for all time by putting some system in place that we do that. >> all right. that's it? we will move along quickly. >> you don't want us to go into our policy substance right now speak with you got seven to 10 minutes that i would urge you to get out what you want to get out. >> some of you remember the movie the graduate come at a time young dustin often western forget what to do with his life, and his father-in-law looks at him and he says to him, secret sauce your remember what the secret sauce was? plastic. this was 1968 which was in the heart of my life, my adolescence, vietnam, early marriage life and everything else. i didn't follow that advice. i didn't go into plastics. i think to some extent there are

a lot of secret sauce is today in different worlds but one of them is food and agriculture which has become much greater highlighted in the might of the public, people are much more interested in this thing. there's a lot more self-help, a bob bork ngo private sector interest in news relating to food and health and nutrition everything else. if they can change in terms of the role of food and agriculture were as what it was 50 years ago where medical schools didn't get much attention to it. it was all thought to be a foreign basic issue, and you ate what you put on the plate for the most part. a few people like mike jacobs invited into this a biz of trying to provide some consumer help but there wasn't much there so that been a metamorphosis in terms of people's interest in these issues and concerns of outside folks that are interested in them as well. i would have to say that i agree with donna that moving boxes around in government is

generally not a very productive idea. for some time i thought if we started food safety by combining all food safety function in the federal government, poultry along with nonmeat folder items, that would've made a lot of sense. you probably would have about 45 senators stand up from rural states and ginseng no way, we're not going to give up our jurisdiction. so those things are not likely to happen formally but what happened i think in recent years under the obama administration, there's been a lot more collaboration and cooperation on issues like the food safety modernization act and food safety enforcement issues. collaborating of working together is a better way of doing things than moving boxes around. i would say a couple things that i would recommend. i us to believe. one is that appointing

competent, able, and intelligent leaders in cabinet and some cabinet posts who know something of what they are doing is critical, and that is often not the case. often the people who are picked at the top, people notwithstanding you are sitting next to me, are often picked for political reasons or for relationship reasons and not always the right people to manage the affairs of the food safety, food issues down the government bureaucracy. i remember at usda myself, i was at times picked people he didn't have the knowledge of the subject matter. they were not stupid but they came into other lines of work. it's important that president and the vice president and cabinet level leadership appoints competent, able people who know something about what they're doing and have a broad view of the subject of what they're talking about. that second thing i would say is that in the case of usda, we

were more than just a regulatory agency. we were a policy agency. i always thought usda handled not only for programs but most federal nutrition programs whether much of food safety was there, virtually all the conversation programs affecting private lands were there. snap in school meals and related things. it would be useful that the department name of a change to o reflect that either the department of food and agriculture or the department of agriculture nutrition and forestry to represent what it does. the department of agriculture is basically the leading through department in the government. over all. and yet it's kind of hindered by this language that it's the department of agriculture or the department of farmers went in fact it has a far broader role.

in my judgment if we give that characterization of what it actually did it would be a lot more helpful in working with the other departments on issues that needed to be done. i think secretary vilsack has done an excellent job of working across lines, with with the fda or ep. just to give you one example. when you go out into farm country today energy meet with farmers, you mentioned that three letter word, the three \30{l1}s{l0}\'30{l1}s{l0} words to farmers, epa. and invariably people see that as the enemy. they don't see the fda as the enemy. some do but they see the epa as the enemy. a lot of this is political. a lot of this is style. a lot of this is sometimes not the best political judgment be made at the highest point a lot of this is people just don't want to listen out in the countryside.

but if the departments were characterized in such a way where it looked like they had a much more leadership role on the items within their jurisdiction, that i think you could probably do a better job politically with some of the other issues, these environmental conservation issues that are coming up. we can talk more about policy judgments by they don't think reorganizing the government for reorganization sake makes a lot of sense. leadership is the main thing that counts. >> i think most people would agree agency leadership really made, they make more than it gives anything else including statutory mandate. commissioner hamburg, you are being recruited to be the food czar for the next president. what's your advice? >> i would agree this is not a model for reorganization. if we were starting from scratch no one could decide our current system at the notion of a

single, strong food agency have a lot of appeal. but at the present time i think there are too many important activities underway that need attention, focus and resources and that reorganization would actually great a terrible scrum where work would not get done, where new legislation would offer opportunities for things that were unhelpful rather than helpful to be introduced. i think this is a moment to really focus on the tasks ahead. thinking about the food very broadly in a comprehensive way that recognizes the importance of food safety but also food security, the issues of quality and nutrition, the linkage of our food system to other major pressing public health concerns such as antibiotic resistance and use of antibiotics in animal agriculture, and the

relationship of food production to broader environmental concerns, food production i understand is the leading cause of environmental degradation today, which is no small problem for our country and for the world. so it is a complex arena, and i think we need to address it in all its many components. with respect to whether or not there should be a czar, i really disagree with my former boss -- rarely -- donna shalala. czar, i don't know what the point of real coordination in the white house is very important what of the struggles we had at the idea is we never knew who to talk to in the white house about our issues. we assume often mistakenly that people within the white house were talking to each other, and we often found ourselves in the situation where important issues

were not to be taken up because of a failure of a person in the white house who was fully nondigital and accountable. and, frankly, an advocate for our issues because of all the competing priorities, sometimes these issues would drop lower on the agenda. i don't know whether i should tell one story. will i get into trouble? one shocking moment for me -- >> nonpublic stories. >> when we're trying to move forward with the proposed changes to the nutrition facts label which was put out in final form just recently, but we were trying to get a briefing with a wider than briefing with a wide and it wasn't getting done, wasn't getting done. finally, i called and said what's going on? this time urgency because we first have to get the proposed rule out and then we've got to get a final before the administration closes. i was told we are having trouble

getting on schedule because the same people need to be at that briefing are working on syria now. so -- last that i resisted thing i hope they are expert on syria than they are nutrition labeling the entity case there was this problem of leadership within the white house in terms of who do you talk to and who is accountable for making sure issues move forward and decisions get made. expertise matters and i couldn't agree more with the notion of the new administration needs to really continue its tradition i think the obama administration broad of putting people with expertise into critical roles and then listening to them. i think this is a critical time in terms of you mentioned some policy goals our activities and focusing on food safety for the purposes of this meeting and the panel. to make sure that the food

safety modernization act dick fuld applet. this is one of the most important, historic undertaking in food safety in the history of our country to its the first major set of new regs and new authority in about 70 years to israel in an effort to try to shift our system for food safety from one that is reactive waiting until the problem occurs and then trying to address it to one that focuses on prevention which, of course, you know, a core component of public health and this would benefit patients and consumers. there will also reduce preventable cause for health care system and will advance our economy because it will prevent serious problems that undermine food producers and industry, and that undermine the confidence in their products.

so this shift of focus to prevention is absolutely key and it requires really a lot of work at every level across sectors come across levels of government, across agencies of government to make this real but another important component reflects a broader reality which is working across borders as well. anin the food supply is the increasingly globalized. in fact i was shocked when i got to fda and learn some of the numbers about 50% of fresh fruit and produce is coming from countries outside of the united states. over 85% of seafood is coming from outside of the u.s. waters. these are products that are highly foldable to contamination and other alteration, and products that are increasingly

hard to oversee in terms of fda's responsibility for the protection of american consumers. the only way to do it is to actually understand, care about and, in fact, strengthen oversight and countries around the world. we are now talking about food coming in from well over 100 different countries, coming in through multiple different ports of entry several hundred different ports of entry, and from countries that have various sophisticated -- unsophisticated system in many ways. so you can no longer do what fda wants to do, stop the ship, inspect the barrel of the losses and say this is sugar water, you can't come in. so really focusing on globalization, the need for new global governance mechanisms to better address the oversight of food safety.

and applying that are suspect this is a time when science has advanced so credit that we have new tools that we can already see him make a difference but we have not adequate invested in them. whether it's using sequencing to enable much more rapid detection of outbreaks especially important in a complex global food supply where products that are contaminated can suddenly appear in multiple countries in multiple parts of the country, better point of use diagnostics so that you can quickly detect if there's a problem. and also really much more investment in understanding some of the important aspects of disease surveillance with respect to antimicrobial resistance, understand how at about it is used. fda took an important step forward during my tenure to

eliminate the use of antibiotics for growth promotion purposes but we still need to better understand a complex ecosystem that underlies use of antibiotics in agriculture and impacts on imported drugs for human use and human disease. the lots were i to talk about but i think i have probably used up my seven to 10 minutes. >> you have but secretary shalala and secretary glickman have not, so would you like to comment, secretary shalala? >> i want to go back to the reorganization issue, because i assume it doesn't surprise you none of us think that the next president should spend a lot of time on reorganization. though they will because there'll be people in the white house that think that we are to have a rational system, it will be people in all will be the think we ought to rationalize the system. -- omb.

the problem we have is-but officials is that we seem the energy wasted and we see the politics as wearing us down on the we organization. every one of these agencies or responsibilities house their own constituency outside of politics around them. plus a jurisdictional question of which congressional committee is responsible for them. to go through that when there are so many more important issues both my colleagues here have pointed out, it doesn't seem to be worthwhile to us. we always get recommendations of rationalizing the structure. that briefing book that is now being prepared for the next president will have a recommendation, let me assure you, for rationalizing the structure both in food safety as well as a host of other issues. mostly done by kill people or former omb types that think that's the first thing that the new secretary or the new president ought to do.

none of us want to take our energy into debt. were more interested in the outcomes and in applying new science to all of this. second while i don't believe in stars it doesn't i don't believe in coordination, or a layperson so peggy knows who we should call about these issues of whether it's the domestic policy council. what i don't like is when presidents appoint people that think they have line authority over cabinet officers or agency heads who were in the indigo to be held accountable for this, for decisions made by that person. at the people who coordinate out of the white house have to understand their roles and be sophisticated enough to understand they are not the people who will have to testify and, therefore, they should not have light authority as opposed to convening authority in the coronation authority, and

enforcing consensus or consensus has to be. there's a big difference between that and someone who thinks of themselves as a czar can easily point i would make about all of this. >> i just agree with what donna says as well but let's start out by saying if you're coming into this new administration you've got to think to yourself what are the big problems? what are the asteroids that are going to hit the earth that could impact the ability to produce enough safe healthy produce produce any sustainable way, way to feed the country and the world. and then once you know what those big items are then you can try to the they got how to organize the government? is going to do what it was the best way to do it? it looks to me like that needs to be done. i don't think it's been done very much but our government in the past at all because food and agriculture issues have not had high priority attention in less there's a massive outbreak of

the zika virus is hitting or a bullet this year or there's an e. coli epidemic. so the first question i would do is to have some say what others asked what? number one is we've got to double food production in the next 30 years to feed a growing world and in a way that doesn't with a fragile land, rain forests and everything else that we need to preserve our environment. that is the real challenge to its global but it's a gigantic challenge. we need to produce more and the need to produce more in the context of climate change, weather variability, water shortages, resources generally as well as health and nutrition because our understand of those issues are changing as time goes on and, of course, to find a safe way to do these things in terms of food safety. and so those astroid with intent to determine what policies we should pursue.

and what i found most disconcerting is the level of dollars in commitment and the research and development functions of the food and agriculture arena are dwarfed by the level of commitment in other sectors. i understand why the health sector gets so much because cancer is a big draw or infectious diseases are a big draw and people give them and to relate to your mortality much more directly. but the level of funding in the r&d side of food and agriculture, in real terms has been following year by year by year. the private secretary of state that some of this but not the most important part abou that ot to be done in the public sector to regular universities, land grants or everything else. and so i guess from my perspective is that what we don't know is going to kill us. we know there are variables that

are happening out there that would change the ability to produce food to feed hungry people come and we need to be focused on that from the top down. one specific issue which i will raise in this area is water. you cannot produce food without water. agriculture is responsible for 70% of the fresh water that is used in the world. and yet world issues in rural people are responsible for about 22% of the people living in the world. the rate of urbanization is happening dramatically all over the world. not so much in the u.s. but globally, india, china, south asia, sub-saharan africa. the conflict between water utilization to produce food and water utilization to keep us alive as urban residents is one of the massive challenges in our future. i think we've neglected that problem. water is to agriculture and food what energy is to our lives

every day. that's of course another issue. i only mention it because if i were president i would want to bring people together to not only decide how we're going to regulate this food safety issue or regulate this particular farm program i want to know how we're going to meet these challenges in the next 20 or 30 years. those are the ones that will be determining whether we can feed the world safely and environmentally soundly. >> okay. so let's drill down a little. commissioner hamburg talked about food. secretary clinton reminds us that somehow or another we needed double food production in the next 10 years, quite a challenge. last week the new york times reported the incidents of a superbug that was completely resistant to antibiotics. that's scary. so we are all these utopian

futures ahead of us. how are they going to avoid it? let's focus on antibiotics in the food chain. i know commissioner hamburg spent a lot of time working on this but i would like to get each of your comments about how we successfully navigate this. would you like to start off? >> this is really a pressing problem. it's not a new problem. it is sadly one of those issues where many have recognized the growing concern and spoken to some of the possible solutions, but we have not moved as quickly as we could have and should have have, and we now really do find ourselves in a frightening situation that we are starting to see seriously resistant organisms. at the same time we are not seeing a probable expansion of new drugs in the pipeline to treat critical aspects of human and, frankly, animal disease as well, a new vaccines that could

make a difference. this is a problem that we need to address in an urgent way. it is one of those things that incoming administration has to make a priority. .. how we support animal husbandry and agriculture in this country to reduce the load of antibiotic use, elimination for growth promotion which perhaps the secretary understands bert than i. i don't know why it works but it does work, in allowing healthier and more rapid development of various kinds of animals, but it

really has throwing antibiotics in the feed to animals, and it is something that doesn't need to occur, has negative consequences, and so finally in this country, we are seeing elimination in for growth promotion and that's happening in other places in the word. the next challenge for the fda is to create a framework for oversight of appropriate use with the veterinary community, and has been disconnected in many ways from the use of antibiotics in agriculture. it's a very different system than human disease, and healthcare providers, but also think about the appropriate use for preventive purposes, because there is a gray area between growth promotion and prevention. they're clearly some very real

and appropriate uses for animal health and agriculture for antibiotic prevention but you don't want it to be an ill-defined zone that can sort of spread into broader and inappropriate use. so, i think that is a big issue. this is an area where we also need to work on a global scale. we need to have common ways of addressing this problem across countries because these resistant organisms move around. we're now tracking them and really understand that we live in a global world, and that these threats to health are global as well. >> secretary glickman. >> well, first of all you have done a lot of great work on this area, which moved the ball forward in terms of antibiotic resistance and getting the science done. ordinarily don't read "mother

jones" magazine but i happened to read it on the plane and a big story of purdue farms. purdue, one of the largest poultry producers has gone to an antibiotic-free system of -- for growth promotion. the still use antibiotics for disease because if an animal catches a disease you have to treat the disease or it can infect everything else. but the idea of using massive amounts of antibiotic for growth promotion -- they found that the animals would grow faster and fatter when they had the growth promotion but after a period of time resistance would come in and affect them negatively. a few others are taking this attitude. purdue's attitude was i did it because consumers demanded it, so, good lesson in agriculture and food, is that the power of consumer has grown rather significantly. part of this problem has to do with how we raise animals in the

industrialized world. they're not raised in little five-room hotels. they're raised in 500 room hotels, the equivalent of 50,000 or 100,000 animals in one unit, whether it's pigs, cows or chickens, and when you put -- if you put three or four times the people in this room and you kept us in here and we couldn't go to the bathroom when we had to be with each other all the time we 'd probably all get sick. the methodology of what i call mass production of animals leads to diseases and that's one of the reasons they inoculate them, and both for prevention as well as for growth promotion. what i do see happening is there is clear lay movement away from usingabilities for growth promotion. you have done a lot of that at fda, and the companies have voluntarily done this on their own because their customers want antibiotic-free as much as that

means something in the world, and i thank frank purdue has done a good job of trying to promote this. the area of research and development, how you keep animals well, because we're a protein-based world. people eat protein. they ate meat. pork, beef, lamb, chicken. it's part of the world's diet forever. and so how we keep these animals well to feed a large and growing world, and do it with modern sensible agricultural practices is a challenge and that's something that the research and development agenda needs to get very high attention to. >> secretary doyle. >> we have been using antibiotics for animals since then 1940s and there have been numerous studies by the institute of medicine and others, the world health organization has a position. cdc has been warning doctors about the overuse of antibiotics

in humans we have known the connection between antibiotics and animals and human health for a long time. underlying all of this -- and i believe there is a consumer movement that is going to move the ball -- but underlying all of this is whether we're going to make science-based decisions in this country, and whether we have enough faith in science and scientists. almost every issue we're talking about, we have a body of research that we ought to be listening to, and we have to figure out a way to put together the politics or inform the public in a way in which we can drive these kinds of decisions, and i find over the last 20 years i've been unnerved by the selective moving away from the science as we make decisions, and all of us ought to be concerned about that, and this is a perfect example where we have known is in for a long time and, in this case, where the

consumers are going to drive us in one direction, but the consumers can also drive us in another direction, when there isn't clear science, and we have seen that in agriculture and food safety as well. so, i just think that government in particular has to make science-based decisions, and we have to explain it to the public, and get a level of science literacy and comfortableness with our scientists so we can do this. >> let mow follow up on secretary glickman's point about consumers moving the needle on antibiotic use. so, it's easy to see why chicken producers are sensitive to the market because their name is on the product. right? so, go to the grocery store, you know you're buying chickens from purdue. you don't know that with respect to meat products. and so how do you -- what is the transmission belt for informing consumers about antibiotic use

in beef? so, it doesn't come labeled necessarily. is this an issue where we ought to focus on labeling of products and sort of letting the consumers choose by putting a stamp on those herds that have been raised with prophylactic antibiotics? >> ohama steak. >> or trump steak. >> you know, it's an interesting issue there was a movie years ago, i was involved in the motion picture city. a movie called "field of dreams." they were building a mythical baseball stadium in iowa and the line was, build a stadium and there was negative feeling, and final i think it was kevin costner who was the guy and he said, the famous line "if we build it they will come." it always struck me that in agriculture, the reverse is almost always true. if we grow it, and if we raise

it, they will buy it sight unseen. think in a sense that's the tradition of agriculture because people always assumed that the products were safe and cheap and they were on the shelf and this growry stores were reliable, we had a lot of trust in them, trust in the food companies and that's the way it was. that has gone through a revolutionary period of time now. for different types of agricultural products but it's more like now, if you grow it and we know where it's grown, and we know what kind of feed that's put in and if we know where the product comes from, and if we think it's safe, and if it doesn't have any gmos or does have gmos and if it doesn't have any antibiotics, and if it is sold at whole foods dirk don't know what all the things are -- then we'll buy it. my point is the consumer overall has become a bigger factor than 50 years ago.

that good is good. and it's been driven by the marketing of foods so walmart markets 23% of all grocery food in the united states. one store. so walmart and target and others like them can effectively set the agenda for what is actually bought. either -- their pretty smart at figuring out what consumers want. it's a long way of answering your question because i don't know what kind of label ought to go on what kind of product. i suspect that some people would like an antibiotic-free label on meat or hormone-free label on meat, and by and large labeling is a good idea. with two provisos. one there has to be unlv real estate on the piece of food your a big for the label to make some sense so it's nothing -- you don't need a microscope to figure out what is in the product and that's why modern

bar coding maybe takes that particular thing up. and number two is that just because a consumer wants something in their food, doesn't necessarily mean it is the scientific thing or the right thing. it mail be a cultural thing or ethical thing that some people want and may have nothing to do with food safety whatsoever. it's more of an item of choice. and so -- but i suspect that going back to my original point, the consumers are going to want to be more and more educated as to what they're eating, and it's the job of the food industry and the regulators to make sure that people have the right, as donna says, best scientific education so they can make intelligent choices, not choices based upon fear or the latest news story. >> well, let me ask both commissioner hamburg and secretary shalala this question

and let me add one more factor. there's enormous controversy over gmo labeling. and there's questions about labeling, for example, whether the animal was raised with hormones. what do you think is the right balance for consumer labeling with these kinds of products in the united states? do you favor greater -- in assessing secretary gluckman's point there is limited real estate and you don't want to sort of fan suspicions that are not science-based. so where do you come out on labeling things like gmos, hormone use, antibiotics? are these the kind of things we need to provide to modern consumers or do we need to be more restrained? i guess we'll start with the commissioner. she has had 'omake disease decisions. >> it's a complicated area and i support consumers' desire to

have information about the products they eat. i think it links in to a number of comments that have already been made about the complexity of labeling as well as the need to have science-based approaches in terms of what the government would require as mandatory labeling, and i think the gmo issue is particularly troubling because it is an arena where many people quickly jump to the level of anxiety about an arena of science they don't fully understand to adopt a negative stance towards gmo. despite the fact that there have been lots and lots of scientific studies looking at the safety of these products. you can't know everything, but the vast body of science -- there was just a recent review i

haven't had a chance to look at but saw reported by the national academy of sciences, taking, again, deep dive, and the opportunities for gmo foods in terms of addressing the critical issue of food security and how can we produce enough food going forward? how can we produce plants that are drought-resistant or disease resistant so we can respond to growing demands for food? and how -- also can we enhance the protein density and other nutritional aspects of the food supply. i think this is the area that worries me the most that we not enter a period of what some call science denialism out of fear when the positives are very compelling, especially if we

care about food security around the globe, and i do worry that the calls for mandatory labeling of gmo potentially sends the message that these are dangerous and that concerns me going forward. i think if people don't want to consume gmo containing foods, they should be able to access products that meet those needs, and voluntary labeling can address that. i do worry about government deciding to do mandatory labeling in that context. >> secretary shalala. >> dgmo is the exact issue i worry about where you cannot -- you have to make science-based decisions. more importantly, you have to protect the fda as a regulatory

agency to make science-based decisions. think i spent most of my time at hhs over an eight year period protecting the fda from political pressure, both from the white house and from the hill, from being interfered with on science-based decisions. and personally i've been dealing with gmo issues in every job i've had. i remember in wisconsin we had the bovine growth hormone issue with the milk. oh, my god. was chancellor of the university. the way in chit was stopped was the pediatricians in the state went and testified before the legislature, arguing that it was the milk was safe for kids. and that stopped it at least for a while. but if we're not willing to tie ourselves to science-based decisions we'll be in big trouble in this country and part of the responsibility that i

felt as secretary was to protect the fda, which was a regulatory agency, and on occasion i had to say to the white house, it's a regulatory agency and neither you nor i should be interfering in their decisions, and as long as they're making science-based decisions and they continue to, i think that it's very important. otherwise we undermine science in general when we selectively pick out these issues. and i consider that probably the most dangerous aspect of government. >> secretary glickman. >> several things. one is i do think there is a kind of growing lack of trust by americans in all of their institutions. government, politics, business, regulation. and i think that while i agree

with both of you on the gmoo issue and i eat those foods and they're perfectly safe but we have to make sure we have regulatory system that is modern and deals with these issues as they are now because the whole field is changing so dramatically. there's new ways to manipulate genes that we didn't have before, and in order to give the public the trust that the decisions are made independently and on the level, and that doesn't mean excluding industry from this process. but it does mean that just saying something is safe doesn't make it safe unless you have a regulatory process that people believe that fully examines these particular issues. while in the house i was involved in the organic standards act reauthorization, and then while at usda we implemented the organic standards act, and the act created a whole new industry in agriculture, where by and large you boy a food certified

organic, doesn't have gmos in it with certain limited circumstances, and i agree that finding a way to allow people to buy nongmo foods without mandatory labeling is a much better way to go. i see some of the food manufacturers have now made the decision to go with labeling, a mandatory labeling scheme. but -- and also quite honestly, some in the farm community, the feed community, haven't done a good job of explain thing benefits of gmos, consumers don't see right now a lot of the things that happened in gmos to actually benefit themselves. if we could develop products that did have drought resistance, pest resistance, growth qualities that people can see -- i used to make kind of half facetiously say if you could have a gmo seed that would grow hair on my head it would be a massive thing. it would be a tremendous

opportunity but that hasn't obviously happened yet, likei alis or something lick that has done. but in any event, these issues do require a regulatory system that the public has trust in, that believes is on the level, and that system may need to change as time goes on, particularly as consumers want to know more about what is in their food. at the same time, i agree tote live with the donna. it was damage patrick moynihan you can have your own point but you can't have your open facts and in -- your own facts and in this debate on foods and gmos, people often let their ideology and their opinions equate to facts, and that can't be helpful either. >> unfortunately, the food agencies are vulnerable to pressure from both the public as well as congress, and it's reflected in congress. i remember the authorization of the fda, trying to get it

through. tell you the truth we got drug advertising because of the deal cut on the reauthorization of the fda. i wasn't desperate to get the reauthorization. i left the congress at 3:00 in the morning after arguing vehemently with a senator fritz, and huh now admitted it was a mistake, and i said the administration's position is that you have to take drug tiding we will not agree to the reauthorization of fda. we can live without that reauthorization at this point in time, but the senators were so desperate to get it off their plate they cut the deal on the reauthorization at 4:00 in the morning, i unfortunately left at 3:00 in the morning thinking head made it clear what our position was, and we got the expansive healthcare costs as result of the connection with

the fda reauthorization. and not acceptable. i give you some sense of why the financing of the food safety system is not outside of the political realm. it's very much tied into it. and we're very vulnerable because of the way we finance safety in this country, because you cut deals as you're going along, and as long as the public is pressuring congress on some of these issues we'll continue to be backing up on what we think our good science-based decisions. >> i just have to step in and applaud donna for her leadership when she was at hhs and recognizing the importance of fda -- >> we're takenning now panel discussion on food policy and heath hosted by the georgetown law center -- >> i'm also thrilled to be is in

role because i have the distinct honor of not been able to stand in your way of food, coffee, or kind bars, let aloe the honor of introducing the honorable doug o'bryan. this issue is really an important emerging issue, better food, better health, better ecosystems, better policy, better marketplaces. all interlinked, and we at the global social enter prize initiative focus -- enterprise initiative focus on key issues that leverage the greatest assets of georgetown university, and health and well-being, impact and investing, economic security, are just some of the areas where we focus. we have had the distinct honor or also partnering with the white house rural council secretary vilsack on issues

related to rural economic development. on may 3rd we co-convened a conference, actually the third in a series, that was conducted collaboratively also with the georgetown law center and with the global social enterprise initiative. each one in different years. that focus on rural opportunity investment. and on may 3rd the focus was really around food systems and also conservation. some of the issues that have come up today. douglas was there. and doug being senior adviser for rural affairs at the white house is really at that point which donna shalala talked about today. if we want to for the rest of the afternoon program we can call him the czar, but -- >> no, you can't. >> we won't. but doug is at that confluence of the coordination point that

we really need, have needed and will need going forward, even in a new administration, to deal with the issues to ensure that the emerging context of food, markets, policy, health, wellness, access, and security, all come together. so, with that, i'm going to introduce doug o'brien, you all have his bioin your folders. i think it's far more important that we hear from you and get a chance to ask you some questions. doug o'brien. [applause] >> thank you. thank you. thank you for the introduction, and i do want to thank the school and the georgetown law center. that collaboration around the rural opportunity investment is a -- i think is a great example of what i want to talk about

today and that is how -- from the federal level, we need to think about collaboration, think about ways to either break down the silos or to deal with the silos as they are, to get to more of the impacts that society expects from the food system these days. so, i want to talk a little bit about the food policy environment. with this crowd i don't have to spend much time at that at all. want to make the point i think in this changing dynamic, the obama administration has really captured the potential, and i'll provide some outcomes outcomes d results on that and want to talk about two or three different examples of policy approaches that we have taken within the obama administration that aren't necessarily in the textbook.

they're not necessarily legislative. they're not necessarily in the apa, but i'd argue they are critical to moving the ballford in the food policy sphere. so, for a moment, to think about -- kind of the window i'll think about is the beginning of 2009 to nearly mid-2016 and how much has changed in the culture of food and food policy. i happened to be on a list serve for the grocer manufacturers, and daily -- this is the list serve is designed for food manufacturers, for grocers, and the kind of the latest state of the art, how the private sector is moving toward accelerating more and more healthy options across the board. almost falling over themselves

to try to figure out how to access that new and emerging market. they don't do that by accident. they're responding to what society demands. think about seven or eight years ago. part of my frame is i have three little kids, two and five and seven years old, including the fact i've been up since 4:00 this morning. that's part of the frame. i'll caveat that. but when we go to fastfood restaurants, decisions very often -- but now we can get cut fruit and milk anywhere we go. that seven or eight years ago wasn't a -- a possibility at all. certainly firms, big and small, are providing more and more information, and again, that is being responsive to society at large, and i think i'd argue, both in my work around food policy and also done a lot of community economic work in the

world geography in the past seven or 12 years, that one of the biggest changes that is going to occur around food policy -- it's beginning to occur -- is at as the millenials move into a major not only kind of consumer cohort but also leaders in policy, from my observation, the way that millenials -- i think perhaps one of the greatest factors is they grew up connected. you grew up connected. maybe over half of you in here grew up connected. the way you deal with information, the way that you network, and the way that the generation feels empowered to change, to make change. i think will accelerate change within the food policy environment that more than a lot of people i think can -- people from my generation or perhaps older can really imagine how quick things can happen.

just a few kind of personal things about the culture of food policies, this morning i had a 9:00 meeting at the department of agriculture. i'm over there every week or two, and we had a meeting under a tent by the people's garden. enough it's sort of this -- it's right next it to was an all-day farmer's market that is also hosting some incubating innocences from the union market. they do an evening market now there. seven or eight years ago there was a farmer's market at usda, tucked into a parking lot and now it is front and center as this is part of the u.s. department of agriculture, the people's department and that beautiful garden they have tend over the last seven, going an eight years, is now a staple of the mall. that didn't happen eight years ago.

it's actually reflective also of the amazing growth of community gardens and actually gardens on federal property that has occurred in the last eight or ten years. and talking about food culture, my five-year-old boy, jimmy, yesterday when i was pouring cereal of. he was trying to negotiate a different type of cereal than the one i wanted to offer him, and he wanted to pull out the data point on how many grams of sugar are in his preferred one. he knows this. it's partly because my wife and i are seriously conscious of this but i think he gets that from his daycare, and when i was five years old, i grew up on a farm in iowa, and what i knew about breakfast was butters white toast and bacon every morning, and i didn't know if it had any sugar in it. i did enjoy sandwiches on a daily basis.

but even from that -- from a very early stage, think we'll see people being much, much more cognizant of what is in their food, how it's grown, where it comes from, and i think that -- part of that cultural change is really reflective in what i mentioned before and what society wants to get out of the food system. i think a generation ago, most people, at least from the federal policy level, would think that we are looking for affordability, we're looking for some basic nutrition, but making sure that families in, poor families can have access to food. we're laking to make sure that the farm economy is viable as part of the food system and that was mostly what we we are looking at. but now, beyond those considerations are still very important ones but now society

is much more interested in what type of environmental outcomes we can get from the food policy system, what type of individual community health, public health, outcomes we can see from the food system, and i think it really demands more for public policymaked and part of what want to talk about before i'm done is what -- the way the obama administration has responded to society's demands for more from it public policymakers. but take a minute to think about -- again, this is from the federal level. i hope my talk compliments dr. inning gals. saw the talk before lunch it and would fantastic. the work done at state and local levels to inform, nudge, move, not only those communities but the national level, think is absolutely right, and it's critical. from the federal level you think

of the last seven years or so, what has happened in food policy, and right off the bat, when the obama administration came in, two things happened. one was the first lady embraced, made her priority the "let's move" initiative to deal one one of the critical public health issues and that's obesity, and that initiative continues with huge momentum, just last week with major announcements about that priority moving forward. over at the department of agriculture, secretary vilsack and then deputy secretary marigan rolled out something called: know your farmer, know your food. and this initiative to look across the department of agriculture, it's depending on -- 17, 23 agencies, dozens of programs, how those programs across the food system, the research, the production,

nutrition, can support food systems in 2010 the congress passed and the president signed an absolutely transformative school nutrition act, the healthy hungry-free kids act, and in 2014, we saw a farm bill from the farm bill that typically really comes from the ag committees of the house and the senate, finally passed, the president signed, and was the most significant work around local and regional food systems, around s.n.a.p. access issues, around organic systems, relative to prior farm bills it nearly doubled the mandatory resources for these types of programs. and then we saw a usda that implemented that farm bill in record time. this bill of -- with hundreds of pains, -- pages and moved out nt

only on those priorities but on many of the traditional programs. so, what did all of that kind of big federal policy transformational federal policy, what did it result in -- this is the part where i give numbers -- from the farm level, through the food chain, usda, since 2009, has invested over a billion dollars in 40,000 firms, many farmers but also small businesses, that are part of the local regional food system. things like high tunnel. kind of a maybe for some, seems like a particular thing. high tunnels are these plastic kind of hoop buildings that go over a plot of land that do

critical things, of stepping the growing season for farmers so they can actually participate in the economically viable way in local regional food systems and can grow things that so many more people are hoping and demanding that they grow. today there's over 160,000 farmers selling into local and regional markets. we know that in this -- the market in the local and regional food scene is $12 billion in 2014. up from $5 billion in 2008, and many industry experts are projecting that market to grow to 20 billion in the next few years. so, some major moves and just in the farm side. and infrastructure, hundreds of investments in food hubs and warehouses and local processing and food banks, to help support the local and regional food system. there have been $60 million in

support for over 900 projects, for farmers market promotion projects and other local food projects. there have been nearly 200 community food projects that the federal government funded, providing dollars to communities to build out food systems that are healthier and that are supporting the local economy. in terms of communities, consumers, people, families, kids, over 30 million kids today, relative to 2009, are eating healthier school lunches and that could be the data point that is most impactful. there's over 6400 local food vendors, farmers markets, that accept s.n.a.p., and today -- that's up from nearly 750 in 2008. so by a factor of nine or so, more places that allow people who are uns.n.a.p. to shop at

that local food market. there's $800 million spent by schools on local and regional food. in 2013 and '14, and that's more than doubled that was just two years prior to that in 2011 and '12. there's a lot happening. a lot of outcomes in changing the way that food is produced, that it's distributed and that it reaches our consumers. so, how we got to many of those outcomes and different ones -- i know this is a food policy council -- food policy conference about the future but ike going to talk about retrospect and look backwards. some thing wes did in the obama administration can inform the future. i'm not going to talk about legislative work and not going to talk about regulatory work that is more textbook. i'm an attorney.

kind of more textbook tools that lawyers and policymakers have but i'll talk about three different efforts quickly on what we have done to really hot-wire and build collaboration within the federal government to get to some different outcomes. the first one i'll mention is the know know your farmer, know you food." how many folks in this audience are familiar with that initiative at usdna well over half. that great. so, i mentioned this before that in 2009, secretary vilsack and then secretary marigan lifted up this initiative, which today actually, at least from where i sit, just makes a lot of sense. all the -- in 20 or two dozen or so agencies within the u.s. department of agriculture, that the authorities and the funding streams they have are very

obvious and relevant to those firms that want to participate in in local and regional food systems. that wasn't the case in 2008, and in 2009, as the rolled this out -- and did the really kind of nuts and bolts work that has to happen within a big agency or across agencies, to really move the ball forward, and the first thing i'll talk about in this policy strategy isn't policy but it's people. when we think about moving any type of policy -- we're talking about food policy -- who is on top of or part of that work is really critical. in this case you had a secretary of agriculture who was a two-term governor, who had a very good grasp of what executive could do with the myriad of tools in trying to move forward a big initiative.

you had a deputy secretary who was steeped in local and regional food policy, both on the hill and research and then academia, was kathleen marigan, who knew and actually served in the clinton administration and knew where the tools were in the depth of agriculture and knew how to navigate the initiative within this town, so that it succeeded. having those two people on top, moving this particular type of initiative, was essential, actually. in my opinion there's just no wait would have moved forward bus at the beginning having the utah department of agriculture strategically look at how its programs and funding streams could be used for local regional food systems was quite controversial. it's not miami. that's for a lot of reasons -- part it this cultural change.

what "know your farmer know you food" it lookedded a programs and evol wait weed there was already authority. didn't need to do big brand new regs or didn't need to do some kind of big initiative on the hill. these are things that were already within the agency's authority that they were receiving resources through the appropriations process, and just lifting them up to make sure that people understood. another thing that -- going back to peep point. another thing that "know your farmer know your food" did was identify people within the system, within the agency, who were interested, had expertise, and wanted to work on these kinds of issues. these are -- when you think about moving policy, that human element, is critical. within the -- within "know your farmer now you're food" there was making sure that the people were identified and given space to do the work ask threaten then there was a significant external

strategy. creation of a really comprehensive web site that made clear what the programs were, what they could do, actually now if you go on the web site you can map not only where usda investments where a number of federal agencies are investing in local and regional food, all of this information is downloadable, people can use that information to slice and dice and along at it in other ways, and making sure that partnership can occur across -- between the federal government and the private sector. another initiative i'll mention, another really policy strategy around food but really more broadly around rural is thewhite white house rural council in 2011 president obama created the white house rural council that includes all the federal agencies that have some type of responsibility to serve the rural geography or rural people and that is to say all of the

federal agencies sent maybe the state -- except maybe the state department and that council is cared by the secretary of agriculture, in this case, the only chair has been tom vilsack, the longest serving cabinet member, and what the white house rural council was designed to do was make sure that the federal agencies were working together in a way to make the greatest impact in rural places as well as make sure that there's a place within the federal government, within the white house, for partnership with external stakeholders with the private sector. rural opportunity investment is a perfect example of that. and the rural council focus -- has focused on a number of priorities, including job creation, and economic recovery, drought response. it's focused on manufacturing and rural places and accessing export markets. more recently rural child poverty has been a priority.

but in the food space, what the white house rural council has done -- i'llplex a couple things -- is something -- i'll mention one really granular one. the u.s. department of agriculture food nutrition service, the folks who administer the s.n.a.p. program and other programs such as summer meals, one of their priorities in recent years has been make sure that rural places serve as many kids who are eligible for summer meals as possible. it's a big challenge because by and large the only way that kids can get summer meal us is good to a site, actually go to school or a community center where they can be observed. the big problem in rural. how to dead the kits -- get the kids to a place. the rural council made it possible for the department of agricultural food nutrition service to work with hud, the housing urban development agency which has a lot of multifamily properties in the rural sphere, and is the perfect place for

that congregate feeding site. so, two agencies working together towards a goal of access to nutrition, getting over a major obstacle and getting better impact in the rural place. this is an example of what the white house rural council has done. another one i'll mention is local food, local places. this is a program that is also very closely aligned to what the white house has worked on and across the administration, on place-based policy. basically place-based policy -- you can look at -- there there was a memo from a set of leaders in the white house in the early 2009, the memo directed the agencies to, when at all possible, orient their programattic delivery in a more place-based way. what does place-based mean? that means ensuring that the

federal government has really more, i'd say, proper role in communities. by that, the way that the federal government engages -- that they're supporting the local priority. it's really playing out in the food space here, think. play space means that those local strategies in the best practice of place space, those strategies are arrived at through a collaborative means where all the stakeholders, the diverse set of stakeholders are re table. the place-space strategy looks at the assets of the place in a very clear-eyed way and it measures for success. if the goal is to improve health outcomes for that community, then what are they measuring, and could they have a rigorous set of measurements to get there that's a place-based approach, and what the white house, what

the obama administration has done, is when possible, orient its programs to support the local communities. local foods, local places, is an example of that. this is an interagency, it's usda, the epa office of sustainable communities, cdc, sometime this department of transportation, delta regional authority, the appalachian regional commission and others, that basically came together, pooled their dollars, for a program and anyonetive so that communities who had -- initiatives so communities who had a strategy, many of them having to do with an economic development, community development objective, many of them both. but when the community has a strategy like that, these strategies aren't that easy to pull off. to do the assessment, to do the strategic planning to do some of the early implementation to move it forward, and what local food, local places did is have all of

these federal agencies that somewhere in their mission was to support a community that was trying to do these objectives, they could come together with other everythings, pool the funds, and then the communities were chosen, the best of these strategies were chosen, and they received and are receiving technical assistance to held build up and accelerate their strategy. not only that but you have that -- those communities now have a special relationship with the agency. the agencies have some ownership of those strategies and want those strategies to succeed. now we have had three different series from local food, local places. i'll give you one concrete example in williamson, west virginia, someone who was from williamson, and went away, went to med school, came back. realized -- williamson is one of the poorest counties in the country, a county that is experiencing some acute economic

distress, and he came back and he realized that the community was suffering in a very comprehensive way some significant public health challenges. he partnered with a farmer, and they had a vision and have a vision and are implementing this vision that a community health and wellness center, when coupled with work force development and agricultural and farming, that the outcomes that are both economic, creating jobs, now over 100 jobs in the small town, and improving public health, making sure that people, many of them very low resource, have access to nutritious food, you draw this together and get better outcomes in that town. now, in the federal government,

there's a lot of different outcomes there. their strategy touched on usda programs, hhs programs, department of transportation and department of labor programs, and what the obama administration has done is brought together these different everythings so they can work with the community to move forward these comprehensive strategies. now, i'm not going to pretend that the entire federal government has sort of been transformed into and all the silos are down, but i will tell you there is a culture within the obama administration, and there is now a culture more and more in the career staff, for this type of interagency collaboration. it is typically only the wonkiest of wonks in washington, dc who are interested in these kinds of strategies, but if i'm talking to people that care about food policy, you should know about this.

you should understand that this type of cross-collaboration is critical to support communities, individuals and families. so, with that i think i'll just conclude and thank you for the time to be able to spend some time on this critical issue with you and i look forward to some questions. [applause] >> i'll ask one. tom sherman. so, typically when we see food deserts, urban areas and that's not true in rural areas have their own challenges and you talked about some of them. is there anything new in terms of on a greater scale, in terms of transportation or in terms of access that is different or most challenging for rural areas that

just makes it a very different problem than urban? >> well, thank you for that question. a couple of things. depending on how you measure poverty, rural places actually have greater poverty than urban places do. if you look at the official poverty measure, the old poverty measure that backs out most of federal income assistance, then things are worse off in rural. if you look at the supplementary poverty measures that include s.n.a.p. and social security and ssdi, and actually rural places aren't as bad off. that fact is instructive and there's an excellent report that the council of economic advisers, domestic policy council, and office of management and budget dade in may of 2015 -- look at the white

house blog -- that really details and pulls some of that out. in terms of you asked, are there new challenges or dynamics affecting access to food in -- fresh and healthy food in rural places? i would say yes and no. part of the rural reality is less scale, and more remoteness. that goes like literally with the territory. right? so, some of that isn't new. i think what might be new is that in the last ten years -- now i have a code on here that has a happy story to it, but if i have my dates right, 2003 to 2014, poverty in rural places increased significantly. economic research service from usda came out with a report two

weeks ago that made clear that the major driver of increased poverty in rural places and those ten years was inequality. i recommend you, commend you to that report from the economic research service. so, that's new. there's more families that have problems. in the last year and a half or two years, that poverty rate is starting to trend down again, which is fantastic. but in response, there's been work in both the 2008 and then the 2014 farm bill to adjust a little bit. there's a program called the healthy food financing initiative that is a partnership between hhs, health and human services, and treasury, particularly the cdfi group, and usda to target financing, to stores in areas of low access, food deserts has become --

that's a term of art, so i'm going to stay away from that term, but that program. is starting to grow, and i think we'll see -- hopefully see more and more. candidly, i think there's a lot to learn yet about those areas of low food access. think we learned a lot in the last seven or eight years, but in terms of exactly what strategies work, that really results in families buying and consuming more healthy foods in the rural sphere. i think there's still some to learn and a lot of people are doing that important work. so thank you. >> chris, fda. talked about local initiatives or initiatives at the state or city level that can be brought into national projects. interested how the administration looks for those types of initiatives going on at the state and local level and

bring them up. >> that's a great question. dr. inningle made a fantastic point of food policy utilizing the laboratory that is the federal system. part of the goals was to identify the great things that are happening in the local sphere. so we're able to left them up. didn't even mention and it really feeds into the later points about the effect that a comprehensive set of indicators in communities have towards health, and we have going now in the third round of promise zones that the obama administration has moved out on with over a

dozen agencies working on food, housing, health, business, issues, that try to move the entire community forward, and those that have been designated promise zones are those areas that have kind of the sweet spot for the place-based work has been places of great need, which typically the indicator could be either income or poverty but those are the typical indicators, or unemployment. places of great need and places that indicate they have capacity and vision. in the places are out there. eastern kentucky is a great example of it. there's one in south carolina in pine ridge, south dakota. so, we do a lot of work with this places, and part of it is lifting those up to both tell the story to policymakers, but perhaps as important or more importantly, make sure we can dig in very rigorous metrics we're pulling out from the communities and their strategies

so that by the end of the administration, we have a better sense of what type of comprehensive intervention are effect enough getting the impact we want, and those that don't work, too. so, to inform future policymakers. thank you for that question. >> okay. >> thank you very much. [applause] >> we need that one still. sarah is going to come and introduce our next panel. thank you again, doug, and we look forward to continued progress from the white house rural council and other agencies. ...

[inaudible conversations] >> good afternoon, ladies and gentlemen. and welcome to our panel on sugar and obesity. before we get started, i wanted to mention that over lunch i was checking twitter that vote food 2016 is, indeed, trending and this morning we reached number two spot on twitter, which is amazing. somewhere ironically doughnut day was number one. [laughter] >> maybe we can get that number one spot.

my name is sarah roach, i'm a associate at the o'neil institute here at georgetown university law center. today we will be hearing from three panelists. michael jacobson, bruce silver silverglade and debra. before hearing on each of our panelists, i will give brief overview and laws and regulations can help reduce public issues. we will hear presentations from each of the panelists and finally we will invite audience questions and finish around 3:30. around 35% or 80 million u.s. adults and around 17% or 30 million u.s. children are obese. of course, there are many factors that contribute to this

epidemic and in this session we will be focusing on overconsumption of added sugars. according to dietary limits, we should limit no more than 10% of daily calories. that equates 12 and a half teaspoons of sugar. this sounds like a lot but in reality we are consuming 22 teaspoons each day which is almost doubled the recommended amount and that's daily consumption. in relation to chronic disease more broadly, racial ethic and socioeconomic disparities in sugar consumption and prevalence of obesity. among u.s. adults black and latino populations have higher than white populations. also lower income are more likely to be obese.

we see similar disparities in consumption of added sugar as percentage of daily calories. while many agree that we need to improve our diets and health, there seems to be less consensus as to how we should be doing so. sugar, salt and fats is complex and can sometimes be divisive. some see as personal choices and choices should be protected for the individual. others see consumption not so much the choice but as a result of our environment, the informational environment, social environmental and physical aspects of our communities. on another front some see food and beverage as a key partner in improving nutritional while other skeptical.

as we heard before lunch in relation to new york city, policies can address different aspects of the food production chain. and at the national level from manufacturing, preparation and of course, con subjects. policies and laws to restrict unhealthy products or focus on encouraging and facilitating access to healthier alternatives. we also have options in terms of how we implement policy decisions. some interventions, for example, taxes and illegal in nature but most of the diet interventions, things like product reformulation and removing sodas from school could be binding law or voluntary community based initiatives. and we heard this morning some interesting examples of the

latter. i want to turn over to our experts and invite each of them to present on their insight on effective and feasible and legal policy interventions to improve nutrition and improve health. our first speaker michael jacobson, cofounder and executive director of cspi, key player in battles against obesity and other health problems and these education legislation litigation among many other tools. michael has led cspi's campaign on surgery -- sugary drinks and salts. thank you very much, michael. >> thank you, sarah. i greatly appreciate the opportunity to -- as i was

saying -- [laughter] >> thank you very much, sarah, and i really appreciate the opportunity to participate in this interesting conference. i'd like to talk about the rates of sugar consumption, the problems with excess sugar consumption and offer legal approaches for solving these problems. so this is a partial history of sugar consumption in the united states. you see it's gone up quite steadily from 1875 to which is the earliest for which i can get records through 1999 and the

period from roughly 1980 to 2000 is the obesity epidemic. that's when obesity rates doubled and tripled in different segments of the population. it's not to say that it's a correlation, it's not to say that added sugars, refined sugars have been the only thing to contribute to obesity, many other things have been up in our diets particularly white flour, consuming huge amounts white flour in 2000 than we did back in 1970 or 1980, but -- but this is the trajectory of sugar consumption. now, since -- and people between 1990 i would say in 2000 began to think, huh, maybe it's sugar

and soda pop. soda consumption shot up to 1950 to 2000 or so. sugar is sort -- sugar drink, soda pop, fruit drinks in particular, energy drinks and sports drinks to more recently provide almost half of all refined sugars in the american diet. so until -- until the obesity epidemic, there really wasn't that much research on sugar. at least in the united states. it was considered -- caused tooth decay but not much else. it wasn't a serious problem. in britain there was more concern about sugar and heart disease. i remember in 1996 study that found no link between sugar and chronic diseases and that was

partly because they weren't looking at refined sugars. they were looking at all sugars. they are combining the sugars in milk and peaches with the sugar in soda and sugar crisp breakfast cereal. but the obesity epidemic got researchers to really pay more attention. one of the things researchers have -- and nutritionist have always said don't fill on sugar because you're not going to eat healthy foods. this is a graph showing the more sugar you consume, you know, along this here, the dash line is the average level of sugar consumption and i think this was around 2006 maybe. but it showed the more sugar you consume, the less nutrients you tend to consume and the black

line is the average of all roughly ten different nutrients. so at the average level you're seeing about a 15% less consumption of these various nutrients in these -- with that level of sugar compared to no sugar in the diet. so that's the first kind of study confirming that sugar leads to lousy diets. and then beyond that, researchers looked very carefully at the relationships between high sugar intake and different health problems and in clinical studies the findings are very clear. you eat a lot more sugar, your bad cholesterol goes up contributing to heart disease, greater risk of heart disease. blood pressure goes up

contributing to heart attacks. in the obesity epidemic a number of studies were done, these were intervention studies, controlled studies in which groups of people, you have a group of people, interesting study was done in holand and they gave them 8-ounces a day, small amount in american diet, 8-ounces a day and others diet soda and the kids who dranked regular soda gained more weight than the kids who drank diet soda. a study that went on one and a half years a very long intervention study and got similar results to the studies done in the united states at a children's hospital in boston to same a -- name a prominent one.

and that really for most researchers and health officials that nailed it that sugar drinks contribute to obesity. there are other studies showing that beverages like soda pop contributes more to weight gain than solid food. if you eat 100 calories of solid food your body tends to compensate that by eating 100 calories less in a day but for beverages like soda the body doesn't compensate so the body ends up consuming more calories. those are double-blind clinical trials. there's also study that is can only find associations between one thing and another, but many of these studies have been done

meta analysis that combine a who little studies into one study finding a strong association between increased sugar drink consumption and diabetes and increase sugar drink con suimción and -- consumption and heart disease and also with heart disease total refined sugars from candies and cereals and other things. there's far more evidence on sugar drinks than the whole range of sweeten foods that include can peaches, sweeten i don't -- yogurts that may reduce heart disease. he's a prominent epedimioligist who estimated that sugar drinks in the united states are

responsible for 25,000 deaths per year. which is a useful metric. others have estimate that had if we could cut sodium consumption in half that would save a hundred thousand lives a year and trans fat should save about 50,000 lives per year. so sugar is kind of up there among the -- or soda pop is up there among the major killers in our food supply. that body of evidence that has persuaded the health community including the world health organization which has recommended that people consume no more than 10% of calories from what they call the

etringent sugars which are added sugars. and so the who recommended no more than 10% and ideally less than 5% and in the united states the american heart association has recommended closer to -- about 6% sugar from beverages and candy bars and other foods and the dietary guidelines for americans recommends 10%, more liberal recommendation than the heart association. the dietary guidelines is america's nutrition policy and it said for sugars there's strong evidence for mostly perspective cohort studies but also that the epedimiology but control trials that show eating patterns are associated with

reduced risk of cardiovascular disease in adults and moderate evidence indicating that these eating patterns are associated with reduce risk of obesity type 2 diabetes and some type of cancer in adults. and that kind of a document serves as a foundation for building policies. and that's where the legal georgetown law school come in. so i wanted to indicate in these few minutes the kinds of legal tools that can be brought to bare to reduce sugar consumption and reduce risks of chronic diseases. and some of these, you know, obvious. getting better nutrition labels, the government came out two weeks with a revised nutrition

label that added one of the main improvement was adding that line for added sugars. so it'll tell you how many grams of sugar. oops, of course, nobody know how much a gram is. we wanted teaspoon but the government wouldn't allow that. 20% of the recommended daily intake. so that gives a benchmark for how much -- how does 10 grams fit into a diet and i'm sure that every kid in america is going to be taught how to read the label and teachers are going to look at the sugar line in particular and explain that to kids and say, okay, kids, how many -- if there's four grams of teaspoon how many teaspoon of sugar are in this food? soda doesn't look very good. 40 grams, 20-ounce container is 65 grams.

that would saves 30% of the daily value and hopefully persuade some people to drink half of the bottle of soda, maybe even less. a number of years ago, 11 years ago, shocking when bruce silverglade issued warning on soft drinks and we are not show if the fda moved the envelope. the fda hasn't responded to that petition. getting a warning label on soda presumably will help choosing without warning labels. warning labels are not -- are not going to solve to problem but presumably would reduce consumption by several percent and everything -- everything

helps. what really would solve the problem is to change the legal status of sugar and high fructose corn syrup. they are considered generally as safe graph of of the lingo of the fda. we put in coffee or cereal or whatever and salt safe, and hydrogonated oil and those turned out to be the biggest killers in our food supply. we wanted the fda to change the regulation so that sugar would be brought down to a safe level in our food supply.

so it's general recognized as safe based on the foods in which it's used and so our petition was fairly complicated and it asked the fda to restrict the sugar content of soft drinks to roughly a fourth of the current levels, and we recommended that the fda come up with voluntary targets for other major sources of sugar. so grain-based desserts, pies and cookies, dairy desserts, ice cream, frozen yogurt, cereal, category by category and we

hypothesized and 10-15% in the other categories and they -- the resultant of all of that refined sugars 87-grams per day to -- to 36 grams per day. 8 and a half teaspoons which is roughly what the american heart association has recommended. and we told the fda that reducing sugar in beverages by 70% is feasible because of different things. , one i don't think you taste the difference between a coke with 37 grams instead of 39 grams, in other words, you can reduce sugar without even seeing a taste difference, to a small extent. various artificial sweeteners,

using other devices to reduce sugar and new things coming on the market called sweetness enhancers so that a gram of sugar, one gram taste as sweet as two grams. with this variety of new technologies you can reduce the sugar content of beverages. and we put in voluntary consumer changes, saying consumers need to be part of the solution in reducing their consumption and this petition is only three years old and so surely we are pretty confident that the envelope hasn't been opened yet. but this would be a very tough petition for the fda to respond to but we think legally this is the correct solution to the sugar problem.

another thing would be -- that's the food and drug administration, warning label and limits on sugar. the federal trade commission, david bladik which you heard from before, they have a role when it comes to the marketing of soft drinks. the soda companies say we would never market our beverages to kids, but when you actually look in marketplace and see what's going on there, there's an awful lot of marketing to little kids and in the past the federal trade commission has alleged that marketing of any foods let alone sugar water is an unfair and deceptive marketing practice and when the ftc said that threatening to ban all marketing to little kids, if tc had its head handed to it by the food industry, the advertising

industry and the broadcasting industry and the washington post that called the ftc the national nanny. and that was the genesis. this is undeniably marketing to kids. a toy bear. here is the bear at coca-cola world in atlanta, kind of in-door museum theme park and also coca-cola, they have a curriculum for first grade teachers that has marketing. it's basically -- isn't coke wonderful because you have all the stuff, marketing around you. this is a middle school in -- i forget where it is. in the united states, this is a boys and girls' club and you

recognize the bearded guy that has certain attraction for little kids. the ftc should investigate the marketing of sugary foods that seem directly aimed at young children. the title of this session is congress sugar and obesity. at this point i would say forget congress. this congress is not going to do anything or not do anything good. if they wanted to -- congress could require warning notice. congress could tax soda. a penny an ounce, 12 cents a can would raise $10 billion a year, reduce consumption by 5 to 10%, it's unclear exactly how much, and do wonders for the national economy and public health. there's a bill in congress by senator soloro, it's not going anywhere.

let's forget congress change the title of the session. [laughter] >> as dr. ángel mentioned, there's going on there around the country and san francisco is requiring warning notices in soda ads, billboards, bus kiosks and soda coolers. they may have to put a warning there. baltimore may vote next week on a similar measure that require warnings and advertising warning people about sugar drinks. fruit drinks, soda pop, energy drinks. new york city tried, dr. ángel, didn't stress this particular point, tried to limit the sugar -- limit the size of soft drinks at restaurants and the industry

sued and new york lost for whatever reason, but i think other cities will be looking at that approach also. they have different laws, different structures than new york city does. and in taxes, berkeley passed a tax a penny an ounce, san francisco voted in favor of a tax, 55% of san francisco voted for a tax, but they needed two-thirds because they were going to earmark the money, they are going to vote again possibly in november. oakland may vote this year, philadelphia has a vote, i think, next wednesday in the city council. so there's a lot going on. and this is happening globally with méxico having a small tax on soda that is reducing sugar consumption by 5 to 10% and providing money for water, safe water in schools and britain is

going for soda tax by 2018. so there's a lot going on here. local areas where things are happening and if we can get -- there's one warning in san francisco, a different one in oakland. at some point -- and california -- the health advocates lost a vote to get a warning label on soda cans. and you could imagine the chaos if san francisco voted, one wording on soda can and oakland had one warning. that would bring the industry to washington to try to preempt those local laws and if necessary accept a federal warning label.

so good things are going on. so no federal law has had an effect on this, but per capita consumption of sugar drinks has gone down by 27% since 1998. coca-cola, coke plastic has gone down by 35% per capita. pepsi by 54% per capita. enormous changes that are bringing the industry to the bargaining table and realizing they better diversify like milk, fruit juice because this is a dying industry and as soda consumption has gone down so has sugar consumption. this is a graph similar to the one i showed early on that has -- chose 2013 about refined sugar consumption. we are seeing major changes that

will continue, i believe, with all the local action, education, regulation, legislation and hopefully some federal action, and let me stop there but just mention that i have a report marketing to kids, i have a few copies here. there's some copies upstairs if you would like to grab one and see what coca-cola is doing to our kids. thank you. [applause] >> thank you, michael. that was a wonderful way to start our panel and we will now hear from bruce silverglade. practice includes responses to fda proposals and regulatory enforcement action challenging food labeling and advertising. bruce has extensive experience working with a wide range of stakeholders in both domestic and international food policy including the fda, ftc, usda,

the board health organization as well as consumer groups. thank you very much, bruce. >> thank you. good afternoon, everybody, i would like to thank the o'neil institute for inviting me. i don't know, did you leave out the part that i worked for csbi? [laughter] >> i left voluntarily, right, in 2010? [laughter] >> you -- >> i thought you left it out of your official biography. >> it's there. it's there in the context that i fought for the labeling law of 1990 and education act and spent five years of my middle-age

youth on that. [laughter] >> so, you know, i'm proud to have worked at cspi but working at a law enforcement representing food industry has broaden my perspective and i've learned kind of the other side of the viewpoints and i think that i hope to really present some innovative, that's the title of the conference here, innovative approaches to diet and health problems. what we have to really do and grief and this is the theme of my presentation is change the food culture, and when we -- and by this, though, i mean change what consumers want to buy and eat. if we can do that, the food industry will respond with those types of foods, but you have to -- we are in a market economy

and you have to get consumers in a place culture place where they want to buy foods that are healthy for them. if we don't do that, then it's just a war, fighting regulate the industry, put on warning labels and questionable whether you get to the end point of changing the food culture and the food people want. an example that does not involve nutrition but a real-life example involves the recent decisions by campbell soap to label gmo ingredient's. i never thought i would see the day when major food companies would agree to labeling gmo products or going nongmo. putting agood day whether it's a good idea or healthy or not healthy or based on philosophy

or whatever, why do they do it, because consumers started demanding it. if that kind of change can be achieved, then i think other changes in nutritional values of foods can be achieved if consumers demand it, so how do we get consumers to demand healthier foods? i think that's really the issue. well, dr. jacobson has gone over a number of legal approaches and look, there was no one more than me that wanted nutritional labeling to work, i fought for it for years and it's a proud of achievement. csbi was nice enough to give me an award before leaving. it hasn't in my mind achieved the results from 1990 that we have hoped for.

in fact, obesity went up. one of the reasons it didn't achieve the results that were expected is that there's an emphasis on single nutrients and back in 1990 emphasis was on fat. and fat was listed as total fat, saturated fat, calories from fat were listed and as a result, you had unanticipated consequences. who responded with low fat foods but they are higher in sugar. so labeling can be a two-edge sword. i'm going to actually turn on some slides now. okay. the real tricky one. [laughter] >> okay.