electio elections. later treasury secretary jack lou on the upcoming debt ceiling debate. every five years, the departments of agriculture and health and human services issue dietary guidelines and nutritional information to the public. next the house agriculture committee hears from tom vilsack and silvia burwell about the process. this is two and a half hours. good morning. let's go ahead and get started. trent, will you open us with a prayer please? >> dear heavenly father, we ask

that you bless this committee. we ask that you bless this government. we ask that you bless all those who lead this nation. amen. >> this meeting committee of agriculture regarding the development of the 2015 dietary guidelines for american will come to order. i want to thank our witnesses for being here this morning. it is no small feat to get two of the secretaries of two of the most important agencies in government to sit at the same table at the same time, so i thank you secretary vilsack, secretary burwell, for making this happen. we appreciate it. we are joined by the secretary of agriculture and secretary of health and human services to develop the important document, the 2015 dietary guidelines for americans. it's not this committee's intention to legislate specific recommendations or guidelines, however, we will demand that the guidelines be developed in a transparent and objective manner. the dta is not only a

recommendation to the american people on how to make healthy food purchasing decisions to live a healthy lifestyle, but it forms the basis of federal nutrition policy, education, outreach efforts used by consumers, industry educators and professional health care professionals. it's essential that the guidance that comes out of this process can be trusted by the american people to achieve this it must be based on sound and irrefutable science. the national nutrition monitoring wheat and related research acts of 1990 according to the act the dga shall contain nutritional and dietary guidelines for the american public, shall be based on the preponderance at the time the report is prepared and promoted by each agency carrying out food or nutritional program. a sound development process is important because it is extremely difficult to reverse or change public policy once implemented without causing consumer confusion. at a time when consumers are already subjected to conflicting and often contradictory health information, staying within scope of the intent of the law

by providing the public with science-based information is more likely to contribute to improve public health outcomes. the process of the 2015 gga began in 2012 when secretary vilsack and secretary burwell's predecessor secretary sebelius created and then appointed the 15 members to dietary guidelines advisory committee. though this committee is not specifically authorized, all committees must be chartered under the federal advisory committee act that requires it be accessible by the public and is to be operating, overseeing and terminating committees. this makes the committee solely responsible to the usda and hhs who are then responsible for continually reviewing the committee's performance and process compliance which includes activities as detailed as approving all of the meeting agendas. it is, therefore, the responsibility of usda and hhs to maintain control of the scope and methods used by dgac. i personally weighed in with

both of you as have many of my colleagues about the concern of the process of developing the guidelines. i raised concerns about the committee's report shortly after its released and called on you to extend the public comment period which you did, and i appreciate that very much. the usda and hhs received over $29,000 public comments developed by nutritionists and other experts in the study of human health. included in comments were scientific studies and other evidence that observers assert had been ignored by the committee. as a result i repeatedly requested each and every comment be considered by usda and hhs before the final guidelines are published. in may the ranking member i started writing details on your plan to review the more than 29,000 comments and to make sure that they are reviewed properly. your response to us on that plan, though, was less than sufficient, so i look forward to hearing today on this matter. uncertainty leads to concern about whether the committee's

recommendations will maintain the scientific integrity accessed by americans. it's my hope the review of the 2015 recommendations, that they are mindful of the process failures that lie between each of the recommendations. it's imperative to hear assurances from each of you that americans will ultimately be presented with the best and most reliable information for making healthy food and beverage choices. again, thank you secretary vilsack, secretary burwell, for being with us today. i look forward to our conversation. comments from ranking member. >> thank you, mr. chairman, i welcome both secretary burwell and secretary vilsack to the committee and look forward to your testimony. given that usda and hhs are still reviewing comments, we're probably getting ahead of ourselves here, but i do hope that today's testimony can shed more light on the process to establish new guidelines and what they will actually mean for our constituents. there's been a strong reaction to the dietary guidelines

advisory committee report. i've heard concerns about future sodium targets, difficulties of small schools meeting the guidelines and what this could mean for cranberries and sugar. but these are mostly coming from those who are directly impacted, industry, schools, medical community. we're not really hearing from the public. and i don't think the general public is paying much attention. for those who are, i think they are very skeptical of the whole process. for example, we were once told that butter and eggs were bad for you. now i guess they're okay, according to "the washington post" this morning, they were wrong on milk as well. and i don't know how much government subsidized powder we bought because of it. so people, i think, may be losing confidence in these guidelines. given the public's skepticism, maybe we should reconsider why we're doing this. is it because it's something

we've always done? maybe we should first look to expand on a provision of the 2008 farm bill that would help us understand more about what people are actually eating and then go from there. i am a little concerned that we've lost sight of what we're doing and there seems to be more focus on ideology and marketing food products than providing clear nutritional advice to the general public. but i do hope we can have a productive hearing, achieve a good outcome. i know you're going to do the best that you can. breaking through all of this noise and i thank the secretaries for appearing before us today and i yield back. >> i thank the gentleman. my colleague, ms. burwell, has a hard stop at 11:30. she has an international flight to catch. and so with that, you can go first. >> thank you. good morning, mr. chairman,

ranking member peterson, as well as members of the committee for the opportunity to discuss the dietary guidelines. i want to begin by thanking the committee for your interest in the dietary guidelines and for your work to support americans and a healthy agriculture sector. one of the most important responsibilities that our government is entrusted with is protecting the american public and that includes empowering them with the tools they need to make educated health decisions. since 1980 families across the nation have looked to the department of health and human services and agriculture for science-based dietary guidelines to serve as a framework for nutritious eating and healthy lives. our guidelines also help lay a foundation for preventing diet-related health conditions like obesity, diabetes and heart disease. as is required by the national nutrition monitoring and related research act, the departments update these regulations and guidelines every five years. the key elements that make up a healthy lifestyle remain consistent -- fruits and vegetables, grains, and lean proteins, and limited amounts of

saturated fats, added sugars and sodium. we anticipate these will continue to be the building blocks of the 2015 guidelines updated to reflect the latest research and science as well as our current understanding of the connections between food and health. as part of our effort to rely on the best science available, we have appointed an independent advisory committee of nutrition and medical experts and practitioners to inform each edition. the 2015 committee evaluated research and considered comments from the public to develop recommendations included in its finished report. it is important to note that the advisory committee report is one input into the dietary guidelines. the guidelines themselves are written and reviewed by experts at both of our departments. in addition to the recommendations of the advisory committee, our department's experts perform their own extensive review and consideration of public

comments. in fact, as was mentioned, we received 29,000 written comments during the 75-day public comment period. as a result, the 2015 dietary guidelines will be formed by review of thousands of scientific papers and decades of nutrition and medical research as well as input from the public. we know that the guidelines are of critical importance to many americans. they contribute to a culture of wellness and empower individuals to better manage their own health, help keep their families healthy, reduce the onset of disease, and reduce the amount of money that we spend on health care. they also provide guidance to public and private programs and support efforts to help our nation reach its highest standard of health. at hhs the dietary guidelines provide a road map for the nutrition, advice, and services that we deliver such as chronic disease prevention efforts, food assistance programs, and educational initiatives.

hhs and usda are working together to finalize the 2015 dietary guidelines which are expected to be completed in december of this year. without a finished product, i'm unable to comment on the fourth edition at this time. i expect the new guidelines will importance of healthy eating habits and individual food choices. i want to thank you again for your interest in this topic as well as the feedback that we have received. i know many of you have specific questions and concern, and i want to assure you that we are taking your concerns into consideration. and we're working hard to answer your questions as thoroughly as we can as we are in the process of doing the guidelines. i look forward to continuing to work together and look forward to your questions today. thank you. >> thank you, secretary. secretary vilsack? >> thank you, mr. chairman, and to ranking member peterson and all the members of this committee. i want to thank the chair for

the opportunity to be here today, and i want to thank my colleague silvia burwell for the extraordinary work that she and her team have done in concert with the department of agriculture in getting us to this point today. i will tell you that i struggle with the dietary guidelines because i think it's important for people to understand precisely what they are and what they are not. these guidelines are a set of recommendations. based on a series of well informed opinions that create a framework that is designed to encourage and to educate americans about what they can do to increase their chances of preventing chronic diseases. this is not about treating disease. this is about trying to prevent chronic diseases. as a result the guidelines that we formulate are and should be restricted by law to nutritional and dietary information. the advisory committee report which secretary burwell mentioned is not the guidelines and sometimes there is confusion

about that. the report informs our work but certainly does not and should not dictate it. only hhs and usda can and should write the guidelines based on a variety of inputs. this has been an open and transparent process. questions were posed by and to the advisory committee. a number of studies, indeed thousands of studies and tens of thousands of documents were reviewed. those reviews went through a very strict and gold standard process for determining what is the strongest, best, and most available science. multiple public meetings took place. information was posted on the web. and we indeed received 29,000 comments as a result of the extended comment period of which 8,000 comments are probably

considered unique. recognize our process here is probably to determine the best available science and based upon that the preponderance of that we formulate the guidelines. i believe i have the same goal secretary burwell has which is to finish our work on time before the end of the year so that we can use these guidelines as directed by congress. i, too, look forward to your questions and comments and think this is an important opportunity to educate folks about what these guidelines are and what they are not. >> thank you. i got ahead of myself. the chair requests members submit their opening comments for the record and i rudely failed to introduce secretary tom vilsack, secretary of agriculture, and the honorable sylvia burwell, secretary of health and human services. two folks who need no introduction and i didn't introduce you. i apologize for that. members will be recognized for questions at the start of the

hearing. after that, members will be recognized in order of awrrivaa. i appreciate the members understanding and i recognize myself for five minutes. ms. burwell, you said in your comments that the guidelines don't change substantially from one set to the next but yet in '95 to 571 pages for this one. i'm not sure we've gotten ten times better information today than we did at that point in time. as i mentioned in my opening statement, the oversight we're conducting today is on the development of the guidelines out of concern for the integrity of the process and its resulting recommendations. the federal advisory committee act defines how they operate.

the law put special emphasis on open meetings, chartering, public involvement, reporting. according to statute the federal advisory committee among other things require the membership to be fairly balanced in terms of the points of view represented and the functions to be performed, contain provisions that they will not be inappropriately influenced by the appointing authority or by special interests but will be the result of advisory committee's independent judgment. despite these safeguards, serious questions have been raised about the overall oversight of the process while it was ongoing. this tended to fuel concerns that members of the commission may have been appointed to achieve certain policy outcomes outside the purview of the committee. i would refer to an op-ed by former deputy secretary who currently is director of the sustainability institute at george washington university. i note that the secretary was serving as usda, deputy secretary, during the time the dgac was chartered and appointed. the suggestion of including a sustainability and tax issues by the dgac has been a topic of

intense discussion for sometime. you both jointly published a blog yesterday. i hope to get some comments from you about tax issues as well. i'd like to likewise -- i'm likewise sure you recognize the inclusion of these issues in the process could have resulted in misguided recommendations which would have ill effects on consumer habits and agriculture production. the counter to potential bias in the process is the public comment period. the 75-day period was the public's first real opportunity the review the 571-page document. in your written statement, secretary burwell, you mentioned usda and hhs staff have already fully reviewed all the comments. you also mentioned that you focused most heavily on those with scientific justification. help us understand then what's going on right now. what have you done with the studies such as those evaluating the low carbohydrate consumption patterns since the reviews have been taking place? >> i think there were a number of issues raised and i apologize, i could not hear your

final question. >> what have you been doing -- we've got the study in. then you've been studying the comments and the report itself. can you talk to us about how you've been evaluating other information like low carbohydrate consumption patterns as a part of that sg'z review? >> with regard to one issue that you touched on earlier that i want to go ahead and address which i think you asked was the tax issue and the question of tax policy. i think like our comments yesterday in the blog that secretary vilsack and i put out about the issue of sustainability, i think while we are not -- because we are not -- we haven't received recommendations from our staff speaking to the specifics of the dietary guidelines, that is a question of scope like the sustainability question and that is not an issue that we would address. so on the tax issue, want to address that. with regard to the process that we are now going through and how whether it's the carbohydrate issue or any of the specific issues, what's happening is we

received the guidelines. we received the report of the committee, our staffs are reviewing that. at the same time we are reviewing all of the public comments that we have received. in addition to that, we are bringing in the experts from all of our departments to make sure that they weigh in as we do the consideration. and for us that includes the food and drug administration, the nih, center for disease control, office of the assistant secretary for health, and any others. so that's the process that we are using now to review what we received and to put together the guidelines. >> the guidelines would be -- could have things in them that weren't necessarily directly reported in the recommendation from the commission -- from the committee? you could have outside your own wisdom, your own thoughts would be reflected in the guidelines as well? >> in terms of the expert advice of our staffs that exist with regard to the question of studies and pieces of work, i think it is important to reflect what secretary vilsack said which is there has been a systemic literature review with regard to the studies and that's part of keeping integrity to the

process. with regard to our experts who are constantly involved in those issues, yes, they will be a part of that process. >> thank you. ranking member? >> thank you, mr. chairman. i think you both know that sodium not only provides a benefit in making products shelf stable, it also improves taste and is an important food safety component in cheese. studies have shown there's an inconsistent and insufficient evidence to conclude that lowering sodium intake below 2,300 milligrams per day decreases risk of cardiovascular disease and the dietary guidelines advisory committee agreed. so why has the committee continued to support further sodium reduction, and is this something that you'll be able to address in your guidelines? >> let me take at that stab at that.

first of all, i think it's -- again, we're probably going to respond to a number of these questions that we can't comment on the specifics of what the guidelines will be because we haven't had an opportunity to prepare them and review them. having said that, the advisory committee basically is formulated. they go through a process, as secretary burwell indicated, of reviewing a variety of studies. there no doubt were studies that linked prehypertension, hypertension to sodium consumption. they probably looked at the national academy of medicine, studies in terms of sodium, and they probably concluded there was evidence relating to sodium consumption and these chronic diseases which is why they have recommended what they've recommended. the reality of this situation is that science changes and we learned more information and that's why it's important to have a process that we have in place to review what the advisory committee recommends

then to have public input, to have public comments, to have our own staff review studies based on information they've accumulated during the course of the five-year period since the last dietary guidelines and to refer back to the last set of guidelines which is a foundation for this set of guidelines. so, congressman, i can't comment specifically on why the advisory committee did what they did because they sort of operate independent. we don't inject ourselves into that process. but we do basically take their input into consideration along with many, many other studies, many, many other opinions to try to formulate the best set of guidelines and framework for the country. >> thank you, secretary. i don't know if you both have seen "the washington post" story today, secretary vilsack, i guess you've seen it. >> i've seen it and i've read

-- several people were mentioning. i have read books based on this. this is what has caused my concerns about what they are and are not. >> my concern is we have these guidelines that have pushed people away from eggs and butter and milk and so forth and then they come back and say, well, we were wrong. and so my question is for both of you, what are we going to do to make sure that doesn't happen in the future? first of all, do you agree with this and, second of all, how are we going to keep this from happening? why are we going off on these tangents, you know, if we have a process that's so heavily vetted? >> i would say a couple of things. first, the consistency over time for most issues has been there and it's right to point out with regard to the issue specifically of dietary cholesterol, there has been a change over time. and i think a couple things to answer your question, first, for the most part, things are consistent over time. second, we need to make sure we

use the most scientific evidence we can, and there has been an evolution in change and that does get reflected in what the advisory committee has given us. they no longer will do recommendations based on expert opinion. instead, they will only do recommendations based on the science and that is a change that will occur. i think the other thing that is an important thing to reflect is that in some cases science does change and in the case of our understanding of blood cholesterol versus dietary cholesterol there is an evolution in understanding the difference of those and what they cause and i think we want to be prepared to make sure we review in a rigorous way times it happens. i think there's not one simple answer to the problem that you raised but a number of pieces of how we can work to get to a place where we have the most consistent science-based advice. >> and let me just simply add congress has directed us to take a look at the preponderance of that available science, which

suggests, a term that i'm familiar with in the practice of law -- it suggests there may be studies on both sides of an issue. and one of the challenges of this is to distinguish between one single quality study that is absolutely solid versus a bulk of studies over time that may have a slightly different view. and this is the challenge here. and it's a reflection of the ; evolving. you're never going to have something that just basically is going to be a fact about this because science evolves. we learn more. we understand more and i would hope that we would be flexible enough to appreciate that and to take that into consideration. >> well, i thank both of you for your observations and i think you've made some points but i just want you to understand from my constituents most of them don't believe this stuff anymore. you have lost your credibility with a lot of people. and they are just flat out ignoring this stuff. and so that's why i say i wonder

why we're doing this. from what i'm hearing from my constituents. for what it's worth. >> can i respond to that for just a second? here's the challenge, though. we take these guidelines, we incorporate them in our website, choose my plate. we've had over 290 million hits on choose my plate. it may very well be that there are folks who are concerned about this, but i still think there's merit in it as long as people understand what they are and what they're not. they are not, you know, a hard fast set of rules. they are a guideline, a set of guidelines. a framework. they're not about treating disease. they're about preventing it. >> thank you. >> thank you, mr. chairman. i want to go back to something that the chairman was asking, and i want to make sure that we are all on the same page here. so taxes are off the table as far as consideration and the guidelines, is that correct?

>> with regard to the question of whether it be a tax recommendation in our dietary guidelines, we do not believe that that is something that is in scope of the work that we're doing. >> secretary vilsack? >> well, that's not within the scope. it's not dietary. it's not nutrition. and it doesn't belong in this context. there are many other ways that conversation should be taken as is the case with sustainability. it doesn't belong here. it belongs elsewhere. and i'm happy to have that conversation with folks, if they're interested. >> sustainability, both of you agree then, sustainability and taxes are off the table as far as these recommendations are concerned? >> both important issues that we believe should have conversations but not in the context of this document. >> thank you. hhs and usda have always stated that they have looked to appoint members to the dgac so it consists of nationally recognized experts in the fields of nutrition and health. as you know the dgac is subject to the federal advisory

committee act, which is widely used throughout the federal government. this act is designed to ensure that the advice of various advisory committees formed over the years is objective and accessible to the public. the act was formalized a process of establishing an opening on operating and terminating these advisory bodies from 2015 once selected and appointed the dgac was composed of academics, including professors, epidemiologists, and even a physician scientist. from prior guidelines, nutritionists and food scientists were not selected to serve on this dgac. understandably questions are being raised by the fact no food industry scientists were included in the dgac committee.

additionally, after the dgac had officially disbanded, the former advisory committee members decided to hold a public event acting in their capacity as dgca members, which they were not according to the act. is it the dgca's responsibility to make recommendations to both of your departments, which is then developed for final recommendations for the public? it is, however, not the responsibility for the dgac to education the general public on a report that still needed to be considered by the hhs before claiming nutritional recommendations were based on dietary guidelines. secretary burwell, what instructions were given the advisory committee members regarding the advisory committee's disbandment? >> with regard to the specifics of the disbandment, i can get back to you, congressman, with

regard to the direction that was given to review the science with regard to the issues that were in front of them with regard to the dietary guidelines and present a report about that. so with regard to the question of disbandment, i don't know what, if any, specific direction was given, but i think the point that you've made, which is this is about an advisory committee producing a document, an independent group of people producing a document, that then is an element in the basis of what our decisions will be on the guidelines in what their role is. >> was the role to then go out and start doing a road show on their recommendation? is that a part of the scope of that committee? >> with regard to what followed -- what we followed at the department and what i know about is once we received the committee's recommendations and those became public that there was a public comment period. that was the part that we have both been focused on and the 29,000 comments that have come in from the public as well as

when we heard from you all that you asked for an extension of the public comment. secretary vilsack and i very quickly agreed that that was something we thought was an important thing to do. that's the part of the process in terms of public input. >> one is -- did they follow the guidelines, and what steps were taken to make sure the committee followed the law and then from an ethical standpoint once you've served as your capacity of that advisory committee and made your recommendations, what is your responsibility in movinc moving forward? and one of the things we don't want is these advisories committees turning this into a profitable situation on their behalf because of their participation on that advisory committee. >> with regard to voluntary, nonpaid, they all have to file financial disclosures on an annual basis as they go through this process and so those are all things we want to protect against. with regard to the specific question of a press briefing or some kind of briefing, i

apologize, not familiar with that, as i said. we have focused on the public comments and the steps and process that we are following. >> gentleman's time has expired. mr. scott for five minutes. >> thank you very much, mr. chairman. i'm very concerned that you're not using the most relevant, basic, and the best science related information in formulating these guidelines. you certainly did not use some of the most recent peer reviewed and published nutrition and diet related science. it was not even considered by the advisory committee. and not even included in the evidence-based library to be considered by the advisory committee when they were finalized in the report. that's a fact. and, mr. vilsack, you said you were using the best information. your quote was we have the best informed opinions, but if you're not using the most recent peer review, that information that is there and your committee has not

even agreed to put it into the final report -- so maybe you all can give me some level of confidence that your staffs and you will take into consideration the strong scientific evidence with the final policy document, even though it was not included in the evidence-based library throughout the working group process. >> congressman, can you be specific about which study you're talking about? >> i'm talking about the scientific study that came out that gave evidence that certain things were very important. let me just give you one example. let's look at the whole issue of the involvement of sugar and how it's not even included. why, for example, that low calorie sweeteners is not being

recommended when the study pointed out that low calorie sweeteners could be used to lower weight to be able to help with what is called adiposity and it's not even being used. what's wrong with low calorie sweeteners that can be used and it's not even in the report? >> congressman, let me try to respond to the question as best i can. first of all, when you have a process that is every five years, you're obviously going to have at some point in time a cutoff of what information you consider because theoretically the minute before we publish the guidelines someone could publish a study and you would be criticizing us for not taking the latest science into consideration, so there has to be a cutoff time in terms of

consideration. having said that, over 4,000 studies were reviewed, 300 manuscripts reviewed and went through a gold standard for appropriateness and efficiency of the study. i think it is unfair to the committee and unfair to the process to suggest that we're not looking at the science. we are. number one. number two, as far as sugars are concerned, look. here is the problem. our children, 15% to 17% of what they consume is sugar, so obviously we're looking for ways in which we can reduce that, and i think what they were recommending if you have sugar in your diet, you ought to at least look for the most nutritionally dense foods that you possibly can consume for that sugar. that you don't use empty calories to obtain it. you could have something like chocolate milk versus a low-cal drink. you would get more nutrition bang for your sugar buck, if you

will, out of that process is what they were suggesting. >> but you are familiar with that report, the added sugars working group said that moderate and generally consistent evidence from studies conducted in adults and children supports replacing sugar containing sweeteners with low-calorie sweeteners to reduce calorie intake, body weight, and adiposity. so why would the dgac then recommend that the consumers not? you've used this evidence, pointed to where it could be helpful but then the committee recommends that the consumers not use low-calorie sweeteners

as a tool in the tool box to reduce added sugars. if this report is going to have value for the welfare of the american people and you all say you're using the most relevant, basic information, then this clearly contradicts that. >> i think with regard to -- there are two different things. one is what's in the advisory report and the specifics of that as we said are not something we received in the recommendations. my understanding of what is in the committee report with regard to the question of substitution of the drinks is that not enough evidence exists one way or the other to make a recommendation and that that is where the committee left the issue of the specific of the substitution. >> thank you very much. i thank y'all for being here.

you've both made reference to the fact that you take these comment periods seriously and that you consider these comments 234 your guideline making process. i take you at your word. one particular area of concern for me and producers in my district in the dietary guidelines recommendations is regarding red meat. the current dgac report recommends that americans consume less red meat. will your agencies be reviewing studies submitted during the comment period that address the recommendations for red meat both pro and con, and can you tell me more about that? >> do you want to take the red meat one? >> in terms of the issue of red meat, i think it is fairly clear that there's a recognition that

lean meat is and should be a part of a healthy diet. i think the challenge is to understand that as americans if we look at the obesity epidemic that we're confronting in the country that some of us are consuming more calories than we should. in relationship to the overconsumption of calories and one way to reduce the overall consumption is to eat less of certain things. and within that category would be red meat but that's by no means the only category. so i want to be clear here -- >> i don't understand. i'm sorry, mr. vilsack, why would you include in that category red meat? why wouldn't you say anything that takes you over a caloric level that's unacceptable you shouldn't eat? why would there be a category of things not to eat? >> because of the importance of having balance in terms of what you consume, in terms of what a healthy diet consists of. again, remember what this is. it's a set of guidelines which is designed to give you the best chance of reducing

cardiovascular, cancer, and cardiac diseases. >> wouldn't red meat be part of a list of things you should eat as long as you eat lean? >> it is. it is. that's what i'm saying. >> i'm sorry. i thought you said you put it in a list of things not to eat. >> no. sir, what i said was if you're concerned about overconsumption of food generally, then obviously you're going to suggest that people should eat less of something that they are eating a lot of. that's the key. >> i agree. >> to suggest we're not going to have a guideline, i think it's fair to say regardless of the fact the guidelines aren't fixed yet that lean meat is going to be a part of a healthy diet. there's no question about that. >> the advisory committee's recommendation on this is exactly the same as 2010. so i think the secretary's comments hold. i think the secretary's comments are also reflected. i have fiesta ware. those are those plates, the

chl colorful plates. my mothers used those. the plates that i have for my mother and the one i got for my wedding, they're a different size reflecting the issue that we as a nation -- i just think that's a visible thing that people see. my mom's plates, they're littler. the ones i have from her. the ones i got. and this gets to the issue of the totality that we need to work on. at the same time that we think about the nutritional content. so we've got too much and we have to get the right nutritional content. i think what everybody wants is an opportunity to be able to have guidelines to do that and i think that's what the my plate hits are about and everything is about. being the mother of an 8 and 6-year-old and having worked for the largest grocer in the country, walmart, the time -- average time for a working mom or dad is like to -- 20 minutes. your ability to get in there, get it done, and try and do it in a way that's healthy for your children, you need ease in decision making. this is step one. it's just the guidelines. how it gets translated into other things are the next steps and i think that's what the secretary's comment about what this is and what this isn't and why we want something that is useful for working families who are just trying to get this right for themselves and their

children. >> thank you both. i yield back. >> mr. walsh, five minutes. >> thank you, mr. chairman. i want to thank both of you for being here for the work you do and secretary burwell, i appreciate that last comment too as a father of a young son and someone -- i supervised the lunchroom for 20 years, and you see that side of years and how the school lunches impact. i think you brought up great points and this is an important hearing. i think articulating what this is and isn't is really important because at the heart of this with so much information americans are going to try to find it from their uncle's e-mail to dr. oz and others, they're looking for the gold standard on what makes a difference. all we have to do is look at the coast of obesity in the united states estimated at between $150

and $200 billion a year. this is an important subject. we need to help people find the information. they're busy. there's lots of it. and that's why i think the questions that are coming up from colleagues, the integrity of your suggestions as many of us saw and still do believe as the gold standard on how this gets done and valid concerns about the decisions we make here -- and in full disclosure, i have the ninth largest agricultural district in america. we produce lots of pork, milk, turkeys, and all of those things. when we make those decision, they have an economic impact. the concern is valid. it's warranted. i think we have a responsibility to move head long into this, to help the american public get it. so i think for me it's more of a statement on this. we're concerned on process and hearing that. it's important to hear both of you articulate that and important for the american public to know they can trust these as guidelines for them and they're getting to make decisions for their own family based on them.

maybe what i would do is just ask you when you're hearing on the process, do you feel the concerns you're hearing from members on the totality of the evidence and things, are you comfortable if those are included when you make your guidelines? you're hearing members talking of things that aren't included, specifically commodities that aren't in that? are you comfortable? secretary burwell, i'll start with you. >> i think, yes, we are including these comments and whether that's the blog that we issued yesterday, we'd had a number of questions about that sustainability issue or the tax issue that we tried to address here today that we are across the board hearing and listening and i think you can be assured that the questions that you all are asking us are the questions we will be asking our teams as the recommendations come forward and whether that's -- it was mentioned cranberries and the issue of something that's a high nutrient, has high nutrient value, and the question of how that interrelates with added

sugar and we think about those issues. your questions become our questions as part of this process. the comments that came in, as the secretary mentioned, there were a number of repeat -- 8,000 were probably singular. there were 19,000 comments on sustainability. 97% of those comments, we were clear and transparent, were positive and that we should include sustainability as part of the dietary guidelines. and i say that to make the point that we want to hear, we're going to ask the questions, and then based on what the dietary guidelines are on the scientific evidence, that's how we will go about making the decisions. >> i'd only add that the debate we're having here and the debate taking place outside of this room is a reflection of people's interests in where their food comes from, how it's produced, who is producing it, and who is benefitting from it. and i think that's a healthy debate for us to have in the right context. i think it's a healthy debate in

the context of the development of a farm bill. in the context of conservation, in the local and regional food system effort, all of those are avenues and vehicles for having that conversation and we are having that conversation and we should have that conversation. this, however, is about dietary and nutrition and that's what we're going to focus on as we develop these guidelines. >> i appreciate that point of view. i'm not going to miss this opportunity with my last 40 seconds, mr. chairman. mr. secretary, off topic but i'm going to use it, sequestration, i'm going to ask my folks are out there if you could help me. >> 6.8% reduction. across the board regardless when they came into the fsa office or when they -- >> what they're hearing is true, there will be a reduction? >> yes, unless something happens with sequestration. >> i yield back. thank you. >> mr. gibbs? >> i have to tell you, hearing

the ranking members' comments, i agree with about everything you said. why are we doing all of this, if it's really necessary? i make the comment that there's a lot of information out there for consumers. you've got the medical association, the cancer, heart, there's all kinds out there. but i do -- i am encouraged to hear you say that the process to make sure the tax, sustainability issues aren't part of this, because they shouldn't be. i guess my only demand, quote, demand would be use common sense and say moderation that i think people out there can make a lot of decisions on their own. there's a lot of information out there. i think these guidelines should be common sense things that if you have a weight problem, you need to lower your calorie intake. that's my comments. i won't even bother to ask how much all this process costs, but i can just imagine. secretary vilsack, i want to ask you these guidelines are

supposed to be guidelines and how does that affect the school lunch program? we've seen the school lunch program turned on its head and there's been all kinds of reports of certain school districts that want to get out of the program. are these guidelines part of that effect of determining what's happening in the school lunch program? >> the school lunch program is obviously focused on compliance with the healthy free kids act which passed congress in 2010. and in that congress directed us to do a better job in terms of the quality and nutritional value of those meals. more fruits and vegetables, more whole grains, more low-fat dairy and less fat, sugar and sodium, and we are complying with that and, in fact it 95% of school districts have been certified as following the standards. surveys of children, surveys of school administrators, surveys of parents and surveys of the public all indicate strong support for what we're doing, and we're helping school

districts that are struggling through a series of programs, team up for success, with succeeding schools and we're finding good success with that program as well. so the dietary guidelines help to inform as they do with some of the other nutrition programs, as they do with the department of defense in developing what they're going to serve our military. these dietary guidelines help to inform the process. >> okay. because i'm just really concerned with what's happening with the school lunch program. i'm hearing issues out there that kids aren't eating. the food is going to waste. i guess when i think back on it, there were kids that i wouldn't eat that i love to eat today. there's different behaviors. >> i'd say a couple things about that. number one, there are several studies, the university of connecticut, harvard public health school that suggests food waste is not as significant as it has been reported and, in fact, is no greater than it was prior to the new guidelines. number two, it is a matter of time. there is some research to suggest that if kids are given more time to eat, there's less food waste and the timing of the meal in terms of whether it's before or after recess may also

impact that. and then, finally, interesting conversation with the president of tufts yesterday. they did away with food trays at tufts and what they have found that has reduced significantly the amount of food waste because kids come in with a tray and they feel they have to fill up the tray as opposed to a plate. they fill up the plate, they get satisfied. they don't go back for seconds. there's less food waste. there's an opportunity for us as a nation to reduce food waste but i don't think it's a reflection or indication of the new school guidelines. >> when usda is working on the school lunch program stuff, is there much discussion about physical activity? i think that's probably maybe more so than what -- especially in kids. >> we have over 6,000 schools that have now been certified under the u.s. healthier school challenge which is an effort on our part to encourage both calories in and calories out. and we reward and acknowledge school districts that are doing

a good job of balancing nutrition and exercise. we also have an interesting relationship with the dairy association and the nfl on their fuel up to play 60 program so there is an emphasis on exercise. >> secretary, a comment about sustainability. all the comments you had. i guess my only comment would be some of that gets a little weighted by certain agendas, by certain organizations. we saw this in the water rules -- the waters of the united states. we saw a lot of comments come in and that was orchestrated. you have to take those agendas out there and i think just so you're aware of that, some of those comments are sometimes subject to criticism. i yield back. >> gentleman yields back. mrs. fudge, five minutes. >> thank you very much, mr. chairman.

i thank you both for being here this morning. on august 24th, they asked for input as to how to inform the public about the 2015 dietary guidelines. i think that's a great idea. because so many americans really do not understand and are confused about the guidelines and the dietary patterns. tell me how you are planning your messaging around the guidelines. and if you have any just straightforward suggestions as to how americans can improve their eating habits. >> well, we take the guidelines and incorporate it into our my plate initiative which is secretary burwell referred to it earlier. it's an opportunity for us to visually give people an idea of what a healthy plate looks like. the choose my plate website is also part of our effort to try to do outreach. we also have a super tracker program that's basically if you are struggling with weight -- i have got it on my iphone. it basically gives you daily

updates and suggestions on how you might be able to control your weight, tips on substituting foods and so forth so that you have a healthier balanced diet. there are a series of ways in which we incorporate the information from the guidelines in our educational materials which we then disseminate through a variety of mechanisms, social media and legacy media. >> thank you. how many american households do you believe are at risk for food insecurity? and how can the 2015 dga address the critical needs of our most vulnerable populations? >> well, i can tell you, our focus has been obviously on children. there are 15.8 million children who live in food insecure homes. that number is down, which is good news. we obviously still have work do. there are a variety of ways in which we can provide help and assistance. some of the obvious ways are the snap program and expansion of summer feeding. weekend feeding programs during

the school year. there's an opportunity for us to also work with daycare facilities and childcare facilities to ensure youngsters in the facilities get decent snacks. we mentioned the school lunch program. unfortunately, a lot of kids today get half or at least a third in some cases half and in some cases all of the calories they consume in school. to the extent we can do a good job of not only providing school meals, school breakfast but school lunch, after school snacks through our snack program, those are all a variety of ways to provide help. we're trying to find creative ways for families to extend their snap dollar by giving them tips on how they might be able to use fruits and vegetables effectively in recipes. we are making access to farmers markets more available. over 6,200 farmers markets today. that's an increase in the number now have the ept card to allow snap beneficiaries to access farmers markets.

>> which by the way works very effectively. i have it in my district. i thank you for that. lastly, tell me how important it is to maintain the five-year cycle for the dietary guidelines so that americans really do get the benefit of the current science for diet and health. >> i think we think that the five-year review is a very important part of doing many of the things that we're being asked to do, which is make sure that we have the most up to date science and make sure that we're listening to the public. because it's a formalized process that we do hear from the public. and there are those opportunities. i think while it's in statute -- that's why a big part of why we do it. i think we would agree that it is important to have points in time where you do the work and settle and do the analysis and the listening. so i think we think that updating it on a regular basis on a five-year cycle is important. >> i agree. >> thank you very much. mr. chairman, i yield back. >> gentle lady yields back. mr. scott, five minutes. >> thank you, mr. chairman. madam secretary, mr. secretary, thank you for being here.

i think as we talk about the reports, the credibility of the report is arguably the most important thing. it doesn't matter how much time and money went into it if we have a credibility gap, we have a problem. there are certainly some questions about the fact that miss miland was from the private sector. i have read her resume. 30 years at one of the major institutions. certainly qualified in every way, shape and form from her academic career to be there. but there are questions about the fact that she's now a member of the private sector chairing the committee. historically, we have not allowed industry representatives on the panel. and i recognize that she doesn't represent, for example, the cattle industry or the corn industry because we would believe that there would be the

assumption whether true or not that there would be bias in the opinions of people who represented a certain industry on the panel. when we see issues like -- when i see issues like tax on soda and other things being recommended, it seems to me that ideology is taking precedent over science. and that creates a tremendous credibility gap, as well. and i would just -- you know, as we go forward, how are we going to -- how do we make sure that we don't have that credibility gap in the report? because the cdc and the others do use this information to send out recommendations to the american public. if the nutrition evidence library is not being used, how do we guarantee the credibility of the report?

>> do you want to speak to the nutrition library? >> yeah. >> with regard to -- i think the credibility is a very important element of the trust of what we have in front of us. and i think that's why we are having the conversation in the places where we can provide clarity, we do. as well as providing clarity -- that's a little bit of some of our follow-up questions about, there is a scientific approach to what documents are included, how they are included. that's the standard of scientific research, the gold standard is used. i have checked even with our economists. had them come in and look at it. >> can i ask a question there? if the standard is scientific research, how do recommendations for tax on sodas get into the report? >> i think it's important to reflect that i think in the advisory committee's report there wasn't a recommendation. it was an articulation that some use policy. i don't think there were recommendations. they did not make recommendations. but i think with regard to the issue that's been raised, i think when we get to the dietary

guidelines, how we take what we are given, that is one input and use it will be an important part of establishing a process that i think people believe in. >> i'm down to a minute. i would like to hear what secretary vilsack has to say. i would suggest that when you see those things in the report and whether it's a jump to )e8vú conclusion or not, there's a belief then that the people on the committee entered with a bias in some way, shape or form and were searching for the science to back up what they already believed to be true instead of using the best available science, whether it's true or not, we can debate. but there is that -- there's a credibility gap from those things working their way into the report. >> congressman, i would like just simply to again emphasize, there is a fundamental difference between the advisory committee's report and the guidelines. and there is confusion out there for some reason people seem to think that the report equals the

guidelines. it does not. it is one aspect of information that will be taken into consideration relative to the dietary nutrition guidelines that we have to put together. number two, the national education library was used. and there's an extensive process that's involved in accumulating information and putting it through a filter, if you will -- >> secretary vilsack, i'm down to 30 seconds. i apologize. i think it was used for 30%. there was at least -- the reports, a tremendous number of things were not taken from that library. i have a quick -- this is a text i got from a dad yesterday that i know very well. he is saying that their school can't sell candy bars, which they used to do to help pay for a kids' trip. they're being told from the local school system that that comes from the federal government that they can't sell candy bars to raise money. >> that's not true. folks can sell outside of school, which is what these

candy deals are, outside of school. there's no prohibition. there are exceptions and waivers that can be granted. oftentimes it is not the federal law in place. it can be a state law that is that or it could be -- >> i don't think we would have that. >> that may be the case. then folks are mistaken about that. >> thank you, sir, for clearing that up. >> gentleman's time has expired. mr. delbene? mr. mcglompb? >> thank you. secretary vilsack and secretary burwell, thank you for being with us today. thank you both for your respective agency's work on the 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 thousands of stakeholder comments and collaboration. i want to say that i appreciate the process that the advisory committee went through. i think it's a solid process, one that was open and included, as you mentioned, many opportunities for the public to weigh in. i think it's important to kind of put this in perspective here. my colleagues understand that in this country today, one in three school-age children and adolescent is overweight and has obesity. more than one in three american adults suffers from cardiovascular disease and diabetes. we can do better. we're all talking about here today. this is an attempt for us to get it better. if people aren't interested in the well-being of our citizenry and all they are interested in is the bottom line, they should be supportive of what you are talking about today because at the end of the day, healthier people mean lower healthcare costs. so we all benefit here. you mentioned earlier that -- you referred to the hhs blog yesterday where the issue of sustainability were taken off the table.

for inclusion in the final guidelines. i get that's the case. i respect your decision. but this is an important issue. i think you both have acknowledged that. sustainability somehow in this congress is a dirty word. i don't get it. but it's important. and we ought to be taking about sustainability when we're talking about issues of diet and food security. and i do think that's -- that it is important that we start this conversation about this issue in the context of dietary guidelines. i also appreciate that both of your testimonies do a good job of emphasizing the importance of nutrition on disease prevention and putting these recommendations into context. in congress, we ought to be focusing on prevention as a way to reduce healthcare costs and improve overall well-being and economic productivity. we should be highlighting what the science says on good nutrition for our kids and our families.5j@ko i have an op/ed here that was in

today's hill newspaper penned by the presidents of american academy of pediatrics and the american medical association. it's titled, physicians perspective, keep politics out of dietary guidelines. i would like to insert that in the record. in it they talk about the importance of dietary guidelines and the soundness of science used to inform them. i think the issue is raised, you know, sometimes science changes. it does. everything changes. we know more today than we knew yesterday. our research techniques have improved over the last ten, 20, 30 years. so when we learn the latest science then we need to make the necessary adjustments. but as you know some of the biggest critics of these guidelines are from industries that produce the least healthy foods and from special interests with questionable credentials. reading about some billionaire from texas who is a former enron

executive who's funding some nicinitiatives to raise some questions about what you're doing. i don't know what enron knows about dietary guidelines but nonetheless there's special interests out there trying to raise issues of credibility, trying to question science. i just would conclude by saying, i encourage you to keep first and foremost the health and well-being of our kids and our citizenry in the forefront as you move forward and maybe in my last minute you can talk -- explain to me about if we all improved our diets, what would be the impact on the rates and costs of diabetes and heart disease and obesity. secretary burwell? >> i think with regard to when i examined medicaid and medicare costs over the ten-year period and as a trustee as one goes out over periods of time, both heart disease and something that we know about how to do and diabetes are two very, very large cost drivers for us as a nation. they are cost drivers because those are both conditions that

can continue over an extended period of time and especially as we have a population that lives longer, which is a good thing. but the idea that these are costs that are controllable. i would also say that in my engagement with the private sector and ceos of companies -- i'm sure you all hear this in your districts. they talk about wellness. the reason they are so deeply focused on this and want to engage with us is because they are putting initiatives in place because they are starting to see and i was just with nam this week the national association of manufacturers and had one of the ceos who says she has done it for almost ten years. she has the analytics to show it. those are analytics companies can make decisions on. we want to see those to see if they are worthy enough for us to make decisions on the taxpayers' money. it's across the board in both the public sector spending and private sector spending on the health issues. diabetes and heart disease are two of the leading costers we have publicly and privately. >> gentleman's time is expired.

i'd ask my colleagues' indulgence. secretary burwell has a hard stop at 11:30 and the apparent interest of colleagues, unanimous consent to go to four minutes for questioning to give a chance for everybody to get here. to make that happen. we will go to four minutes at this point forward. mr. crawford for four minutes. >> thank you, mr. chairman. kind of keeping on that subject, a lot of attention has been paid to the dietary guidelines and the fact that they are guidelines. they're not rules. am correct in that? >> yes, they are guidelines. that then are used as a basis for program attic and policy decisions. >> they are used pretty hard and fast on rulemaking then, correct? >> it depends on which programs. so, for instance, i think school lunch programs in our area, the administration for community

living in terms of meals on wheels and those programs, they're used and they are applied in different settings in different ways. >> we have heard a lot of talk about the school lunch program and it seems that -- i know my colleague mentioned he had gotten a text just in the last few minutes. i've gotten phone call after phone call after phone call once the new school lunch program was implemented fully in 2012. there's been very little attention paid to how we roll this out and apply it rigidly to snap program. so it seems like using the argument that, well, we can be pro active and we can help to regulate the food that people eat that we can control, the secretary mentioned department of defense and meals that our soldiers, sailors, airmen, marines receive, we mentioned the school nutrition program, meals that our students receive. but we're not talking about actively engaging in how we do a better job in administering the

snap program with respect to the sugary drinks that are purchase and the other things that are bad according to the guidelines. why aren't we doing a better job of actually going in and proactively engaging in rules that help us do a better job on dietary structure as it applies to snap program? >> well, first of all, we are trying to address this through a variety of mechanisms. the farm bill provided for the food nutrition and security initiative which is designed to provide assistance and help for snap families to purchase more fruits and vegetables. the expansion of access to farmers markets is giving them that opportunity. we are looking at a -- we had a database research based program to determine what would actually provide direction for snap families in terms of purchasing nutritious food, making nutritious choices. what we found was that also, there's a fairly serious technology challenge in terms of trying to prohibit people from using snap for certain products.

>> let me stop you right there, mr. secretary, because i know that our travel card will deny a purchase if you try to fill up your car on official business with your travel card and then put a snickers on there, it will decline the purchase. i know the technology exists that we can do a better job in administering what it can be used for. >> there are 300,000 products sold in a grocery store. across the united states. >> right. we ought to identify the one that is aren't allowed. >> there's the problem. sugar drinks? does that include 100% apple juice? do you want to prevent that? >> that's my question. why are we not addressing that? >> i'm asking. do you want to exclude that? >> i'm asking you. we're not marking up a bill here. i'm trying to get feedback from you on why the guidelines are not more rigidly utilized in the snap program when they are in the school nutrition program. >> they are used in the snap program in terms of providing guidance and direction to snap families where they can buy fruits and vegetables, how they might use recipes. >> you mentioned incentives. what kind of incentives are

being made to incentivize people to make those smarter choices? >> the food and security initiative is providing resources to groups that are providing cash increptive -- incenti incentives. when a person goes to a farmers market and buy $5 worth of tomatoes, they will be able to market and buy $5 worth of tomatoes, they will be able to buy $10 because of the additional incentive. they get more bank for their buck. it's an opportunity for associations involved to provide sales to provide promotions to provide recipes. there's a series of programs. we will provide you a list of all the grants that have been made under that initiative and what actually is being done. i think that might be helpful. >> thank you. i appreciate it. yield back. >> gentleman yields back. mr. aguilar, five minutes. four minutes, excuse me. >> thank you, mr. chairman. thank you both to the secretaries for being here. i wanted to expand a little bit on that discussion. i participated and i mentioned it to my colleagues before in the snap challenge earlier this year. the biggest piece that struck

me -- clearly, there was an end in sight when i went through this challenge. but it was the budgetary constraints on healthy eating. mr. secretary, you were just talking about those programs 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 dietary guidelines, both usda and hhs plan to release marketing materials. mr. secretary, you talked about choose my plate as an example. showing folks how to live on a low budget and a balanced diet. in the advisory committee report, it is mentioned that the best food patterns of healthy living include healthy u.s. style, mediterranean and vegetarian pattern. do you know approximately how much it would cost to afford each of these lifestyles per week?

could you expand a little bit on the programs that educate low income families on healthy purchases like the food insecurity program? >> well, the guidelines help to inform a series of meal patterns. it goes from the high end to the low end. the thrifty food plan basically is the plan -- i don't know the specific dollar amount. obviously, it depends on the choices that people make, congressman. i think we need to sort of dispel the myth that healthy eating necessarily has to be more expensive. here is why i think people think that. if you take a portion of potato chips and a portion of broccoli, in the past the way we judge the value of that was by looking at 100 calories worth of potato chips and 100 of broccoli. 100 calories of broccoli, probably fill half this room. that's going to be more expensive. what we ought to be doing is looking at portion size. people eat more than three potato chips. they don't eat half a roomful of broccoli. when you look at portion size, fruits and vegetables become

affordable. number one. number two, if you look at recipes, the use of canned and frozen vegetables and fruits is also an opportunity. we can stretch dollars. we want to provide people with recipes and information that will allow them to use fruits and vegetables more effectively, to understand it doesn't necessarily have to be more exee expensive and then the incentive programs where we work with foundations to encourage farmers market purchases by incentive -- grocery stores to offer bonus points if you will for snap families to purchase fruits and vegetables. there are a wide variety of things and we are also working with food banks to make sure that the areas of opportunity that they have to help struggling families also includes more healthy choices. so there's a wide variety of steps and ways in which we're attempting to make a difference. >> i would love to see more as we can stretch to become healthier.

i would say, it was incredibly tough, mr. secretary, to -- my wife and i, $66 on the snap challenge, to include healthy portions and managing our portions. i ate peanut butter and jelly every day for at least one meal because we were trying to have a couple salads for the week. >> the snap program, as everyone knows, is a supplemental nutrition assistance program. it is not designed and not engineered and not funded to be the be all and end all for -- >> for countless americans, it is. >> i understand that. but it's -- that's why we work with food banks. that's why we work with foundations. that's why we work with shelters. that's why we work with other avenues. that's why we have a school lunch and school breakfast program. why we have a summer feeding program, to try to supplement. and to fill up those -- >> i look forward to working with you to carry out the mission of those programs.

>> gentleman's time is expired. mr. desjarlais? four minutes. >> thank you. i thank you both for being here. secretary burwell, i can count on one finger the number of times a sitting secretary has reached out to the members of a committee prior to the hearing to ask if they had any concerns. so thank you for that. i appreciate you doing that. i know that's time consuming but very thoughtful. historically, the dietary guidelines for america policy documents, which you say will be released in december, have not made suggestions about specific ingredients or commodities, yet that has prevented the committee from taking a look at aggregate consumption by the u.s. population and potential health risks of ingredients such as low calorie sweetener. aspartame is up with of the most widely studied food additives. fda asserted the safety of it.

fd yet dgac used a dubious process to call into question its safety, citing weak science against the backdrop of decades of research that shows otherwise. now we're calling for more research in spite of the fact that fda spent over a decade studying this ingredient and safety and concluded there is no increased risk of cancer from aspertame. during your review of the guidelines, are you consulting with the fda on recommendations after they spent years reviewing the science? >> yes. fda is a part of process at hhs. with regard to the issue of the safety of aspartame -- there are basically five products that fda has said in gip contents are fine and safe. and so, yes, fda is a part of the hhs process. >> how do the inner agencies review impact the final recommendations? >> the review is an extremely important part of the process. i think both the secretary and i have indicated that the input of the advisory committee is something that we are reviewing. but our own experts across our departments, not just fda for us

but cdc and nih, as well, the whole department is a part this process. it comes together, reviews everything together and that is what forms the recommendations that we will receive from our departments collectively together. >> additionally, dgac recommends replacing sugar drinks with low fat milk and water. we need to meet them in the middle and offer guidelines that's realistic, not idealistic. in your final recommendations, how do you intend to balance that are realistic and achievable? >> with regard to that question, you are getting ahead of where the recommendations are from our staff. wouldn't be able to comment on the specifics. we do look for a balanced approach and an evidence-based approach with regard to where we have the evidence about issues of when we say balance, it's also about the issue the secretary raised of nutritional value. so when you are trying to have a set number of calories and you have to get in certain numbers of nutrition, how you can get

that puzzle to fit together is an important part of what we will think about as we put together the final guidelines. >> thank you. secretary vilsack, at the december meeting before the final advisory committee recommendations were voted upon the committee got in a discussion about the definitions of red versus lean versus processed meat. at the end of the discussion they decided to remove lean meat from the healthy dietary pattern even though the scientific data in their own report was not changed and the same as the 2010 dietary guidelines which recognize lean meat as a nutrient dense food and nutrient dense foods were increased. it was important to give clear advice on the diets and health k. you please give me the assurances that you have both taken into account to insure strong scientific evidence is the foundation for the 2015 guide loins? >> i can and i can also suggest, 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 guidelines with reference to lean meat. i would be surprised if our final conclusion is not to include that as part of a healthy diet. >> thank you, sir. >> mr. costa, five minutes. >> four minutes. i got it. thank both secretaries for your efforts in reaching out. i do appreciate that. i think to the degree that we collaborate on a greater basis, we would all do a better job. a lot of discussion this morning has been talked about the process in these guidelines. i do appreciate you emphasizing that they are guidelines as a part of a total work product. and i guess i would like to get your take, both of you, on how we measure success. clearly, we all believe, i think -- i hope it's not in debate, that part of healthy americans is a healthy diet. it's part of preventative

healthcare, as our mothers told us a long time ago. an ounce of prevention is worth a pound of cure. how do we measure success in terms of the incredible changes that have taken place in terms of america's dietary habits over decades? this effort to use these guidelines as a means to provide better diets so that we have healthier lifestyles. have you thought about that in this process? we're asking you the questions. how can we make this process better? >> with regard to when we think about success, first, the guidelines themselves being quality product. we need to start with that. that's a lot of the conversation that we're having today about an evidence-based and quality product. i think the second thing is how the guidelines get used in an appropriate fashion in terms of people understanding what they are -- >> you think we're making progress along those lines? i mean, there's a lot of advertising out there that tries

to -- especially among young people, skew their eating habits. >> yes. i think that comes to the third, which is the knowledge has to be activated so that people are acting and behaving. i think those are all places where we believe that we as a nation can improve. we can improve it both at a population health level and then we improve it in the ways we use in the programs, whether that's the programs at usda or the programs at hhs in terms of applying. cdc is another place we can make progress. >> secretary vilsack, you have been at this for seven years. >> congressman -- >> how do you measure success? >> i would only add to what secretary burwell said is that, one way potentially of looking at this is to look at the healthy eating index that we have, which is a 100-point system. and currently today, the average american is about 57. we have seen improvement over the last couple of years. that's good. obviously, i don't know what your mother said about 57 out of 100. my mother wasn't satisfied with that.

>> no. >> so it's important for us to continue. that's one index. that's one way of measuring. another way is to measure whether or not we're making headway on obesity. i'm pleased by the fact at least among young children we're seeing some indication of a plateauing and maybe even a slight decline in obesity rates. that's good news. we have work to do. in terms of improving the process, i would simply -- i think this debate is healthy because it allows people to understand what these recommendations are and what they aren't. i think it's also -- there's i think a misunderstanding between a prevention orientation, which is what these guidelines are, versus a treatment orientation, which is a lot of the criticisms often are because you aren't dealing with certain diets that would be helpful in dealing with obesity. so maybe there's a way of which we could potentially expand or create an avenue for that kind of treatment discussion to take place. >> i have other questions regarding gmo labeling and

bio tech traits as it relates to that. i will submit that for the record because there's not time. i guess just a final comment. i guess it's getting back to good habits. when i grew up, it was a few years ago, eight-ounce was considered a regular thing. 12-ounce was big. and then i remember, i mean, we were all floored by 16 ounces. today, to see these 24 -- i mean, it's, i think, a large part of our just sizes and amounts as it relates to obesity and how we combat to obesity. that's just a comment. >> time expired. >> thank you, mr. chairman. thank you, secretaries. i appreciate the work you are doing. i taught nutrition for many years. it's very, very important and very important to be science based. i'm encouraged you to hear that you make sure it does include a sustainability tax program issue. i wanted to focus on the nutrition evidence library. we heard about it with even the usda officials describing it as

a gold standard. i have heard concerns that they the nutrition library has ignored a growing body of peer reviewed science on low carb diets as it contradicts the evidence from previous guidelines. can you elaborate on how scientific studies are added to the nutrition evidence library and what can be done to ensure that cutting edge research in nutrition science is considered? >> well, there are four approaches as it relates to the library. the original systematic reviews. there are existing reports. there are new reports funneled in from a variety of different locations. there are a review of what the typical diet of american might be. food pattern modelling is included. there's a broad array of things included in this effort. the issue of low-carb diets raises the point i just made with representative costa.

i think that's ultimately in the context of how do you treat a particular condition, obesity, for example? it may very well be that a low cash diet or a high protein diet may be a way a physician would prescribe for an obese individual to deal with obesity. that's not what these guidelines are about. these guidelines are about preventing that to begin with. there is isn't an avenue within the guidelines for that treatment discuss. that's i think why there's confusion about all of this and why there's a lot of angst about it because some people are looking at the guidelines as treating all health issues. we're looking at what the law requires us to do, and that is focus on dietary and nutritional guidelines relative to prevention. >> i have some people point out that 52% of u.s. adults are prediabetic and they allow a low cash diet helps prevent people becoming prediabetic. it actually -- would be helpful to include that. >> in that circumstance, you

have competing studies, which is why it's important to understand that this is really about well-informed opinion. i wish there were scientific facts. but the reality is stuff changes. right? stuff changes. the key here is taking a look at the preponderance, 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 you have 15 on another side, the evidence may be on this side with the 15 studies. that's a challenge. that's why we do this every five years, to give an opportunity for that quality study to be further enhanced so that five years from now maybe there are 15 studies on this side and 15 studies on this side. it's an evolving process. >> in the guidelines, are there disclaimers mentioned in there that say, for certain populations this may not be true or certain populations this might be helpful? do you include that? do you just pick one and say this is it? >> it isn't so much that. it's a caveat that these are recommendations focused on prevention.

they are guidelines. they are not -- you shall do this. there are recommendations and suggestions you should do this. i think that sort of an indirect way -- i'm not certain. we haven't crafted the guidelines yet. i don't know whether they will be caveats -- >> is there any population -- there's got to be differences perhaps for different populations. >> there are if -- >> the guidelines may not be one size fits all. do you present it as this is for everybody? >> it's a general guideline. it's a general set of recommendations. i mean, in theory, you could have 317 million different guidelines because we're all slightly different. slightly different circumstances. you have to create a wide berth here. within that wide berth, this is what we're recommending. if you are interested in a healthy diet, in reducing your risk of diabetes and cardiovascular, this is a course you might want to consider. obviously, people are going to make choices and decisions based

on what's best for them. >> gentle lady's time as expired. ms. plaskell for four minutes. >> yes. thank you, mr. chairman. good morning to you both. 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 report came out. can you explain how you are going to and will you be able to meet the timeframe that you have for an evaluation of all of those responses to be able to issue that report, the guidelines? >> yes. our staffs have gone through all of the comments. one of the things that is helpful in a sense is that a large percentage of them actually were form letters. as the secretary reflected, only about 8,000 were individual, not only, but that's less than 29,000 in terms of our ability to get through. the secretary and i are both working very hard with our teams to meet the deadline of this year. >> great. i guess my other question is

related to moderate alcohol intake. looking at the guidelines that were issued in 2010, and wondering if that at all -- i noted in the 2015 committee statement that confirmed the conclusions from 2010. do we think that that's going to remain the same or what will moderation -- what is considered moderation? will that change, as well? >> so as i think you appropriately reflect, the advisory committee has the identical recommendations from the 2010 report. while we're not going to comment on specifics, i think it's important to reflect that there was no change. >> after this hearing, i may be consulting that guideline. >> the fda would say he meets age requirements. >> i think that's two for male. right? >> good enough. >> i just want to thank you all for the tremendous work that you have done.

this is really important to the american people. i'm just echoing my colleagues' discussions about proportion sizes and the need for healthy diets, particularly in communities in which there may be a dearth of fresh foods that are available to them, as well. let's not forget the thing we haven't talked about which is your exercise, as well. which i think is something that americans have been woefully lacking in for our young people for some time now. thanks very much. i yield the balance of my time. >> gentle lady yields back. and i don't think the secretary was saying 5:00. did you? mr. rouzer for four minutes. >> it will be 5:00 somewhere. >> thank you, mr. chairman. secretary vilsack, secretary burwell, thank you both for being here today. i appreciate it very much because this is an incredibly important issue. i'm looking at this from a very

macro perspective. we have close to a $20 trillion debt. medicare and medicaid, which you referenced a little earlier, is such a huge component of that debt because a vast majority of our spending is medicare and medicaid. so you consider the obesity issue we're facing. you mentioned obesity and heart disease is two major components that drive the cost of medicare and medicaid. all that gets back to what we consume. and i think back to my time when i was in k through 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 are in school that you have today. i visit all kinds of schools all across my district.

and i would say a third of them are clearly overweight. some of them are really young. i mean, exceptionally young. some of them i know their parents. i knew their grandparents. obesity was not an issue in the family until this generation. so that leads me to think clearly something has changed in our society over the last 20 years, in particular. and i look at it from the perspective of you have got different movements out there influencing public policy. in the dietary guideline advisory committee, you know, there's the statement in there that says, common characteristics of dietary patterns associated with positive health outcomes include lower consumption of red meat. it was mentioned earlier about

caloric diet, trying to maintain a certain number of calories. not all calories are the same. i would suggest from a common sense perspective, 2,000 calories of beef versus 2,000 calories of doughnuts are very different. your body reacts to it very different. your body takes the carbohydrate and turns it into sugar. that often goes straight to the belly. whereas, consumption of protein, same calorie amount, the body treats it very differently. in fact, i think if you go and have a blood test done, they measure protein level in your blood, which suggests that, obviously, protein is a key component to a healthy lifestyle. so my main point that i want to drive home this morning is, i think it's very, very important to understand that there's a difference in terms -- not all calories are the same. from a public policy standpoint, i think perhaps maybe we have gotten too smart for our own good. i recognize science has improved

dramatically. but mankind has survived for many thousand a year on red meat, whole milk. in fact, i remember growing up when there was a report that came out that said apple juice was bad for you. then they came out and said, no, actually, we're wrong. eggs, bacon. i remember growing up where they said, it may contribute to high cholesterol and heart disease. i want to make sure that we get back to common sense and that we do what's right for future generations. not only for the health standpoint but that translates directly in terms of the public policy decisions we have to make as it relates to our budget. finishing up here, i want to ask both of you -- >> you can't ask anything at this point. we have to keep going. >> no problem. >> ms. delbene, four minutes. >> thank you, mr. chair. thank you both for being here and for your time today.

first, i want to ask you about dairy. as you know, it has been a distinct food group in the past. according to the report, dairy products contribute many essential nutrients, vitamin d, calcium, magnesium iron, vitamin a, riboflavin. and yet, since 2010, 1% flavored milks haven't been allowed in schools. and we also know dairy consumption has dropped in girls ages 4 to 8. i had a couple questions of how do we continue to make sure students have access to appealing and nutritious dairy products? do you expect dairy would remain its own food group going forward? >> i don't want to assume what we're going to do in terms of guidance. but i will tell you that one of the things we have done is to work yogurt into the school lunch program. we're also taking a look at the issue of milk relative to school meals.

so that's in the process, not in the context of the guidelines but in the context of our efforts the try to encourage healthier choices in schools. i don't think there's any question that dairy is an important component. it's recognized and should be recognized. >> kind of on a different note, given that we have regional, cultural, socioeconomic diversity throughout the country, how will the dietary guidelines meet 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 they are eating? >> i think that many of the programs that the secretary has spoken about in terms of how you put those out, i think it's about having information that's simple enough that you can use it is in your own cultural

context and then it is about a number of the programs in terms of how the information moves not just the guidelines themselves but then the programatic piece that follows on. i think it's the step beyond the guidelines. having guidelines that are clear and simple enough that can be applied across context is the first step. but then it's how the guidelines are then implemented. >> right. we're working at usda, native american populations, for example, 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 i think there is a greater sensitivity and i think that's the challenge for us in the future which is to understand those differences and to 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 the guidelines, which is a sort of general recommendation. >> thanks.

i guess it's also then important to understand what the messaging might be going forward and how different folks will understand and be able to learn about the guidelines, as well. >> there will be an expensive effort as both departments. we will use of the tools that we have, which have been pretty effective. the my plate has been more effective efforts on the part of usda. the choose my plate. the super tracker. the snap education and nutrition information that we provide to snap families. the work that we will continue to do on menus with school lunch personnel. there's a variety of ways in which we can incorporate and assist folks in trying to follow these recommendations. >> thank you both again for being here. i yield back. >> gentle lady yields back. >> i need to apologize. mr. rouzer, i was brusk and rude. i simply should have said your time expired. accept my apology. >> not a problem, mr. chairman. >> mr. kelly, five minutes. four minutes.

>> thank you, mr. chairman. thank you, witnesses. the dietary guidelines for americans have been published every five years since 1980. we're concerned that the public at large has lost faith in the process to develop the dietary guidelines which will ultimately decrease the adherence to them with potentially costly affect on public health. in the military in my service we say you can have an sop, standard operating procedure, but if your units and soldiers don't know them and use them, you don't have an sop. same thing with guidelines. before coming to congress, i was a prosecutor. i understand that two people can look at a problem and come to a different solution. secretary vilsack, during your process you talked about many times the preponderance of evidence. as a prosecutor, i didn't get by with that standard. the things i would do and were so important that i had to prove beyond a reasonable doubt my case. because for different things and different priorities, the importance of them, sometimes we have to use a different

standard of evidence. i would say maybe a preponderance of the evidence for scientific evidence is not the right standard. maybe it's clear and convincing evidence. or maybe it's beyond a reasonable doubt that when we have science that we hold them to a standard that makes sure that the end result is something that we have a good belief that it will be viable and it will be the right answer. although, we want to always be correct. if we raise the standard, maybe we will be correct more often. >> congressman -- >> if i can finish. there have always been disagreements about this. there always will be about what the scientific is. i just say, sometimes we may want to look at the standards. but over 1,350% 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 -- it doesn't matter how good the standards are and it does not matter if we're doing right things, if the public doesn't have trust that it's the right thing, we have to build that trust.

secretary vilsack or secretary burwell, what would you do to make sure our public believes the standards of the guidelines we are putting forward are the true and correct ones? thank you. >> congressman, first of all, the preponderance of the evidence standard is a congressional mandate. so we have to follow the congressional mandate. if you all believe that it should be a higher standard, that's your call and whatever your call is, we will follow it. secondly, i am not sure despite the fact that we had 29,000 comments, we had 290 million hits on our choose my plate website which would subject people are interested in these guidelines and they haven't necessarily lost confidence in them. that's another data point that i think is important to take into consideration. i see this as a positive thing. maybe i'm looking at this wrong. but i think the more public input that you have, the better the decision making can be. we're obviously going to take

all this information into consideration as we should and there are a variety of input focuses on all of this. hopefully, we will come up with a best guidelines that continue to have the faith and confidence in the american public. >> i would just add, even as we implement the statute in preponderance that as you appropriately indicate, there are different levels of evidence. we do -- it's related to your colleagues' earlier comment about, aren't there different populations affected in different ways? the evidence that we look at and whether that's on the issue of sodium and 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 is important to do. i think we do follow statute. but we hear your point and a scientific review actually when we get our documents -- >> if i just -- i got ten seconds. if i can have just one further point. i just think it's -- i think

it's important that the citizens want to know we're not using science to justify ideology. that it's the other way around. thank you. i yield back. >> gentleman's time is expired. mr. davis, four minutes. >> thank you, mr. chairman. thank you, secretary burwell. it was great to speak with you last week. thanks for being here. and talking about this very important subject. secretary vilsack, i know you are going probably going to be surprised by this, but i'm not going to ask you about the school lunch today. it has been discussed already so i will skip over that. i do have some concerns. my most serious concern today is what i see as a lack of evidence to show that it the recommended dietary patterned proposed have been based on any evidence on children. according to the citations in some previous advisory reports for recommendations, the recommended diet has been tested almost exclusively on middle-aged men and women whose nutritional needs obviously are very different from young people and growing children. in particular, i'm concerned

because young children need certain vitamins and minerals, obviously, in order to grow and develop. we're talking about where in previous reports the expert report states that the recommended dietary patterns do not meet sufficiency goals for potassium and vitamin a and e. vitamin a sufficiency may be marginal. these are essential basic nutrients for growth and health in children. as a dad of a freshman in high school and a coach, these are things that concern me on a regular basis, too. at the same time, the dgac appeared to be be deficient in the role in developing nutritional guidance to meet the basic nutritional sufficiency for children to grow and be healthy. they were expanding their review of what has been referred to as the dining out topic. specifically, the fast food category was broadened to capture other types of dining out venues including casual formal restaurants and grocery store takeout.

given today's busy lifestyle, and really when you look at restaurants, they have offered a lot more healthy choices than what we saw just a decade ago. with that, i'm kind of disappointed, and i think others are disappointed that 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 impacts the quality or nutritional value of the food served. i certainly understand that some restaurants may serve better food than others. but that's the consumer that can make that final decision on that, too. so secretary burwell, wouldn't you agree that the nutrient content of food is more important than where the food is purchased and that rather than directing people away from dining out maybe we should focus

on helping to educate them on their nutritional choices? >> with regard to the issue of children and the amount of research and evidence that we have in that space, even as we are preparing to complete where we are now, the conversation -- my team actually brought up the issue of children yesterday as we look to making sure we have appropriate evidence for a number of the things that you are talking about for the next set because i think what you are reflecting is the research doesn't exist because it is on older. we need to get started on that now. th regard to the issue of do we need to understand this better? we don't have the facts yet. we don't have a science base. if we start now, we will for the next. with regard to the question -- >> great. appreciate that. >> with regard to the dining out, question right now 30% of your calories for americans are consumed outside the home. with regard to how we think about making sure that -- >> what percentage? >> 30%. so when that is happening, i think what we need to focus on with regard to this issue is making sure people have appropriate information. that's what i think we want to

do is make sure that people have appropriate information to make the choices. as you reflect, it's up to people to make their own choices in that context. i think that's where we touch on that issue. again, always separating the advisory committee's work with the work that we are doing. >> thank you again both. my time has expired. >> gentleman's time is expired. dr. ben check, four minutes. >> thank you, mr. chairman. thank you both for being here today. i want to follow up on a few of the thoughts that representative hartzler had. as a physician, i have been involved in peer reviewed science in my training and in my career. i'm a little bit concerned about some of the things guys have said here. you brought up the fact that -- i think it was the journal of -- the ama brought out that 52% of americans are prediabetic or diabetic.

and yet, the dietary and yet, you know, the dietary recommendations that -- as i understand it, are not really appropriate for that. we have -- there's too many carbohydrates. these people have a carbohydrate intolerance. more carbohydrates in the diet you recommend than is appropriate for that. you mention that this would be a treat. but this is really not a treatment. this is a preventative problem. i think you have to address that more. i guess those are some of my comments. one of the questions that i had is, how are the studies taken -- you know, how do you determine what study to put -- to base your science on? i've got evidence that this evidence library included some trials while excluding several other larger trials, some of

which were funded by the nih. i don't know why all the studies aren't included in the data. i mean, how does that not lead me to believe that there's a predetermined result that's been looked for? >> well, the process starts with a series of questions that are formulated and then information is accumulated and it's gone -- it goes through a process of evaluation. >> is the nih involved in the process? >> well, it's involved in the sense that the nih helps to fund studies that -- >> i mean, they're not involved as an interagency review of how the study are picked? >> with regard to i think there are two different processes. there's -- well, three. one is the library of materials that people use. and that's housed at usda. i think the second is -- >> is stuff excluded from the

library? who makes the choice of what goes in the library? >> there's a process that the folks at the national -- >> that's what i'm asking. is the nih involved in that process? i'm surprised that nih funded studies, some of which are larger than the studies that you rely on for your data, contradictory studies, funded by the nih are not included in the data. i'm wondering why. >> if you can give me specific -- >> yeah. i can do that. >> i will be able to provide you a specific answer as to why that particular study or series of studies were not included or perhaps they were and we're having a misunderstanding. >> my understanding is they are not. that's why i'm concerned. it is leading to me, some of your comments suggested that with diabetes and prediabetes and obesity are major problems in this country. because of the cutdown on the fat portion of the diet, we're recommending more carbohydrates. that's exactly the problem that

prediabetics and diabetics have, is not being able to respond to carbohydrates. 52% of the people being prediabetic, this is the wrong diet to recommend. when you say it's a general diet, that's great. but shouldn't it be with a caveat that ms. hartford mentioned. i mean, this is pretty serious stuff here. somebody mentioned we weren't as fat when we were kids and we were eating more fat. were eating more fat. were eating more fat. were eating more fat. were eating more fat. were eating more fat. were eating more fat. frankly, it's not an exercise thing as far as i can see. because i'm experienced with it. if you eat a lot, you can