- What I'd like to do now is
introduce Professor Susan Nitzke,
who is a professor emeritus from UW-Madison.
And Susan we thank you for being with us this evening.
And we shift gears and talk in more details
on a topic related to what Professor Dr. McBride
talked about last week.
The question that relates to food, nutrition,
and related aspects of it.
So, Professor Nitzke.
- Thank you, Bassam.
I'm very pleased to be here.
So the points that I'm going to emphasize tonight are that
nutrition issues are really at the crossroads
for chemistry and where it meets social issues.
One of the things that affects the advice that we give
about nutrition is the serious public health concern
in the United States over the last decade or so.
Well, actually, a couple decades, about the expanding
rates of obesity, and how that affects how we see
the recommendations for how Americans
should change their diets for better health.
I chose the topic of sodium today
because sodium chloride is a very simple chemical compound.
There are many compounds that are essential for life
and sodium chloride is one of them.
You and I would not be alive if we did not
take in some sodium chloride in our diets.
But like so many things, too much is harmful,
and sodium chloride is a great example of that.
I'm going to also mention some other
nutrients that are of concern.
In addition to sodium chloride: saturated fat.
It is recommend that we reduce our intake of saturated fat
for some reasons I'll share with you in a minute.
And then there are some nutrients
that we should seek more of:
vitamin A, vitamin D, vitamin E,
vitamin C, folate,
calcium, magnesium, fiber and potassium.
Plus, if you're a woman of childbearing age, iron.
I call this slide "Says Who?" and, as a scientist,
as Bassam and I both try to
present the most reliable information we can find,
we are always concerned about
where do these recommendations come from?
Who's saying this, and what do they have to gain
by getting us to believe what they're reporting?
I have a link here.
I'm using a lot of the information from a report that came
out earlier this year
from the Dietary Guidelines Advisory Committee.
By law, every five years,
the U.S. Department of Agriculture
and the U.S. Department of Health and Human Services
get together and review an official document
called the Dietary Guidelines for Americans.
And then that, that science-based document
is used as the basis of a lot of policy decisions.
Everything from what's available in the WIC program,
if you know what WIC is.
It's a supplemental nutrition program
for women, infants and children.
What's served in the school lunch program,
and what kind of public health incentives
there are to, for instance, reduce sodium in the diet.
I just wanted to quickly show you that this
scientific report put together by the advisory committee.
The advisory committee has nothing,
no close ties to the U.S. government.
Congress can't tell them what to say.
Food companies can't tell them what to say.
They are people like Bassam and myself
who work at universities, mainly.
There are also some physicians
and some public health experts.
There are 14 of them.
And they have gone through a 2-year process of reviewing
the scientific evidence behind the dietary guidelines
and writing a report to the secretaries of Agriculture
and Health and Human Services.
And then, as I mentioned, by law every five years,
those two agencies get together
and put together their report for Congress,
for the public, for everyone,
about how the American diet should change.
So there will be some politics
that get into the process as
the Dietary Guidelines Advisory Committee's report
goes into the policy documents.
But the advisory committee's report was put together
by a panel of scientists who have
almost no political affiliations.
I'm also going to share with you information
from the U.S. Centers for Disease Control and Prevention.
In fact, I recommended that you read a short report that
they have on Q&A's about salt and sodium,
and that comes from the Centers for Disease Control.
I have a little bit of information
from the U.S. Department of Agriculture''s
diet recommendation system called MyPlate.
And when it comes to advocating for change
and talking about how we can take these issues
and talk about social ramifications,
I thought Michael Pollan's piece was a good summary.
Now, normally I don't quote Michael Pollan
because he's a journalist, and journalists,
when they write about science, sometimes they get it right,
sometimes they get it a little confused.
But Michael Pollan, when he talks about advocating
for change, that's his territory, and I thought
he did a very good job on that topic.
So I mentioned obesity as an overarching condition
that affects our nutrition recommendations.
It raises the risk of heart disease and stroke,
also other diseases like diabetes and cancer.
In 2008, $140 billion
of medical cost were attributed to obesity.
For an individual who is obese,
on average, that person's medical costs
are $1,400 a year higher.
So already you can see some
social ramifications to obesity.
Obesity is more prevalent in some subgroups
of our population than others.
Non-Hispanic blacks, a designation of African Americans,
have the highest age-adjusted rates
of obesity in the country, about half,
and as a matter of fact, this was from a JAMA article
in 2012, it's now over 50%.
Compared with Mexican-Americans who also have a high rate,
and Hispanics.
This slide does not show the rates for Native Americans,
or American Indians, but their rates are the highest of all.
Now, how do you know if you're obese?
The common measurement that's used
is a quick calculation that can be done
in any clinical setting, any, those of us sitting here,
if we took a few minutes with our smartphones,
we could do it.
You just take your weight in pounds and you divide it
by your height in inches squared,
and you multiply that number by 703.
The people who actually do these scientific calculations
on a routine basis use the metric system,
but I converted it here to pounds and inches.
So for example, a person who weighs 150 pounds
and is five-foot-five would get a number
of 24.96, right on the edge.
If that person had come out with a number
of under 18.5, it would be considered underweight.
There aren't too many people that are in that category,
but there are people in that category.
18.5 to 24.9
is the range that's considered a healthy, normal weight.
Now more than half of Americans, and as a matter of fact,
two-thirds of Americans are in one
of these last two categories.
In the category of 25 to 29.9 is considered overweight.
And then over 30, or 30 and over, is considered obese.
Just because you need to know that it's not
just the diseases I mentioned a few minutes ago,
but also gallbladder disease, arthritis,
apnea and breathing problems, inflammation disorders,
several kinds of cancer,
and there's actually a longer list but I stopped here
because it's too depressing.
(laughter)
How many of you have seen maps like this,
showing the prevalence of obesity?
How many of you remember hearing
that Wisconsin has the highest rates
of obesity in the country?
Yeah, I think everybody who raised their hand
is maybe over 30,
maybe even getting up into my age category.
When the Centers for Disease Control started putting out
these maps, they didn't have the data for every state.
They had the data for over half of the states,
and Wisconsin, being a progressive public health state
in the '70s, had good data.
And our data showed that
we had one of the highest obesity rates in the country.
Since then, all 50 states have joined the survey,
and this is based on, actually,
a telephone survey that's done every year,
sanctioned by the CDC, in which they call households,
now they call also on cell phones because so many people
don't have a home line,
and ask a bunch of questions about whether you smoke
and whether you use seatbelts and all of that.
And one of the things they ask is,
for a selected adult in the household,
how tall and much that person weighs.
And the simple calculation of BMI that I showed you,
Body Mass Index, leads to these figures.
And if you can see on the bottom,
the kind of yellow is for people,
or states, that have less than a quarter
of their population in the obesity category.
Not overweight, but obese,
the highest number, the over 30.
And the light green,
oh I'm sorry, that's the 20% to 25%.
Then 25% to 30% is
the category that Wisconsin is in.
We have 25% to 30% of our population
categorized as obese.
Isn't that a relief, We're not the highest
in the country anymore, for a number of reasons.
If you remember one thing I said a few minutes ago
about the ethnic representations?
The number of blacks and Hispanics
are quite a bit higher in some of the other states
than they are in Wisconsin,
and that's probably part of that reason.
And before we feel too proud about being in the yellow,
let me point out to you
that the latest numbers are like 29.8.
So all we need is a few more people to gain five pounds
and we spill over into the orange category,
which is 30% to 35%.
And then a few unfortunate states,
West Virginia and Mississippi, have more than 35%.
More than 35% of their population,
not adults, not just overweight, but obese.
This is what, you have to be like 30 to 40 pounds
overweight to get into that category.
This is a serious public health issue.
Personally, for the person
who has obesity as a health condition,
and for our nation, that has the health care
costs associated with obesity.
The rates have changed over time.
This is from the Dietary Guidelines Advisory Committee
report that I told you was put out earlier this year.
And you'll see three shades of gray.
The one on the bottom is for the percent
of the population that's overweight.
Over time, starting from 1988
to '94 is the first time period.
And then ending up in the 2011, 2012 time period.
You can see that for males on the left,
the rates of overweight have actually
gone down a little bit, yay.
However, in that overall
chart on the left, you can see that the number
who are obese have gone up.
So that totally the number who are overweight,
obese, or extremely obese,
extremely obese is a BMI of 40 or higher,
make an overall trend to increase,
with a little bit of dip
right at the last couple of years.
Let's cross our fingers and hope that little dip doesn't
go back the other way.
For females, the overweight has been pretty steady.
The rates of obesity increased a lot
around the turn of the century.
And unfortunately, you can see,
it's a really statistically significant trend
that the rates of extreme obesity have gone up,
especially for females.
Extreme obesity, this, these are people
who are like 80 pounds overweight.
Now, over the years it's been really hard
to try to detect this condition in children
because of how we define overweight
and obesity and how we want protect the sensitivity
of children by not giving them labels.
But the Centers for Disease Control decided
that we actually need to use these terms
"overweight" and "obese," and based on some historic data,
based on the number of kids
who were at the top 10% and the top 5%
back in the 1968 time period,
we now have those rates
of that level of body fatness
affecting 10% and 30%
of our children, cumulatively.
So what used to be the top 10% of body weight in children
is now exhibited by 30% of the children in this country,
and it's true for both boys and girls.
That prompted the Economist magazine
to put out this cover
in 2003, over 10 years ago.
And I think those of you who are fans of evolution might
see either the humor or the tragedy
in this particular depiction.
Now, if you're not obese, good for you,
but you still need to eat well.
A lot of those disease conditions that I reported
are still affected by how much you exercise
and how well you eat.
And we have good data that just being thin
doesn't get you off the hook.
A few of you are a little disappointed by that,
but oh well.
Which nutrients do we need more of in the American diet
and which ones are overconsumed so that the official
recommendations say to have less?
Guess which ones are going to be on the list
I'm going to show you next.
These are the shortfall nutrients,
and the nutrients with the stars are the ones
that the Dietary Guidelines Advisory Committee
said are public health concerns.
They're not only significant less than recommended levels
for the American population based on a lot of biological
calculations but they're associated
with a significant rate of chronic disease risk.
So that low intakes of these nutrients
have a measurable and definable
and detectable public health consequence,
and personal health consequence.
So you can see vitamin A is number one on the list.
I have a colleague in the Department of Nutritional Sciences
who is one of the top experts in the world,
and she would be happy to give you a lecture
all about the chemistry of vitamin A.
And how it's also easy,
and in some parts of the world prevalent
to get too much vitamin A.
So just like carbon dioxide and all those wonderful
things, we need enough but not too much.
But in this country, especially unless you're taking huge
supplements, you're likely under the recommended
amount of vitamin A.
Vitamin D has a star.
And as many of you would have mentioned to each other,
there's been a lot of publicity about vitamin D.
When I was a kid I even knew about vitamin D
because it's related to your, the health of your bones
and it was one of the reasons you needed to drink your milk.
But nowadays we have a number
of health consequences that are associated
with low intakes of vitamin D,
and low levels of levels of vitamin D in the body stores.
Vitamin E, vitamin C are quite familiar.
How many of you mentioned folate to each other?
Folate is one that people don't hear about a lot.
It doesn't have a star, so we don't have for sure
some disease conditions that are associated
with low intakes within the range
that are a problem in this country.
But the typical intakes are much lower than recommended.
Folate is one of the nutrients associated with cell growth.
So it's pretty important, especially for young children
or people who, pregnant women, people who are undergoing
a lot of cell division like,
that is prevalent when a baby is growing
or when a young child is growing.
Calcium has a star.
I think you are all quite aware of the osteoporosis
associations with both calcium and vitamin D.
How many of you mentioned magnesium?
Ah, there's a hand back there, okay.
Magnesium doesn't have a star, but it's definitely
on the list of nutrients that we don't
take in anywhere near, on average,
the recommended amounts.
The next one has a star and it's really important
and a lot of people don't think of it as a nutrient
because it's chemically a little more complicated
than, say, vitamin C.
How many of you mentioned fiber?
Okay, a few hands.
Good for you, you get a star.
And notice that there's a star next to fiber.
It is a nutrient of public health concern
and I'm going to talk a little bit
more about that in a minute.
And I'm willing to bet very few
of you mentioned potassium.
Two people, three, okay.
It has a significant effect, along with sodium chloride,
which is the nutrient that
I am emphasizing today on blood pressure.
And I'll get to that in a minute.
And I already mentioned iron.
It's got a special little category.
It gets a star for women of child-bearing age.
Over-consumed nutrients, there's two of them:
sodium and saturated fat, along with added sugars.
Added sugars, that's a funny name for a nutrient.
Of course there's no chemical difference between the sugar
that's added to food, like the sugar in a Coca-Cola,
or a Pepsi or a Squirt or Gatorade,
than there is in the sugar that's in, let's say, pineapples.
Chemically there's no difference
but we do a really good job of consuming
too much, not pineapples,
but the other kind of sugar, the sugar that's been taken
out of one food and added to another.
The Dietary Guidelines Advisory Committee says we should
have less than 2,300 milligrams of dietary sodium per day.
That's about a teaspoon.
The typical intake in this country is much higher,
as I'll tell you in a minute.
Less than 10% of our calories should
come from saturated fat.
The recent, the 2010 edition
of the dietary guidelines
made a big deal about solid fats,
which included saturated fats and trans fats.
Dr. McBride probably talked to you
quite a bit about trans fats.
You probably know that the Food and Drug Administration
has issued an edict and told food companies,
"Okay, you've got three years,
"and in those three years you gotta get
"your trans fats out of the food supply.
"No more ifs, ands or buts.
"The evidence is just too strong."
So, I'm not going to talk about solid fats as a combination
of saturated and trans fats like I have
for the last five or ten years,
I'm now going to focus in on saturated fats,
with the caveat that over time trans fats
will leave the food supply.
And then the setting of a limit for added sugars
has been incredibly difficult
for scientists to agree on,
but the latest recommendation is 10% or less
of your calories should come from added sugars.
That seems like that should be easy, but most of us aren't
doing a very good job of meeting this recommendation.
And if you know any teenage boys,
I guarantee they're way, way above.
Okay, so let's talk in terms of food.
That's enough about nutrients.
We don't eat vitamin A, we don't eat potassium.
If we did eat potassium we'd probably be in trouble.
We eat these nutrients in salts
and in chemical combinations
that put together to make our food.
And the Dietary Guidelines Advisory Committee said there
are several recommended dietary patterns that will help us
meet those nutrient recommendations.
One of them you're quite familiar with, I bet,
is the Mediterranean diet.
Another one is the diet pattern recommended in the U.S.
Department of Agriculture's MyPlate food guidance system
that I talked about a minute ago.
Either way, we need to eat more fruits, more vegetables,
more whole grains.
We need to eat more low-fat or non-fat diary
or the equivalent.
More seafood, more legumes,
which if you don't use that term a lot,
is peas and beans,
soybeans, and nuts.
We should eat less red meat and processed meats,
for a number of reasons.
One has to do with that water chart
that Bassam showed you a little while ago
about how much of our water supply
is threatened when Americans eat so much red meat.
Some of these things go around and come around
and I'll talk about that again in a minute.
Less sugar-sweetened foods and drinks.
Oh, darn, that's my downfall.
And less refined grains, which is the source
of a lot of added sugar in our diets.
So I think many of you know sodium chloride
is the chemical name for salt,
which is abbreviated N-A-C-L.
Food labels use both terms, sodium and salt,
so some people get a little confused.
Salt is 40% sodium and 60% chloride.
A high sodium intake is related to high blood pressure
and stroke and heart disease.
And as I mentioned, we're recommended to have less than
2,300 milligrams, less than a teaspoon a day, of sodium,
and we get 3,400 milligrams as an average
and many people get a lot more.
The sources of sodium in the American diet,
according to the latest figures.
See that big gray half of the circle almost, on the right?
If you can't read the little words there in white, it says,
"Mixed dishes," and then those are broken up
in that bar on the left.
Pizza 6%, burgers 21%.
Meat, poultry and seafood dishes 6%.
Rice, pasta and grain dishes 7%.
And soups, 4%.
So if you add those all up, "Mixed dishes" accounts
for 44% of the sodium in our diet.
Another big category there is grains.
And another big category is protein foods.
Protein foods being meat and poultry and eggs.
And then, but really all of the food groupings
contribute quite a bit of sodium.
This is one where beverages kind of get off the hook.
One thing that may surprise you
is how much of it comes from grains.
If you eat bread, those of you who make bread,
know that most of the bread that we eat
in this country has quite a bit of sodium
added to it in the form of salt.
It helps control the action of the yeast
and it helps the bread taste better
and it keeps it from getting stale faster.
For a number of reasons
there's quite a bit of sodium
or salt in bread foods.
Dairy might surprise you.
In that case, it's one of the few foods that just is
naturally occurring to be,
not high in salt, but more salt
than a lot of other foods would have if we didn't
add any sodium.
And if any of you have been put on a, like, you have to go
on the strictest diet possible for your sodium intake
for medical reasons, you might have actually been told
that you have to be careful of your dairy intake.
The rest of you that's not so much of an issue.
I thought this was interesting
from the Dietary Guidelines Advisory Committee's report.
They looked at the amount of sodium we get
if we get our food from stores.
That's the dark diamond-shaped bar on the bottom.
The stars represent schools and daycares.
The little open triangles represent quick serve
restaurants, the kind of drop-in or drive-through kind,
or the other kind of restaurant is the open square.
That's more like the sit-down restaurant,
like going to Applebee''s or something like that.
So you can see that it's almost
like the faster it is,
the more trouble you're going to get into.
But the sit-down restaurants are really good also
at giving us a lot of sodium.
So it's one of those cases where going
to a sit-down restaurant isn't going
to make your diet that much better
than going to McDonald's or Burger King.
The dark line is the middle is HEI limit.
HEI stands for the Healthy Eating Index.
It's an overall index that's used as a measure
of diet quality in the U.S.
So you can see that no matter where you get your food,
the density of sodium per thousand calories
is above the recommended levels.
And you're going to need to be really careful if you want
to obey the recommendations for sodium.
I gave you on the top of the slide the link
to the full recommendations of this tip sheet.
If you're concerned for eating less sodium,
the very first thing is to think fresh.
That's because over three-quarters of the sodium
in our food supply comes from salt that somebody put there.
Not necessarily in the milk you drink but in just about
everything else, somebody salted it
before you ever got your hands on it.
If you went out for pizza,
you can be darn sure that's the truth.
But even if you made your sandwich with a piece of bread
and some ham, somebody put a lot of sodium in those
components, the mayonnaise, the mustard, everything.
While you're thinking fresh, Enjoy home-prepared foods
because then you have control
about how much sodium is added
once the food gets home from the store.
Fill up on veggies and fruits.
Mother Nature gave us some very low-sodium food products.
And if you have a garden like mine right now
that is the easiest thing to do in the world.
In fact, before I came here today,
I picked raspberries and peas.
Choose dairy and protein foods that are lower in sodium.
Protein foods: beef, pork,
chicken, fish, eggs.
Those foods many of them have a lot of sodium added
before you buy them or before you eat them.
Adjust your taste buds.
Research has shown over and over again, we're not born
with a preference for salt like we are for sugar.
Little babies, they'll smile
when you give them sugar-water.
They even think they feel pain less
when you give them sugar-water.
That is reinforced over time.
But the preference for how much sodium we like in our food,
that is learned.
We have come over the years
to decide that food doesn''t taste salty enough
because it's not what we're used to.
So the good news is we can unlearn that.
If you try to do it right away, you're going to go,
"Oh, this food, it doesn't taste right!"
A year and a half ago I went to Tuscany.
And those of you who have been
to Florence and Italy and that area
might know about the historic reason that they
don't add salt to your bread, their bread and butter.
It has to do with wars, like everything else.
But anyway, they learned to have butter and bread
without sodium and they never did start putting it back in.
So the restaurants that serve traditional foods
have low sodium bread and butter.
And, of course, when my husband and I from Wisconsin
were there we're going,
"This is so bland!"
because we're more accustomed to what bread and butter
tastes like in our country.
But you can adjust your taste buds.
And the people in Florence tell me they think it tastes
better the way they eat it.
Skip the salt, take it away from the table.
If somebody wants to add salt to their food,
make them get up and go find a salt shaker.
One of your big incentives to deciding,
"Well, maybe it's salty enough."
Read the labels.
(sighing)
I feel like I should wag my finger.
You know I go to the store
and I just find labels fascinating,
but some people don't for some strange reason.
But here's the good news.
Most of us buy about 80% of the same things this trip
to the store as you did to the last trip to the store
as you did to the trip to the store before.
So once you've read the labels
on the hot dogs versus the bratwurst,
you don't have to do that again,
because you already figured that out
and you can go for the one
that you already figured out is low sodium.
So spend a little time and then you'll know
some very useful information.
Pay attention to condiments.
It's the things that we put on top of our foods.
Just think of the last time you had a hot dog.
As if a hot dog wasn't salty enough, right?
If you're like me you like sauerkraut on your hot dog,
ketchup, mustard, pickles.
I mean, can you think of anything you put on a hot dog
that isn't high in sodium?
A good example of being careful of your condiments.
And then, this tip for eating less sodium
ends up with the recommendation,
"Boost your potassium intake."
Now boosting your potassium intake is not
going to automatically make you eat less sodium.
But, it's a very important nutrient
because potassium helps to counterbalance
some of the effects, the chemical effects on the body
that makes sodium raise your blood pressure.
That's true if you have high blood pressure
or if you have normal blood pressure.
I once asked my primary care provider,
"Gee, my blood pressure is low, should I be worried?"
My husband is so jealous, he gets mad at me every time I go
because it's like 110 over 70 at its highest.
And she said, "Listen, If you're conscious, it's good."
So unless you're passing out from low sodium,
don't worry about low, low blood pressure.
So even if your blood pressure is in the normal range,
lowering it a little bit by eating more potassium
and less sodium isn't going to get you in trouble.
The recommended amount, for those of you who like numbers:
4,700 milligrams of potassium a day.
The best food sources are leafy greens.
Examples are spinach and collards.
Fruit, especially fruit that grows on vines.
Root vegetables were mentioned earlier
about how much water they take,
but they are excellent sources of potassium.
And citrus fruits.
Now the next slide I'm showing you
is a little bit hard to interpret
so let me spend a minute on it with you.
One of the recommendations that I bet everybody in this
room needs to pay more attention to,
is the recommendation to eat more whole grains.
Not just for fiber, but importantly for dietary fiber,
but for a number of those nutrients
that we're recommended to have more of.
Potassium, even.
And whole grains in this country,
no matter how much I've been telling people for 30 years,
"Eat more whole grains," they're not doing it.
This chart, if you see where the zero line is
in the middle, the black line shows the percentage
of the population that has intakes of whole grains
below the recommendation that,
which is roughly the equivalent of 3 ounces a day.
The little white bars that you can hardly see are the ones
who meet or exceed the recommendations
of about 3 ounces of whole grains a day.
Roughly a slice of whole wheat bread,
100% whole wheat bread.
Some of you probably are eating whole wheat bread,
whole wheat pasta, most of your grains
in the form of whole wheat, most of you are not.
When I go to a restaurant and I ask
if they have any whole wheat
to put in the little bread basket on the table,
they look at me like, "Oh, nobody's ever asked that before."
I'm like, "What is this about?"
This is not a new recommendation,
this has been around for 20 years.
For some reason, people aren't doing it.
I think it tastes better when it's whole grain bread,
but maybe I'm just goofy.
Now refined grains, on the other hand,
we're all doing a splendid job, too splendid.
Refined grains are the ones that are made out of enriched
flour or non-enriched flour, processed flour, that has
the bran and the germ taken out of it,
and many times sugar and other things added.
So notice how tiny the black lines are for refined grains,
and how huge the white and gray bars are for meeting
and exceeding the recommendations.
Over time, we've done actually a little better.
The black bars are for 2001 to 2004.
The good news is, for many of these age groups,
the ones with the little stars, the ones that are higher
are the ones that are different are higher.
So some people are actually eating more whole grains.
Nobody's, no age group is anywhere
near the 3 ounces a day,
but at least they're creeping in that direction.
I take hope on small, wonderful changes.
I call this one "Whence Cometh Thy Grains?"
So on the left side is whole grains
and on the right side is refined.
And the same little symbols that you saw before
for going to the grocery store
and going to a sit-down restaurant,
going to a quick-serve restaurant
or eating at a school or daycare.
You can see that for whole grains, they're all low.
But the people who get their food from the store
do a little better.
And for the refined grains, they're all high.
But the quick-serve restaurants
are the biggest source of the refined grains.
Now, we are in Wisconsin and I love to talk about dairy.
And I also get a lot of skeptical looks
when I talk about dairy because a lot of my friends,
my hobby, now that I'm retired is I'm a watercolor artist.
And when I talk to my art friends,
they all think they're supposed to eat less dairy.
They're something inherently wrong with eating dairy.
It's mostly fat or gives you some kind of awful disease.
But I can assure you all those scientists
that I mentioned a while ago that talked
about the nutrients we need to eat more of
and the food group we need to eat more of,
they say consume more dairy.
If you have lactose intolerance or for some reason,
a personal reason, you're a strict vegetarian or whatever,
you need to be very cognizant of getting
a good intake of alternate sources.
And alternate sources are not always
good sources of the same nutrients.
So read the labels, look at soy milk or almond milk
or whatever it is that you're using as a dairy equivalent
and make sure you're getting a fortified version that has
as many nutrients added back as possible.
For most adults, on a 2,000 calorie diet,
the recommendation of dairy is three cups a day.
That's not three cups of milk,
but three cups of what would have
been milk when it started out.
So cheese and yogurt and all of that.
Notice most of these black lines are way longer
than the white and gray lines.
And the older you get, the longer the black line is
compared to the white and gray line, meaning the more
people are not getting their recommended intake of dairy,
which usually means they're not getting their recommended
intakes of calcium, vitamin D,
and one of the nutrients
that dairy's a good source of: potassium.
Remember what we said about potassium a few minutes ago?
And over time, it's not unlike whole grains.
It's not gotten better; when there's changes,
many of them are in the wrong direction.
Here's one of my favorite topics: the added sugars.
If you eat pineapple or if you're like me and went out
to the garden today and picked some raspberries,
the sugar in there is not added sugar,
that's the sugar that Mother Nature put in your food.
If you had a Coke or a Pepsi
or a sports drink or an energy drink
or something that's marketed as being really good
for you because it's high in electrolytes or something,
if it's sweetened with sugar, that's still added sugar
and it affects your body in the same way
as if you had a Coke or Pepsi.
By age group, remember when I said teenage boys?
The black bars are for their calorie intake
where their limit is for how many added sugars
they're supposed to stay under.
Notice for a 14- to 18-year-old male,
way more than twice that much.
They are champions at eating foods
that are high in added sugars.
When my kids were growing up,
when they would go to the school bus,
the middle-school age boys who lived next door
had Mountain Dew for breakfast every day
and went through life with a diet that wasn't much better.
And I was like, "Don't look at him."
But it's what's happening in our society.
Now many people might be surprised.
This list is out of the Dietary Guidelines Advisory
Committee report combined
with the 2010 version
of the Dietary Guidelines for Americans.
These are the words that you might find on food labels
that are counted as added sugars.
And some of them will surprise you.
You all know white sugar's chemical name is sucrose,
and that, of course, is sugar.
Dextrose is a little more of a chemical name,
you might see anhydrous dextrose.
A lot of people tell you brown sugar
is better than white sugar, I wish that were true.
Confectioner's powdered sugar is just sugar.
Corn syrup and corn syrup solids, sugar.
Fructose, sorry, it's sugar.
High-fructose corn syrup, sorry, it's sugar.
One thing that surprises people:
from a chemical standpoint, the amount
of sucrose and fructose, the chemical makeup
of high-fructose corn syrup is very similar
to that of sucrose.
It's really hard to say that it has much of a difference
in its effect on the body.
Honey.
To heart, I wish honey was off the hook, but it's not.
Its effect on the body is very similar to sugar.
Invert sugar, lactose, which is the sugar
that's naturally occurring in milk,
malt syrup, maltose, maple syrup,
molasses even is a form of added sugar.
You can't even get off the hook with that.
One of the things you'll see on many of the products that's
marketed as better for you than foods that are sweetened
with sugar are sweetened with a concentrate that's
extracted from a very sweet fruit like pears or pineapple.
That's considered added sugar.
And then pancake syrup.
And one of the banes to my existence:
the food products that,
if I had a good lawyer and unlimited resources, I would try
to get them to stop calling sugar "cane juice,"
because all sugar starts out as cane juice.
And finding the words "cane juice" on a food label,
you can go right back up to the thing
that's on the top of this list.
It's equivalent, it's the same chemical.
The sources: look at that big white,
almost half of the circle on the right.
Remember those teenage boys I talked to you about?
Beverages.
Please read the labels.
Don't be fooled by names like "energy boost."
Many of them are sweetened with one of these.
So, soft drinks, fruit drinks.
Many people add sugar to their coffee.
I add sugar to my tea sometimes.
Alcoholic beverages not so much for most people.
But sports and energy drinks,
as I mentioned, are not off the hook.
And then of course you're probably not surprised
by the gray semi-circle over there about 10 o'clock:
snacks and sweets.
I happen to be a chocoholic.
I can attest to the fact that
that's a big source of added sugars.
Now another thing that we're recommended
to eat less of is saturated fats.
It has to do a lot with heart disease rates
and the different types of cholesterol
and how they're transported in your body.
Notice the sources of the saturated fats in our diet.
If it weren't for pizza and burgers, we'd actually not
have to talk so much about saturated fats.
Dairy, if you consume the cream portion of the milk,
that's where you would get a lot of saturated fat.
Protein foods, I think Bassam mentioned a steak
earlier on, and if you have a barbeque,
now you get to not only feel guilty
about all the water that went into that beast but also
all the saturated fat that's in a good,
well-marbled piece of meat.
So the easy rule for that one is to favor meats that
require a lot of cooking to soften them up,
because those are usually not that well-marbled
and don't have so much fat in the muscle.
Snacks and sweets are there again
as a big source of saturated fat.
If you look, a lot of them have coconut oil or might even
have a vegetable oil of sorts, not just animal fats.
But there are a few vegetable fats, like coconut oil
and palm and, palm kernel oil,
that are also high in saturated fats.
Remember what I told you about where, what kind of store
you go to or what kind of restaurant you go to?
Again, if you buy your food more from the store
than from a restaurant or sit-down restaurant,
you're more likely to be buying foods
that are a little lower on the saturated fat intake.
Still, a little bit over the limit that's recommended,
but a lot closer to that dividing line.
Now I want to get to an issue that goes back
to what Dr. Shakhashiri said.
This is almost word-for-word out of the Dietary Guidelines
Advisory Committee's report.
And I want to show you something that was in the news
today and has been in the news on and off
the last few weeks.
The Dietary Guidelines Advisory Committee,
not government people,
not people who work for the food industry,
but people who work in public health, clinical settings,
and university researchers.
The major findings regarding sustainable diets
was that a diet higher in plant-based foods,
such as vegetables, fruits, whole grains, legumes,
nuts and seeds, and lower in calories
and animal-based foods is more health-promoting
and is associated with less environmental intake
than is the current U.S. diet.
While they might've, this is like, buried on page 42
in a whole list of recommendations,
but don't think that people
who make that lower-ends food list
didn't take notice,
and immediately send their lobbyists to cCongress.
And in fact, there have now been laws proposed
to direct the Secretary of Agriculture
- and the Secretary of Health and Human Services,
to tell the Dietary Guidelines Committee,
the next one, to cut that out.
They're not to consider sustainability
in their recommendations.
And to tell the secretaries
that when their people work on the official guidance
for the public and policy makers, et cetera,
that they are only to consider,
each recommendation has a category
next to it about how strong the evidence is.
There's weak evidence, there's moderate evidence,
and there's the strongest evidence.
Well, it happens that some of these recommendations
about eating less meat for the health reasons
are in the moderate evidence category,
so they said, "Tell them they can only
"consider the strongest category."
That way, they can't tell the public to eat less meat.
I'm not a vegetarian. I eat meat, I enjoy meat,
I think if you're a vegetarian, that's also terrific.
You can have a healthy eating pattern either way.
But, come on.
Most Americans, if they ate less red meat
and less processed meat would overall
have a healthier eating pattern,
and sending your lobbyist to Congress, enough said.
(laughter)
Here's another hot button.
The Dietary Guidelines Advisory Committee says that
most of us aren't eating as much seafood as we should get
to get our Omega 3 fatty acids
and some other health benefits.
It's a very highly nutritious protein source.
However, there's been overfishing
in the last couple of decades.
So the sustainability of fish in the food supply
is becoming an issue in many areas.
You're probably noticing that there's more and more fish
that you've never heard of at the fish counter
at the grocery store and some of that
is because they have to go to deeper waters
and market fish that people considered inedible
maybe a couple decades ago.
Concerns have been raised about the safety,
mercury, for pregnant women and nursing mothers,
and the nutrient content of farm-raised
versus wild-caught seafood.
If you get wild-caught salmon,
it's almost always a nice dark pink.
That color comes from the carotenoids that are
in the natural diet of the seafood-eating stuff
that salmon eat up in the Alaskan waters.
If the salmon is farm-raised,
the fish eat what the fish farm feeds them.
And it may or may not be high in these carotenoids.
Carotenoids are a plant form of vitamin A.
So how we can rely on fish as a source of vitamin A
and even omega 3 fatty acids depends
on how those fish were fed.
If they're fed from the oceans up in Alaska,
we kinda know,
but if it's from a farm-raised fish, not so much.
So the bottom line is to supply enough seafood to support
meeting our dietary recommendations, both farm-raised
and wild-caught seafood will be needed in our food supply.
And that policymakers should take that into consideration.
So the Dietary Guidelines Committee ended with some
overall advice about how to take all of this stuff I've
been talking about and a lot of stuff I haven't even gotten
to and make that into a to-do list.
They didn't call it a to-do list, I am.
The first thing they're saying is to know and understand
how to modify your diet and physical activity.
A lot of people I talk to think they know.
But when I quiz them, "Okay, why do you need to do that?"
"I think I read it in the New York Times."
They can't explain the biological reason
that it's a good thing to do.
And don't think that food manufacturers and supplement
sales people and beverage manufacturers aren't taking
advantage of that, because they are.
And if I hear the word "antioxidant" one more time,
I'm going to scream.
"I need to eat this, it's high in antioxidants."
Bassam can tell you, oxygen is good for you,
too much oxygen is bad for you.
Depends on how you get it, where you get, where it goes
in your body, what's going on in your body.
I have an inflammation processes happen.
I could talk to you about arthritis and how sometimes
too much oxidation,
antioxidants are not a good thing,
but we won't go there right now.
Just, I'm just saying, try to understand the dietary
recommendations, where they come from, and ask yourself
that same question I had in my second or third slide,
"Who says?"
And do they have something financial or personal
gain at stake if I believe what they're telling me?
If they are, find a source to verify it.
I used to say, when I was with UW-Extension, "Come to me!"
Because nobody pays me for the advice I give out.
I mean, I got a paycheck, but it was to give out
non-biased advice as much as I could humanly do.
The second one: know your current dietary pattern,
including your healthy choices that can be maintained.
If you're already eating lots of fruits and vegetables,
keep doing that.
As well as areas that you could work on changing.
And areas that you're willing to work on changing.
You might not want to tackle all those
things I mentioned at once.
And then the third bullet: act on it.
Don't say, "Oh yeah, that's good to do.
"I'll do that someday," do it now.
Seek to make gradual and sustainable changes
in your dietary behaviors.
Make a plan.
Figure out something you can do to make your diet better.
And what each one of you can do will be different
from the person sitting next to you.
Both because of what your physical needs are
and what your personal resources are.
So this is my challenge to you: the Dietary Guidelines,
USDA's MyPlate food guidance system,
they summarize what scientists tell you
about what and how to eat.
You are the one who has to decide how
to put that into action.
You have to find a way that
fits your personal life situation.
Do you have little kids at home that are watching how you
eat as an example of how they should eat?
Your values and belief systems.
Do you, are you really, just like so much into animal
welfare that you couldn't possibly think of eating honey
because it comes from bees that should be wild and free?
I know lots of vegetarians that won't eat honey,
let alone wear leather shoes.
And with that sermonette,
I will stop and pause and ask for questions.
- Thank you very much.
- You're welcome.
[applause]