- What I'd like to do now is

introduce Professor
Susan Nitzke,

who is a professor
emeritus from UW-Madison.

And Susan we thank you for
being with us this evening.

And we shift gears and
talk in more details

on a topic related to
what Professor Dr. McBride

talked about last week.

The question that relates
to food, nutrition,

and related aspects of it.

So, Professor Nitzke.

- Thank you, Bassam.

I'm very pleased to be here.

So the points that I'm going
to emphasize tonight are that

nutrition issues are
really at the crossroads

for chemistry and where
it meets social issues.

One of the things that affects
the advice that we give

about nutrition is the
serious public health concern

in the United States over
the last decade or so.

Well, actually, a couple
decades, about the expanding

rates of obesity, and how
that affects how we see

the recommendations
for how Americans

should change their
diets for better health.

I chose the topic
of sodium today

because sodium chloride is a
very simple chemical compound.

There are many compounds
that are essential for life

and sodium chloride
is one of them.

You and I would not
be alive if we did not

take in some sodium
chloride in our diets.

But like so many things,
too much is harmful,

and sodium chloride is
a great example of that.

I'm going to also
mention some other

nutrients that are of concern.

In addition to sodium
chloride: saturated fat.

It is recommend that we reduce
our intake of saturated fat

for some reasons I'll
share with you in a minute.

And then there
are some nutrients

that we should seek more of:

vitamin A, vitamin D, vitamin E,

vitamin C, folate,

calcium, magnesium,
fiber and potassium.

Plus, if you're a woman
of childbearing age, iron.

I call this slide "Says Who?"
and, as a scientist,

as Bassam and I both try to

present the most reliable
information we can find,

we are always concerned about

where do these
recommendations come from?

Who's saying this, and
what do they have to gain

by getting us to believe
what they're reporting?

I have a link here.

I'm using a lot of
the information from
a report that came

out earlier this year

from the Dietary Guidelines
Advisory Committee.

By law, every five years,

the U.S. Department
of Agriculture

and the U.S. Department of
Health and Human Services

get together and review
an official document

called the Dietary
Guidelines for Americans.

And then that, that
science-based document

is used as the basis of a
lot of policy decisions.

Everything from what's
available in the WIC program,

if you know what WIC is.

It's a supplemental
nutrition program

for women, infants and children.

What's served in the
school lunch program,

and what kind of public
health incentives

there are to, for instance,
reduce sodium in the diet.

I just wanted to quickly
show you that this

scientific report put together
by the advisory committee.

The advisory
committee has nothing,

no close ties to
the U.S. government.

Congress can't tell
them what to say.

Food companies can't
tell them what to say.

They are people like
Bassam and myself

who work at
universities, mainly.

There are also some physicians

and some public health experts.

There are 14 of them.

And they have gone through a
2-year process of reviewing

the scientific evidence
behind the dietary guidelines

and writing a report to the
secretaries of Agriculture

and Health and Human Services.

And then, as I mentioned,
by law every five years,

those two agencies get together

and put together their
report for Congress,

for the public, for everyone,

about how the American
diet should change.

So there will be some politics

that get into the process as

the Dietary Guidelines
Advisory Committee's report

goes into the policy documents.

But the advisory committee's
report was put together

by a panel of
scientists who have

almost no political
affiliations.

I'm also going to share
with you information

from the U.S. Centers for
Disease Control and Prevention.

In fact, I recommended that
you read a short report that

they have on Q&A's
about salt and sodium,

and that comes from the
Centers for Disease Control.

I have a little
bit of information

from the U.S. Department
of Agriculture's

diet recommendation
system called MyPlate.

And when it comes to
advocating for change

and talking about how
we can take these issues

and talk about
social ramifications,

I thought Michael Pollan's
piece was a good summary.

Now, normally I don't
quote Michael Pollan

because he's a journalist,
and journalists,

when they write about science,
sometimes they get it right,

sometimes they get
it a little confused.

But Michael Pollan, when
he talks about advocating

for change, that's his
territory, and I thought

he did a very good
job on that topic.

So I mentioned obesity as
an overarching condition

that affects our
nutrition recommendations.

It raises the risk of
heart disease and stroke,

also other diseases like
diabetes and cancer.

In 2008, $140 billion

of medical cost were
attributed to obesity.

For an individual who is obese,

on average, that
person's medical costs

are $1,400 a year higher.

So already you can see some

social ramifications to obesity.

Obesity is more prevalent
in some subgroups

of our population than others.

Non-Hispanic blacks,
a designation of
African Americans,

have the highest
age-adjusted rates

of obesity in the
country, about half,

and as a matter of fact,
this was from a JAMA article

in 2012, it's now over 50%.

Compared with Mexican-Americans
who also have a high rate,

and Hispanics.

This slide does not show the
rates for Native Americans,

or American Indians, but their
rates are the highest of all.

Now, how do you know
if you're obese?

The common measurement
that's used

is a quick calculation
that can be done

in any clinical setting, any,
those of us sitting here,

if we took a few minutes
with our smartphones,

we could do it.

You just take your weight
in pounds and you divide it

by your height in
inches squared,

and you multiply
that number by 703.

The people who actually do
these scientific calculations

on a routine basis
use the metric system,

but I converted it here
to pounds and inches.

So for example, a person
who weighs 150 pounds

and is five-foot-five
would get a number

of 24.96, right on the edge.

If that person had
come out with a number

of under 18.5, it would
be considered underweight.

There aren't too many people
that are in that category,

but there are people
in that category.

18.5 to 24.9

is the range that's considered
a healthy, normal weight.

Now more than half of Americans,
and as a matter of fact,

two-thirds of
Americans are in one

of these last two categories.

In the category of 25 to 29.9
is considered overweight.

And then over 30, or 30 and
over, is considered obese.

Just because you need
to know that it's not

just the diseases I
mentioned a few minutes ago,

but also gallbladder
disease, arthritis,

apnea and breathing problems,
inflammation disorders,

several kinds of cancer,

and there's actually a longer
list but I stopped here

because it's too depressing.

(laughter)

How many of you have
seen maps like this,

showing the
prevalence of obesity?

How many of you remember hearing

that Wisconsin has
the highest rates

of obesity in the country?

Yeah, I think everybody
who raised their hand

is maybe over 30,

maybe even getting up
into my age category.

When the Centers for Disease
Control started putting out

these maps, they didn't have
the data for every state.

They had the data for
over half of the states,

and Wisconsin, being a
progressive public health state

in the '70s, had good data.

And our data showed that

we had one of the highest
obesity rates in the country.

Since then, all 50 states
have joined the survey,

and this is based on, actually,

a telephone survey
that's done every year,

sanctioned by the CDC, in
which they call households,

now they call also on cell
phones because so many people

don't have a home line,

and ask a bunch of questions
about whether you smoke

and whether you use
seatbelts and all of that.

And one of the
things they ask is,

for a selected adult
in the household,

how tall and much
that person weighs.

And the simple calculation
of BMI that I showed you,

Body Mass Index, leads
to these figures.

And if you can
see on the bottom,

the kind of yellow
is for people,

or states, that have
less than a quarter

of their population in
the obesity category.

Not overweight, but obese,

the highest number, the over 30.

And the light green,

oh I'm sorry, that's
the 20% to 25%.

Then 25% to 30% is

the category that
Wisconsin is in.

We have 25% to 30%
of our population

categorized as obese.

Isn't that a relief,
We're not the highest

in the country anymore,
for a number of reasons.

If you remember one thing
I said a few minutes ago

about the ethnic
representations?

The number of
blacks and Hispanics

are quite a bit higher in
some of the other states

than they are in Wisconsin,

and that's probably
part of that reason.

And before we feel too proud
about being in the yellow,

let me point out to you

that the latest
numbers are like 29.8.

So all we need is a few more
people to gain five pounds

and we spill over into
the orange category,

which is 30% to 35%.

And then a few
unfortunate states,

West Virginia and Mississippi,
have more than 35%.

More than 35% of
their population,

not adults, not just
overweight, but obese.

This is what, you have to
be like 30 to 40 pounds

overweight to get
into that category.

This is a serious
public health issue.

Personally, for the person

who has obesity as
a health condition,

and for our nation,
that has the health care

costs associated with obesity.

The rates have
changed over time.

This is from the Dietary
Guidelines Advisory Committee

report that I told you was
put out earlier this year.

And you'll see three
shades of gray.

The one on the bottom
is for the percent

of the population
that's overweight.

Over time, starting from 1988

to '94 is the first time period.

And then ending up in the
2011, 2012 time period.

You can see that for
males on the left,

the rates of overweight
have actually

gone down a little bit, yay.

However, in that overall

chart on the left, you
can see that the number

who are obese have gone up.

So that totally the
number who are overweight,

obese, or extremely obese,

extremely obese is a
BMI of 40 or higher,

make an overall
trend to increase,

with a little bit of dip

right at the last
couple of years.

Let's cross our fingers and
hope that little dip doesn't

go back the other way.

For females, the overweight
has been pretty steady.

The rates of obesity
increased a lot

around the turn of the century.

And unfortunately, you can see,

it's a really statistically
significant trend

that the rates of extreme
obesity have gone up,

especially for females.

Extreme obesity,
this, these are people

who are like 80
pounds overweight.

Now, over the years
it's been really hard

to try to detect this
condition in children

because of how we
define overweight

and obesity and how we want
protect the sensitivity

of children by not
giving them labels.

But the Centers for
Disease Control decided

that we actually need
to use these terms

"overweight" and "obese," and
based on some historic data,

based on the number of kids

who were at the top
10% and the top 5%

back in the 1968 time period,

we now have those rates

of that level of body fatness

affecting 10% and 30%

of our children, cumulatively.

So what used to be the top
10% of body weight in children

is now exhibited by 30% of
the children in this country,

and it's true for
both boys and girls.

That prompted the
Economist magazine

to put out this cover

in 2003, over 10 years ago.

And I think those of you who
are fans of evolution might

see either the
humor or the tragedy

in this particular depiction.

Now, if you're not
obese, good for you,

but you still need to eat well.

A lot of those disease
conditions that I reported

are still affected by
how much you exercise

and how well you eat.

And we have good data
that just being thin

doesn't get you off the hook.

A few of you are a little
disappointed by that,

but oh well.

Which nutrients do we need
more of in the American diet

and which ones are overconsumed
so that the official

recommendations
say to have less?

Guess which ones are
going to be on the list

I'm going to show you next.

These are the
shortfall nutrients,

and the nutrients with
the stars are the ones

that the Dietary Guidelines
Advisory Committee

said are public health concerns.

They're not only significant
less than recommended levels

for the American population
based on a lot of biological

calculations but
they're associated

with a significant rate
of chronic disease risk.

So that low intakes
of these nutrients

have a measurable and definable

and detectable public
health consequence,

and personal health consequence.

So you can see vitamin A
is number one on the list.

I have a colleague
in the Department of
Nutritional Sciences

who is one of the top
experts in the world,

and she would be happy
to give you a lecture

all about the
chemistry of vitamin A.

And how it's also easy,

and in some parts of
the world prevalent

to get too much vitamin A.

So just like carbon dioxide
and all those wonderful

things, we need enough
but not too much.

But in this country, especially
unless you're taking huge

supplements, you're likely
under the recommended

amount of vitamin A.

Vitamin D has a star.

And as many of you would
have mentioned to each other,

there's been a lot of
publicity about vitamin D.

When I was a kid I even
knew about vitamin D

because it's related to your,
the health of your bones

and it was one of the reasons
you needed to drink your milk.

But nowadays we have a number

of health consequences
that are associated

with low intakes of vitamin D,

and low levels of levels of
vitamin D in the body stores.

Vitamin E, vitamin C
are quite familiar.

How many of you mentioned
folate to each other?

Folate is one that people
don't hear about a lot.

It doesn't have a star,
so we don't have for sure

some disease conditions
that are associated

with low intakes
within the range

that are a problem
in this country.

But the typical intakes are
much lower than recommended.

Folate is one of the nutrients
associated with cell growth.

So it's pretty important,
especially for young children

or people who, pregnant women,
people who are undergoing

a lot of cell division like,

that is prevalent
when a baby is growing

or when a young
child is growing.

Calcium has a star.

I think you are all quite
aware of the osteoporosis

associations with both
calcium and vitamin D.

How many of you
mentioned magnesium?

Ah, there's a hand
back there, okay.

Magnesium doesn't have a
star, but it's definitely

on the list of
nutrients that we don't

take in anywhere
near, on average,

the recommended amounts.

The next one has a star
and it's really important

and a lot of people don't
think of it as a nutrient

because it's chemically
a little more complicated

than, say, vitamin C.

How many of you mentioned fiber?

Okay, a few hands.

Good for you, you get a star.

And notice that there's
a star next to fiber.

It is a nutrient of
public health concern

and I'm going to
talk a little bit

more about that in a minute.

And I'm willing to bet very few

of you mentioned potassium.

Two people, three, okay.

It has a significant effect,
along with sodium chloride,

which is the nutrient that

I am emphasizing today
on blood pressure.

And I'll get to
that in a minute.

And I already mentioned iron.

It's got a special
little category.

It gets a star for women
of child-bearing age.

Over-consumed nutrients,
there's two of them:

sodium and saturated fat,
along with added sugars.

Added sugars, that's a
funny name for a nutrient.

Of course there's no chemical
difference between the sugar

that's added to food, like
the sugar in a Coca-Cola,

or a Pepsi or a
Squirt or Gatorade,

than there is in
the sugar that's in,
let's say, pineapples.

Chemically there's no difference

but we do a really
good job of consuming

too much, not pineapples,

but the other kind of sugar,
the sugar that's been taken

out of one food and
added to another.

The Dietary Guidelines Advisory
Committee says we should

have less than 2,300 milligrams
of dietary sodium per day.

That's about a teaspoon.

The typical intake in this
country is much higher,

as I'll tell you in a minute.

Less than 10% of
our calories should

come from saturated fat.

The recent, the 2010 edition

of the dietary guidelines

made a big deal
about solid fats,

which included saturated
fats and trans fats.

Dr. McBride probably
talked to you

quite a bit about trans fats.

You probably know that the
Food and Drug Administration

has issued an edict and
told food companies,

"Okay, you've got three years,

"and in those three
years you gotta get

"your trans fats out
of the food supply.

"No more ifs, ands or buts.

"The evidence is
just too strong."

So, I'm not going to talk about
solid fats as a combination

of saturated and
trans fats like I have

for the last five or ten years,

I'm now going to focus
in on saturated fats,

with the caveat that
over time trans fats

will leave the food supply.

And then the setting of
a limit for added sugars

has been incredibly difficult

for scientists to agree on,

but the latest
recommendation is 10% or less

of your calories should
come from added sugars.

That seems like that should
be easy, but most of us aren't

doing a very good job of
meeting this recommendation.

And if you know
any teenage boys,

I guarantee they're
way, way above.

Okay, so let's talk
in terms of food.

That's enough about nutrients.

We don't eat vitamin A,
we don't eat potassium.

If we did eat potassium
we'd probably be in trouble.

We eat these nutrients in salts

and in chemical combinations

that put together
to make our food.

And the Dietary Guidelines
Advisory Committee said there

are several recommended dietary
patterns that will help us

meet those nutrient
recommendations.

One of them you're quite
familiar with, I bet,

is the Mediterranean diet.

Another one is the diet
pattern recommended in the U.S.

Department of Agriculture's
MyPlate food guidance system

that I talked
about a minute ago.

Either way, we need to eat
more fruits, more vegetables,

more whole grains.

We need to eat more
low-fat or non-fat diary

or the equivalent.

More seafood, more legumes,

which if you don't
use that term a lot,

is peas and beans,

soybeans, and nuts.

We should eat less red
meat and processed meats,

for a number of reasons.

One has to do with
that water chart

that Bassam showed
you a little while ago

about how much of
our water supply

is threatened when Americans
eat so much red meat.

Some of these things go
around and come around

and I'll talk about
that again in a minute.

Less sugar-sweetened
foods and drinks.

Oh, darn, that's my downfall.

And less refined grains,
which is the source

of a lot of added
sugar in our diets.

So I think many of you
know sodium chloride

is the chemical name for salt,

which is abbreviated N-A-C-L.

Food labels use both
terms, sodium and salt,

so some people get
a little confused.

Salt is 40% sodium
and 60% chloride.

A high sodium intake is
related to high blood pressure

and stroke and heart disease.

And as I mentioned, we're
recommended to have less than

2,300 milligrams, less than
a teaspoon a day, of sodium,

and we get 3,400
milligrams as an average

and many people get a lot more.

The sources of sodium
in the American diet,

according to the latest figures.

See that big gray half of the
circle almost, on the right?

If you can't read the little
words there in white, it says,

"Mixed dishes," and
then those are broken up

in that bar on the left.

Pizza 6%, burgers 21%.

Meat, poultry and
seafood dishes 6%.

Rice, pasta and grain dishes 7%.

And soups, 4%.

So if you add those all
up, "Mixed dishes" accounts

for 44% of the
sodium in our diet.

Another big category
there is grains.

And another big category
is protein foods.

Protein foods being meat
and poultry and eggs.

And then, but really all
of the food groupings

contribute quite
a bit of sodium.

This is one where beverages
kind of get off the hook.

One thing that may surprise you

is how much of it
comes from grains.

If you eat bread, those
of you who make bread,

know that most of
the bread that we eat

in this country has
quite a bit of sodium

added to it in the form of salt.

It helps control the
action of the yeast

and it helps the
bread taste better

and it keeps it from
getting stale faster.

For a number of reasons

there's quite a bit of sodium

or salt in bread foods.

Dairy might surprise you.

In that case, it's one of
the few foods that just is

naturally occurring to be,

not high in salt, but more salt

than a lot of other foods
would have if we didn't

add any sodium.

And if any of you have been
put on a, like, you have to go

on the strictest diet possible
for your sodium intake

for medical reasons, you
might have actually been told

that you have to be careful
of your dairy intake.

The rest of you that's
not so much of an issue.

I thought this was interesting

from the Dietary Guidelines
Advisory Committee's report.

They looked at the
amount of sodium we get

if we get our food from stores.

That's the dark diamond-shaped
bar on the bottom.

The stars represent
schools and daycares.

The little open triangles
represent quick serve

restaurants, the kind of
drop-in or drive-through kind,

or the other kind of
restaurant is the open square.

That's more like the
sit-down restaurant,

like going to Applebee's
or something like that.

So you can see that it's almost

like the faster it is,

the more trouble you're
going to get into.

But the sit-down restaurants
are really good also

at giving us a lot of sodium.

So it's one of those
cases where going

to a sit-down
restaurant isn't going

to make your diet
that much better

than going to McDonald's
or Burger King.

The dark line is the
middle is HEI limit.

HEI stands for the
Healthy Eating Index.

It's an overall index
that's used as a measure

of diet quality in the U.S.

So you can see that no matter
where you get your food,

the density of sodium
per thousand calories

is above the recommended levels.

And you're going to need to
be really careful if you want

to obey the
recommendations for sodium.

I gave you on the top
of the slide the link

to the full recommendations
of this tip sheet.

If you're concerned
for eating less sodium,

the very first thing
is to think fresh.

That's because over
three-quarters of the sodium

in our food supply comes from
salt that somebody put there.

Not necessarily in the milk
you drink but in just about

everything else,
somebody salted it

before you ever got
your hands on it.

If you went out for pizza,

you can be darn sure
that's the truth.

But even if you made your
sandwich with a piece of bread

and some ham, somebody put
a lot of sodium in those

components, the mayonnaise,
the mustard, everything.

While you're thinking fresh,
Enjoy home-prepared foods

because then you have control

about how much sodium is added

once the food gets
home from the store.

Fill up on veggies and fruits.

Mother Nature gave us some
very low-sodium food products.

And if you have a garden
like mine right now

that is the easiest
thing to do in the world.

In fact, before I
came here today,

I picked raspberries and peas.

Choose dairy and protein foods
that are lower in sodium.

Protein foods: beef, pork,

chicken, fish, eggs.

Those foods many of them
have a lot of sodium added

before you buy them or
before you eat them.

Adjust your taste buds.

Research has shown over and
over again, we're not born

with a preference for salt
like we are for sugar.

Little babies, they'll smile

when you give them sugar-water.

They even think
they feel pain less

when you give them sugar-water.

That is reinforced over time.

But the preference for how much
sodium we like in our food,

that is learned.

We have come over the years

to decide that food
doesn't taste salty enough

because it's not
what we're used to.

So the good news is
we can unlearn that.

If you try to do it right
away, you're going to go,

"Oh, this food, it
doesn't taste right!"

A year and a half ago
I went to Tuscany.

And those of you who have been

to Florence and
Italy and that area

might know about the
historic reason that they

don't add salt to your bread,
their bread and butter.

It has to do with wars,
like everything else.

But anyway, they learned
to have butter and bread

without sodium and they never
did start putting it back in.

So the restaurants that
serve traditional foods

have low sodium
bread and butter.

And, of course, when my
husband and I from Wisconsin

were there we're going,

"This is so bland!"

because we're more accustomed
to what bread and butter

tastes like in our country.

But you can adjust
your taste buds.

And the people in Florence
tell me they think it tastes

better the way they eat it.

Skip the salt, take it
away from the table.

If somebody wants to
add salt to their food,

make them get up and
go find a salt shaker.

One of your big
incentives to deciding,

"Well, maybe it's salty enough."

Read the labels.

(sighing)

I feel like I should
wag my finger.

You know I go to the store

and I just find
labels fascinating,

but some people don't
for some strange reason.

But here's the good news.

Most of us buy about 80% of
the same things this trip

to the store as you did to
the last trip to the store

as you did to the trip
to the store before.

So once you've read the labels

on the hot dogs
versus the bratwurst,

you don't have to do that again,

because you already
figured that out

and you can go for the one

that you already figured
out is low sodium.

So spend a little time
and then you'll know

some very useful information.

Pay attention to condiments.

It's the things that we
put on top of our foods.

Just think of the last
time you had a hot dog.

As if a hot dog wasn't
salty enough, right?

If you're like me you like
sauerkraut on your hot dog,

ketchup, mustard, pickles.

I mean, can you think of
anything you put on a hot dog

that isn't high in sodium?

A good example of being
careful of your condiments.

And then, this tip
for eating less sodium

ends up with the recommendation,

"Boost your potassium intake."

Now boosting your
potassium intake is not

going to automatically
make you eat less sodium.

But, it's a very
important nutrient

because potassium
helps to counterbalance

some of the effects, the
chemical effects on the body

that makes sodium raise
your blood pressure.

That's true if you have
high blood pressure

or if you have normal
blood pressure.

I once asked my
primary care provider,

"Gee, my blood pressure is
low, should I be worried?"

My husband is so jealous, he
gets mad at me every time I go

because it's like 110
over 70 at its highest.

And she said, "Listen, If
you're conscious, it's good."

So unless you're passing
out from low sodium,

don't worry about low,
low blood pressure.

So even if your blood pressure
is in the normal range,

lowering it a little bit
by eating more potassium

and less sodium isn't going
to get you in trouble.

The recommended amount, for
those of you who like numbers:

4,700 milligrams
of potassium a day.

The best food sources
are leafy greens.

Examples are spinach
and collards.

Fruit, especially fruit
that grows on vines.

Root vegetables were
mentioned earlier

about how much water they take,

but they are excellent
sources of potassium.

And citrus fruits.

Now the next slide
I'm showing you

is a little bit
hard to interpret

so let me spend a
minute on it with you.

One of the recommendations
that I bet everybody in this

room needs to pay
more attention to,

is the recommendation to
eat more whole grains.

Not just for fiber, but
importantly for dietary fiber,

but for a number
of those nutrients

that we're recommended
to have more of.

Potassium, even.

And whole grains
in this country,

no matter how much I've been
telling people for 30 years,

"Eat more whole grains,"
they're not doing it.

This chart, if you see
where the zero line is

in the middle, the black
line shows the percentage

of the population that has
intakes of whole grains

below the recommendation that,

which is roughly the
equivalent of 3 ounces a day.

The little white bars that you
can hardly see are the ones

who meet or exceed
the recommendations

of about 3 ounces of
whole grains a day.

Roughly a slice of
whole wheat bread,

100% whole wheat bread.

Some of you probably are
eating whole wheat bread,

whole wheat pasta,
most of your grains

in the form of whole
wheat, most of you are not.

When I go to a
restaurant and I ask

if they have any whole wheat

to put in the little
bread basket on the table,

they look at me like,
"Oh, nobody's ever
asked that before."

I'm like, "What is this about?"

This is not a new
recommendation,

this has been
around for 20 years.

For some reason,
people aren't doing it.

I think it tastes better
when it's whole grain bread,

but maybe I'm just goofy.

Now refined grains,
on the other hand,

we're all doing a splendid
job, too splendid.

Refined grains are the ones
that are made out of enriched

flour or non-enriched flour,
processed flour, that has

the bran and the
germ taken out of it,

and many times sugar
and other things added.

So notice how tiny the black
lines are for refined grains,

and how huge the white and
gray bars are for meeting

and exceeding the
recommendations.

Over time, we've done
actually a little better.

The black bars are
for 2001 to 2004.

The good news is, for
many of these age groups,

the ones with the little
stars, the ones that are higher

are the ones that are
different are higher.

So some people are actually
eating more whole grains.

Nobody's, no age
group is anywhere

near the 3 ounces a day,

but at least they're
creeping in that direction.

I take hope on small,
wonderful changes.

I call this one "Whence
Cometh Thy Grains?"

So on the left side
is whole grains

and on the right
side is refined.

And the same little
symbols that you saw before

for going to the grocery store

and going to a
sit-down restaurant,

going to a
quick-serve restaurant

or eating at a
school or daycare.

You can see that for whole
grains, they're all low.

But the people who get
their food from the store

do a little better.

And for the refined
grains, they're all high.

But the quick-serve restaurants

are the biggest source
of the refined grains.

Now, we are in Wisconsin and
I love to talk about dairy.

And I also get a lot
of skeptical looks

when I talk about dairy
because a lot of my friends,

my hobby, now that I'm retired
is I'm a watercolor artist.

And when I talk
to my art friends,

they all think they're
supposed to eat less dairy.

They're something inherently
wrong with eating dairy.

It's mostly fat or gives you
some kind of awful disease.

But I can assure you
all those scientists

that I mentioned a
while ago that talked

about the nutrients
we need to eat more of

and the food group we
need to eat more of,

they say consume more dairy.

If you have lactose
intolerance or for some reason,

a personal reason, you're a
strict vegetarian or whatever,

you need to be very
cognizant of getting

a good intake of
alternate sources.

And alternate sources
are not always

good sources of
the same nutrients.

So read the labels, look
at soy milk or almond milk

or whatever it is that you're
using as a dairy equivalent

and make sure you're getting
a fortified version that has

as many nutrients
added back as possible.

For most adults, on
a 2,000 calorie diet,

the recommendation of
dairy is three cups a day.

That's not three cups of milk,

but three cups of
what would have

been milk when it started out.

So cheese and yogurt
and all of that.

Notice most of these
black lines are way longer

than the white and gray lines.

And the older you get, the
longer the black line is

compared to the white and
gray line, meaning the more

people are not getting their
recommended intake of dairy,

which usually means they're
not getting their recommended

intakes of calcium, vitamin D,

and one of the nutrients

that dairy's a good
source of: potassium.

Remember what we said about
potassium a few minutes ago?

And over time, it's not
unlike whole grains.

It's not gotten better;
when there's changes,

many of them are in
the wrong direction.

Here's one of my favorite
topics: the added sugars.

If you eat pineapple or if
you're like me and went out

to the garden today and
picked some raspberries,

the sugar in there
is not added sugar,

that's the sugar that Mother
Nature put in your food.

If you had a Coke or a Pepsi

or a sports drink
or an energy drink

or something that's marketed
as being really good

for you because it's high in
electrolytes or something,

if it's sweetened with sugar,
that's still added sugar

and it affects your
body in the same way

as if you had a Coke or Pepsi.

By age group, remember
when I said teenage boys?

The black bars are for
their calorie intake

where their limit is for
how many added sugars

they're supposed to stay under.

Notice for a 14- to
18-year-old male,

way more than twice that much.

They are champions
at eating foods

that are high in added sugars.

When my kids were growing up,

when they would go
to the school bus,

the middle-school age
boys who lived next door

had Mountain Dew for
breakfast every day

and went through life with a
diet that wasn't much better.

And I was like,
"Don't look at him."

But it's what's
happening in our society.

Now many people
might be surprised.

This list is out of the
Dietary Guidelines Advisory

Committee report combined

with the 2010 version

of the Dietary
Guidelines for Americans.

These are the words that you
might find on food labels

that are counted
as added sugars.

And some of them
will surprise you.

You all know white sugar's
chemical name is sucrose,

and that, of course, is sugar.

Dextrose is a little
more of a chemical name,

you might see
anhydrous dextrose.

A lot of people
tell you brown sugar

is better than white sugar,
I wish that were true.

Confectioner's powdered
sugar is just sugar.

Corn syrup and corn
syrup solids, sugar.

Fructose, sorry, it's sugar.

High-fructose corn
syrup, sorry, it's sugar.

One thing that surprises people:

from a chemical
standpoint, the amount

of sucrose and fructose,
the chemical makeup

of high-fructose corn
syrup is very similar

to that of sucrose.

It's really hard to say that
it has much of a difference

in its effect on the body.

Honey.

To heart, I wish honey was
off the hook, but it's not.

Its effect on the body
is very similar to sugar.

Invert sugar, lactose,
which is the sugar

that's naturally
occurring in milk,

malt syrup, maltose,
maple syrup,

molasses even is a
form of added sugar.

You can't even get off
the hook with that.

One of the things you'll see
on many of the products that's

marketed as better for you
than foods that are sweetened

with sugar are sweetened
with a concentrate that's

extracted from a very sweet
fruit like pears or pineapple.

That's considered added sugar.

And then pancake syrup.

And one of the banes
to my existence:

the food products that,

if I had a good lawyer and
unlimited resources, I would try

to get them to stop
calling sugar "cane juice,"

because all sugar starts
out as cane juice.

And finding the words "cane
juice" on a food label,

you can go right
back up to the thing

that's on the top of this list.

It's equivalent, it's
the same chemical.

The sources: look
at that big white,

almost half of the
circle on the right.

Remember those teenage
boys I talked to you about?

Beverages.

Please read the labels.

Don't be fooled by names
like "energy boost."

Many of them are sweetened
with one of these.

So, soft drinks, fruit drinks.

Many people add sugar
to their coffee.

I add sugar to my tea sometimes.

Alcoholic beverages not
so much for most people.

But sports and energy drinks,

as I mentioned, are
not off the hook.

And then of course you're
probably not surprised

by the gray semi-circle
over there about 10 o'clock:

snacks and sweets.

I happen to be a chocoholic.

I can attest to the fact that

that's a big source
of added sugars.

Now another thing
that we're recommended

to eat less of is
saturated fats.

It has to do a lot with
heart disease rates

and the different
types of cholesterol

and how they're
transported in your body.

Notice the sources of the
saturated fats in our diet.

If it weren't for pizza and
burgers, we'd actually not

have to talk so much
about saturated fats.

Dairy, if you consume the
cream portion of the milk,

that's where you would get
a lot of saturated fat.

Protein foods, I think
Bassam mentioned a steak

earlier on, and if
you have a barbeque,

now you get to not
only feel guilty

about all the water that
went into that beast but also

all the saturated
fat that's in a good,

well-marbled piece of meat.

So the easy rule for that
one is to favor meats that

require a lot of cooking
to soften them up,

because those are usually
not that well-marbled

and don't have so much
fat in the muscle.

Snacks and sweets
are there again

as a big source
of saturated fat.

If you look, a lot of them
have coconut oil or might even

have a vegetable oil of
sorts, not just animal fats.

But there are a few vegetable
fats, like coconut oil

and palm and, palm kernel oil,

that are also high
in saturated fats.

Remember what I told you about
where, what kind of store

you go to or what kind
of restaurant you go to?

Again, if you buy your
food more from the store

than from a restaurant
or sit-down restaurant,

you're more likely
to be buying foods

that are a little lower on
the saturated fat intake.

Still, a little bit over the
limit that's recommended,

but a lot closer to
that dividing line.

Now I want to get to
an issue that goes back

to what Dr. Shakhashiri said.

This is almost word-for-word
out of the Dietary Guidelines

Advisory Committee's report.

And I want to show you
something that was in the news

today and has been in
the news on and off

the last few weeks.

The Dietary Guidelines
Advisory Committee,

not government people,

not people who work
for the food industry,

but people who work in public
health, clinical settings,

and university researchers.

The major findings
regarding sustainable diets

was that a diet higher
in plant-based foods,

such as vegetables, fruits,
whole grains, legumes,

nuts and seeds, and
lower in calories

and animal-based foods
is more health-promoting

and is associated with
less environmental intake

than is the current U.S. diet.

While they might've, this
is like, buried on page 42

in a whole list of
recommendations,

but don't think that people

who make that
lower-ends food list

didn't take notice,

and immediately send their
lobbyists to cCongress.

And in fact, there have
now been laws proposed

to direct the Secretary
of Agriculture

- and the Secretary of
Health and Human Services,

to tell the Dietary
Guidelines Committee,

the next one, to cut that out.

They're not to
consider sustainability

in their recommendations.

And to tell the secretaries

that when their people work
on the official guidance

for the public and
policy makers, et cetera,

that they are only to consider,

each recommendation
has a category

next to it about how
strong the evidence is.

There's weak evidence,
there's moderate evidence,

and there's the
strongest evidence.

Well, it happens that some
of these recommendations

about eating less meat
for the health reasons

are in the moderate
evidence category,

so they said, "Tell
them they can only

"consider the
strongest category."

That way, they can't tell
the public to eat less meat.

I'm not a vegetarian. I
eat meat, I enjoy meat,

I think if you're a vegetarian,
that's also terrific.

You can have a healthy
eating pattern either way.

But, come on.

Most Americans, if
they ate less red meat

and less processed
meat would overall

have a healthier eating pattern,

and sending your lobbyist
to Congress, enough said.

(laughter)

Here's another hot button.

The Dietary Guidelines
Advisory Committee says that

most of us aren't eating as
much seafood as we should get

to get our Omega 3 fatty acids

and some other health benefits.

It's a very highly
nutritious protein source.

However, there's
been overfishing

in the last couple of decades.

So the sustainability of
fish in the food supply

is becoming an
issue in many areas.

You're probably noticing that
there's more and more fish

that you've never heard
of at the fish counter

at the grocery store
and some of that

is because they have
to go to deeper waters

and market fish that
people considered inedible

maybe a couple decades ago.

Concerns have been
raised about the safety,

mercury, for pregnant
women and nursing mothers,

and the nutrient
content of farm-raised

versus wild-caught seafood.

If you get wild-caught salmon,

it's almost always
a nice dark pink.

That color comes from
the carotenoids that are

in the natural diet of
the seafood-eating stuff

that salmon eat up
in the Alaskan waters.

If the salmon is farm-raised,

the fish eat what the
fish farm feeds them.

And it may or may not be
high in these carotenoids.

Carotenoids are a plant
form of vitamin A.

So how we can rely on fish
as a source of vitamin A

and even omega 3
fatty acids depends

on how those fish were fed.

If they're fed from the
oceans up in Alaska,

we kinda know,

but if it's from a
farm-raised fish, not so much.

So the bottom line is to supply
enough seafood to support

meeting our dietary
recommendations,
both farm-raised

and wild-caught seafood will
be needed in our food supply.

And that policymakers should
take that into consideration.

So the Dietary Guidelines
Committee ended with some

overall advice about how to
take all of this stuff I've

been talking about and a lot
of stuff I haven't even gotten

to and make that
into a to-do list.

They didn't call it
a to-do list, I am.

The first thing they're saying
is to know and understand

how to modify your diet
and physical activity.

A lot of people I talk
to think they know.

But when I quiz them, "Okay,
why do you need to do that?"

"I think I read it in
the New York Times."

They can't explain
the biological reason

that it's a good thing to do.

And don't think that food
manufacturers and supplement

sales people and beverage
manufacturers aren't taking

advantage of that,
because they are.

And if I hear the word
"antioxidant" one more time,

I'm going to scream.

"I need to eat this, it's
high in antioxidants."

Bassam can tell you,
oxygen is good for you,

too much oxygen is bad for you.

Depends on how you get it,
where you get, where it goes

in your body, what's
going on in your body.

I have an inflammation
processes happen.

I could talk to you about
arthritis and how sometimes

too much oxidation,

antioxidants are
not a good thing,

but we won't go there right now.

Just, I'm just saying, try
to understand the dietary

recommendations, where they
come from, and ask yourself

that same question I had in
my second or third slide,

"Who says?"

And do they have something
financial or personal

gain at stake if I believe
what they're telling me?

If they are, find a
source to verify it.

I used to say, when I was with
UW-Extension, "Come to me!"

Because nobody pays me
for the advice I give out.

I mean, I got a paycheck,
but it was to give out

non-biased advice as much
as I could humanly do.

The second one: know your
current dietary pattern,

including your healthy choices
that can be maintained.

If you're already eating lots
of fruits and vegetables,

keep doing that.

As well as areas that you
could work on changing.

And areas that you're
willing to work on changing.

You might not want
to tackle all those

things I mentioned at once.

And then the third
bullet: act on it.

Don't say, "Oh yeah,
that's good to do.

"I'll do that
someday," do it now.

Seek to make gradual
and sustainable changes

in your dietary behaviors.

Make a plan.

Figure out something you can
do to make your diet better.

And what each one of you
can do will be different

from the person
sitting next to you.

Both because of what
your physical needs are

and what your personal
resources are.

So this is my challenge to
you: the Dietary Guidelines,

USDA's MyPlate food
guidance system,

they summarize what
scientists tell you

about what and how to eat.

You are the one who
has to decide how

to put that into action.

You have to find a way that

fits your personal
life situation.

Do you have little kids at
home that are watching how you

eat as an example of
how they should eat?

Your values and belief systems.

Do you, are you really, just
like so much into animal

welfare that you couldn't
possibly think of eating honey

because it comes from bees
that should be wild and free?

I know lots of vegetarians
that won't eat honey,

let alone wear leather shoes.

And with that sermonette,

I will stop and pause
and ask for questions.

- Thank you very much.

- You're welcome.

[applause]