The sugars line in particular and explain that to kids and say, okay, kids, if theres 4 grams per teaspoon, how many teaspoons of sugar are in this food . 12 ounce teaspoon is 9 grams of sugar. That would be 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, we petitioned the food and Drug Administration to require Health Warnings on soft drinks. That petition, were not sure if the fda has opened the envelope. Its a slow moving agency. In any case, the fda hasnt 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 recognizes as safe or gras in the lingo of the fda. Everybody knew that sugar is safe. Its 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 the source of trans fat 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. Its generally recognized as safe based on the foods in which its 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 hypothisized different categories. The resultant of all that would be a reduction of sugar consumption 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 dont think you taste the difference between a coke with 37 grams instead of 39 grams. You can reduce sugar without even seeing a taste difference to a small extent. There are various artificial sweeteners and there are natural sweeteners that could be used leaving 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 were pretty confident that the envelope hasnt 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 thats the food and Drug Administration. Warning labels and limits on sugar. The federal trade commission, david, whom you heard of before was head of 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 whats going on there, theres 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 fdc said that, threatening to ban all marketing to little kids, the fdc had its head handed to it by the Food Industry, the advertising industry, the broadcasting industry, and the washington post. That was the genesis of the nanny state. This is undeniably marketing to kids. A toy bear. Heres that bear at the cocacola world in atlanta kind of an Indoor Museum theme park. They also cocacola have a curriculum for first grade teachers that has marketing. Isnt coke wonderful because you have all this stuff, all this marketing around you. This is a middle school 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. 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 on soda, would raise 10 billion a year, reduce consumption by 5 to 10 . Unclear exactly how much. And do wonders for the National Economy and for the publics health. Theres a bill in congress thats not going anywhere. Lets forget congress. Change the title of the session. As dr. Angel mentioned, theres 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 billboards,s but kiosks and even on soda coolers where it says cocacola, 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 didnt 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 twothirds because they would earmark the money for health purposes. Theyre going to vote again possibly in november. Oakland may vote this year. Philadelphia has a vote i think its next wednesday in the city council. Theres lot going on. This is happening globally with mexico having a small tax on soda thats 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 theres a lot going on here. Local areas where things are happening. If we can get theres 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. Per capita consumption of sugar drinks has gone down by 27 since 1998. Cocacola, 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. Were 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. Theres copies upstairs if would you like to grab one and see what cocacola is doing to our kids. Thank you. [ applause ] thank you, michael. A wonderful way to start our panel. Well now hear from bruce silverglade. His practice includes responses to fda regulatory proposals, management of classaction lawsuits and regulatory 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, ucda, world health world consumer groups. Thank you very much, bruce. Uda, world health world consumer groups. Thank you very much, bruce. Usda consumer groups. Thank you very much, bruce. Good afternoon, everyone. Did you leave out the part that i worked for csbi for 28 years . Just i left voluntarily, right, in 2010. Right. Okay. I thought you just left it out of your official biography. Its there. Its there. In fact, its there in the context that i fought for the original nutrition labeling law of 1990 and spent five years of my middleaged youth on that. So im proud to have worked at s cspi. I have learned the other sides, other viewpoints, and i think that i hope to really present some innovative as title of the conference here innovative approaches to diet and health problems. What we have to really do this is i guess the theme of my 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 were 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 dont do that, then its just a war, regulate the industry, put on warning labels and its questionable whether we get to the end point of changing the food culture and the foods people want. An example that does not involve nutrition but its a real life example involves the recent decisions by Campbell Soup and kelloggs 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 nongmo. Putting aside whether its a good idea, bad idea, healthy or not healthy or based on philosophy or whatever, why did they do it . Consumers started demanding it. And so if that kind of change can be achieved and other changes in nutritional values of foods can be achieved, if consumers demand it. So how do we get consumers to demand healthier foods . I think thats 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. Its a proud achievement. Cspi gave me an award upon my departure for helping get labeling passed, but it hasnt in my mind achieved the results from 1990 that we hoped for. In fact, obesity went up. And one of the reasons, i think, it didnt achieve the results that were expected is that theres 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. Food industry responded with lowfat foods but theyre higher in sugar. So labeling can be a twoedge sword. Im going to try to turn out some slides now. This is the real tricky one. When we focus on individual nutrients, in this example its 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 wasnt correct and eggs are a cheap source of protein and nutrients for lowincome people. 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 dont know if cspi has. But guidelines say that 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, mono saturated fat, fiber, sodium, so forth. Sa fat, fiber, sodium, so forth. Its not added sugars by itself but 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. Brazils approach to improving diet, they suffer from obesity and same problems we do, countrys 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 bedroom or elsewhere watching tv. That kind of thing. To prepare meals from fresh foods. To practice food preparation. 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 its funny. Dr. Jacobson is the scientist and im the lawyer. You recommended legal approaches and i recommend what brazil has done which is something else. Its a form of social change. But not involving outright regulation, which is among some of brazils suggestions. The factors i named dominate the theme of brazils approach to the obesity problem. Lets be innovative. And happy to answer questions. [ applause ] thank you. Thank you very much, bruce. Well hold our questions until after our third speaker. So let me now introduce deborah atwood. Deborah joined the Meridian Institute in 2011. 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. Grateful. Thank you, all. Shes poking buttons here to advance my slide. First, i think you need to add to your chart, michael, what wine and sugar equate to. When i looked at your chart, forget the candy. I want to know what wine looks like in terms of teaspoons of sugar. You may want to add a full ipa up there as well. That said, i know were 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 ive had in washington, d. C. And outside of washington, d. C. , ive always had to have good Legal Counsel with me. So while i am innovating and getting crazy about my ideas, ive 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 already exist. If they do, lets map them out and look at how we can actually go to where i want to go. And its usually not just me by myself. Im acting like im telling the lawyers help me be creative. Its always been a Team Approach with good Legal Counsel walking right with us. And im always pushing the lawyers that ive worked with over the years to find the yes answer. Yes we can do this. Unless its just totally crazy and well put somebody in jail, 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 thats housed at the Meridian Institute, thank god, has this effort because the idea was could nine foundations actually come together, which they did, and fund an eightyear 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 lets go boil the ocean. And i can appreciate that. It was a big, big task. The Meridian Institute, thank goodness, undertake very complex facilitation efforts to connect people to solve problems, which is their tag line. So ive had the good fortune of having backbone of meridian to help us navigate forward. Agree started in 2011. 45 advisers. I think at one time we counted 150 different people we thought would be groovy to have the room that covered all of the issues from input and finance all of 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 is one of our cochairs and he spoke this morning. The breath and depth of people that we have are just have been really incredibly innovative and creative in terms of identifying, not only the problems. Weve done a very good job as we say at the Meridian Institute, we admired the problem long enough. So the first two years from 2011 to 2013 was, okay, lets admire the problem. Lets define the problem. Lets see if we can even get along with one another in the supply chain. Very tricky. The supply chain is very, very diverse. People in production agriculture whether its fruits and vegetables or organic, are not really sure what walmart is up to. Its their customer, ultimate customer, but its 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 were going to feed 2 billion people nutritionally and sustainably was a big tall order. We got there through breaking bread and drinking wine and a little excess sugar im sure tossed in. And trans fat. 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 go to the Grocery Store and engage with our families and friends. We came up with eight initiatives. They publicly out there on our website. My third slide gives you all of the beta on where to go to follow us. We have a news feed every morning thats really good. It captures four or five articles of interest around the eight initiatives that weve identified. Interestingly enough, we didnt know i didnt know being the gyroscope with these 45 advisers, nine foundations and eight academics and four cochairs whether we could agree on anything. I start with this because its important. It started with a small holder organic hog farmer in culpeper who says what keeps him up at night is he doesnt have a regular legal supply chain. He doesnt 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. Its 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 im spending time here is because ill get to food and nutrition and it will reflect a heck of a lot what dr. Angel talked about it 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, 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 and once the dam broke open about what are true things that this Diverse 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 Snack Program like w. I. C. All of the bullets. Theyre not bullets. Its silver buckshot. We have to think about things in terms of silver buckshot. What we did is we literally did exercises, okay, lets stand up and align. Those of you that want to regulate the 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. Theres a reason why congress cant do anything. Theres a reason why new york city cant 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. Its not science. Enough science here of those that stood up along the spectrum whether it was taxes or kind of a nanny state approaches that have been identified, was very telling. We thought to ourselves theres a lot of people in this crowded space. 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 room before. Theyre 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 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 have to 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