Health Equity Forum Podcast: Episode 8 - Transcript
RADM Araojo: Hello, and welcome to the Health Equity Forum Podcast, hosted by the FDA Office of Minority Health and Health Equity. I'm your host Rear Admiral Richardae Araojo, the Associate Commissioner for Minority Health and Director of the Office of Minority Health and Health Equity at FDA. In this episode, we will continue our conversation with Dr. Susan Mayne, Director of the FDA Center for Food Safety and Applied Nutrition.
Our discussion today will focus on heart disease and nutrition. Heart disease is the leading cause of death for people of most racial and ethnic groups in the United States. An unhealthy diet can increase your risk of developing the conditions that lead to heart disease, including high cholesterol, high blood pressure and obesity.
Dr. Mayne, welcome back to the Health Equity Forum Podcast.
Dr. Susan Mayne: Thank you, Richardae.
RADM Araojo: Dr. Mayne, for those listeners who haven't tuned into episode seven(7) on food safety and nutrition, can you give us a brief overview of the work of the FDA Center for Food Safety and Applied Nutrition?
Dr. Susan Mayne: Absolutely. The FDA Center for Food Safety and Applied Nutrition is focused on ensuring the safety of almost 80% of the US food supply, including dietary supplements. We also work on nutrition and food labeling as part of our overall public health mission, in addition to overseeing the safety of cosmetics.
RADM Araojo: Heart disease is a broad term. Can you explain what heart disease is and how it develops?
Dr. Susan Mayne: Heart disease is a catch all phrase for a variety of conditions that affect the heart structure and function. The most common type is coronary heart disease, which occurs when plaque, which is a combination of fat, cholesterol, and other substances found in the blood, builds up in your arteries. This process is called atherosclerosis.
Plaque blockages can cut off blood flow by narrowing arteries or completely blocking them. If blood flow to the heart is blocked, a heart attack can occur when the muscles of your heart become starved of the oxygen and the nutrients they need to pump blood to the rest of the body. Alternatively, if an artery supplying blood to the brain is blocked, a stroke may occur.
RADM Araojo: How big of a role does sodium and the foods we eat have on our risk for developing heart disease?
Dr. Susan Mayne: Research has shown that excess sodium consumption is a factor that contributes to development of high blood pressure, which is the leading cause of heart disease and stroke. So we know diet plays a significant role in the likelihood that a person will develop heart disease. And that heart healthy eating isn't just about avoiding the foods that you know are bad for you. It's also important to make sure that your diet includes enough of certain foods and nutrients that are vital for healthy living. As we discussed on our last episode, in our overview of good nutrition, according to the latest Dietary Guidelines for Americans.
RADM Araojo: Earlier, you mentioned that the dietary guidelines also discuss limiting sodium, saturated fat and added sugars. Can you tell me more about sodium?
Dr. Susan Mayne: Yes. Sodium is a mineral that is one of the chemical elements found in salt. Sodium is important for many body processes, such as muscle contraction and nervous system function. However, sodium attracts water and a high sodium diet draws water into the bloodstream. This increases the volume of blood leading to higher blood pressure.
The Dietary Guidelines recommend adults limit sodium intake to less than 2,300 mg per day. That's equal to about one teaspoon of table salt. As you can probably guess, the average American consumes nearly double this amount on a daily basis.
Only a small amount of our sodium intake is naturally from foods. You'd probably think the rest comes from a salt shaker, but the reality is that most of the sodium we eat comes from added salt in packaged or prepared foods. In addition to taste, sodium may be added to these processed foods as a preservative. Sodium also is used for texture, leavening, and fermentation.
There are six foods in particular called the salty six that the American Heart Association warns can add high levels of sodium to your diet. These high salt foods include breads and rolls, deli meat, sandwiches, pizza, burritos, tacos, and canned soup.
RADM Araojo: How does sodium affect heart health?
Dr. Susan Mayne: Consuming foods that have high levels of sodium can increase your chances of developing high blood pressure, which increases the risk for heart attacks and strokes or cardiac vascular disease. Every year in the United States, approximately 800,000 people die from cardiovascular disease. Reducing your sodium intake can significantly reduce your chances of dying prematurely from cardiovascular disease.
More than one in three American adults have high blood pressure. And that number increases to almost one in two for African American adults. Food manufacturers and restaurants can also play a key role in this effort by reducing the amount of sodium they put in processed and prepared foods. By gradually reducing the amount of sodium from these foods can help consumers to slowly stop consuming so much sodium with little to no change in their behavior or habits.
RADM Araojo: This was the basis of the recently released FDA food industry guidance on sodium reduction goals. Can you tell us more about the guidance?
Dr. Susan Mayne: Yes. There have been multiple public health efforts over the past 40 years to reduce the amount of sodium Americans consume. These efforts were largely unsuccessful because over 70% of the sodium we consume comes from foods where sodium is added during food manufacturing and commercial food preparation. So without an overall reduction in the level of sodium in the food supply, most consumers will find it very difficult to reach the recommended sodium intake of less than 2,300 mg per day.
Americans currently consume about 50% more sodium than recommended. The new voluntary guidance therefore focuses on setting voluntary targets for food industry to reduce sodium content in their products over the next 2.5 years. This voluntary guidance sets targets for food manufacturers, restaurants, and food service operators for 163 categories of processed, packaged, and prepared foods. The agency expects that if the food industry reaches the initial targets broadly, it would reduce average US sodium intake to about 3,000 mg per day, about a 12% reduction.
Although 3,000 mg per day is higher than the recommended intake of 2,300 mg per day, the 3,000 mg per day goal balances the need for broad and gradual reductions in sodium with technical and market constraints on sodium reduction and reformulation. We will continue discussions with the food industry as we monitor the sodium content of the food supply to evaluate progress. In the future, we plan to issue revised, subsequent targets to further lower the sodium content incrementally and continue to help reduce sodium intake as has been successfully done in other countries. This iterative approach will help support gradual reductions in sodium levels broadly across the food supply so that consumers tastes adjust, health outcomes improve, and no one company or food category is singled out.
RADM Araojo: What can our listeners do to limit sodium intake?
Dr. Susan Mayne: When it comes to sodium, we encourage preparing your own fresh foods. That way you can season your foods with herbs and spices rather than salt or salt based seasonings. When shopping look for products labeled as low sodium or no salt added. You can check the nutrition facts label on packaged foods for the percent daily value of sodium. Daily values are the recommended amounts of nutrients to consume or not to exceed each day. As a general rule of 5% daily value or less of sodium per serving is considered low and a 20% daily value or more of sodium per serving is considered high.
RADM Araojo: Dr. Mayne, what is FDA doing to help prevent disease and premature death from nutrition related chronic diseases?
Dr. Susan Mayne: We took a fresh look at what can be done to reduce preventable death and disease related to poor nutrition. Almost 40% of US adults are obese. However, when we add the number of adults that are overweight, the statistics are even more alarming. A combined 70% of adults in the country are either obese or overweight.
Poor nutrition plays a key role in these patterns of chronic, preventable and non-communicable diseases like heart disease and stroke and certain cancers, which are experienced at higher rates by racial and ethnic minorities. With that in mind, we developed key activities that can help reduce the burden of chronic diseases through improved nutrition. We also want to empower consumers with information and facilitate industry innovation toward healthier food options that consumers want.
RADM Araojo: Dr. Mayne, can you tell us more about what food choices can help prevent heart disease?
Dr. Susan Mayne: It's important to eat healthy meals that are packed with fruits and vegetables, whole grains, and beans to add fiber to your diet. And limit foods that are high in sodium, added sugars, saturated fats, and cholesterol.
RADM Araojo: Do you also get calories from fats? What's the difference between saturated and unsaturated fats?
Dr. Susan Mayne: Yes, you do. Fats also help the body absorb certain vitamins and they support many vital body processes like reproduction and maintaining healthy skin and hair. Unsaturated fats are also known as good fats. They are often liquid at room temperature as oils and are found in nuts, seeds, avocados, and seafood. Most saturated fats or the bad fats are animal fats and are often solid at room temperature.
Think of butter, lard, and fatty meat. The human body makes all the saturated fat that it needs. So it's not necessary to get saturated fat from food. Eating lots of foods high in saturated fat may contribute to developing heart disease. The amounts of saturated and unsaturated fat in packaged foods are listed on the nutrition facts label. To reduce the amount of saturated fat in your diet, try cooking with vegetable oils instead of butter. Buy leaner, skinless meat, and look for low fat dairy products instead of full fat or whole milk dairy products. All fats, including unsaturated fats should still be consumed in moderation though, as fats have twice as many calories per gram, as sugars and proteins. So calories from fat can add up quickly.
RADM Araojo: And Dr. Mayne, how would our listeners know how many calories they should be consuming each day?
Dr. Susan Mayne: 2000 calories a day is used as a general guide for nutrition advice for the average person. Your calorie needs may be higher or lower and vary depending on your age, sex, height, weight, and physical activity level. To achieve or maintain a healthy body weight, the number of calories you eat and drink must be balanced with the number of calories your body uses. Visit myplate.gov to get a personalized estimate of how many calories you should aim to consume each day with a MyPlate Plan.
RADM Araojo: Thank you for all of these helpful food tips. What else can our listeners do to help prevent heart disease?
Dr. Susan Mayne: In addition to choosing healthy food and drinks, it's important to get regular physical activity to help maintain a healthy weight. Don't smoke. If you smoke, work with your healthcare provider to make a plan to quit. Smoking increases your risk for heart disease.
Lastly, avoid drinking too much alcohol. Too much alcohol can raise your blood pressure and increases your risk for obesity and type 2 diabetes. Men should have no more than two drinks per day and women no more than one drink per day.
RADM Araojo: Dr. Mayne, thank you so much again for sharing these important tips on heart disease and nutrition.
Dr. Susan Mayne: It's never too early or too late to eat healthy. Thanks for having me.
RADM Araojo: For more information about the Health Equity Forum Podcast series, visit our website at www.fda.gov/healthequity. While you are there, check out our library of resources and sign up for our newsletter. Also, don't forget to follow us on Twitter @FDAHealthEquity. Remember, together we can create a world where health equity is a reality for all.
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