time to look at the programs both in terms of its impact and in terms of its actual implementation on the ground. 71 agreement and we all decided to the study that we are now issuing the report about today. there were obviously other reasons to do this at that point and let me just point out two or all of us. one was, was clear that in this evolution of evolution if i could use that term, immigration authority to the state level, the program provides a very important lens to look at other partnership agreements between ice and states and localities. of increasing importance here is the ice' new program which around the country is going to become a national program by 2013 and the increasing use of

the program. is so it was clear that these programs were going to be an increasing element of the relationship between states and the federal government.

>> good morning. i amylin goldman, dean of the school of public health and health services here at the george washington university. it's my pleasure to welcome you this morning. i'm particularly proud our school is part of today's announcement. our dedicated research faculty work every day on issues related to food safety, obesity, policy, and epidemiology and public health students, many of whom are in attendance today, are studying how these issues affect the public's health. i also have to acknowledge and thank our wonderful staff as well as the staff at the usda and hhs for putting this event together this morning. we at g.w. share the commitment to promote health, wellness, and nutrition. our urban food task force is working to identify ways the university can support scholarship and instruction on sustainable urban food policies and provide practical information on healthy eating and food preparation to the greater g.w. community. i want to particularly

acknowledge diane robinson napp wife of g.w. president. for her work and involvement in leading this effort. thank you very much. we are honored to have here today two of our country's leading health and nutrition advocates, secretary of health and human services kathleen sebelius, and secretary of agriculture, tom vilsack. as a state insurance commissioner, governor of kansas, and today as the country's highest ranking health official, secretary sebelius has been a leader on health care, family and senior issues for more than 20 years. secretary sebelius is guiding the implementation of the historic affordable care act. she also is at the forefront of the obama administration's efforts to build a 21st century health care system for putting a new focus on prevention to promoting electronic health records to expanding the primary care work force.

the partners across the cabinet, she has launched new efforts to make government work better for the american people, including working with secretary vilsack to build a 2112 century food safety system and new guidelines to be announced here today. throughout his distinguished career in public service as mayor, state senator, and governor of iowa, secretary vilsack has had a remarkable record of making positive change in the lives of those who he has served. in the past two years usda supported struggling farmers and ranchers, provided food aid to one in four americans, and implemented the recovery act to create jobs and build a foundation for future economic growth. under secretary vilsack's leadership, usda is working to conserve america's forests and private working lands, clean our water supply, and revitalize rural communities. at the same time usda's strengthening the american agricultural economy, promoting agricultural production and

exports, and working to combat hunger around the world. secretary vilsack is committed to improving the health of america's children by providing the nutritious and balanced meals, encouraging increased physical activity, and improving our food safety system. ladies and gentlemen, please join me in welcoming secretary of agriculture tom vilsack. >> thank you very much. good morning, to everyone. i want to thank the dean and also thank president napp and the george washington university community for giving us this great forum for an important set of announcements and discussions today. that are important to this country, as i'm acknowledging folks let me start by acknowledging dr. van horn who was the chair of our advisory group who was working for a number of years in establishings these guidelines. her leadership was very much appreciated. working with folks from h.h.s.

and usda they really put a great deal of effort into these guidelines as reflected by the detailed nature of the guidelines and the important work that's involved. also want to thank all those who were involved in publicly commenting on these guidelines. when we reach out to the public, we obviously have a more informed set of guidelines as we try to address to the needs of the american population and to folks who are very concerned about the situation involving food and nutrition in the united states. so this is an opportunity for us to celebrate the work of this advisory group, to acknowledge that what we announce today is certainly based deeply and steeply in science. the science behind these guidelines is unquestioned. and certainly it's important for us to send a message to american families that these guidelines are designed to provide them an opportunity for healthy eating habits and healthy lifestyles. the president in his state of

the union address talked about an america that outinnovated, outeducated and, and outbuilt the rest of the world. it's extremely difficult to do any of that unless we are a healthy nation. i want to acknowledge the leadership of secretary sebelius in particular as she is helping us sort of redesign our health care system as the dean indicated. a system that will be focused on wellness and prevention and not simply sick care. and it's a system that obviously we are in need of in this country. when we take a look at the high levels of obesity among adults and among children, it is important to have guidelines that will help us deal with that issue of obesity. certainly pleased that congress last year passed the healthy and hunger free kids act of 2010, designed to allow us to do a better job in school lunches and breakfast programs and our nutrition programs in schools. and today's announcement is yet another step in the right

direction. today we announce guidelines. these are basically an opportunity for families to understand and appreciate how to make sure that the calories in and calories out are balanced. i must admit personally that i had never read the dietary guidelines until i got this job. but i read them in detail. i read all of them. and i realized how significantly different my eating habits were from what constituted a healthy patern. so personally my life has changed by virtue of these dietary guidelines and my kristi and i are following the guidelines. we have our little sheet every day. we record what we eat. and we are very, very concerned about calories in and calories out. there are two concepts incorporated in these guidelines that i want to comment on before i turn the podium over to my good friend, secretary sebelius. one of them is this notion of proper balance. if folks want to maintain a

healthy weight, they obviously have to be sensitive to the calories in and calories out. and these guidelines basically talk about the need to balance good eating habits with physical activity. the first lady's let's move initiative has focused attention and resources on this notion of getting people, particularly children more physically active. that is certainly incorporated in these guidelines today. when we talk about calories in and calories out, we also talk about the density, nutritional density of those calories. not every calorie is the same. and these guidelines graphically point this out. we want to place a greater emphasis on meal paternses -- patterns that focus on lean proteins, including fish and seafood. we want to move away from our overreliance in the past on sugar and sodium and saturated fat. we want to make sure that folks understand that eating real food as opposed to necessarily

fortified or dietary supplements is probably the best way for you to make the best use of your calories. and the guidelines clearly point that out. we try to provide healthful hints to folks as they begin to try to maintain that healthy balance. foods to avoid. percentages of foods to avoid. and foods that you want to consume more of. over the course of time, we are going to supplement these guidelines with additional educational information that will make it easier for the american public to understand how to follow these guidelines. and these guidelines also place an additional emphasis on food safety which i certainly appreciate and i know that secretary sebelius does as well. we want to talk about clean, separate, cook, and chill as ways in which we can better handle food so we can substantially reduce the number of food-borne illnesses that are still far too high in this country.

whether it's maintaining a healthy balance, instructions in terms how you might be able to lose weight with calories in and calories out, focus on nutritionally dense calories as opposed to empty calories, the notion of physical activity and food safety, this is a comprehensive science-based effort we announce today. so with that, i'd like to turn the podium over to my good friend, kathleen sebelius, as the dean was correct there is no person more passionate about healthy lifestyles than secretary sebelius. she is a runner. early in the morning i suspect. the rest of us are sort of jogging later in the day. we -- i just can't get up early in the morning. but the secretary has been tremendous advocate and has an extraordinary responsibility with the affordable health care act and doing a great job. kathleen? >> thank you. >> i'm going to start by also

thanking the dean and president knapp and those of us on the g.w. faculty and staff and students for having us back here. the last time i was here we were making an important announcement on tobacco and we are back to talk about the new dietary guidelines. i think it's appropriate to be here at g.w. which has had such a leadership role in the health of all americans. and it's great to be here with my good friend and partner, agriculture secretary tom vilsack. you have heard the dean say that we both were governors and we are governors from food states, kansas and iowa. so our work on these issues did not begin with our new assignments. they have been long-standing and a great collaboration. we also have worked on issues

from food safety to making sure we reach out to children with healthy insurance programs and the partnership with usda has really been invaluable and continues to be, i think, an important initiative moving forward we have had a great team on the expert advisory committee that has been hard at work and i particularly want to recognize our leadership team who has been part of that effort and led by assistant secretary howard koh who is here who if you have tough questions he gets to answer them. later on. but there have been lots of dedicated public servants who make sure that we were basing today's announcements on the best science available and that we move this effort forward. the mission that we have at health and human services is to improve the health and

well-being of every america. we know we can't just concentrate on what happens when people come in contact with hospitals or go to a doctor's office. we also need to pay attention to what impacts everyone's health, that's the air we breathe, food we eat, the lifestyles we lead. and the obesity epidemic, secretary vilsack has mentioned, carries a really steep cost. obesity brings a far higher risk of heart disease, stroke, certain cancers. chronic diseases like these still account for seven out of every 10 deaths in america and most are preventable. 3/4 of our health care costs are directly related to chronic diseases. the costs also weigh heavily on business owners, government budgets, also our ability to grow and innovate as a nation.

you can't be educated if you're sick each and every day. you are not a good student. you won't be as productive or innovative as a working member of this society if your health condition is debilitating. this has a tremendous cost overall on america's prosperity. and it's why the administration has really launched a broad agenda to help give americans the tools they need, the information they need to stay healthy, stay well, and thrive and prosper. and one of the most important things we can do is to get people information based on the latest science and research. and we are updating that information all the time. so they can make the best choices for themselves and their families. that's what the latest edition of the dietary guidelines are all about. concrete steps every family can

take to incorporate into their everyday lives and improve the lives of themselves and their children. steps like controlling calorie intake, moving more and sitting less so you burn more calories. and altogether eating a healthier diet. more fruits and vegetables and whole grains. less sodium, sugar, and saturated fat. we know if we want to become a healthier, stronger, more competitive country we need to give americans the tools they need to make healthy choices. of so we have as a result a healthier student force and a healthier work force. and these guidelines are really powerful tools. now, we know there are also other obstacles to living a healthier lifestyle. if you are going to a grocery store and have one or two children tugging on your arms, you don't always have time to read nutrition facts on the back of a bottle. so we are working on updating that information and making it

easier to find and easier to read on the front of a pack. when you go out to eat, sometimes it's difficult to tell if you want to make a healthy choice what are the healthy choices? and that's why the nutrition information will be more readily available on menu boards. we are taking steps to get that information into people's hands. to work with the food industry, work with restaurant industry to give people additional information. and that's all part of the affordable care act passed last year. calorie information right at the front of a menu where customers can again take that information in and make the choices they want to make. the health care law also is reducing some of the financial barriers that have prevented millions of americans from getting preventive care. we want to make sure that folks can access key screenings at no

extra cost. to find out if they have high cholesterol or high blood pressure, then work on getting those conditions under control. even when people have the best information and a clear plan to translating it, there can still be challenges. when you have to walk two miles in some neighborhoods to get fresh producer at the near supermarket but only a block away it's easy to get chips or other kinds of high calorie foods, that makes it very difficult to eat nutrition meals. when it's not safe to play outside or send your children outside, it's very tough for kids to get the exercise they need. so again the recovery act is helping neighborhoods and cities invest in ways to make it easier for people to make healthier choices from serving health irschool lunches to designing more walkable neighborhoods.

what all these examples have in common is that our understanding that underneath the sticks about -- the statistics about our health care system are families and human beings. there are children and families, workers who really do want by and large to do the healthy thing, to eat the right diet, exercise more, follow the doctor's instructions. but they are not always the easiest things to do and often there are financial challenges to make healthier choices. with this new addition of dietary guidelines, we are putting some best information in people's hands and that's a real step forward. it's going to help us become a healthier country, a more productive country, and more competitive country. so thank you all again for being here today. i think we are going to invite tom vilsack to come back to the mike. >> dr. post is from usda and dr.

koh from h.h.s. just in case there are questions that require detailed scientific answer which the secretary and i would like to try to answer but probably won't do as much as you guys can. so with that we'd like to open it up to quiss folks might have about the guidelines -- questions folks might have about the guidelines. yes, sir. >> good morning, my name is james reed, a reporter for the campus radio here at g.w. i know as a teenager still growing there are not specific guidelines for teenagers and having noticed my friends in college and my family back home, many who like to eat more than the recommended guidelines, exercise more, or often eat less and exercise less, what recommendations would you give

to teenagers at such a critical time for their developing bodies and their health? >> before i turn it over to either one of these two doctors to respond to that question, i think it is important to note that these guidelines are beginning to distinguish between various stages in life and there are adjustments that have to be made as we move through various stages of life. which is reflected in the guidelines generally in terms of focusing on meal patterns. i don't know if one of you want to address the issue of teenagers. >> we stress these guidelines apply to all adults and to children over age 2. so the general theme is that both secretaries have put forward apply to teenagers as well. we are concerned about child obesity because one of three kids are overweight or obese. these major themes are calorie balance and focusing on nutrient dense foods and also making sure that kids are active and meet

physical activity guidelines. these are all themes that are relevant to teenagers. as well as adults. >> and i can also add there is an excellent resource that's found in the dietary guidelines that gives you a couple of different meal patterns or eating patterns that embody the dietary guidelines. so you will be able to find your needs at the various calorie levels and that could 24e7b be individualized so you -- could be individualized so you could find out what you need. >> at the usda website you have the ability to type in information about yourself, what kind of lifestyle you have, how much physical activity you are engaged in on a daily basis, and then that gives you a sense of how many calories you should consume if you want to maintain weight or lose a weight how you do it in the proper way. so there are ways in which you can at usda.gov determine for yourself a personal eating. that's what my wife and i are

basically doing right now. >> this report says that people should reduce their daily sodium intake to less than 2,300 milligrams and people over 51 and some others should reduce it to 1,500 milligrams and also less than 300 milligrams of cholesterol. can you tell us what is the current level of consumption for the average american? how big a change would this be? >> i think it's 3,400 milligrams of sodium. this is obviously a significant reduction that's being proposed. and one that we hope food processors in particular will take into account. again these two gentlemen could probably talk a little about that. >> major recommendation from this report is that virtually all americans could benefit from

a reduction in their sodium intake. and those two targets that you mentioned do apply to first the general population and then to specific populations. we are particularly concerned about the specific populations who need a 1,500 milligram target because that represents about half the general population and most adults. so there's been a lot 6 attention -- lot of attention to that issue for the guidelines. we thank you for your attention to that. >> currently men are getting over the 300 milligram a day target whereas women are getting somewhat less. we are hoping that's a reachable target for the future. >> katherine with the american dietetic association representing 70,000 dieticians across the country. thank you so much for putting

these guidelines together. i have a question. it's interesting that the secretary mentioned that he had never read these guidelines before he became secretary. and i think there's a problem in the way these guidelines, as excellent as they are, are marketed. the budget behind the guidelines , the material is excellent. the scientists put two full years into coming the -- combing the evidence and put together a comprehensive report for the committee. and then the staff at the center for nutrition policy and promotion work very hard to put excellent guidelines together for the public which almost no one sees. so how can this be remedied? what needs to be done? >> let me talk from the usda perspective and i would like secretary sebelius to weigh in. she did an excellent job of pointing out the number of initiatives taking place today that have not been taking place

for some time in this space. for example, in areas that we are involved with, our snap program, the supplemental nutrition assistance program, is currently working on a program to try to see if we can innocent the purchase of fruits and vegetables. that's not been done before. it's being done now because we are aware of the need for more fruits and vegetables in folks' diets. the issue of food deserts, we have a healthy financing initiative that h.h.s., usda, and treasury department are working on. so many in the areas in the country do not have access to a full-scale grocery store. we are working with the food industry on labeling which the secretary mentioned. so within schools we are excited about the potential for their healthy and hunger free kids act of 2010 to engage schools in a meaningful way to improve school breakfast and lunch and do a better job of educating parents and students about the choice that is they make and making sure that the choices are

consistent. so this is the dietary guidelines fit into this and allow sort of a road map, if you will, in all of these spaces to help inform. i think grocers, food producers, are becoming much more concerned about the obesity issue and are trying through the first lady's let's move initiative, to focus on this. i think there is a lot of energy in this space that hasn't been the case before. we are always looking for more creative ways to get information out. >> i think the secretary's right. not only have a lot of this information been sort of opaque in the past, but there really hasn't been much of a focus on how this impacts us as a nation. how it impacts our students. and i think that in addition to these specific initiatives that the secretary outlined, there also is a very exciting set of programs going on around the country, putting communities,

putting prevention to work efforts which is in everything from schools to neighborhoods trying to determine what are the best strategies to really begin to impact folks' behavior and how to get people's attention. so not only i think the information available that never has been available in an easy to read, easy to understand way, but understanding that information is step one, and having access to choices is really a critical piece of the puzzle. and we, frankly, have one of the best spotlight microphones with the first lady leading this effort. i think americans who have never really thought about this or didn't know where to get the information or didn't have an understanding of how this impacted themselves and their children now will have a great opportunity to do that. i think what you are going to find is a lot more attention to the science. a lot more information being

spread on a regular basis and a lot more ability of people to make better choices for themselves and their families. >> and also to add the -- to the discussion that you heard, there is a very good resource that is part of this dietary guideline that's found in the appendix. it's actually a listing of the key consumer behaviors and strategies to implement them. so we hope that this is a different approach than in the past in the dietary guidelines and that will be the jump-off point for a lot of our partners to take that information and magnify it. >> can you go into more details about the incentives for fruits and vegetables. how those programs would work? >> we are currently experimenting in the state of massachusetts with an effort to see whether or not we can within

the electronic benefit transfer card itself, we can incorporate a discount procedure where the grocer basically gets paid full value for the fruit or vegetable being purchased but it is -- it's only credited 70% or 80% on the card so it allows the snap beneficiary to expand, if you will, their purchasing power. we've got a year-long scientific review of this to determine whether or not that actually moves the needle in terms of purchasing decisions. >> recently i think it's been in the last few years the w.i.c. program has been expanded so that under the women, infant, and children program now fruits and veggables are able to be purchased. with that -- vegetables are able to be purchased with that buying power. we also have as part of this

community putting prevention to work effort, i know in louisville they are now subsidizing fruits and vegetables in what are basically dollar stores to make it much more convenient for people to buy fresh fruits. mayor bloomberg has a green cart strategy that literally is coming into neighborhoods in a way that old milkmen came throughout neighborhoods delivering milk. this is delivering fresh fruits and veggables in areas that they weren't available. i know secretary vilsack has done a great job mapping the food desert areas that we really couldn't even identify before because there wasn't a very careful calculation of how far people had to go and working with local leaders on strategies. part of it is access and part of it is pricing and i think both are being addressed as we move forward. >> one other program is in farmers' markets.

again making snap benefits beneficiaries available to use their cards at farmers' markets and many farmers' markets are developing discounts where you essentially for every dollar of fruits and veggables you -- vegetables you purchase you get a 50 cent discount if you will so you will be able to purchase twice as much. a lot of different opportunities here. >> i'm an mph student here at g.w. apart from what you just mentioned about fruit and vegetables. how can we recognize the fact a lot of other foods recommended by the guidelines are much more expensive than the foods we are supposed to avoid? >> well, one of the things that we are trying to do is to provide people with information at least on the usda website about recipes and ways in which you can stretch your food dollar and still purchase foods that are good for you.

it doesn't always have to necessarily be that it's more expensive. particularly if you know how to use these foods in very creative ways. one thing we have been doing is accumulating recipes and making that information available on our website. the second thing is, by encouraging community gardens, farmers' markets, and things of that nature, i think there is a growing supply which makes it perhaps potentially more accessible and possibly more affordable depending upon the local market. sometimes you don't have as much transportation expense involved in pricing those. the first lady's recent announcement with wal-mart is a good example of the kind of purchasing power that will potentially result in some of those products being far less expensive than they have been in the past. i think there is a lot going on in this space, but our view is there are creative ways. don't necessarily have to

concede it's always more expensive. >> marion, politico. at the very first dietary goals back in the 1970's said eat less meat for which george mcgovern was roundly criticized. so it got to be eat lean meat. why don't your guidelines which specifically discuss fruits and vegetables and whole grains specifically discuss meat? you have to go deep into the guidelines themselves to see that you are suggesting that ground beef might be one place where there's too much fat. why do you call it solid fat instead of porterhouse steak? or why do you call it solid fat and yet in the guidelines on dairy include cheese? it's confusing. >> well, i'll let the two scientists talk about this. the guidelines do mention the need for more consumption of

fish and seafood in the lean protein area. that's a specific recommendation which goes to your question. secondly, again the focus on calories in and calories out and food dense foods, i think is an important frame that folks are going to use to make decisions about where they want to spend their calories, if you will. once they understand how many minutes or hours they have to be on a treadmill to work off some of the areas that we have talked about in terms of sugar, i think they are going to begin making even more informed decisions. in those guidelines, i think there are specific references here, and we are going to object quousely -- obviously continue to educate folks about that. >> i would also add that dietary guidelines stress variety and also stress building healthy eating pattern. there's a flexibility in building those eating patterns

so your protein sources could come from a variety of places as the second mentioned, seafood is one of them. it could be that you have your protein from beans and other nuts and seeds as well. you have the ability to craft a pattern that meets your needs within your calorie needs and difference the nutrients you need without focusing on specific foods that should be eliminated from the diet. [inaudible] >> i'm saying, what i'm saying is you do not anywhere specifically -- why don't you specifically say, eat less meat? why not? >> in suggesting that you should have more fish and seafood, you are essentially saying that that is a good substitute and it's a good lean protein. i think it's a way of saying

what you're saying. there a he low-foot cheese. -- there's low-fat cheese. it does talk low-fat dairy. it's not as if we are trying to eliminate all foods and all categories. it's about making sure that you have a balanced approach to your eating. and that you are focusing on calories in and calories out. >> christopher exercise science here at george washington. i have kind of a two-part question. in the past i think we all agree that whole foods are probably the best way to get a balanced diet. but in the past the guidelines have often recommended foods like liver and kale, sort of foods that are probably not going to hit with the american public at large any time soon. my question is, do the

guidelines address supplementation in any way whatsoever? and i ask that question being from exercise science because the portion of the population who is interested in improving their performance it's not a small part of the population, either. people who want to gain lean body mass, it's not a small portion of the population. i'm interested in how the guidelines address that population to a certain extent and maybe to the extent that it involves supplementation are we addressing that at all? thank you. >> if you look at the report there are sections on food groups to reduce and then also food groups and minerals to increase. and if you look at the latter chapter you'll see items like vitamin d and calcium and potassium and nutrients like that being discussed. this is all again a part of a broad view on healthy eating and on maintaining healthy weight. and that's where i think your question comes in.

>> i'll also emphasize the guidelines are generally for americans 2 and older. we do recognize that there are some subpopulations in need of supplements for promoting health. women who may become pregnant for example. there are specific recommendations for populations like that. we do acknowledge where fortfication or supplementation is needed certainly to promote health or to avoid chronic illness. a of alice, national fisheries institute. you say -- you recommend higher seafood or eating more seafood but that differs now from the f.d.a. guidelines. how do we explain that to pregnant or breast-feeding women when they are supposed to be careful about what they eat. they might be worried about

differing guidelines on seafood intake. >> well, what we know is with the dietary guidelines become the action now for federal agencies to make changes to their programs in concert with these guidelines because they are in fact being national nutrition policy. we'll expect consistency as we move through this year and into the second years. -- into the next years. >> there is a special section on dietary recommendations for pregnant women, the spefpk issue of fish is brought up there. -- specific issue of fish is brought up there. and the balance again is to recommend fish intake for pregnant women while making sure they don't consume certain types that might expose them to mercury. there is dedicated language if you look at the report there. it's carefully put forward. we have time for two more questions. yes, sir.

>> peter, with the nutrition and metabolism society. there is a growing body of evidence that restriction of carbohydrate intake has a big impact on reducing obesity, as well as dealing with the chronic diseases you mentioned as well as metabolic syndrome and type 2 diabetes which you haven't mentioned. i was wondering if any attention has been given to that in the guidelines. they don't seem to be mentioned at all in the summary that you handed out this morning, thank you. >> we did receive an awful lot of public input on the issue of carbohydrates and the amount to be consumed or perhaps to be concerned concerned with. ultimately the evidence that was considered first by the dietary guidelines advisory committee and then translated in plain language in the document that we are releasing today, really portrays or conveys the eating pattern -- that is one that

deals with carbohydrates. most concerned with the empty calories, for example, added sugars, and it does deal with carbohydrates, but it doesn't specify a consideration that carbohydrates should come from any particular type of food or in an amount greater or perhaps in concert with those comments. the evidence is just not there to support the views that were expressed and the comments received. >> hi, brook, from the arrye tiss foundation. in your report you mentioned many different chronic diseases, heart disease, obesity, stroke. one thing that i haven't heard mentioned is arthritis which serves as an underlying cause to many of these chronic diseases.

what programming or marketing do you-all have going on now catering to the arthritis community which is very hard to reach that promotes these healthy eating habits and guidelines and a prevention of these other chronic diseases. >> certainly obesity drives many adverse health outcomes and osteoarthritis is a major source of morbidity for people who are affected. thank you for raising that point. the overall message is a healthy weight can help people avoid adverse outcomes like heart disease, stroke, diabetes, hypertension, and certainly arthritis as you mentioned. >> thank you very much. appreciate the opportunity to be here this morning. this is the first of obviously will be many opportunities for us to highlight the dietary guidelines.