace environment-- a place like Google, for example, is pretty forward thinking. And they might pay attention to this and think what can we do to encourage our employees to eat a little bit better and set up an environment such that it's really easy for them to eat according to these guidelines and to discourage over-consumption of meat or other things like that.
A couple of things in here I really thought were interesting that was said in the report. One, I thought it was a really positive thing first off to recognize the role of the environment-- the decision environment. To a certain extent, they recognized that they don't have this first-order impact.
They aren't a whole bunch of consumers waiting for the guidelines to decide what to eat. Rather, it's the environment that makes the difference. And so if we're going to talk about changing this in encouraging better diets, we've got to think about that environment.
And the other thing that I thought was a really positive step was the encouragement for policymakers to work cooperatively with industry. And there are a few different reasons why that's a good idea. I know that some people look really skeptically at that.
But it's a very good idea first off because I looked at the controversy just this last week about meat-- meat consumption. If the food industry feels like they are a target, they have very, very easy means to go out and get the consumers on their side against the policy because the policy looks like it's then trying to target the consumer's behavior. And it's going to hurt this industry at the same time.
Where if you can work cooperatively with the industry, very often they can find ways that preserve their own interest. And industry is not going to do things that tick off the consumers because that loses their audience. They are going to try and find ways and do this that are friendly to the consumer and encourage the consumer. That actually makes it so it's much more effective for the consumer. They are much more willing to listen and follow along with an intervention that works through that industry, if you will. I think I'll quit there.
ALLISON AUBREY: OK, well, let's pivot off that point. And let's go to you, Tom. So let's imagine-- now I realize this probably would not happen where staff would be working with a report to then turn that report into dietary guidelines, which we'll see later this year.
But let's just imagine that Secretary Vilsack and HHS Secretary Sylvia Burwell called you into their office. And they said, Tom, we're a little confused. We really there's a lot of dismay about the meat issues. We're hearing a lot from the industry, as you know.
And as I read your report, I am confused about the language. On the one hand I see a broad statement about Americans should be moving towards less red and processed meat. On the other hand, I see a footnote that, hmm, lean meat is part of an overall healthy pattern of eating. How do I reconcile those two things and turn them into a simple guideline?
TOM BRENNA: Well, I think the report-- particularly the footnote that there are other places in the report that refer to lean meat that refer to them as being part of healthy dietary patterns. And the food modeling that was done showed that to be the case.
In dietary patterns-- and this is something of a technical discussion because the dietary patterns really has some technical meaning-- one looks at compliance to the dietary pattern-- let's say the top third versus the bottom third. So all at the top third have a lower risk of chronic disease than the lower third. And if you see a significant relationship and say, well, OK, so maybe there should be a bottom third-- closer to the bottom third than to the top third.
And that's the kind of information that these dietary patterns deliver. If you look at red and processed meats, that's a compilation of everything. So in a way, you're throwing bacon and lean meat all into the same group. And it's not as specific to a particular food. So I don't see a fundamental contradiction in those two things.
ALLISON AUBREY: So you think it needs to be specified in the guidelines to eat less of these foods-- bacon, hot dogs, and things that might fall into the category of processed? Does it need to get to that so people understand it?
TOM BRENNA: Yeah, good question. Our data really don't address that. So remember, [INAUDIBLE] people should eat less bacon. And most of our data really don't address that. The food [INAUDIBLE] empirical data on dietary patterns doesn't address that. Food pattern modeling addresses the lean meat question.
If you put together the other recommendation-- let's put two and two together for a minute. So you've got to lower your saturated fat diet a little bit-- not a heck of a lot-- a little bit-- something like 11.4% to 10%. And then we say, and lean meat is part of a healthy dietary path. You put two and two together. And it speaks towards lean meat as something that will help you get there. So I think that's an implication also-- maybe we didn't spell that out the way we should have in the report again as a policy question.
ALLISON AUBREY: So let me put this in question to you, David, and this time Tom Vilsack and Sylvia Burwell call you in and they say, David, we are trying to figure things out here. We want to nudge people towards that healthier choice. Yet we want not to [INAUDIBLE]. We're sensitive to the meat industry's concern.
What advice might you offer them? Would it be helpful to people if you say-- if the guidelines said something like eat less red and processed meat and in parenthesis gave examples? Is that helpful? I am just trying to figure out within my group of writing that would be more helpful to the pedestrians-- to us-- to people-- the eaters.
DAVID R. JUST: Sure. I guess it depends on what the goal is. If it's to get people to understand, then I think positive statements of what they should do actually make a big difference instead of-- so say you need to eat less. People understand less and more.
But they also-- it's a broad audience. And you don't know who you're talking to. So making positive statement is this is how much you should eat on average. And really getting much more complicated than that-- you're going to lose your audience.
ALLISON AUBREY: So let's move again in this scenario. Sorry to keep sticking you in this unlikely scenario here. But Secretary Vilsack-- and I love the emphasis of this. So we'll go with it. So they call you in and they say, we are-- we got a lot of pushback on this.
They veer into this territory of what policy steps-- taxing sugar-- might help nudge people to a healthier way of living you guys got-- there's criticism that perhaps you overstepped your boundary. Why did you include these in the report? And how strong do you think the evidence is?
TOM BRENNA: Well, it's gee, decades that nutritionists-- decades ago nutritionists were criticized because they were lab rats and developed ideas about what people ought to eat based on, well, what they fed their rats. And so then the question always was, well, how do you translate that?
So the way you translate that is you have people on your nutrition faculty that think about how people make food choices and economists and other folks like that. So we had quite a few people who spend their [INAUDIBLE] professional career looking at how people make food choices.
And they say, OK, I have a food environment that is conducive the right kinds of choices. And there's a list of things-- taxes was something that if you look carefully at the various bullets that are shown in that-- in that section of the report that mentions taxes said, well, this is something that ought to be looked at because price is a consideration. But the legislature decides with taxes.
ALLISON AUBREY: Since that's fair enough-- the legislature decides outside the purview who might use economics as a way to nudge people's habits. Take that question, David, from the perspective of Nestle calls you up, and they say, David, they have Digiorno pizza. It's a great selling item for us. People love the convenience of our pizza.
There's some sugar in the dough-- what might we be able to-- in some of the options-- what might we be able to do to bring our top-selling items more in line with the dietary guideline pattern eating? What might be some suggestions that are industry-friendly and healthy?
DAVID R. JUST: Right, so I guess the way I would put it is it's a good idea working to try and reformulate to try and meet these guidelines. You've got to be careful about the way you go. The more you trumpet these health claims for coming closer to the guidelines, the more people start to abuse the food.
So if you have the giant banner on the front saying lower in fat because we decided we wanted to try and be healthier. Well, people start then over-consuming or rewarding themselves in other way to try and compensate. And they over-compensate.
So it's actually must nicer if they can find ways to reformulate or to try and repackage their products so that they are healthier portions-- things like that. The consumer doesn't even think about it. So it's in the background. It's something that naturally occurs in their mind.
ALLISON AUBREY: Go it. So let's take that-- take that point of abusing the idea that something might be good for us of siloing things as devil or angel, which Americans seem to be quite good at. Sugar, for instance, there is in the report a recommendation that Americans limit sugar to 10% of the diet.
There is some addressing intrinsic sugars versus added sugars. Give it a little bit-- this is also relevant because of the reformulation of the label. The label may include an added sugar line. Is there a difference between the intrinsic sugars and the added sugars. There is a big fight as you probably know, lobbying fight, about whether the separate-- the separate lines should be on there. Does it give consumers more actionable information to separate natural or intrinsic sugars from added sugars?
TOM BRENNA: Well, I am confused by the sugar story. Sugar is, best I can tell, at some level [INAUDIBLE]. And added sugars are relevant, of course. But good points on both sides. People say, well, sweeten up a healthy food and people more of that healthy food as long they don't overdo it. That makes sense.
But then folks are also concerned with the so-called empty calorie story where soda pop is mostly sugar and water with a little bit of flavor. And people are concerned about that in terms of total calories. Remember that part of the dietary guidelines is to stay within calories that will maintain a healthy weight.
That's always there. So if we reformulate anything to be guidelines, and people eat more if it, then it doesn't meet guidelines. So that's an important point to keep in mind.
ALLISON AUBREY: So to you, David, making these distinctions between added sugars and total sugars-- given what you know about how decision making is made-- take the example of raisins and cranberries. So these are things that moms buy all the time for kids. It's a very common snack-- craisins or raisins into a lunch or into a snack.
And if you were to add-- if the new label has an added sugar line, the all of a sudden raisins come out looking sweet because it's natural sugar because raisins are sweet. Whereas craisins come out looking not so good because you've got to add sugar or whatever to it. And people are taught look for the added sugar. Look for the added sugar. Well, does that create a dichotomy that is not useful to the consumer?
DAVID R. JUST: It can be deceptive. And essentially what happens if all the trade offs are going to be within categories. It's going to be like you say. You're looking at the craisins versus the raisins.
And what happens is it leads you to ignore the baseline-- the amount of natural sugar that's in there-- it highlights-- or all it tells you is the added sugar, then you might be making a trade off for half the added sugar of natural sweetness. And that's the danger.
ALLISON AUBREY: Yeah. Let's move onto omega-3s. So you mentioned that you're an omega-3 guy.
TOM BRENNA: Thank you.
ALLISON AUBREY: And you mentioned that within the purview of the dietary guideline committee of that year, you did look at some of the accumulating evidence around this concept of nutrition above the neck-- from the neck up.
So what is it that made it into the report-- to my understanding-- and maybe I'm just not remembering it well. I didn't see anything top line that would change what the recommendation is about getting more fish into your diet. So what was the discussion in the panel? What's in the report that people may have missed? And is there any new, top line recommendation coming to the committee?
TOM BRENNA: Well, the committee doesn't discard what has been said from previous committees. So there was recommendations [INAUDIBLE] consumption of seafood while pregnant or lactating as well. And then seafood was called out and some of the top line stuff was being protective or part of a healthy dietary pattern.
As we then delved into the question of neurocognitive outcomes-- mental health-- depression and age-related cognitive impairment. Again, we've looked at the dietary patterns prompted in part from a lot of data that has appeared in the last 5, 10 years that indicate that omega-3 fatty acids are therapy for depression.
ALLISON AUBREY: Eating fish? Or taking omega-3s? Or both?
TOM BRENNA: Well, great question. The cleaner study-- the kind of study that you can design very carefully. It can really be a proper placebo-controlled trial are going to be the supplements. But if I take a two ounces of omega-3 fatty acids in a pill or I eat some salmon that delivers the same thing, I think it's reasonable to conclude that I'm accomplishing the same thing.
And fish doesn't just have three omega-3s. It's got [INAUDIBLE] too. So the question of how you establish mental health outcomes is really still early on from a nutrition point. I think we had an awful lot of discussion about the strength of that recommendation and the it was one of these line setters it ended up a little bit below. It could have ended up a little bit above the line. Then it would have been a top recommendation.
But again, you can talk an awful lot about the American Heart Association recommendations for omega-3s and not talk very much about the fact that the American Psychiatric Association has practice guidelines that [INAUDIBLE] as well.
So the brain is an omega-3 organ. It's full of fish oil. Don't write that down-- and the eyes. These are omega-3 organs. And that's not going away. The heart is actually not an omega-3 organ. But the brain is full of omega-3. So you've got to get it from somewhere. And eating it is the best way.
ALLISON AUBREY: I feel like if I asked a follow up question about that, it might take an hour.
TOM BRENNA: At least.
ALLISON AUBREY: Talk more about that. So let's move on. You mentioned this concept of confirmation bias. One of the things about fish consumption in our country is that pregnant women were scared off eating fish because of recommendations that came out from the EPA and FDA looking at the body of evidence on mercury and fish consumption.
And when I say scared off, I'm referring to studies that suggest consumption of fish among child-bearing age women drops to incredibly low. It's also low population-wide. So what is it-- how is it that in your world of economics, meaning behavior, you might be-- what would the technique be to get a message out about omega-3s in fish that might change this thinking?
DAVID R. JUST: Yeah, actually, it's really difficult to have a nuanced message that is effective. That's why I think, again, you have to go over something that is a positive message that says eating this amount of fish is good for you, even in child-bearing age or even among pregnant women.
ALLISON AUBREY: Especially?
DAVID R. JUST: Especially, thank you. It's got to be a very simple message like that because that's what catches fire. That confirmation bias plays in in a funny way because it's got to be something that people are willing to take into their diet. If it's something that they naturally have aversion to it or Americans generally [INAUDIBLE] they won't respond. It's got to be something that's attractive to them-- a simple, positive message.
ALLISON AUBREY: Got it. So let's move into the eggs and cholesterol. And I'm going to open it up for questions. So think of your questions. And so I will do that soon. I'm curious on the cholesterol issue. So pivoting off of this concept that things need to be simple or people just don't know what to do with the information.
One of the things about communicating the newer recommendation that the dietary guideline came out by saying we don't need to put in limiting dietary cholesterol to 300 milligrams a day. That can go away. That's your-- that's the guideline recommendation?
TOM BRENNA: That's what the committee said.
ALLISON AUBREY: Yes, that's what the committee said. So one of the things about interpreting that is that cholesterol is often delivered with saturated fat and a range of foods-- particularly meats. And it's led to some confusion that the coupling effect or the multiplying effect of the confusion is that is why we think that there is a nomenclature problem.
So the words we use to talk about the lipids in our arteries is also cholesterol. So the minute you start saying to people, oh, well, people start having this [INAUDIBLE] conversation of, oh, I've heard cholesterol is no longer a problem.
And it's like, wait a second here, no. I think what the dietary guidelines may be saying is that dietary cholesterol doesn't need to be limited to 300 milligrams. But, of course, the body of evidence suggests that people do worry-- need to be concerned about cholesterol in the bloodstream. Maybe this is the question for you guys.
TOM BRENNA: I was going to say that's perfect. They don't need me.
ALLISON AUBREY: Yeah, but how would we overcome this nomenclature problem and stop talking about the cholesterol in our bloodstream and our arteries as the same thing that we're talking about [INAUDIBLE].
DAVID R. JUST: That would be easy if there were just different words to talk about these things. But barring changes in the language, which I don't think are likely, it's got to be stated exactly that way. I think we've got to be careful when we talk about this to the public that we are actually saying dietary cholesterol. Cholesterol is still is something you've got to worry about just not dietary cholesterol [INAUDIBLE].
ALLISON AUBREY: Got it. All right, I'm going to open it up to questions. And [INAUDIBLE] I kind of want you to talk a little bit more about coffee-- about the growing body of evidence. It's not just OK for you. The panel says it may help cut the risk of type II diabetes. So answer that. And then raise your hands.
TOM BRENNA: We went after the safety question. And so you go and look at the data and the statistics not only don't show any problems between, again, three to five of the standard cups. But they are drifting. And they seem to go the other way.
Now, I personally, not personally, not speaking for dietary guidelines, but personally not terribly comfortable saying, right, you should drink more coffee. It'll cure cancer. I'm thinking that's not the message.
The really solid message is that drinking three to five cups of coffee, on average, is not a problem. And you didn't see increased risk or premature birth in pregnant women. That's got to be something [INAUDIBLE]. Because gee, pregnant women can actually eat something. They're told they can't eat anything.
ALLISON AUBREY: So just identify yourself for your question.
CHASE PURDY: Yes, this is Chase Purdy. I'm with Politico. I have two questions about meat. The first is how did the lean meat in a beneficial and balanced diet become a footnote? And is that something that the fact it's a footnote is something that we should be reading into? And also if you could go into the benefits of the red meat? Is that something [INAUDIBLE]
TOM BRENNA: I have a solid answer for how the footnote got there-- I don't know. I don't remember, and I suppose I should have checked, whether the last draft that I saw before the final draft had that footnote. I don't know if it was me in there.
So I don't know if we actually saw that drafted because there were so many drafts. There was a question about whether lean meat was included in the processed meats category in the last meeting of the committee. The meeting was in December. And there was a webinar. And you can look at what was said if you wanted to. It's on the web.
And so this question whether lean meat was in there came up. And I think the answer was yes. And so I suspect that's how it ended up there. But suspect is the operative word there. What was the second part of that-- red meat? What was the second part of the question?
CHASE PURDY: I was curious about the benefits of lean, red meat. Cut back on red and processed meats? [INAUDIBLE] versus their lean, red meat.
TOM BRENNA: Well, there's actually recommendation in the report saying that individuals ought to be [INAUDIBLE] I forgot what the category is that is thought to be consuming red meat-- red meat as a source of iron. So it really is not 100% negative.
ALLISON AUBREY: Another question. April.
APRIL FULTON: Hi, April Fulton with Geographic. I had a couple of questions. My first question was for Dr. Brenna. How much pressure-- because I know you were talking about the dietary patterns being the focus this year-- the whole pattern with the whole thing.
But sometimes I think people really want a list. Like what can I eat? What can I not eat? Is there political pressure that plays into the decision not to name certain foods or to name certain foods? Or how did that play out in the committee?
TOM BRENNA: I felt zero political pressure-- full stop. The respective staffs from Health and Human Services and USDA struck me as very careful to not push us in one direction or another. There was certain ground rules that they established to make sure we stay within them. But I felt no political pressure. I had no independence outside the committee. I don't know any folks getting a hold of me saying, hey, you ought to say something nice about-- pick something.
APRIL FULTON: And it would have to be positive, right? Not negative.
TOM BRENNA: Yeah, right. Get some more water or something. No-- so no political pressure.
APRIL FULTON: My other quick question was how does-- do the United States guidelines have relevance for the globe? Is there efforts to promote this as the way everyone should be eating?
TOM BRENNA: I think most people around the world-- most countries around the world look to whatever happens in the United States as something of a guide. But I can tell you that they don't slavishly follow what we say. In fact, I think the cholesterol recommendations [INAUDIBLE] due to the fact that hardly any other country has made recommendations on cholesterol.
They never pulled the trigger-- most of them. And so, well, OK, maybe we should rethink it. We've thought this for a long time as a community, not as a committee, but as community that we ought to rethink it because maybe we jumped the gun a little bit early on.
ALLISON AUBREY: A question over here?
EVAN HALPER: Hi, my name is Evan Halper. I am with the "Los Angeles Times." Can you talk a little bit more about the institutional impact of these guidelines? You mentioned school lunches, for example.
My children last week had a school lunch three times. It was pizza, pizza bagel, and grilled cheese. And it's a relatively enlightened public school in the districts here. So is that going to change? And how does it change? And how do these guidelines affect decisions made by these institutions?
TOM BRENNA: So my understanding is that dietary guidelines for Americans-- not the dietary guidelines of the advisory committee report, but the guidelines that the policymakers ultimately published are US government policy, US government has lots of them. So there's lots of meals-- military, hospitals-- all those sorts of places.
And it has a strong influence on that. And I suppose with the food and school lunch program, it would have influence on that. There's WIC-- there's other things. So this is part of that process. As to whether your kids are going to get something other than pizza, I am not so sure. Maybe they will get better pizza.
ALLISON AUBREY: Yeah, Larry?
JERRY HAGSTROM: Jerry Hagstrom from the "Hagstrom Report." I came in late because I was covering [INAUDIBLE]. So forgive me if you've been already been asked this. But when I read the report and I saw in the sustainability section what the committee said was the impact of agriculture on climate change.
I saw those statistics. And those statistics are controversial. And I wondered if members of this committee felt confident that they have the expertise to include that information in the report as an official statement of your views.
TOM BRENNA: This was the first time that sustainability, I gather, has been taken up by the dietary guidelines. We haven't discussed this [INAUDIBLE]. So it was a good question. And the committee had a couple of consultants that were not part of the committee, but were vetted the same way as the committee was in all of our discussions.
And the material in the report-- it's a report written by a lot of people. I'm not backing off on what I said about going another direction. But there's a lot there. And it should be considered for the evidence that it summarizes.
ALLISON AUBREY: Can you tell a little bit about how the consultants were brought into the process. Did they present the data on agriculture and climate change? Or how did that work?
TOM BRENNA: They were brought in, in fact, quite late because there was a vetting process for the six months or however long that they came in [INAUDIBLE]. And they were there to mostly answer questions. They were on calls and that sort of thing to kind of keep us grounded to say you ought talk with this guy about a particular issue and that sort of thing.
So they didn't come in and say, here's what I think you ought to include in this report to know. And I'm glad you asked the question because I hadn't thought of it that way before. So what's there is the responsibility of the committee.
JERRY HAGSTROM: So just a little follow up to that. Are they the ones who presented that material on the impact of agriculture on climate change? On the environment?
TOM BRENNA: They did not present it to us. We pulled together the data. We had the-- I don't want to take too much more time in answering the question. But there's a process. We asked a question. The federal staff go execute the process. We got a handful of papers. We look at the papers. And we draw conclusions from that. And they would have advised us on what those conclusions actually mean.
ALLISON AUBREY: Alan.
ALAN BJERGA: I'm Alan Bjerga from "Bloomberg News." You earlier mentioned how you felt no political pressure. And there were certain ground rules set for the beginning. But other than that, you just ran off as the data and the science seems to fit.
Immediately after the report came out, the secretary-- Agriculture Secretary Vilsack sat down some pretty strong ground rules as far as what he thought should go on with the consideration of the data before, which was he really wanted to focus on diet and nutrition.
When you guys were doing your work, did you have any sense of anticipating that your scope might indeed be limited post facto? And even you did or not, did you wish you had might of known that in advance rather than be in a situation where a lot of the work that you did could potentially be tossed out?
TOM BRENNA: So let me just clarify-- you probably are referring to the sustainability material. In part, yes.
ALAN BJERGA: That would be the main. But also from the public policy recommendations.
TOM BRENNA: Right, OK, sure. You're right about that, sure. So we were aware that-- I don't remember what house committee it was put it in a paragraph of language that said we're going to direct the secretary to ignore all this sustainability stuff. And I think we were ultimately aware that is part of US law now I gather because it was passed in a law. And I was certainly aware of it. I think we all were aware of it, which happened very early in the process.
And we just pressed forward with it. And I don't know how that feeds into what the secretaries are going to do. I assume they follow the law. So I think there was a significant amount of work done there. But I don't think it was the majority of the work we did. And in terms of recommending policy, well, [INAUDIBLE]. Again, it's recommended among a number of steps.
ALAN BJERGA: So it sounds like you recommend there was bully pulpit function to what your committee was doing [? and why you were going to use it. ?]
TOM BRENNA: I would say that was probably part of it. But there was also people who worked in the areas particular for the tax thing that I commented on earlier.
ALLISON AUBREY: Yeah, over here.
SPEAKER 2: Yeah, I'm [INAUDIBLE] nutrition and foods. So I just want to be clear going back to [INAUDIBLE]. How much of an alignment is the bottom line proposal with 2010? Is there a significant difference? Or is it very much the same?
And given that the secretary is saying that he is going to concentrate on nutrition and diet [INAUDIBLE]. If they came out with a final recommendation that looked very much like what came out in 2010, would that be consistent with what the advisory committee issued?
TOM BRENNA: I think it's quite consistent. It's a simple answer to you. It's [INAUDIBLE]
SPEAKER 2: All right. So the sustainability is [INAUDIBLE].
TOM BRENNA: The sustainablity-- is-- that's new.
ALLISON AUBREY: Go ahead.
SPEAKER 3: [INAUDIBLE] with The Washington Post. My question is about where exactly nutritional science is right now. We waver a lot over what we should be whether we should-- we should listen to in figuring out to eat and someone once told me something-- I think this might not be true-- that nutritional science is several centuries behind medical science.
I don't know if that's true. But the point is that it's very difficult to test. My understanding is that ti's difficult to run these long tests. You take what people say what they eat, which has been shown not to reflect exactly what they eat. And if you look back, there's some influence on patterns that people employee when choosing what to eat. It might be their egg consumption. It might be fish consumption.
Can you talk a little bit about the difficulties that nutritional science faces in knowing exactly whether people should eat something or another and not target the exact recommendation because people also [INAUDIBLE]
TOM BRENNA: Remember the purpose of this is ultimately to advise the government on policy. So the government is not advising people. It's advising-- it's making policy on how we ought to eat well. So overall [INAUDIBLE]. The difficulty in-- without getting into what's good about medicine and not so good about medicine--
SPEAKER 3: I didn't mean--
TOM BRENNA: --and what's not. That's OK. I appreciate that we'll have a day-long press conference for that one. But we also focus in nutrition. We tend to focus on this report focuses a lot-- it's no exception-- on chronic disease development.
And one of the things I've thought about is we think about chronic disease developing in 50-year-old men. And a lot of that. But the population isn't just 50-year-old men. It's pregnant, lactating women. It's kids. The purview of the committee is every American other than age zero to two years. Two years and up-- that's the purview of the committee.
And one of the reasons I was so delighted that we were able to do something about the neurocognitive mental health business is because we haven't addressed that before. That's really key particularly for kids, but also for military-- for all the stages of life.
Yeah, those are very difficult studies. We want to do randomized, controlled trials, but you can't do a randomized, controlled trial over 80 years. We can't feed kids one thing or another thing and then keep them masked from [INAUDIBLE] to another until they drop dead when they are 80. We can't do that-- that little experiment.
So you have to work with the material that you have. That's why we talk about associations. You measure things, and then see if people get sick or not. And [INAUDIBLE] both sides.
ALLISON AUBREY: Is it true to say that within the purview when you're looking at a body of evidence you want to see that, for instance, we take the issue of omega-3 fatty acids-- in this condition, you do randomized control trials, which is similar to a medicine that is tested. And then you can also do epidemiology to protect populations that eat a lot of fish or [INAUDIBLE] over time.
And if you use the triumvirate of data-- epidemiology, respective studies over time, and randomized control trial-- would you want to see everything pointing in the same direction? Is that how you start to consider a body of evidence?
TOM BRENNA: Yes, that's exactly what you're looking for. So you can do a proper, randomized control trial on omega-3 fatty acids [INAUDIBLE] as I said before. And then you can look at something about whether people that eat fish have medical issues that are consistent health-- that is consistent with that.
That's how we learn what nutrients do. We isolate them. And we study them. And we say, well, they are in food. That's how in the first half of the 20th century, vitamin C was discovered-- all the vitamins were discovered basically that way by narrowing it down-- narrowing it down chemically-- narrowing down what chemical fractions had bioactivity. So if your teeth are falling out, you say, well, you have-- you eat limes and they stop falling out. So there must be something in limes that's good for keeping teeth falling out. And you narrow it down to vitamin C. And that's the case.
ALLISON AUBREY: Final question?
SPEAKER 4: On the topic of nutrition science being centuries behind medical science. Could you comment briefly on the role of witchcraft in biodiversity? Just kidding. Final question.
ALLISON AUBREY: Yes, go ahead.
SPEAKER 5: You spoke about the difference between food decisions and habits of behavior. Can you talk a little bit about patterns [INAUDIBLE] is that case? How these-- how recommendations [INAUDIBLE]
DAVID R. JUST: So how does it affect patterns of behavior of individuals?
SPEAKER 5: Sure.
DAVID R. JUST: Really the interface-- so the biggest changes happen when institutions adopt some difference-- some change. So the new school lunch guidelines require a lot more fruits and vegetables actually being offered. And we do see more fruits and vegetables being consumed-- probably not as much as we'd like to see. But we did see an increase.
You find a lot of workplaces that have taken-- I mentioned Google-- they are not alone. There are lot that have actually tried to structure their cafeterias and workplace eating environments so that workers are naturally going to be eating healthier foods, snacking less, and when they snack, snacking on things that are good for them because it saves them money. And it gives them a more productive workforce. So those sorts of things-- really you do see a big change happening.
ALLISON AUBREY: Well, I want to think Tom Brenna and David Just. It's been a great conversation. Thank you.
TOM BRENNA: You're welcome.
[APPLAUSE]
Two of Cornell's leading nutrition experts, Tom Brenna and David R. Just, appeared in Washington, D.C. March 18, 2015 to discuss an extensive proposed rewrite of the federal government's official Dietary Guidelines for Americans, which are updated every five years. National Public Radio correspondent Allison Aubrey moderated the panel. The event was part of Inside Cornell, a series of public policy roundtables for journalists.
Tom Brenna, professor of human nutrition, food science and technology, served as a member of the 2015 Dietary Guidelines Advisory Committee. David R. Just is the director of the Cornell Center for Behavioral Economics in Child Nutrition Programs and a professor in the Dyson School of Applied Economics and Management.
