the other critical piece is to maintain the efficiency of production, maintain the low cost, ultimately, of food that we're producing. so that, i think, in time we will -- in ten years time, we'll see things completely different or very different than what we see today in terms of maybe how some of those practices are employed. i think the challenge around what does the short-term effect or long-term effect have is really real. again, the data is not necessarily all conclusive, but you brought up the issue around cages with hens. and there's evidence that shows if you move from traditional cage type laying system into modified or into free-range type programs you can see an impact on mortality. i think a lot of that, a lot of that comes from the fact it's implementing a change to a practice we have become very accustomed to and understand how to manage it.

there's a management component of that. i think that doesn't necessarily provide us a silver bullet to health, and again, comes back to the long-term kind of access and importance of all kinds of tools we have to manage health. but that's something i think if we think about what more is needed, what more research, that systemic evaluation of decisions we make and how we can ultimately optimize from this one health perspective is an area that i think presents great opportunity for us to really refine a lot of the practices we have used in the last 50 years that have been so effective to this point but may need to be re-evaluated as we go forward. >> how will we know whether we're making some progress? i know bill, fda released a rule in may, i think it was, around reporting on a species by species basis. how do we know, will we know in 2017 or 2018 whether or not the guidances that have been issued and the other steps taking are effective?

>> that's a critical issue that we're struggling with. first, again, i think there is sort of an expectation issue that we need to, you know, try to manage here in terms of recognizing that this is a long-term effort that we need to be committed to stick with it. and that it, again, all the issues that we know need to be addressed aren't going to be resolved this year. that there's more work that needs to be done and which does mean then that we need to be particularly if we recognize we're in it for the longer haul, that we need to make sure we have a way of collecting information over a span of period of time so we can understand whether or not we're actually, you know, moving the needle here in terms of making a difference. and i think that's a critical thing. i think we -- we held a public meeting on that issue last fall

in september. in collaboration with usda and cdc on that very issue of what kind of information should we be looking at, and do we have all the data that we need to adequately assess the progress that's being made. i think certainly one factor is simply looking at, you know, quantity of product that is actually going into distribution channels for use in animals. the concern that we have is that i think it doesn't give us the entire picture of what's happening, and we need to look at it more holistically than that or look at other broader set of information to understand what's going on, because i think ultimately our desire is to impact behaviors on farms in terms of how -- and again, here we're talking specifically about animal agriculture, but again, i want to reiterate the one health aspect of this is that we need to look across all these different sectors and identify

things we can be doing to implement that will help support the goal of minimizing resistance. again, keeping tethered to the idea that the objective here is to try to take steps to have a positive effect on resistance. measuring that downstream impact is a challenge. and so i think it is a need to make sure we're looking at a broad set of information as that includes a variety of things. you mentioned the fact that fda does collect and pharmaceutical companies are obligated to report to us on an annual basis the amount of quantity of antibiotics that are being sold or distributed for use in food animals. that data comes in to us and we report out an annual summary report, since 2009. it's a fairly detailed report, although again, there's limits with that because that represents what's being sold or what's going into the

distribution pipeline, so to speak. it doesn't necessarily tell us specifically what's actually being used at the end use or the farm. there's limited in terms of the granularity of that, and one of the changes recently made was requiring the pharmaceutical companies provide us an estimate of a breakdown of the sales data by species because that's one of the challenges dealing with the animal side of the equation, is there's more than one species. we have many species to deal with, and many of the products that are marketed are marketed with uses for more than one species. if you're looking at sales data, it's aggregated for all of the species. that was one change, an estimate of how that might break down. that's one piece of information. again, our belief is you can't look at that in isolation. there's other information we need to look at. there's a monitoring system in place that's been in place since the late '90s.

provides a robust source of information on food-borne pathogen resistance trends. that's another piece of information that is important. i think an additional piece is that we feel it would be helpful to have further information about actual use at the farm level. and ideally some information on resistance tied to that use at the farm level so that we have sort of the other end of the pipe, so to speak, not only understanding what's going into the distribution pipeline, but understanding better in terms of what's happening at the farm level. and right now, i think that's a gap we're hoping can be filled. and again, speaking of inneragency collaborations, i think the usda who is not here at the table, is also playing a critical role and working closely with them. particularly as it relates to the role that they play in terms of farm management practices and the history they have had in terms of collecting a variety of types of information about

production practices and one of the things we're looking at is ways in which we can work with usda to leverage some of those existing infrastructure to gather information about on-farm practices and the fact also that usda plays a key role in looking at the issue we just talked about, which is, you know, alternatives to management practices. i think it's important to look at critically what are the drivers of antibiotic use. why these farmers or producers need to rely on antibiotics in certain circumstances. what are the disease conditions they're trying to manage and are there in fact better ways to manage the disease conditions to reduce the reliance on antibiotics. again, while the antibiotics is an important pool they have to have access to, you know, we want to shift away from them always reaching for that as the first option. there are other ways we can manage some of the disease

conditions that are driven by a number of different production practices in terms of not only housing but how the animals are fed and other factors that can be risk factors for animals for disease incidents. so i think there's -- there's also mentioned earlier, are we putting enough emphasis and resources towards some of that fundamental work that needs to be done to better understand some of those factors so that we can make the necessary adjustments to try to take some of the pressure off antibiotic use. >> and maybe you can talk a little bit about what pew has been a critic of the approach in the guidances. can you talk a little bit about what are the benchmarks you're looking for in order to measure whether or not the guidances are making progress or not making enough progress? >> i do think that the guidance recommendable is a step in the right direction. we're not all the way there. there's more work to be done, but we think they are a good step in the right direction. we need to make sure that we really have an impact on

antibiotic use with the guidelines. that's that there's actual use on the farms, we need to understand why they're used, we need to understand the target research on better interventions. we need to get a better understanding. we see in the data that antibiotic use and the sale of antibiotic for animals has been turning up for years, but we don't understand why, which species, what indications. we need better data to understand how this has an impact or remaining areas that need to be addressed, whether we need to target our resources. >> i'm going to ask the audience to get involved and think about your questions. while you're doing that and lining up at the microphones, i wanted to ask you guys to think about the role that private companies like mcdonald's and perdue have been playing.

what effect do you think that's having on antibiotic use, and how much should consumers trust the pledges that are being made by companies that are sometimes making pledges at different timelines. it's hard to know how they plan to enforce the pledges that they're making. so maybe karen if you want to start and talk about the role that the consumer's playing in influencing the companies and whether these pledges are ultimately meaningful. >> absolutely. as was alluded to this morning, we're in a unique situation here where consumer demand is having more of an impact on how antibiotics are used than the policies put in place. it was mentioned this morning, we see in the chicken sector, the move away from just from growth promotion practices, but going to systems that pretty much are independent of antibiotics. but having a huge shift in how

antibiotics are used that is driven by market demand and consumers caring about how their meat is raised. caring about the judicious use of antibiotics. it is true there are a lot of different companies out there, a lot of different pledges out there, very different timelines and they mean a lot of different things. it has become clear this morning this is a complicated issue. and it's very difficult for consumers to understand what individual company policies really mean. are they talking about all antibiotics? are they talking about overuse? it is very confusing to the consumer, and then how are the policies actually verified. some companies, for instance, use usda system. the usda inspectors go and verify that the criteria is laid out is being adhered to.

other companies vary in how these criteria are being enforced. we at pew recognize the importance of the consumer demand and developed a standard for chicken, and we chose the usda because there is a lot of trust in their certification program. we decided to go with them, but there is a lot of differences with the different company programs out there. and i understand it's very confusing to consumers. >> we talked to food companies a lot, and they're caught in a position in which their fundamental purpose is to serve their consumer, their customer, and that's what they continue to do. at the same time, they tell us, we feel like we're being asked to be a regulator in some sense, and we don't necessarily feel comfortable with that role. so i think one of the things for us to really think about is how

does that balance work. and the role of the fda and other regulatory agencies that establish safe guidelines and those types of things. then there's consumer choice, is obviously something that we need to be supportive of and cognizant of. one of the things that i think is important, we spend a lot of time looking at consumer market research, monitoring social media, all of those things. the antibiotic conversation is not top of mind for the vast majority of consumers out there. the conversation is increasing. the consumers are increasing. it's really a concern around the public health piece. it's a confused kind of concern. what role do i play and how do my decisions affect some of this. but the antibiotic conversation is less than 2% of the overall social media conversation around food. you know, you can get very granular into where it's being

driven and how it's being driven, but that's one important aspect. that said, these food companies do feel increasing pressure to provide choice to consumers that want to do that. and so you see a range of policies. you see policies that have been implemented, chick-fil-a is an example where it's an antibiotic-free policy. mcdonald's did two things, a global stewardship policy that outlined very scientifically what their standards are, relative to how antibiotics would be used globally. referencing the global regulatory bodies and experts and third-party references all along. and then their u.s. policy applied to poultry production which they said medically important antibiotics would be phased out. you have a range of what those policies have actually said. i think one of the critical things that we have to make sure we understand is antibiotic-free may be a choice for some, and it may be something that people desire, and if that's the case, that's great.

i think the confusing part of that is how does that -- the perception of how does that impact my thoughts around food safety, right? so there are rigorous standards, and the doctor and others could speak much more to that, to the need around insuring that food does not have harmful residues of antibiotics when it's consumed regardless of how it's labeled. an antibiotic-free kind of label conflates that a little bit and confused people. the other factor when you look at, so you take a mcdonald's, for an example, as they have a requirement around no antibiotics used that are important in human medicine, you have scenarios where disease outbreaks occur. so you have a choice. you have one choice or the other. that is to allow the birds to suffer and die or to treat those birds with an antibiotic. if you treat the birds with an antibiotic, you have to figure out somewhere else in the supply chain the birds can go.

as long as we have choice, a model that allows both of those, that works well. when you move to a scenario where you have 100% antibiotic-free, that ceases to work. there's a number of things around that that i think are really critical. i think the supply chains are taking it seriously that have made the commitments. as karen said, there's third party. what i would love to see is more of the labeling not around antibiotic-free, but around raised under stewardship guidelines or judicious use principles, and i think we have a great opportunity to expand how we label and communicate and educate around what that means. >> if i'm a consumer, and just to simplify this a little bit, for folks who are here watching, and i go into a mcdonald's and buy a chicken sandwich there, and there's an antibiotic claim of some kind, and then i go across the street and buy a chicken sandwich at chick-fil-a

and there's a different story that's told, those stories might appear to mean the same thing, but they probably mean something different. is that -- is that the case? and is there a role for fda or usda or government in some way in clarifying what those claims mean, i guess is the question that i think a lot of folks might have. >> i think -- the general, to the general notion, i think clearly market factors have been -- played an important role lately in terms -- and i think overall, that is a good thing. i would say just stepping back and looking at this issue in the context of the last 40, 50 years, i think a significant shift has occurred in the last five or six years, and more sort of positive motion has happened in this last five years than probably happened in the past several decades. so i think, and there may be a number of reasons for that. some of which were talked about

in the session this morning and changes in consumer views and other market factors like we're talking about here that are also driving it. and also some actions that the federal agencies are taking. so i think the good news is that i think that has shifted, at least from my vantage point, the narrative has changed quite a bit. i think in a positive way, in sort of how we're dealing with the industry and the ag community generally where there's more emphasis being turned from, i think prior to this time, a lot of the emphasis was placed on the discussion or narrative around is there really a basis to make any change? is there decision evidence to justify any change in current practices? i think it stalled our ability to move forward in a positive way. my sense is we have shift off that a bit.

it's more now rather than focusing on that, it's focusing on how can we move forward and make change. what are ways in which we can now adopt some changes? clearly, there's a lot of practical challenges to work through, but at least the focus is more on the how part of it rather than the if we should do anything part. to the notion of, so i think the market factors have been important in terms of an additional push to move change along. i think the challenge we have with whether we're talking about products that meet organic standards, which there are standards established, or antibiotic-free standards. those all provide different options in terms of choices for consumers. but having the notion we're going to be able to obtain an antibiotic free uniformly across all animal production is frankly unrealistic. it doesn't diminish the fact that having choices and finding situations where antibiotic-free status can be attained. which companies like tyson or perdue, who may be getting there

with production, that's great. the challenge may be it's one thing to be able to institute those kinds of changes in the context of raising chickens who have a very short life span in a very controlled environment to applying that to other sectors of the industry and being able to maintain animal health. i think it's an important factor, and provides choices for consumers, but it's not necessarily going to be the solution. i agree with grady's comment that a significant element needs to be focused on in encourages standards around the notion of appropriate use or judicious use and consumers can have confidence that the products they're purposing are coming from farms that are applying

good stewardship principles in terms of the use of antibiotics. >> we have folks with questions they would like to ask. marlin gets the first question. >> thanks. thanks to the panel. very much appreciate your presentation. i'm from forever view farms. we run livestock in central virginia and in alabama. we have never used antibiotics. we never will. my question revolves around the practical, the business, the on-farm impact of this broader conversation, which i think is absolutely critical. how, when we look at the business challenge, particularly for younger producers, how do we -- how do we match the difficulty that they face from a capital standpoint against this imperative around the use of antibiotics?

because really, you made a clear point, why do producers use antibiotics? scale, efficiency, that's it, right? but if i have a five goats per acre imperative to maintain a level of what we consider to be responsible stewardship, at rates of reproduction, we know what they are. all of a sudden, at $6,000 to $10,000 an acre, you can see what happens to my capital structure pretty quickly. so for a younger producer, or for a producer who isn't necessarily able to handle that kind of capital intensity, how should we begin to think from a broader policy perspective? and i would ask each of you to extemporize beyond your expertise. how should we think about the broader policy perspective and aiding younger producers while meeting the imperative that we have talked about here relative to antibiotic use.

>> thank you for your question. >> i guess i'll start. i think -- one, i think clearly, we believe that producers, large or small, still need to have access, you know, to these products, antibiotics for managing disease. you know, that's clear that that's important in terms of being able to manage health of animals and it goes to the discussion around being able to continue to have to meet our needs in terms of food production. so i think it really does go to more fundamentally looking at building into or looking at the operations and how the animals are being raised to try to maximize or optimize the use of those antibiotics. and try to identify ways in

which they can limit their use. and you know, again, our focus here is primarily on those antibiotics that have human medical importance. and so the change that's occurring is to eliminate the use of medically important antibiotics for growth promotion and to bring those products to veterinary oversight. there are some classes of antibiotics we don't consider medically important. an example would be a fairly large class. now, they do have antimicrobial activities so they fall under the category of being antibiotics, but there are no uses in human medicine and there's little evidence to suggest that the use of them is contributing to the resistance issue that is the public health concern. there are other alternatives. some of this comes down to making choices about, you know,

how they're meeting their production needs and our desire is that they're not reaching for an important antibiotic for production purposes. let's look to other options, whether it management or other non-medically important products to address those issues. so anyway, i'm not sure that quite answers your question. i think the other factor here is that the challenge we're facing, the vast diversity of the agricultural industry in the u.s., i mean, and the changes we're making are impacting, you know, small backyard operations, 4-hers raising a handful of animals, from that scale all the way up to the multi-state integrator. and everything in between.

there's a challenge to try to apply standards that can cut across that broad swath, you know, and be able to accommodate, you know, all the different practical implications, which there's no denying that these are going to -- these changes are going to have impacts, and there's adjustments that producers are going to be struggling through. you know, as we complete the transition. >> maybe one comment. i completely share the concern and the awareness of the challenge of young producers starting, and i do a lot with young ag students and those maybe that are teetering on the verge of ag or engineering or something else, and very passionate about the growth of the industry from that standpoint. i think i would answer maybe from this lens. much like we have solved many

other problems and challenges that we had in the past is really around innovation. that may be a simple answer, but i think the great -- one of the great values and strengths of american agriculture is the diversity of it. what you have described, the breadth of what the doctor has described. and that continued investment in innovation, that matches that diversity and allows us to bring new practices to the farm, allows us to do more with less in terms of an input/output standpoint is critical going forward. we have recently got a novel product, i think it's now in four continents for dairy production. one of the most significant places where we use shared class antibiotics in dairy production is in the treatment of mastitis. a critical issue and a disease challenge and a technology that is non-antibiotic that helps to reduce the need for treatment of mastitis, an example of continued innovation that i think the industry has to look at.

so we talked a little bit about alternatives, so it's products, it's practices. it's a whole host of things, but i think if we truly feel like we can address the challenges that secretary glickman talks about in terms of meeting the need, the key piece is continuing to focus on innovation and bringing new products, new practices, new things to farmers that you described. >> i would just add the importance of education. education of the veterinarians of how to do things differently, education of the farmers. we have seen there are producers that we talked about earlier that have been trying to phase out antibiotics for five, ten, even more years. they have gone through a learning curve. and there is an opportunity to learn from what others have figured out, how to do things better, and there really is an important piece of sharing the lessons learned and making sure we don't have to refigure out

these things multiple times. >> thanks. so this may be a bit of an unpopular question but i'm curious to ask it anyway. this is a complicated problem that requires a multi-pronged solution, and one potential prong that we haven't talked about yet at all today is efforts to reduce the amount of meat that people eat. i said reduce, not eliminate, but we eat a lot of meat, and it seems to me one valuable way that could contribute to solving the problem could be to reduce that. to what extent do you think that could or should be part of the conversation? >> i think from our perspective, and i'm no nutritionist. i'm not a human nutritionist. i studied cattle nutrition, which they don't eat a lot of meat. i mean, i ascribe to the view

that protein in a diet is a critical part of that, and animal-based protein is a critical part of diet development. and i think when you look outside of the u.s. and you spend time in the developing world and you see the evolution of diets and the socioeconomic ability for people to select diets, animal-based protein is one of the first things that comes into that picture. so, you know, i think the reality is we look at the global perspective is that protein is going to continue to play an important role. and we have to figure out how we do all the things we talked about to be able to bear in a way that is the most environmentally responsible and the most responsible from animal welfare and human health standpoint that we possibly can. i see that as kind of the

outlook from my seat and our chair. we feel like the animal protein piece is a critical part as you look at diets developing around the world. >> either of you want to weigh in? >> just a twist on marlin's question, what are the investments that congress ought to be making to measure success. and to help farmers transition animal producers to transition to systems of raising animals that might reduce the need for medically important antibiotics. i promise it won't be anything more than what they permitted you to suggest, but if you are king for the day and writing the appropriations bill, what are the investments we are not making now that we ought to be making? >> i can take a stab at that.

the critical role has been mentioned a couple of times, but it's critical and we can't emphasize how important it is to make sure we get these data to antibiotics as i mentioned before. how they are used in farms and research and making sure that we have alternative ways of using antibiotics in the long run. parsec tear clinton early this morning talked about if we are not to the broader issues related to food production. we are not putting enough priority on resources towards the end. there is a disconnect where we identify as a high priority issue. it doesn't get the resources it

needs to really dive into some of the critical issues. if we do feel there are important changes that need to be made that affect how we produce food including from food producing animals, there needs to be resources put to stimulate and be able to foster innovation and change at the farm level to bring about those changes and the resources don't seem to be there to do that. supporting the development of those in fostering the alternatives, closer to home for fda and i think we work closely with the fda on the issue, our request for the dollars we requested and the budget to support efforts were not appropriated.

there were no new resources for fda or the u.s. frankly. to support some of these efforts as it relates to the antibiotic issue. that has the factor of slowing down progress. i think most have been discussed. the metrics has been mentioned and focussing on what is important and resistance. from the five or six most critical areas, they are most closely linked to food production and ensuring we have the right funding for that is critical.

increasingly and i don't have the statistics for this, they have born more and more of the burden from agricultural research. if you go to land grant research, you see that over 25 years. all those things are so pivotal around foot production that we need to look at how we drive more research. i think they will look at incentives and disincentives around drug or alternative development.

addressing those incentives or disincentives that would spur more innovation and speed process and if we are concerned about bringing alternatives, how do we expedite approximate incentivize the developments and those effort? the investors and biotech to those types of incentives. we ran out of time so please join me in thanking the experts. >> join us this afternoon when transportation will go on implementation of fixing america's transportation or fast act.

more now from the day long summit, it includes a panel discussion on obesity and sugar consumption, they outline recommendations on diet. it's just over an hour. this morning we reached the number two spot on twitter, which is amazing, somewhat ironically, national doughnut day was in the number one spot.

td we will be hearing from three expert panelists, bruce civ silverglad and debra atwood, and before hearing from each of the panelists. i will had provide a brief over view of obesity in the united states and talk about the laws and regulations and policies that can help to reduce the serious public headliglth issue. we will finish up around 3:30. 17% or 13 million adolesents are obese, many factors contribute

to this. we will focus on the over consumption of added sugars. we should limit our sugar consumption to no more than 10% of our daily calories that equates to 12-1/2 teaspoons of sugar. it sounds like a lot, but we are c c consumming double that. -- in u.s.ed a all thes, black and latino populations have substantially higher rates of obesity than do white populations. individuals with lower income, and lower education levels are more likely to be obese.

i think obesity policy in particular, and policy seeking to address over consumption of nutrients like sugars, salts and fats complex and it can be devisive, some see consumption not so much as a choice, but as result of our information. the informational environment and social environment and the physical aspects of our community. on another front some see the food and beverage industry as a key partner in improving nutrition. and some are skeptical with partnering with companies that profit from the sell of these

products. policies and laws can restrict or we can learn to encourage healthy access to alternatives. and we have options in how to implement policy decisions. some have taxes on sodas and they are legal, but most of the diet and nutrition interventions that we will hear about from our panelists, product reformulation and removing sodas from schools, these can be implemented as binding law or through community based initiatives. and we heard this morning really interesting examples of the latter. so, with this introduction, i

want to turn it to our experts and i will invite each of them to present on their insights on effective and legal policy interventions to improve our intervention and health. our first speaker will be michael jacobson he is the head of cspi, they are a key player in health problems and these education, legislation, litigation among other tools. michael has led cspi's campaigns on sugary drinks, salts and trans-fat, thank you very much, michael. thank you, sarah. greatly appreciate the opportunity to participate --

>> as i was saying, i appreciate the opportunity to participate in the interesting conference, i would like to talk about the rates of sugar consumption, the problems with excess sugar consumption and offer legal approaches for solving the problems. so, this is a partial history of sugar consumption in the united states, and you sea, it's gone up quite steadily from 1875 to, which is the earliest state for which i can get records through

1999. and the period from roughly 1980 to 2,000, is the obesity epidemic. that's when obesity rates doubled and tripled in different segments of the population. it's not to say it's a correlation, it's not to say that added sugars and refined sugars have been the only thing to contribute to obesity, many other things have been going up in our diets. particularly white flour. consuming huge amounts more white flour in 2000 than we did back in 1970 or 1980. but this is the trajectory of sugar consumption. since, and people in the, between 1990, i would say, in 2000. began to think, maybe it's sugar. and soda pop, because soda

consumption shot up from 1950 to 2000 or so. sugar is, sugar drinks, soda pop, fruit drinks in particular, and energy drinks and sports drinks to more recently provide almost half of all refined sugars in the american diet. so, until, until the obesity epidemic, there was not really all that much research on sugar. at least in the united states. it was considered, to cause tooth decay, and not really much else. it was not a serious problem n britain, there was more concern about sugar and heart disease. and i remember 1986 study that found no link between sugar and chronic diseases and that was partly because they were not looking at refined sugars, they

were looking at all sugars. they are combining the sugars in milk and peaches with the sugar in soda, and sugar crisps breakfa breakfast cereal, but the epidemic got researchers to really pay attention. one of the things that researchers have and nutritionists have said, don't fill up on sugar, because you will not eat healthy foods. s that graph showing that the more sugar you consume along this axis, this dashed line, is the average level of sugar consumption and i think it was around 2006 maybe. but it showed as the more sugar you conassume, the less nutrients you tend to consume. and the black line is the

average of all of these, roughly ten different nutrients. at the average level, you are see background a 15 prs less consumption of these various nutrients in these, with that level of sugar compared to no sugar in the diet. so, that was the first kind of study confirming that sugar leads to lousy diets. and then, beyond that, researchers looked very carefully at the relationships between high sugar intake and different health problems. and, in clinical studies, the findings are clear, you eat a lot more sugar, your bad cholesterol levels go up, your triglycerides go up. blood pressure goes up, contributing to heart attacks and strokes.

in the midst of the obesity epidemic, a number of important studies were done, these were intervention studies and controlled studies in which, groups of people, you have a group of people, the most interesting study was done in holland. they had 641 grade school children, and they gave half of them soft drinks, eight ounces a day. which is a pathetically small amount in the context of the american diet. eight ounces a day, others they gave diet soda and the kid who is drank regular soda gained more weight than the kids that drank diet soda, it's a study that went on 1-1/2 years a very long intervention stud and i got similar results to the studies done in the united states out of children's hospital in boston to name a prominent one. and that really, for most

researchers, health officials, that nailed it. that sugar drinks contribute to obesity. there were other studies showing that beverages like a soda pop, contributes more to weight gain than solid food. so, if you eat 100 calories of solid food, your body tends to comp tate for that, by eating 100 less calories later in the day. but for beverages, the body does not compensate, the body ends up consuming more calories. there's double blind clinical trials, and there's always studies that can only see as finding associations between one thing and another. but, many of these studies have been done, meta-analysis that combine a bunch of little

studies in to one large study, have been done, finding a strong association between increased sugar drink consumption and con diabetes and inkreesd sugar drink consumption and heart disease. and also with heart disease, seeing the total refined sugars from candies and cereals and other things. but there's far more evidence on sugar drinks than on this whole range of sweetened foods that include canned peaches, sweetened yogurts, foods that are good for you, have nutrients that may reduce the risk of heart disease. darius mosaferion at tufts university is a prominent and deemologist who estimated that shah sugar drinks in the united states are responsible for

25,000 deaths per year. which is a useful metric. other epidemiologists have estimated that if we could cut sodium consumption in half, that would save 100,000 lives a year and transfat getting rid of transfat should save about 50,000 lives per year. so sugar is kind of up there among the or soda pop is up there among the major killers in our food supply. and that's -- it's that board certified evidence, clinical data and epidemiology that has persuaded the health community, including the world health organization which has recommended that people consume no more than 10% of their calories from what they -- what they call extrinsic sugars which is the added sugars but also the sugars in fruit juice, which are

physiologically, metabolcally equivalent to the similar sugars in soft drinks. so the w.h.o. recommended no more than 10% and ideally less than 5%, and in the united states, the american heart association has recommended closer to about 6% sugar from beverages and candy bars and other foods. and the dietary guidelines for americans recommends 10%, a more liberal recommendation than the heart association. the dietary guidelines is america's nutrition policy and it said for sugars, there's strong evidence from mostly prospective cohort studies, that's the epidemiology, but also randomized controlled trials that show that eating patterns that include lower intake of added sugars are associated with reduced risks of

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

weeks ago with a revised nutrition label that added -- one of the main improvements was adding that line for added sugars. it will tell you how many grams off sugar, and of course, nobody knows how much a gram is. we wanted teaspoons but the government wouldn't allow that. so there's grmz of added sugars. 20% of their recommended daily intake. so that gives a burj mark for how much -- how does 10 grams fit into a diet. and i'm sure that every kid in america is going to be taught how to read the label and teachers are going to look at the sugars line in particular and explain that to kids and say, okay, kids, how many -- if there's 4 grams per teaspoon, how many teaspoons of sugar are there in this food. and soda pop doesn't look very good. 12 ounce soda is about nine teaspoons of sugar. 40 grams is 20 ounce container is 65 grams. that would save 130% of the daily value. hopefully, that will persuade

some people to drink just half the bottle of soda. maybe even less. a number of years ago, 11 years ago, it's shocking when bruce silverglade was at cspi, we petition the food and drug administration to require health warnings on soft drinks. that petition, we're not sure if the fda has opened the envelope. it's a slow moving agency. in any case, the fda hasn't responded to that petition. and getting a warning label on soda presumably would encourage people to choose beverages without warning labels. warning labels are not going to solve the problem but presumably would reduce consumption by several percent and everything helps. what really would solve the

problem is to change the legal status of sugar and high fructose corn syrup. these substances are generally recognized as safe or gras in the lingo of the fda. and, of course, everybody knew from time immerle that sugar is safe. it's on our table. we put a little of it in our coffee or cereal or whatever. and salt was safe. generally recognized as safe. and partially hydrogenated oil, the source of transfat was generally recognized as safe, and those turned out to be the three biggest killers in our food supply. we wanted the fda to change the regulation so that sugar would be brought down to a safe level in our food supply.

it's generally recognized as safe based on the foods in which it's used. so our petition was actually fairly complicated and it asked the fda to restrict the sugar content of soft drinks to roughly a fourth of the current levels. and we recommended that the fda come up with voluntary targets for other major sources of sugar. so grain-based desserts and pies and cookies and that kind of thing, dairy desserts, ice cream, frozen yogurt, candy, cereals, and marched through category by category. we hypothesized different levels of reductions. in this column, so we said 70% mandated reduction in the sugar and soft drinks, 10 or 15% in

these other categories. and the resultant of all of that would be a reduction of sugar consumption, refined sugars from about 87 grams per day to 36 grams per day. 8.5 teaspoons which is roughly what the american heart association has recommended. and we told the fda that reducing sugar in beverages by 70% is feasible because of different things. one, i don't think you taste the difference between a coke with 37 grams instead of 39 grams. in other words, you can reduce sugar without even seeing a taste difference to a small extent. there are various artificial sweeteners and there are natural sweeteners like stevia that could be used leaving, say, 30%

of the sugar in the beverage, but using these other devices to reduce sugar, and there are new things coming on the market called sweetness enhancers that sensitize taste buds so that a gram of sugar, 1 gram, tastes as sweet as 2 grams. so with this variety of new technologies, you can reduce the sugar content of beverages. and we put in there voluntary consumer changes saying consumers need to be part of the solution in reducing their consumption and this petition is only three years old and so surely we're pretty confident that the envelope hasn't been opened yet. this would be a very tough petition for the fda to respond to. we think legally this is the correct solution to the sugar problem. another thing would be -- that's the food and drug administration. warning labels and limits on

sugar. the federal trade commission, david vladek whom you heard from before was the head of the bureau of consumer protection, and they have a role when it comes to the marketing of soft drinks. the soda companies say we would never market our beverages to kids. when you actually look in the marketplace and see what's going on there, there's an awful lot of marketing to little kids and in the past the federal trade commission has alleged that marketing of any foods, let alone sugar water, is an unfair and deceptive marketing practice. when the ftc said that, threatening to ban all marketing to little kids, the ftc had its head handed to it by the food industry, the advertising industry, the broadcasting industry, and "the washington

post." that called the ftc the national nanny. and that was the genesis of the nanny state. but when you look at -- this is undeniably marketing to kids, you know, a toy bear. here's that bear at the coca-cola world in atlanta, kind of an indoor museum/theme park. and they also, coca-cola, i don't show it, they have a curriculum for first grade teachers that has marketing. it's basically, isn't coke wonderful because you have all this stuff, all this marketing around you. this is a middle school in -- i forget where it is, in the united states. this is a boys and girls club and you all recognize this bearded guy who has a certain

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

so let's forget congress. change the title of the session. as dr. angel mentioned, there's a ferment going on there. partly in new york city but also around the country. san francisco is requiring warning notices in soda ads on bill boards, bus kiosks, possibly even on soda coolers where it says coca-cola, they may have to put a warning there. baltimore may vote next week on a similar measure that would require warnings in advertising and at supermarkets warning people about sugar drinks. fruit drinks, soda pop, energy drinks. new york city tried -- dr. angel didn't stress this particular point -- but tried to limit the sugar -- limit the size of soft drinks at restaurants, and the industry sued and new york lost

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

and britain is going for a soda tax by 2018. so there's a lot going on here. you know, it's the local areas where things are happening. if we can get -- there's one warning in san francisco, a different one in oakland. at some point -- and california, the health advocates lost a vote to get a warning label on soda cans. you can imagine the chaos if san francisco voted -- had one kind of wording on a soda can, oakland had another wording, that would bring the industry to washington to try to preempt those local laws and if necessary, accept a federal warning label. so good things are going on. no federal law has had an effect

on this. but per capita consumption of sugar drinks has done down by 27% since 1998. coca-cola, coke classic, has gone down by 35% per capita. pepsi has gone down by 54% per capita. enormous changes that are bringing the industry to the bargaining table, i think, and realizing they better diversify like mad into milk, fruit juice, anything else. because this is a dying industry. and as soda consumption has gone down, so has sugar consumption. this is a graph similar to the one i showed early on that shows 2013. about a 15% decrease in refined sugar consumption. we're seeing major changes that will continue, i believe, with all of the local actions, education, regulations,

legislation, and hopefully some federal action. and let me stop there but just mention that i have a report marketing coke to kids. i have a few copies here. there's some copies upstairs if you'd like to grab one and see what coca-cola is doing to our kids. thank you. thank you. [ applause ] >> thank you, michael. that was a wonderful way to start our panel. we'll now hear from bruce silverglade. bruce is a principal at ofw law and his practice includeses responses to fda regular latory proposals, management of class action lawsuits and regular latory enforcement actions challenging food label and advertising. bruce has extensive experience working with a wide range of stakeholders in domestic and international food policy including the fda, the ftc,

usda, the world health or zarks as well as consumer groups. thank you very much, bruce. >> good afternoon, everybody. i'd like to thank the o'neill institute for inviting me. did you leave out the part that i worked for cspi for 28 years? just -- i left voluntarily, right, in 2010. >> right. >> okay. >> i thought you just left it out of your official biography. >> no, it's there. it's there. in fact, it's there in the context that i fought for the original nutrition labeling law of 1990 and spent five years of

my middle-aged youth on that. so i'm proud to have worked at cspi. but working at lay firm representing the food industry has broadened my perspective. and i've learned kind of the other sides, other viewpoints. and i think that i hope to really present some innovative, as the title of the conference here, innovative approaches to diet and health problems. what we have to really do -- in brief and this is i guess the theme of pry presentation is change the food culture. and by this, though, i mean change what consumers want to buy and eat. if we can do that, the food industry will respond with those types of foods but you have to -- we're in a market economy. you have to get consumers in a place, cultural place, where

they want to buy foods that are healthy for them. if we don't do that, then it's just a war, regulate the industry, put on warning labels and it's questionable whether we really get to the end point of changing the food culture and the foods people want. an example that does not involve nutrition but it's a real life example involves the recent decisions by campbell soup and kellogg's and general mills to label gmo ingredients in their products. i never thought i would see the day when major food companies would agree to labeling gmo products or going non-gmo. putting aside whether it's a good idea, bad idea, healthy or not healthy or based on philosophy or whatever, why did they do it? because consumers started demanding it.

and so if that kind of change kaken an cleebd then i think other changes in the nutritional values of foods can be achieved if consumers demand it. so how do we get consumers to demand healthier foods? i think that's really the issue. well, dr. jacobson has gone over a number of legal approaches and there was no one more than me that wanted nutrition labeling to work. i fought for it for years. it's a proud achievement. cspi was nice enough to give me an award on my departure for helping get labeling act passed, but it hasn't in my mind achieved the results from 1990 that we had hoped for. in fact, obesity went up. and one of the reasons, i think,

it didn't achieve the results that were expected is that there's an emphasis on single nutrients. back in 1990, the emphasis was on fat. and fat was listed as total fat, as saturated fat, calories from fat were listed, and as a result we had unanticipated consequences. the food industry, responded with low-fat foods, but they were higher in sugar. so labeling can be a two-edged sword. i'm going to try to turn out some slides now. okay. this is the real tricky one. okay. so when we focus on individual

nutrients, and this example is cholesterol. when i graduated law school in the late '70s and early '80s, cholesterol was the demon. we were all told you have to eat foods low in cholesterol so the egg took a big hit. everyone was cutting back on eggs and the egg industry was going nuts saying science wasn't correct and eggs are a cheap source of protein and nutrients for low-income people. there were a lot of issues involved here on cutting back on foods like eggs and focusing on cholesterol. and now in the new dietary guidelines for americans that will go from 2015 to 2020, the u.s. dietary guidelines say cholesterol in food is not a concern. this is widely covered in the news media. and took about 20, 30 years, but

the nutrition community has changed its mind on cholesterol. i don't know if cspi has. but the u.s. dietary guidelines say cholesterol in foods is no longer a concern and we can go ahead and eat eggs again. the risk of focusing on a single ingredient and this time it seems to be added sugars, it poses the same questions. is that the best approach to changing culture, changing consumer demand for healthier foods. now, i want to turn off the slides so we can go like that. okay. next point is that the u.s. dietary guidelines, when it talks about added sugars, it says that a dietary pattern, a dietary pattern that is low in added sugars and has various levels of nine other

ingredients, fats, different types of fats, saturated fat, monosaturated fat, fiber, sodium, so forth. it's not added sugars by itself it's added sugars as part of a dietary pattern will help reduce the risk of disease. but the message that comes out from the fda is added sugars is a demon. so i see a disconnect between those two things. again, by emphasizing added sugars, we run the risk we did with cholesterol. so if nutrition labeling and the other things that have been suggested have risks of backfiring, what can we do? well, other countries have taken a somewhat different approach. i think some of you may have heard of what brazil has done.

this was covered very recently in the "atlantic" magazine in january. favorably covered by a food politics blog. brazil's approach to improving diet, they suffer from obesity and the same problems we do. the country's developed -- involves efforts to convince consumers to eat meals at regular intervals. eat three meals a day. not snack. to eat with other people and not eat by yourself. to eat in appropriate environments, which i would take as a dining room or kitchen table as opposed to snacking in the living room or the bedroom

or elsewhere watching tv, that kind of thing. to prepare meals from fresh foods. to practice food preparation. in other words, learn how to cook. and enjoy those skills as a social activity with other people. and plan meals and eat at the proper time and place. so that -- if the government encouraged americans to do those things, i think we would see changes in consumer demand and food culture and what consumers want. and just like the way some major corporations responded with gmo labeling and agreeing to do it, the corporations would respond with the foods consumers want. and it's funny. dr. jacobson is the scientist and i'm the lawyer. you recommended legal approaches

and i'm recommending what brazil has done which is something else. it's a form of social change. but not involving outright regulation, which is among some of brazil's suggestions. but the factors i named dominate the theme of brazil's approach to the obesity problem. let's be innovative. and happy to answer questions. [ applause ] >> thank you. thank you very much, bruce. we'll hold our questions until after our third speaker. so let me now introduce deborah atwood. deborah joined the meridian institute in 2011. as executive director of agree who is one of our partners here at the conference today. deborah has over 35 years of experience in policy and legislative matters regarding food, agriculture, the environment, research and risk

management including extensive experience working with executives in the private sector as well as the federal government and not for profit organizations. thank you, deborah. >> yeah, grateful. thank you, all. while she's poking the buttons here to advance my slide, first i think you need to add to your chart, michael, what wine and sugar equate to. you know? when i looked at your chart, i'm like forget the candy. i want to know what wine looks like in terms of teaspoons of sugar. just saying. you may want to add a full ipa up there as well. so that said, i know we're running late in the afternoon and i thank you all for being here and thank you for agreeing to participate. before i launch into everything here, i want to say in all of the jobs i've had in washington, d.c. and outside of washington, d.c., i've always had to have

good legal counsel with me. so while i am innovating and getting crazy about my ideas, i've always sought out legal advice and people who could take the journey with me and figure out are the laws already on the books, do the rules exist? if they do, let's map them out and look at how we can actually go to where i want to go. and it's usually not just me by myself. i'm acting like i'm telling the lawyers, hey, help me be creative. it's always been a team approach with good legal counsel walking right with us. and i'm always pushing the lawyers that i've worked with over the years to find the yes answer. yes, we can do this. unless it's just totally crazy and will put somebody in jay, which i never want to go there. so i have three slides. one of them is just the big slide here that says agree. agree is an initiative that's housed at the meridian

institute. the meridian institute, thank god, has this effort because the idea was could nine foundations actually come together, which they did, and fund an eight-year time bound initiative to have a dialogue with the whole supply chain in food and agriculture to identify by 2030, 2050, how u.s. policies are going to look in order to feed not only the united states, which is expected to grow by 100 million people, but how do we fit into the global dialogue of 2 billion plus more mouths to feed. that according to my chief of staff was let's go boil the ocean. and i can appreciate that. it was a big, big task. the meridian institute, thank goodness, they undertake very complex facilitation efforts to connect people to solve problems, which is their tag line. so i've had the good fortune of

having the backbone of meridian to help us navigate forward. so agree started in 2011. 45 advisers. i think at one time we counted 150 different people we thought would be really groove i have to have in the room that covered all the issues from input and finance all the way to retail. we were able to identify 45 advisers, one of them was here, claire wang, she had to catch a train to go back to new york. dan glickman is one of our co-chairs and he spoke this morning. but the breadth and depth of people that we have are just -- have been really incredibly innovative and creative in terms of identifying, not only the problems. we've done a very good job as we say at the meridian institute, we've admired the problem long enough. so the first two years from 2011 to 2013 was, okay, let's admire the problem. let's define the problem. let's see if we can even get along with one another in the supply chain.

very tricky. the supply chain is not a monolithic group. it's very, very diversity. people in production agriculture whether it's fruits and vegetables or organic or large scale monoculture are not really sure what walmart is up to. it's their customer, ultimate customer, but it's a scary organization when they tell the supply chain thou shall be sustainable or thou shall do things that improve nutrition or how do you deal with your workforce? those are all value statements that are coming down the supply chain or up the supply chain to production agriculture. having those individuals in the room grasping and grappling with positions and ideas of how we're going to feed 2 billion people nutritionally and sustainably was a big tall order. but we got there through lots of breaking bread and drinking wine, and there was a little

excess sugar, i'm sure, tossed in. and transfat. not so much transfat though. we were kind of against that. we literally engaged over 2,000 people the last 5 1/2 years asking people and identifying what we believe are the categories and issues that are actually linked together. and so the first two years we were socializing the ideas. we were getting to know one another. we accomplished that. the following two years were about truly identifying the big asteroids as dan talked about on the first panel. what are the big issues that we need as a nation to think about as a country, as individuals in our own lives when we go home or when we go to the grocery store when we engage with our families and friends. we came up with eight initiatives. they're publicly out there on our website. my third slide, my last slide,

gives you all the beta on where to go to follow us. we have a news feed every morning that's really good. it captures four or five articles of interest around the eight initiatives that we've identified. interestingly enough, we didn't know -- i didn't know being the gyroscope here with these 45 advisers, nine foundations and eight academics and four co-chairs whether we could agree on anything. and i start with this because it's really important. it started with a small holder organic hog farmer in culpepper who says what keeps him up at night is he doesn't have a regular legal supply chain. he doesn't have a legal set of workers on his operation. and the whole room erupted and said we have a common interest in immigration reform. and so who knew. none of the foundations that were funding this -- none of us in the room realized that immigration was such a powerful policy initiative that needs to be undertaken. and so that was our first

document that came out with a series of recommendations. yeah. it's out there. now, the question is can it be implemented, and we, of course were, one voice among many voices in that regard and teamed up with partners. our whole idea of the first four years of identifying these top initiatives. why i'm spending time here is because i'm going to get to food and nutrition and it's going to reflect a heck of a lot what dr. angel talked about because through our collective impact or whatever you want to call it, we identified eight initiatives and we identified what people cared about and how people operate in their communities to come up with ideas on how to solve the problem. so after immigration reform, we rolled into food and nutrition, working landscapes, research and development, international development when it comes to food and agriculture. next generation of farmers and ranchers. just a very, very rich discussion that took a long time

but once the dam broke open about what are the true things that this really very diversity group could agree to, it became much easier. we built the trust and engaged a lot of different people, not just ourselves but we really relied on the different communities we went into and convened around these subject matters, which takes me to the topic. congress, sugar, obesity. okay. we went through many exercises just with our 45 advisers on taxes, on the issue of should we make the s.n.a.p. program like w.i.c. all the kinds of things pull the different as dan glickman would say, all the bullets. well, they're not bullets. it's silver buckshot. we have to think about things in terms of silver buckshot. what we did is we literally did exercises, okay, let's stand up and align. -- in a line.

those of you that want to regulate the s-n-a-p-program in terms of what people can purchase in the grocery store with s-n-a-p-dollars, you go there. those dead set against it go there and rest of you figure out what your position is. there's a reason why congress can't do anything. there's a reason why new york city can't do anything around some of these sticky issues if you will because people were very, very spread along the spectrum of what they believed in. this is antidotal. this is not science. but there's enough political science here, the people that stood up along the spectrum whether it was taxes or kind of the nanny state approaches that have been identified was very telling. we thought to ourselves there's a lot of people in this crowded space around sodium and sugars and regulating. maybe we ought to examine things that are working in communities that are not so regulatory or legal or top down heavy.

that is when we convened health care, hunger, medical insurance, the food industry, consumers in a room and most of these individuals had never been in a tooth. they're in rooms where nutritionists talk. rooms where health officials talk. rooms where safety net people talk. but we mixed it all up. we said -- of course we had really smart questions and i worked with feeding america on this. and it was telling. what emerged out of it was literally the model that sonya is already doing on the ground in new york. now, this info graphic was actually drafted by a millennial who just graduated from stanford, okay? she pored through all of the materials and said you have to

have an info graphic so i can tweet it and articulate it and what this info graphic says is we've got figure out how to empower families to eat healthier. how do we do that? we have to increase access to healthy foods. medicine, medical care and we give an example here. what you see here are component pieces of people, organizations, in a community that need to come together. but what this big model shows of these -- this info graphic shows is that there's got to be connectivity. how do we take what new york is doing or what portland, oregon, is doing or what nashville is doing and how do we share those stories? how do we take what's going on an at wake forest baptist health and connect it with what's going on in the new york health care system? because you're all having the same conversation. you're utilizing different groups of people to help deliver and address these issues.

in the case of wake forest baptist health where we've been hoping to pilot this we're in conversation with them, but the idea of using churches and faith-based organizations, very powerful in that community. ymcas and the school system. the ymcas are building kitchens right? because there's a legal issue. the schools due to liability issues won't let them go to the schools and use the school kitchens to help show kids how to prepare meals. anyway, i'm talking on and on and on. but the point is, we don't have this info graphic up on our website. i think we probably should. it's confusing. it does -- not for me but i lived through all of these circles and connections, but it articulates the method, the pieces that have to be part of the methodology, the groups, the important team that have to connect not only at the local level but at the federal level.

a task for all of you as you are studying law, if you get into a class where you are looking across the federal government at the federal level, what are the laws that would allow this kind of model to happen that could it could not happen but help incentivize. what are the incentives built in obamacare, in child nutrition act, in just -- pick these laws that deal with feeding programs and health programs. what are the incentive programs that are built in and how do we encourage this cross-jurisdictional conversation. because that needs to be done. that is something that would be incredibly helpful to see all these departmental rules and laws that they're implementing and programs that actually if they came together could help support what dr. angel is doing in new york and help what wake forest baptist health is trying to address in an area that's

both urban and very poor rural. so i've spoken on in my very nonlinear way. oh, by the way, i'm a marine ecologist. so there you have it. >> thank you very much, deborah. [ applause ] >> thank you so much to all of our panelists today. i think we have a little bit of time. if there are any audience members with questions, i would invite you to come to the microphones. we probably have time for two or three questions depending if there are any. >> hi there. i am mya katz and i am really bruce's successor at cspi in a way. i'm the litigation director. this is somewhat of a question and also a comment.

as i sat and listened to a few references about the nanny state, i knew i would leave here a little disturbed if i didn't throw out some of our experiences at cspi in litigation. innovation is a terrific thing. i, too, believe that the private sector can be an enormous force in innovation. the environmental movement is one example of that. they've had to be that in california and elon musk and these sorts of people lead the way. but i think it is -- i throw out a cautionary note with respect to food, which is that consumers are clamoring for healthier food. they are doing that all the research shows, that they are pressing for healthier and hettyer food. if you walk down the grocery

aisle even at whole foods, which is one of my favorite pastimes, you will see some of the foods that we litigate, which are claimed to be whole grain and are not whole grain. claim to be vitamins and water, all you need and in fact are sugar or they claim to be protein fortified when they have no more protein but 17 times the shufg say cheerios as opposed to cheerios protein. slug innovation is critically important, but i don't think we want to blame the consumer here. i just need to throw that out. and to make -- as we talk about congress and obesity to just reiterate what was said this morning that the fda needs

funding for its consumer fraud and enhancing those activities. thank you. >> any other questions? go ahead. >> and actually, i could add to that. tom sherman at georgetown. you know, so if you talk about -- we can't pretend like we don't respond to marketing. you can't pretend that marketing isn't creating a demand that is being countered by other people who are demanding good food and one solution to that is to learn how to cook. dr. angel sort of had it on her last item in that long list of things they're doing in new york city. i would love to hear what she's doing with that. but if you learn how to cook, you don't have to worry about added sugar. you don't have to worry about atted salt or transfats or gmos or whether or not it's whole grain or not because you put whole grain in your cooking vessel. so and it's not on your food as health chart is learning how to cook.

>> can i respond? >> maybe i just missed it. >> yeah, it is actually. it's embedded in here. what you're describing is almost the most fundamental thing we learned talking to people. the business of -- i didn't want to dismiss the nanny state. that came up in discussion. i think what you're talking about in terms of the balance of the need for regulation and keeping, making sure products are actually what they say they are, all that is absolutely vital to the system. and the business of cooking and having the skill set and eating as families is actually fundamental to the changes that need to occur. i mean, i was just -- sorry. i was running through because i saw it was 3:30. >> no, i appreciate that. so there is a solution. but part of it is that families have real challenges and they have real impediments to cooking and so everything from

subsidizing basic ingredients for cooking to making them widely available to be strategies for efficient cooking. all of those are real strategies and real impediments to every family coming home and cooking together and eating together. but it is something that if you set as a goal, either as a family or a community or as a city, that it's a noble goal. >> yeah. and the first point of empowering families to eat healthier foods involves everything you described. that's why it's a set of silver buckshot and not a silver bullet. and it's a combination of what we're saying here. behavior, you know, education, opportunities, access, it's complicated. the social determinants are also a very important factor. it's what we learned. it's us talking to a lot of different individuals with their points of view. this actually is our first

attempt at capturing the moving participants to achieve the goal. >> thank you. >> if there are no more questions, perhaps i'll just end with a question for our panelists. as i mentioned in the introduction, there are some racial and ethnic minorities and individuals of lower socioeconomic status that tend to consume greater amounts of added sugars and that are more likely to be overweight or obese. i'm interested in your ideas on how our laws and policies will encourage reduction in added sugars among all our groups and there are some more equitable in that sense or are there some actions that we can take to make sure that we are achieving these reductions across board? >> can i take a crack at that? i think new york city has pointed the way. getting rid of trans fat from

restaurant foods affected everybody and probably gave a preferential benefit to low-income people. lowering sodium in packaged foods and restaurant foods as the fda is proposing is voluntary guidelines will preferentially benefit low-income people, less educated people, who rely on packaged foods. you know, some of this regulatory work is especially beneficial. even taxing soft drinks which is a regressive kind of a tax, but the benefits are progressive, especially if the tax revenues are invested in promoting health among low income people. but regulation aside, i think school food programs or schools can be a great leveler of helping low income, less

educated people in particular such as healthier school meals, which has been talked about you, that that's especially helpful to low income people and they don't have to pay for them. free lunches and breakfasts. and just following up on the discussion on cooking, hopefully schools will bring back home ec and teach kids how to cook and how to garden. >> snirnts that some schools are doing that already. and alice waters in berkeley has gotten huge attention for doing that in that one community. but a number of schools around the country have gardening programs and then the kids cook what they garden, and hopefully they like what they have cooked. you know? that you can't control. but doing things through the schools is especially helpful to low-income people who don't get

the parental assistance that middle and upper class kids get. >> thank you, michael. any other comments? >> can you advance the slide to the last one in case anyone wants to get our free news feed. >> i don't purport to be an expert on low-income dietary issues, but it's nice to hear some overlap between what's being said about cooking that's in both of our list of recommended policy options. so nice to see some coalescence there. >> thank you very much to our panelists. please join me in thanking our panel congress, sugar and obesity. [ applause ] in the interest of ending our day on time, we'll take a ten-minute break and gather again at 3:45. thank you. >> if you want a copy of

marketing coke to kids, please come up. .

on july 1st, 1976, the smithsonian's national air and space museum opened its doors to the publicing with president gerald ford on hand for the dedication. friday marks the 40th anniversary of the museum and "american history tv"'s live coverage starts at 6:00 p.m. eastern on c-span3. we'll tour the museum and see one-of-a-kind aviation and space art i facts including spirit of st. louis and the apollo lunar module. learn more about the museum as we talk with kits director j. r. daley, curator jeremy kenny and valerie neil. and you can join the conversation as we'll be taking your phone calls, e-mails and tweets. the 40th anniversary of the smithsonian air and space museum live friday evening on c-span3's "american history tv."

>> a panel of foreign policy and national security experts discussed the future of nato. the program hosted by the atlantic council included details from their report storing nato's power and purpose. it identified four strategic challenges, russia, the middle east, u.s. engagement policy and a weakened european union. >> good afternoon, everyone. with why don't we get started. i'm damon wilson, executive vice president of the atlantic council. i'm glited to welcome to y you today. we're here four days after the british electorate after the british decided to leave the eu.

while we're trying to understand what means and what the implications are, i think our community here believes one thing is for certain that, no matter what our alliance will become more important. it will be the glue that helps keep us together both across the atlantic within europe and the vehicle to help defend our way of lives. so we're here today to talk about a report restoring nato's power and purpose that was led by two great americans who be on the atlantic council's board. general jim jones and ambassador nick burns. thank to you you both for your leadership and for being with us today. we're delighted they're joining us for a conversation which one of our senior fellows evelyn farkas will help lead in a minute. we're on this conversation after brexit and joined by a much larger audience online and tv. we encourage all of you to submit your thoughts, your questions, using the #future nato but also the #strong esh

with allies because that is what we believe here. today's product is a result of an atlantic council strategy. about a year ago, we set out to look what was happening on both sides of the atlantic. concerned about america's role in the world and our ability and desire and will to continue to play a leadership role. but at the same time, what was happening in europe as forces of frag mentration were undermining the sense of solidarity among our allies in europe. brexit delivered that message in sharp terps. but what brings these two sets of issues together we come together through nato, through our alliance. the issue of brexit, the uncertainty of where the european project is headed, we do believe the u.s. role in europe going to become even more important to help insure a sense of predictability. i'm going to leave the report to ambassador burns and general jones to lay out their conclusions and findings and key themes but i wanted to put it in

context four reasons why the atlantic council moved forward on this report at this time. one even before the latest debate, there was a concern about perhaps the marginalization of nato, it was no longer really at the center of our national security and foreign policy. there's a lot of talk about nato is them if you sit in washington, we refer to them across the atlantic. if you sit in europe, they refer to them as the americans. if you don't own this alliance, it will wither and i had i that's one of the points we wanted to make a call for leadership and imagination. particularly american leadership. second, we're headed to warsaw which will prove to be a significant summit for this alliance. but our point is that what's happening right now in terms of european security uncertainty in the world, we need to be prepared for the long-term. this is not just deterrence over a short period and if you look at our budgets you look at political resolve, we're not yet pos toured for the long-term reality we face and i think we

worry is our response commensurate with the challenges we face when you look to the east, when you look to the south, when you look to internal challenges. third, there's beginning to be the remnants of a very strong narrative playing out across europe today. it's the broken promises narrative that president poout putin used in the wake of the annexation of crimea that we broke our promises to russia and therefore, their actions. so you hear today in europe the nato exercises in poll poland, the baltic states that, warsaw separate fungi is provocative. yet we felt there was a problem if we couldn't actually exercise, if we couldn't twaels actually dem mon our ability to protect the allies we would be negligent in our responsibilities. is warsaw doing what is responsible or is it overreach and beginning to make the case

for the easing of sanctions against russia. and finally in our own debate, the atlantic council's been one of the strong voices calling on our european allies, canadian allies to do more terms of their own defense investment. that will continue, but if our only debate and prism through that in the alliance in the united states is one of burden-sharing, we're going to undermine that sense of understanding of the value of our alliances, and we believe fundamentally our alliances are force multipliers for our values and our interests and that it's one of our greatest strategic assets that our adversaries only wish that they had. so with that i'm going to invite evelyn farkas up to the stage, one of our fellows who is a deputy assistant secretary of state at the pentagon, a strong voice in and out of government and to help moderate our conversation i'll invite general james jones and add miller burns, former national security

adviser for the purposes of the report and supreme allied command commander and head of the jones group. ambassador nick burns who serves on the atlantic council board serves as undersecretary in addition to being the permanent representative to the nato alines and ambassador to greece, currently a professor at harvard. with that let me turn it over to evelyn to get the conversation started. >> thank you very much, damon, and thank you, all of you, for being here today. i'm very honored to be here with these two gentlemen to discuss this report. i think it's quite timely. i'm hoping that maybe through this report and through this discussion we can transform the discussion and make the discussion about nato and institutions a little bit more sizzling and perhaps we can make these two gentlemen like the spice boys of internationalism so we'll try to keep it a little light and interesting because if bernie sanders can do it, i think you guys can, too. >> oh, god.

>> so let's make it a little more conventional and approachable. and i think it's important just to kind of spring forward a little bit and use some. words that damon discussed about values and defending our way of life. i think this report, while it looks like a very dry, you know, oh, the usual pre-summit kind of report on nato, right, and both of you -- >> that's not how we see it. >> good, good, good. okay. both of you have read a lot of these reports, but the reality is that i think what doesn't convey often when we have these conversations is it's really about our values. why duo we have these institutions? why duo we have collective security? first of all, you have to have some understanding of the history, you know, of what we're trying to prevent but it's also about spreading democracy, strengthening democracy and protecting our economic freedom of navigation, freedom of commerce. these things are not to be taken for granted and without strong alliances, without a military, indeed without deterrents, without defense, you cannot have all of those economic things, the pros ports and then, of

course, democracy so that's kind of my two cents but you're not here to listen to me. you're here to listen to the sizzling spice boys. you have five minutes to sort give your synopsis or just the high points, you know, the things that you think are the most important about the report. i have a few questions for you and then i'm sure these folks also have very interesting questions and comments so over to you, ambassador burns. >> thank you very much, evelyn and good afternoon, ladies and gentlemen. first i want to say thank you to the atlantic council. i told fred and damon earlier it's the fastest growing think tank in washington, and when fred and damon took it over, it wasn't -- it had fallen on hard times. it's now i think one of our most influential centers for learning and for debate in washington so congratulations to fred and damon and david ensore and everyone else at the atlantic council. second, i wanted to say what a pleasure it's been to work with general jones, jim, over the last eight months on this report. we worked together at nato at a tough time, after 9/11, during the iraq and afghan wars, and i

have tremendous respect for jim. and thank him for his continued leadership. what -- why did we write the report? we believe that nato and the european union, european allies are face the greatest set of challenges since the end of the cold war 25 years ago when the soviet union imploded, december 25th, 1991. i never thought we'd come back to this time. i was serving in the administration of george h.w. bush on the nsc on soviet affairs, and we felt liberated from the cold war, from the theat of imminent destruction, and the words of president bush 41 europe had become whole, free and at peace, and that was our strategic mantra through the clinton administration, through the george w. bush administration and into the obama administration. that all changed in march of 2014 when president putin decided that he would invade crimea and then to divide

ukraine after having invaded georgia in 2008. so this report is underlined by some strategic trend lines that we find very negative, both for the united states, canada as well as for europe. first, is this redivision of europe by the russian federation. the search as the czars did for strategic depth, and that's why they went into georgia. that's why they have intimidated armenia and azerbaijan and why they have divided ukraine. the false territorial conflict in moll dovea and the current pressure on the baltic states. it requires a response from nato, and so the number one recommendation that i think is important in this report is nato should station troops permanently in the baltic countries, in lithuania, latvia and estonia, permanently in poland, permanent in romania and bulgaria and the black sea and have capacity to act on the air and the sea in both the black sea and baltic regions. this is not war mongering.

that's what the russian federation, the putin government, wants you to believe. damon and i were in europe last week, in brussels and berlin together, and the russians are out saying nato's provoking a crisis. these are clearly modest in terms of the troop commitments. measures designed to stabilize the alliance, protect our smaller allies in the east and duo what the nato alliance has to duo, protect the member states and collective security in europe, and we need to establish effective deterrents against putin, and that's why our number one recommendation is the permanent basing of nato troops in those areas. second, the united states and canada and europe should maintain the economic sanctions on russia. those sanctions are now in question. prime minister renzi went to the st. petersburg summit and said we ought to the trade more with president. president hollande says we should question these sanctions and maybe take them off in december. there's a big debate in germany, and we saw it in berlin on

thursday and friday between say two political parties, the sbd and the cdu over whether they should maintain sanctions against the russian federation. the europeans will extend them this week, but in december, right in the middle of our presidential transition, some europeans want to make a move to return to business as usual with russia. i think thankfully chancellor merkel has been giving every indication, and she negotiated the misunderstoodings with president putin that unless he adheres to them to the letter germany under her leadership will not relax the sanctions but there's going to be a big battle in europe and i think a battle across the atlantic on this issue, and we believe sanctions should be maintained. that's what effective deterrents is. third, obviously we've got to have a stronger nato as we move forward with deterring the russian federation and president putin, and right now exactly 569 allies of 28 spend more than 2% of gdp in defense.

that is the floor, by the way. those are the minimal expectations. it used to be 3%, that you spend 2% of gdp in defense, and it is true that 20 of the allies have inched up in their defense spending but not many close to 2%, and so we believe that germany at 1.1% of its gdp, spain, italy, the netherlands need to duo more in response to the crisis in europe. when donald trump, and it pains me to say this, because i'm opposed to donald trump, has hit a chord with the american public that somehow we're being taken advantage of because our allies don't spend enough on defense, then that maybe is incentive for the europeans to duo more for their own defense and collectively in nato. we also have other recommendations and that is to be much more proficient in our cyber capabilities, to fully deploy missile defense, to be active to nato's south in places like morocco and tunisia and

jordan and iraq and training the arab forces at their request in these countries. there's a big set of challenges ahead, and we believe it requires american leadership, and i'll end on this point. we're the leader of this alliance. the united states of america. we always have been, and the alliance desperately needs leadership. when president obama goes to the warsaw summit in ten days time, he's going to be going there in the wake of this very dramatic consequential historic british vote to leave the european union, and while it's too early to know exactly where this is leading because some brits want to have a second referendum and to counteract the first, if britain -- if britain does leave, we are looking potentially at a fractured united kingdom with the scotland question and the irish get coming back a century later to bedevil constitutionally the future of the united kingdom. we certainly are going to need to see the united states embrace

the united kingdom in our special relationship. it's the fifth largest economy in the world. it's the second strongest military in nato. we'll still be able to work with them in nato, but we won't have the british to be the tough-minded pragmatic voice within eu councils, on issues like do you continue sanctions against russia, and so, therefore, and we talked about this in berlin in a public forum on friday morning, the united states is going to have to seek deeper relationship with germany. germany, the dominant country in the european unionwoman aamerica el, that relationship i think is one that we'll have to build further in this administration and in the next. thank you very much. >> thank you, nick, and evelyn, thank you very much, and, ladies and gentlemen, thank you very much for being here. i'd like to also echo the importance of this report and certainly acknowledge