>> that's not true. folks can sell outside of school, which is what these candy deals are. outside of school there's no prohibition. times we have that. >> i don't think that's the -- >> they may be mistaken. >> thank you for being with us today. thank you both for your respective work on committee report. i know that this is no simple undertaking. i appreciate the fact that it takes and requires months and

months of scientific analysis and consideration of thousand of stake holder comments and thoughtful collaboration of agency staff and i want to say that i appreciate the process of the advisory committee went through. it's a solid process. many opportunities for the public to weigh in. to put this in perspective here, my colleagues understand that in this country today, one is school age children, more than one and three american adults suffers from cardiovascular disease and diabetes, clearly, we can do better. that's what we are all talking about here. this is an attempt for us to get it better, and if people aren't interested in the well-being of citizen, they should be

supported of what you are talking about today, because at the end of the day, it means lower healthcare costs. so we all benefit here. you mentioned earlier that you referred to hhs blog yesterday where the issue of sustainability issues were taken off the table for inclusion in the if i believe guidelines, and i get that's the case and i respect your decision, but -- but this is an important issue and you both have acknowledged that. sustainability somehow in this congress is auditory word. i don't quite get it. it's important and we ought to talk about sustainability when we talk about issues of diet and food security. it's important that at least we start the conversation. i also appreciate both of your testimonies do good job of emphasizing nutrition and disease presentation and punting

into context. on congress we have to focus on prevention. we should be highlighting what the science says on good nutrition for kids and families. it was in today's hill or newspapers by the presidents of american academy and pediatrics. keep politics out of diet ri guidelines, i would like to ensure that in the record. they talk about the importance of dietry guidelines. we know more today than we did yesterday. our research techniques have improved over the last 10-20 years. when we learned the latest science, then we need to make

the necessary adjustments, but as you know, some of the biggest critics are from the industries that produce least healthy foods. i was reading about some billionaire from texas who is funding initiatives to try to raise questions -- i don't know what enron knows about dietry guidelines, trying to question science, and so i -- i just conclude by saying, i encourage you to keep first and foremost the health and well-being, and maybe in my last minute you can talk about, if we all improved our diets, what would be the impact of rates and costs of diabetes heart disease.

>> as one goes out over period of time, both heart disease and something we know, are two very large cost drivers as a nation and they are cost drivers because they are conditions that continue, you know, over an extended period of time and specially as we have a population that lives longer which is a good thing, but the idea that these are costs that are controllable and i would also say that in my engagement with the private sector and ceos of companies, i'm sure you hear this in the districts, the reason they are so deeply focused on the issue is because they are putting initiatives in place because they are starting to see. i was with the national association with manufacturers and had ceos that says she has dope it for almost ten years now and has analytics, they are

worthy enough to make decisions on the taxpayer's money. diabetes and heart disease are two of the leading costers that we have both publicly and privately. >> time expired. i ask my colleagues, hard stop at 11:30, four minutes for questioning so we we give a chae to make that happen. without objection we will go to four minutes as we go forward. >> thank you, mr. chairman. kind of keeping on that subject, a lot of attention has been paid to the dietry guidelines and the fact that they are guidelines and they are not rules, am i correct in that? >> yes, they are guidelines.

>> so they actually are used pretty -- pretty hard and fast on rule making, correct? >> it depends on which programs, so for instance, school lunch programs in our area, the administration for community living in terms of meals on wheels and those types of programs. >> we heard a lot of talk about the lunch program. i know my colleague mentioned he had gotten a text just in the last few minutes, lunch program implemented in 2012 but very little attention of how we role out and apply it rigidly to snap program. it seems like using the argument that while we can be proactive and sort of help the regulate the kind of food that people eat that we can control, the

secretary mentioned department of defense. we mentioned school nutrition program, meals but not actively engaging in how administering and why don't we do a better job on dietry structure as it applies to snap program? >> first of all, we are trying to address this on a variety of mechanisms. designed to provide assistance ar help for snap programs to purchase more fruits and vegetables and the like, expansion of farmers market is giving them the opportunity, we had a database, researched-base

program to determine what would actually provide direction in terms of purchasing nutrition food, making nutritious food, a very serious technology challenge in trying to prohibit snap for certain products. >> i know that our travel card will deny a purchase, if you try to fill up and put a snickers on there, it'll decline that purchase. i know the technology exists that we can do a better job -- >> there are 300,000 different products that are sold across the united states. >> here is the problem. >> that's the question. do you want to exclude that. >> i'm not asking you. i'm trying to get feedback from

you. >> they are. they are. they are used in the snap program in terms of providing guidance and direction, where they can buy fruits and vegetables and how to use recipes. >> you mentioned incentives, what incentives -- >> cash incentives, when a person goes to farmers market and they buy $5 worth tomatoes will get to buy $10, it's more bang for their buck. associations involved to provide sales, provide promotions torques provide recipes, a whole series of programs. we will be happy to provide you grants under that initiative and what might be done. >> thank you, i appreciate it. yield back.

>> mr. aguilar, four minutes. >> thank you, mr. chairman, thank you for the secretaries for being here. i wanted to expand on that discussion. i participated and i mentioned it to my colleagues in the snap challenge earlier this year and the biggest piece that struck me and clearly but it was the budgetary constraints on healthy eating. you were talking about the program and the success that you are seeing in those and i hope that we can continue to grow those programs, and i understand that within the dietry guidelines also release material, you talk about choose my plait. showing folks how to live on allow budget and a balanced diet in the -- in the advisory committee report it's mentioned

that the food patterns of healthy living, the health healy vegetarian pattern, do you know approximately how much it would afford lifestyles per week and can you expand a little bit on the programs of low-income families like the food insecurity program? >> well, the guidelines help to inform a series of meal patterns, goes from high end to the low end. it's the plan. i don't know the specific dollar am, obviously, it depends on the choices that people make, congressmen. i think we need to sort of spell the myth that necessarily eating has to be more expensive. this is why people think that. if you take a portion of potato chips and broccoli, in the past we looked at 100 calories potato

chips, when you look at portion sizes, fruits and vegetables become, you know, affordable, number one. if you look at recipes, it's also an opportunity. there are ways in which we can stretch dollars. part of initiative is to provide with recipes and informations that allows them to use fruits and vegetables more effectively and also the incentive programs we have where we work with foundations to encourage farmers market purchases by incenting those, food nutrition incentives that allow bonus points, if you will, and wide variety of

things, we are also working with food banks to make sure that the areas of opportunity that they have to help struggling families also include more healthy choices. so there's a wide variety of steps and we are attempting to make a difference. >> i would love to see more, i would say it was incredibly tough, mr. sectary, my wife and i $66 on the snap challenge to include, you know, healthy portions, managing our portions, i ate salads. >> it's not engineered or funded to be the end-all --

>> to american citizens it is. >> that's why we work with shelters and other as, that's why we have a school lunch, school breakfast program. that's why we have afterschool efforts to try to su -- suplemen. >> your time has expired. >> i can count one finger the city has reached to all members of the committee prior if they had any concerns. thank you for that. i appreciate for that. that's time consuming very very thoughtful. historically the dietry guidelines which you say will be released in december have not made suggestions about specific ingredients and commodities by the u.s. population and potential health risk of

ingredients, one of the most widely studied food additives in the history of fda and approval in more than a decade. fda has asserted and reasserted, process to call question of safety citing extremely weak science that shows otherwise. they are calling more research and concluded there's no increase risk of cancer from consumption. during your interagency review of the guidelines are you consulting on recommendations after they spent years reviewing the science? >> yes, fda is part of the process of h hrk s, with regard to safety and basically five products that fda has said in given content are fine and safe.

fda is part of the h hrk s process. >> how did they impact the final recommendation? >> something that we are reviewing but our own experts, not just fda for us and nhs as well, the whole department is part of the process, reviews everything together, that forms the recommendations that we will be receive from our department collectively together. >> okay. additionally recommends replace sugared beverages or low-fat milk only for guidelines to be effective. in your final recommendations how do you intend to balance ideals that are idealistic on

recommendations? >> you are getting ahead and wouldn't be able to comment on specifics. when we say balance, it's also about the issue the secretary raised of nutritional value. when you're trying to have a set number of calories and certain numbers of nutrition, how you can get the puz -- puzzles together is something we will put together. >> thank you, recommendations were voted and discussion of red, versus lien and packaged meat, recognized lien meat dense food and were encouraged to increase, it's important for the dietry guidelines to have background to give americans

clear advise on diets and health, can you give me assurances that you have taken into account to ensure scientific evidence is foundation for the 2015 guidelines? >> i can also suggest that it's my understanding -- maybe i'm wrong about this, that the report basically is fairly consistent with the recommendation that was made in the 2010 guideline to lien meat. >> thank you, sir. >> if i may. >> four minutes, i have it. thank both secretaries for efforts in reaching out. i do appreciate that. i think to the degree that we collaborate on a greater basis we all do a better job. a lot of discussion this morning has been talked about the process in these guyed lines and i do appreciate emphasizing that they are guidelines, part of

total work product, i guess i would like to get your take, both of you on how we measure success. clearly we all i believe, i hope that's not in debate, lealty -- healthy americans is a healthy diet and part of preventive health care, pound of cure, how do we measure success in terms of incredible changes that have been taking place in american's dietry habits over decades and this effort to use these guidelines as the means to provide better diets so that we have healthier lifestyles? have you thought about that in this process? i mean, we are asking you the questions. how can you make the process better? >> first the guidelines them --

themselves about quality product. the second thing is how the guidelines get used in terms of people understanding what they are. >> do you think we are making progress along those lines? skew their eating habits. >> yes, that comes to the third. the knowledge has to be activated so people are acting and behaving. we as a nation can improve and improve it at a population level and improve it in ways that we use the programs and whether that's the programs at usda or hhs in terms of applying them and cdc is another place that i believe we can make progress. >> how do you measure your success? >> i would only add, take a look

at the eating index that we have which is a 100-point system. currently the average american is about 57. we have seen improvement over the years. i don't know what your mother said 56 out of 100. my mother wasn't satisfied with that. >> not good. >> that's one way of measuring. another way is to measure whether or not we are making head way on obesity. i'm pleased that in young children we are seeing some indication and even a slight decline in obesity rates, that's good news, but we still have work to do. in terms of improving the process i would schismy -- simply, i think the debate is healthy. there's a misunderstanding between prevention or

orientation versus a lot of the criticisms often are because they won't be helpful with dealing with obesity. maybe there's a way to expand or create an avenue for that treat discussion to take place. >> i have other questions regarding bio tech trades. when i grew up, it was a few year ago. 8 owns was considered a regular thing, 12-ounce is big. today 24. i think large part of our just sizes and amounts and how we combat against obesity. that's the comment. >> thank you, mr. chairman. thank you, secretaries, i really appreciate the work that you're doing.

taught nutrition for many years. it's very important. i'm very encouraged to hear that you're going to make sure that it is, i wanted to focus on the nutrition evidence libraries, we heard much about it with usda officials, but i have heard concerns that the nutrition evidence library has ignored a large credible and growing body of peer review science on low- carb diets, can you elaborate on out scientific studies are added to the nutrition library and what can be done what cutting research is considered? >> there are existing reports, new reports that are if you if d

in, there are a review of what the capital diet of american might be. food pattern. there's a broad array that's included in this effort. the issue of low-carb diet raises the point that i made with representative costa. how do you treat a particular condition, obesity, for example? it may very well be that allow-carb diet might be a way for a physician might prescribe for an obese individual deal with obesity. there isn't an avenue within the guidelines for that treatment discussion. i think there's a lot of confusion about it and a lot lot of angst about it. we are looking at what the law requires us to do and that is -- >> sure. >> folks on dietry and

nutritional guidelines relative to prevention. >> so it actually would be helpful to include that. >> in that circumstances you have competing studies, which is why it's important to understand that it is about well-informed opinion. i wish there were scientific facts. the reality is stuff changes, stuff changes. the key here is taking a look at the greater weight of the evidence and trying to make a judgment based on the greater weight of the evidence. if you have one study on one side and 15 studies on one side, that's why we do this every five years to give an opportunity for the quality study for further enhanced so that five years from now, maybe there are 15 studies on this side and 15 studies on this side.

the it's an evolving process. this may not be true or certain populations this may not be helpful. do you include that or do you say pick one? >> it's a caveat that these are recommendations focused on prevention. i'm not sure -- we haven't crafted it yet. >> is there any population? there's got to be differences perhaps for different populations? were well, there are -- >> guidelines may not be one-size fits all. >> it's a combenl -- general guideline. in theory you could have 317 million different guidelines

because they are slightly different in slightly different circumstances. you have to create kind of a wide birth here. this is what we are recommending. if you're interested in healthy diet or risk of diabetes or cardiovascular, this is a course that you might want to consider. obviously, people are going to make choices and decisions based on what's best for you. >> four minutes. >> yes, thank you, mr. chairman. good morning to you. thank you so much for your time today. i was just looking at the volume of comments that you had received, the 29,000 comments after the rereport came out. can you explain how you're going to and will you able be to meet the time frame that you have for an evaluation of all those responses to be able to issue that report, the guidelines? >> yes, our staff has gone through all of the comments, one of the things that's helpful in a sense is that large percentage

of them were form letters, as the secretary reflected only about 8,000 were individual -- not only bus less than 29,000 in terms of our ability to get through. the secretary and i are working very hard with our teams to meet the deadline of this year. >> great. my other question is related to moderate alcohol intake. looking at the guidelines that were issued in 2010, i was wondering if committee statement that confirmed the conclusions from 2010, do we think it's going to remain the same or moderation -- what is considered moderation? would that change as well? >> i think you appropriately reflect, the advisory committee has recommendations. we are not going to comment on specifics, it's important to reflect that there was no change. >> okay.

>> after this hearing i may be consulting that guideline. [laughter] >> the fda would say he meets a requirement. >> i think that's two. >> good enough. >> i just want to thank you all for the tremendous work. it's very important for the american people. i'm just echoing my colleagues about proportion sizes and healthy diet particularly in communities in which there maybe fresh foods that available to them as well. also, let's not forget in terms of obesity the thing we haven't talked about, which is not just your diet but exercise as well, which is something that americans have been lacking for young people sometimes. thank you very much, i yield. [laughter] >> four minutes. >> it'll be 5:00 o'clock

somewhere. >> thank you, mr. chairman. secretary vilsack and burwell, this is a very important issue. i'm looking at this from a macro perspective. medicare and medicaid is such a huge component of that debt. the mast majority is spending is huge component of mandatory spending, and so you consider the obesity issue that we are facing and you mentioned obesity and heart disease as two major components that drive the cost of medicare and medicaid. all that gets back to what we consume, i think back to my time when i was in k-12 versus the

schools that i go in today, when i look at the student population, i do not recall at least when i was growing up the number of overweight kids that you have in school. i visit all kinds of schools, a third of them are clearly overweight? some i knew their parents, grandparents and obesity was, you know, not an issue in the family until this generation. ..

it was mentioned earlier about caloric diet, trying to maintain a certain number of calories. not all calories are the same. i would suggest just on a commonsense perspective 2000 calories of beef versus $2000 of doughnuts are very different. your body reacts to a very different. your body takes the carbohydrate and turns it into sugar. that often go straight to the valley. whereas consumption of protein same calorie about the body treats it regularly. in fact, i think you would have a blood test done to measure protein level in your blood which suggests protein is a key component to a healthy

lifestyle. so my main point i want to drive home this morning as i think it's a favorite important to understand that there's a difference in terms, not all calories are the same and from a public policy standpoint i think perhaps maybe we've gotten too smart for own good. i recognized science has improved dramatically but mankind has survived for many a thousand year on red meat, whole milk. in fact, i remember growing up when there was a report that you said apple juice is bad for you. in they cannot and said no, we run. eggs and bacon. they may contribute to high cholesterol and heart disease. so i want to make sure that we get back to commonsense and that we do what's right for future generations because not only for the health standpoint that translate directly in front of the public policy decisions we have to make as well as to our

budget. finishing up, i want to ask both of you -- >> you can't ask anything at this point. we had to keep going. >> no problem. >> ms. zelman in. >> thank you, mr. chair and thank you both for being here and for your time today. first i want to ask you about gary. taligent it has been a distinct food group in the past and according to the report very products contribute many essential nutrients, vitamin d, calcium, magnesium, iron, riboflavin. and get since 2010, 1% flavored milk's have not been allowed in schools and we also know that very consumption has dropped and girls ages four to eight. i just a couple questions of how to continue to make sure students have access to appealing and nutritious dairy

products? do you expect gary would remain its own food group going forward? >> i want to see what we're going to do terms of the guidance but i will take one of the things we've done is to work yogurt into the school lunch program. we are also taking a look at the issue of milk relative to school meals. so that's in the process can not in the context of the guidelines but in the context of our efforts to try to encourage healthier choices in schools. i don't think there's any question that kerry is an important component. it's recognized and should be recognized. >> on a different note given that we have regional, cultural, socioeconomic diversity throughout the country, how will the dietary guidelines be the challenges of being relevant, accessible, achievable for all americans knowing that folks have different backgrounds, cultural backgrounds that may impact the types of foods that

they are eating? >> i think many other programs the secretary has spoken about in terms of how you put this out, i think it's about having information that is simple enough you can use in your own cultural context, and then it is about a number of the programs in terms of how the information was, not just the guidelines themselves, but in the programmatic piece of files on. i think it's a step beyond the guidelines. having guidelines that are clear they can be applied across context is the first step within the first step but then it's how those guidelines are then implemented. >> right. we're working at usda, native american populations is a good example of where we're trying to work to reflect the traditions and culture of native americans and indians to make sure their dietary choices are wide enough range that they can meet their cultural and traditional needs. so that is a greater sensitivity and i think that's the challenge

force in the future which is to understand those differences and try to figure out creative ways from recipes and from direction and instruction to reflect those differences without necessarily getting to a circumstance where we have to move away from the purpose of these guidelines which is sort of a general recommendation. >> thanks. i guess it's also been important to understand what the messaging might be going forward and that different folks will understand and be able to learn about the guidelines as well. >> you will be an extensive effort at both department but certainly we'll be using all of the tools we currently have which have been pretty effective. my plate has been one of the more effective effort on the part of usda. we will refresh that, they choose my plate, super trucker, the snap education and nutrition information we provide to snap families. the work that we will continue to do on menus with the school lunch personnel. there's a variety of ways in which we can incorporate and assist folks and trying to follow these recommendations. >> think about again for being

here, and i yield back, mr. guerre. >> i need to apologize. i was brusque and rude. i simply should of said your time has expired so please accept my apology. >> no problem, mr. guerre. >> mr. kelley, five minutes, four minutes. >> the dietary guidelines for americans have been published every five years since 1980. we're concerned the public at large has lost faith in the process to develop the dietary guidelines which will make -- with potentially costly effects on public health. in the military in my service would often say you could have and standard operating procedures but if your unit and your soldiers don't know them and use them you don't have them. the same thing with guidelines. before coming to congress i was a prosecutor. i extend to people can look at a problem and come to a different solution.

secretary vilsack, to process your doctor meantime the preponderance of evidence. as a prosecutor i didn't get by with a stand because the things i were doing were so important that have to prove beyond a reasonable doubt my case. because for different things in different priorities, sometimes use a different standard of evidence. i would say maybe a preponderance of the evidence or scientific evidence is not the right standard. maybe it's clear and convincing evidence or maybe it is beyond a reasonable doubt and when we have signs that we hold that the statute that make sure the end result is something that we have a good belief that it would be viable and it would be the right answer. also we want to always be correct. if we raise the standard made it will be correct more often. >> congressman -- >> spin if i can finish that there've always been disagreements and always will be about what the scientific is. sometimes we may want to look at the standards but over 1350%

increase in public comments. it raises some concern with me that people don't have faith in the system. so to both of you i just ask you, what can we do, because it is about how good the standards our and it does not matter if we're doing the right thing. if the public does not trust that it is the right thing we have to build the trust. secretary vilsack or secretary burwell, what would you do to make sure our public places tens of the guidelines we are putting forward are the two and correct ones? thank you. >> first of all the preponderance of the evidence stand as a congressional mandate. so we have to follow the congressional mandate. if you all believe it should be highest -- higher standard, that is your call and whatever call is we will follow it. secondly, i'm not sure despite the fact we had 20,000 comments, we also a 290 million hits on our choose my plate but that will would suggest people are

following these guidelines. they are interested in these guidelines that have not necessary loss conference. that's another data point i think is important to take into consideration. i see this as a positive thing. maybe i'm looking at the trunk but i think the more public input document, the better the decision-making can be. we are going to take all this information into consideration as we should, and there are a variety of input focus is on all of this and hopefully will come up with the best guidelines that continue to the faith and confidence in the american public. >> i would just add even as input the statute in preponderance that you appropriate indicator different levels of evidence that we do and it's related to your colleagues earlier comment about aren't there different populations affected in different ways but the evidence we look at, whether that's an issue of sodium of what that recommendation will be, and what we did last time, it does look at different places where there

is more evidence or less evidence. i think that's something that's important to do. i think we do follow statute, but we hear your point and the scientific review actually when we get our documents -- >> i have 10 seconds. if i have one for the point. i think it's just important that citizens want to know we are not using science to justify ideology. that it's the other way around the bank and i yield back. >> mr. davis, four minutes. >> thank you, mr. chairman. thank you, secretary burwell. it was great to speak with you last week, and thanks for being here. secretary vilsack, i know you will probably be surprised by this but i'm not when asked about the school lunch today. and has been discussed already so i will skip over that but i do have some concerns. my most serious concern today is what i see as a lack of evidence to show the recommended dietary patterns proposed by the dga

have been based on any evidence on children. according to the citations in some previous advisor reports for recommendations, the recommended diet has been tested almost exclusively on middle-aged men. and women. whose nutritional needs are very different from young people and growing children. in particular i'm concerned because young children need certain vitamins and minerals in order to grow and to develop. we are talking about where in previous reports the expert reports state that the recommended dietary patterns do not meet sufficiency goals for potassium, vitamin c, vitamin e, vitamin a deficiency may be marginal but these are essential basic nutrients for growth and helping children. as a dad, a freshman in high school, and a coach come these are things that concern me on a regular basis. at the same time the dga see a pretty deficient in one

developing guidance to meet the basic efficiency for children to grow and be healthy. they're expanding their review of what has been referred to as a dining out topic. specifically the fast food category was brought naked of the types of dining out menus including like arcserve, casual formal restaurants and grocery store pickup. given today's busy lifestyle and when you look at restaurants, if offered a love healthy choices and what we saw just a decade ago. with that i'm kind of disappointed, i think others are disappointed, but restaurants seem to be singled out even though they are doing their best to offer healthier options to customers, and that concerns me. i just find it difficult to understand that location in which we would eat without any other consideration automatically tampax the quality

or nutritional value of the food serve. i understand some restaurants may serve better food than others, but that's the consumer to make a final decision on that. secretary burwell, would you agree the nutrient content of food is more important than where the food is purchased, and the rather than trekking people away from dining out maybe we should focus on helping to educate them on their nutritional choice of? >> with regard the issue of children and the amount of research and evidence that we have in that space, even as we're preparing to complete where we are now, the conversation, my team brought up the issue of children yesterday as a look to making sure the appropriate evidence for a number of the things you're talking about for the next set. what you are a probably reflecting is the research doesn't exist because it is on older. we need to get started on another do we need to understand this better? we don't have the facts yet, we don't have a science-based but if we start we will with the next. with regard to the question, that dining out question, right

now 30% of the calories for americans are consumed outside the home. with regard to how we think about making short -- >> what percentage? >> 30%. so when that is happening i think what we need to focus on with regard to this issue that you should people have appropriate information. that's what i think we want to do is make sure that people have appropriate information to make the choice if it accurately it's up to people to make their own choices in the context. that's what we touch on that issue. and again always supporting the advisory committee's work with the work that we are doing. >> thank you again both. i time has expired. >> dr. randy shuck, four minutes. >> thank you both for being here today. i want to follow up on a few of the thoughts that were mentioned. as a position i've been involved in peer-reviewed science in my training and in my career. i am a little concerned about

some the things you guys have said here. you brought up the fact that i think was a journal of american, journal of ama brought out that 52% of americans are prediabetic or diabetic. and yet the dietary recommendations that, as i understand it, are not really appropriate for that. there's too many carbohydrates. these people have it carbohydrate intolerance and there's more carbohydrates you're recommending that is really appropriate for the. you mentioned this would be a treatment but this was not a treatment. this is a preventative problem and i think you have to address that more. those are some of my comments. one of the questions i have is how are the studies, how do you

determine which studies to put into they show signs on? i've got evidence that this evidence library, including some trials while excluding several other larger trials, some of which are funded by the nih. i don't know what all of the studies are not included in the data. how does that not lead me to believe there's not a predetermined result that's been looked for? >> well, the process starts with a series of questions that are formulated, and then information is accumulator, and it goes through a process of evaluation. >> is the nih involved in this process? >> is involved in the sense that the in the age helps to fund the studies that -- >> but they are not involved in

review about the studies are picked? >> with regard, i think they're two different processes. well, three. what is the library of materials that people use, and that's not -- the second is speed it was excluded from that library? who makes the choice of what goes into library speak with there's a process that the folks at the national, i mean speed is the nih involved in the process? unsurprised nih funded studies, some of which are larger than the study you rely on for your data, contradictory studies funded by the nih are not included in the data. i'm just kind of wondering why? >> geeky to give a a specific -- >> i can do that. >> i will be able to write a specific answer as to why that particular study or series of steps were not include or perhaps they were and were having a misunderstanding. >> i understand is they are not.

that's what i'm concerned. some of your comments suggested with diabetes and prediabetes and obesity are major problems in this country. because of the cut down on that portion of the diet, we are recommending more carbohydrates. that's exactly the problem that prediabetic's and diabetics have is not being able to respond to carbohydrates. so i mean for the majority of the people, 52% being prediabetic, this is the wrong guy to recommend. when you say it's a general diet, that's great but shouldn't be with the caveat, carbs were mentioned. this is pretty serious stuff because someone else mentioned when we were kids, people were not have that back when we were kids. we were eating more fat. and, frankly, it's not an exercise thing as far as i can see because i experienced. you eat a lot.

you can't exercise it all off. you have to get it right. >> the gentleman's time has expired. >> mr. chairman, if i could just, 30 seconds. i would say that the website will provide you the information as to why certain studies were not selected. but it is as if the viciousness of information will be able to provide specific answers to specific studies. >> i will just follow up on that question. as far as that was concerned, as far as the dietary guidelines advisory did not use nel for more than 70% of the questions, why was the nel not used in these guidelines speak with her certain issues like food patent analysis that need to do to understand what we are eating, an issue that is broad and been

brought up a number of times industry, that is the information that is available as a deterrent to other sources for that to understand what is at that american americans are eatp resources that are different. there's other issues. the reason is the author, if that's not what the source of information can come from the there are certain data analytics and there are also places with systemic reviews have already been done in the issues involved with his own systemically view, they at least consider the other systemic reviews. i don't think those are counted in that percentage but secretary, probably -- >> the only other thing i would say this for review process goes through a series of mechanisms to try to provide an understanding of what the best sites is the best available science is and the least biased science is. it's a series of things, collaboration, the aging for health care research and quality, a data quality, all

consistent with data quality act. that's the other parameter with the work under, that congress has given us a direction under the data quality act as to how this is to be managed. >> the nel is basically science-based. very little ideology. they go by exact science, and i'm not quite sure, i didn't quite understand why, i still don't understand why you are not using them as more of a resource in the guidelines. spin they are used extensively. >> only when a question can't be answered. one of the issues is certain of the data analytics around what everyone is eating right now are different sources is my understanding of why the advisory committee turned, didn't use it. that's the kind speeches so they can have information on more than 70% of the research? >> i think there's a number of other places the advisory committee has to turn to other

things, and to do that. >> regarding sodium, they're some of us to retain fluid and there are others who did not retain fluid. sodium, back in my athletic career, i took salt pills and i had a hard time retaining fluid. of course, now it's the opposite. i'm on a low sodium diet. all the stuff is very personal. it depends strictly on your dna and that sort of thing. in my opinion it's very dangerous to set for the guidelines when everybody has a different dna and that different age of different requirements and, of course, we already talked about it doesn't apply necessary as much to children. i think the mistrust is this one size fits all thing, because folks who did a lot of, our s.n.a.p. program, they're getting a lot, they are not getting good information, and

then the consequences are the epidemic of diabetes that we have particularly in georgia with folks who do not know how their diet works and how it fits. is there anyway to get is more locally based rather than washington top down speak with we want to get to the place where it is useful and that's a big part of the conversation with regard to the issues like sodium i think we do take care to not put something, a standard that it is the standard for everyone, not the standard for individuals. i think this is about how one implements in terms of if it isn't the standard but if you of a certain disease condition, then we need to figure out how we in a public health said he and other cities can provide the right information for you. the iom has a 2300 milligrams of salt, but perhaps right now for you and your current state that's not actually acted. >> i am less than a thousand and

i yield back. >> so we have to make sure that we can have a format which we can to make it so you know where to turn together with your physician. >> thank you, mr. chairman. and secretary vilsack and secretary burwell, thank you for being with us and my apologies for my voice but it still has it gotten better since yesterday. i wanted to just come a couple of things i've heard, especially you, secretary vilsack, stating today is that you don't want to assume what we would do the guidelines. you don't want to predict them with the outcome will be. is that a fair assessment speak with a process has been completed yet. >> one of the other things i could use it was that more public input you have, the better decisions we will have. is that a fair statement of? >> yeah. >> the concerns i have about the process that you're currently following, my understanding is you have the dietary guidelines that are based on the expert

report from the advisory committee, and that's translated by you and your staff into, or your departments come into actual guidelines. >> that's one aspect of the. it's not the only thing we rely on or look after its one piece of a large puzzle. >> okay. the concern is i know that we've had a comment period to date and it seems right now process only allows for the american people to comment after the committee releases its report but does not allow for public comment after usda and hhs release the final dietary guidelines. i appreciate you did extend the 60 day public comment period by an additional 15 days, following the release of the report this spring. but as you spring. but as you can tell from him today there's still considerable criticisms of the report.

there is a provision in the fiscal year 26 in agricultural appropriations legislation that if an act requires a 90 day comment period after the dietary guidelines are formally released, and this process seems more in line with the administrative procedures act which long predates the current process you're using for the dietary guidelines. considering the fact more than 29,000 comments were submitted on this report, while only 2000 were received on the 2010 report, it shows there's a great deal of interest in this by the public. it seems to me the public should have a final opportunity to comment on the report before it is finalized. spin first of all i would point out there were a number of places where the public could

have input before it in the public comment period as the dietary advisory group was meeting to go a series of public meetings, opportunities for people of input. there's also been continued opportunity to have input in the process. the challenge i have is does the process, your data finale to a. you have to have a stopping point to it. in order for us to be able to factor into that there is other decisions we could make that are in some places based on the guidelines. i'm concerned about how long you extended this process -- >> the last thing i would say is the focus of with commenting on this and that is they could decide not to follow them. they could decide to be critical of them once they are proposed to there is an ongoing debate and conversation. >> my concern is right from the start, you made the comment and i appreciate it, the that you w