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Health Equity Forum Podcast: Episode 7 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 be talking about nutrition and food safety. Nutrition plays a significant role in our overall health and wellbeing. Racial and ethnic minority communities are disproportionate burden of chronic diseases associated with, for diet like heart disease, certain cancers, and type two diabetes.

According to CDC estimates, 74% of adults in the United States are either overweight or obese. These patterns of chronic and preventable disease pose a major challenge to public health and expose widening health disparities across populations. During this episode, we will discuss healthy eating patterns and which foods and beverages can help protect your health according to current dietary guidelines. We will also discuss safe food preparation and storage to avoid common foodborne illnesses. For this discussion, we have invited Dr. Susan Mayne, director of the FDA Center for Food Safety and Applied Nutrition. Dr. Mayne, welcome to the Health Equity Forum Podcast.

Dr. Susan Mayne: Thank you

RADM Araojo: To get us started, Dr. Mayne, can you describe your role as the director of the Center for Food Safety and Applied Nutrition, and the work of your center?

Dr. Susan Mayne: Certainly. In my role, I lead the center with an incredibly important focus, namely assuring the safety of almost 80% of the US food supply, including dietary supplements. We work on nutrition and food labeling as part of our overall public health mission, in addition to overseeing the safety of cosmetics.

RADM Araojo: And can you describe for our listeners why it is important to eat healthy?

Dr. Susan Mayne: Just about everyone, no matter their health status can benefit from making healthy food and beverage choices. The scientific connection between food and health has been well documented for decades with substantial evidence that healthy eating reduces the risk of chronic diseases throughout all stages of life, from infancy to adulthood. As an example, not many children and adults in the United States eat the recommended number of vegetables each day. For adults, that equates to about 2.5 cups a day. This means that most people are missing out on an and source of numerous vital nutrients found in vegetables like potassium.

Potassium is known to reduce the risk of high blood pressure, also known as hypertension, which is a leading cause of heart disease and stroke. Nearly half of all adults in the US have high blood pressure. And often, people are unaware that they have high blood because there are often no symptoms. It's never too late to start eating healthier. Getting good nutrition and eating healthy can help prevent you from developing many common diseases like heart disease, type two diabetes and kidney disease, which is an important aspect of managing many diseases so they don't get worse and cause more complications.

RADM Araojo: Dr. Mayne, how can listeners know if they are following a healthy diet? And what changes should they make if they are not?

Dr. Susan Mayne: That's a great question. I recommend to all your listeners looking for the latest science based diet information to visit the myplate.gov website. It's the current nutrition guide based upon recommendations made by both the US department of agriculture and the department of health and human services. And their review of the latest nutrition research as laid out in The Dietary Guidelines for Americans. There's even an app that you can download.

Also, remember you can talk with your healthcare provider and or nutritionist or dietician about a diet and physical activity program that is right for you. But there's a ton of information and resources on myplate.gov and on health.gov to help you make changes and build a healthy eating plan over time. Start simple, make a small change in your eating routine, such as cooking a healthy dinner once a week, or compare labels for products you routinely buy like bread or pasta sauce to see if you can choose one with less added sugar.

RADM Araojo: Can you tell me more about myplate.gov?

Dr. Susan Mayne: MyPlate is the visual representation of the proportion of each of the five food groups you should aim to include on your plate at each meal. The five food groups are fruits, vegetables, grains, proteins, and dairy. MyPlate replaced the earlier food pyramid to help show consumers what healthy dietary patterns can look like. MyPlate helps take the guesswork out of meal prep. Half your plate should contain fruits and vegetables, ideally with somewhat more vegetables than fruits.

And the other half of your plate should be split between grains like whole wheat bread and rice and protein like meat, poultry, seafood, and beans with slightly more grains than protein. And to side of your plate, where your drink might be located is dairy as a reminder to include some dairy like low fat or frat free yogurt or milk in your diet. An underlying premise The Dietary Guidelines is that when selecting foods and beverages to eat from these food groups, they should be nutrient dense. This means foods that provide vitamins, minerals and other health promoting components and have no or little added sugar, saturated fat, and sodium.

RADM Araojo: Can you provide some examples of nutrient dense foods?

Dr. Susan Mayne: Sure. For vegetables, you should select from a variety of types and colors, including dark green vegetables like spinach or kale, red and orange vegetables like carrots or peppers, starchy vegetables like corn and other vegetables like avocados. Vegetables are an important source of vital nutrients like vitamin A, folate and potassium as I already mentioned. Fruits can be consumed fresh, frozen, canned, and dry to get essential nutrients like vitamin C and dietary fiber.

At least half of your fruit should come from whole fruits, but fruit juice can be counted as well. Just make sure the label says it's a hundred percent fruit juice. When selecting grains, a hundred percent whole grains are better than other types. Whole grains contain dietary fiber and other carbohydrates, protein, vitamins, minerals, and beneficial fats that help fuel your body.

RADM Araojo: And Dr. Mayne, what exactly are whole grains?

Dr. Susan Mayne: Whole grains are grains sold in their whole or original form or haven't had ingredients either added or removed from them through processing. For example, brown rice, quinoa and oats are whole grains. You can also look on labels for the word whole as the first or second item in the ingredients list to confirm if a product is a whole grain product, refined grain products or process grain products. Processing gives them a finer texture, lighter color, and a longer shelf life. But processing removes nutrients like dietary fiber and iron.

White bread and pasta are good examples of refined grains. Manufacturers may add some of the lost nutrients back into refined products, making them enriched grain products like enriched white rice. They may even be described as fortified, which means additional nutrients that were not present in the original food were added in. So in any case, fiber is not added back into enriched or fortified grains. So try to stick to a hundred percent whole grain, if you can, or at least look for grains that are enriched or fortified.

Next to protein foods. Protein is important for many body processes, such as fluid balance, immune system functions, cell and tissue repair. And it's one of the three nutrients that provide us with energy in the form of calories. Protein foods include meat, poultry, eggs, and seafood, as well as plant products like nuts, seeds, soy beans, and lentils. To ensure that you were eating nutrient dense meat, avoid prepackaged and processed meats like hot dogs, bacon, luncheon meats like baloney, and fatty cuts of beef, pork, or lamb, because they generally have high amounts of saturated fat and sodium.

RADM Araojo: You mentioned seafood, is there a recommended amount of seafood people should be eating regularly?

Dr. Susan Mayne: Seafood contains protein, omega three fats called DHA or EPA and more vitamin B12 and vitamin D than any other type of food. Nearly all seafood contains traces of mercury as a result of environmental factors. For most people, the risk for mercury by eating seafood is not health concern, but some fish and shellfish contain higher levels of mercury that may harm an unborn baby or a young child developing nervous system. We recommend that women who are pregnant or breastfeeding or families with small children choose from a variety of seafood that is lower in mercury like salmon, trout, shrimp, and crab.

You can check our list of that fish and shellfish that are lower in mercury online at www.fda.gov/food/consumers/advice-about-eating-fish. And let's not forget the dairy group. We all know that milk helps build and maintain strong bones. The dairy group includes all milk, including lactose free milk, fortified soy milk, yogurt, Kefir, and cheeses. Try to choose products that are fat free or low fat. Certain milk products are not good substitutes for dairy in The Dietary Guidelines, such as certain almond, rice, coconut and oat milks. Because their overall nutritional content is not similar to dairy milk and they may be lacking key nutrients like protein, calcium and vitamin D.

RADM Araojo: Can you explain what the nutrition facts label is, and what's new about the label?

Dr. Susan Mayne: The nutrition facts label is required on all packaged foods and drinks made in the United States and imported from other countries. You can use the nutrition facts label to review the calories and nutrients in packaged products and to choose items lower in saturated fat, sodium, and added sugars. And those with greater amounts of nutrients to encourage, like fiber. The label was recently updated for the first time in over 20 years, based upon updated nutrition science.

It features a refreshed design to make it easier for consumers to make informed food choices. One of the key changes is the listing for sugars. The label must now show added sugars. Added sugars include those sugars that are added to foods in processing. They also include foods packaged to sweeteners like table sugar, sugars from syrups and honey and sugars from concentrated fruit or vegetable juices. They provide no essential nutrients, just calories.

The Dietary Guidelines recommend that the average adult consume less than 50 grams of added sugars per day. Most people living in the United States far exceed this recommendation, resulting in excess calories that contribute to weight gain and obesity, type two diabetes and heart disease. Look out for added sugars in sodas, baked goods, desserts, sauces, salad dressings, even many cereals and yogurt.

RADM Araojo: What else can you tell us about MyPlate and the latest nutrition advice?

Dr. Susan Mayne: MyPlate was developed based on scientific evidence on health promoting diets in people who represent the general US population, including those who are healthy, those at risk for diet related diseases and those living with these diseases. It should therefore, be used as a general guide. You are encouraged to customize and enjoy nutrient dense food and beverage choices that reflect your personal preferences, cultural traditions, and budgetary considerations.

Just remember to choose a variety of options from each food group and pay attention to portion size. Many people mistake the serving size listed on the nutrition facts label for a recommendation of how much of a food they should eat. The label serving size is actually an estimate of the amount of a food the average person eats, not how much of that food the average person should eat as part of a meal or snack.

To take the guesswork out of portion size, MyPlate also breaks down the amount of food from each food group you should consume each day. You can measure your progress on meeting these goals by meal, using the free MyPlate app. You can also find healthy recipes from a variety of different cuisines with accompanying food group, nutrition and serving size information in my kitchen at myplate.gov.

RADM Araojo: Thank you, Dr. Mayne for all of this great information about nutrition. Of course, healthy eating involves not just making sure we eat nutritious foods, but that we prepare and store our foods properly to avoid foodborne illnesses. Can you explain what foodborne illness is?

Dr. Susan Mayne: The most common cause of foodborne illness or food poisoning is contamination of food by bacteria and viruses. Some of the most common culprits you may have heard of are E-Coli, listeria, salmonella, Campylobacter, and norovirus. Every year, one in six people living in the United States is sickened with food poisoning and an estimated 3000 people die from these illnesses. While some cases are linked to bacteria or viruses in a growing area or a food processing facility, most cases of food poisoning are preventable by taking simple steps to keep your food safe.

RADM Araojo: Can you outline these steps for us?

Dr. Susan Mayne: Sure can! There are four basic food safety principles. The first is to clean your hands, utensils and surfaces often. When preparing your eating food, always start with washing your hands with soap for 20 seconds. One trick is to hum happy birthday twice from beginning to end to meet that 20 second mark.

You can also clean your foods, fruits, and vegetables with plain water, but don't rinse meat, poultry, or eggs. You're more likely to spread germs around your sink and countertops from any splashing that occurs. And wash your utensils, cutting boards and countertops with hot soapy water after use, especially after they've held raw animal products.

The second step is to make sure you keep certain types of foods separate from each other, whether at the grocery store, in your refrigerator or when cooking. Germs on raw meat, poultry, seafood and eggs can contaminate other foods. When packing groceries, bag raw meat, poultry and seafood to contain the juices. Store these items in leak-proof bags or containers in your fridge, away from other items and use separate utensils, dishes and cutting boards when preparing these products for meals.

The third step is to cook raw animal products, casseroles and leftovers to a high enough of temperature to kill bacteria and viruses. Different foods need to be cooked to different internal temperatures to be safe. And the only way to be sure of the temperature is by checking with a food thermometer. So pick up a food thermometer if you don't have one and visit foodsafety.gov to download our safe minimum cooking temperature chart for foods by type.

And the fourth step is to refrigerate or freeze food properly. Do you know what temperature your refrigerator should be set to? It's 40 degrees Fahrenheit or four degrees Celsius or below. And your freezer should be set to zero degrees Fahrenheit or negative 18 degrees Celsius or below. Perishable foods should not be left on the counter for more than two hours. If it's very hot out, move food to the refrigerator within an hour. And never thaw frozen foods on the counter, they may not thaw evenly, which can allow bacteria to grow in spots. If you forget to move food foods into the fridge or a freezer, it's always safer to throw it out.

RADM Araojo: Dr. Mayne, how can people tell if something they ate made them sick?

Dr. Susan Mayne: Symptoms of foodborne illness usually appear 12 to 72 hours after eating contaminated food, but they may occur as soon as 30 minutes or as long as a month later. So it may be tough to trace your symptoms back to a particular meal. But nausea, stomach pain, vomiting, diarrhea, headaches, body aches, and a high fever are all possible signs of food poisoning. You may also become dehydrated and dizzy. Food poisoning can be serious, especially for pregnant women, young children, older adults, and those who are immunocompromised.

You should contact your healthcare provider right away if you think you may have food poisoning. You can also report a foodborne illness to your local county or city health department to help them track any potential outbreaks of foodborne disease. However, you should know that the United States food supply is among the safest in the world. Always remember to keep these four important steps in mind, clean, separate, cook, and chill to help keep you and your loved ones healthy while and cooking great meals.

RADM Araojo: Dr. Mayne, what can you tell us about the new era of Smarter Food Safety?

Dr. Susan Mayne: Smarter Food Safety is about more than just technology. It's about simpler, more effective and modern approaches and processes. It's about leadership, creativity, and culture. Our ultimate goal is to bend the curve of foodborne illness in this country by reducing the number of illnesses. The reality is the world around us is changing rapidly. Many believe we will see more changes in the food system over the next 10 years than we have seen in previous decades. Foods are being reformulate.

There are new foods, new production methods and new delivery methods. And the system is becoming increasingly digitized. With that in mind. In 2020, we announced the new era of Smarter Food Safety blueprint. The blueprint outlines the steps the FDA will take over the next decade to usher in the new era of Smarter Food Safety. The document includes goals to enhance traceability, improve predictive analytics, respond more rapidly to outbreaks, address new business models, reduce foodborne illness and foster the development of stronger food safety cultures.

RADM Araojo: Dr. Mayne, thank you so much for sharing these important tips on nutrition and food safety. The FDA is committed to finding new ways to reduce the burden of chronic disease through improved nutrition. We know that good nutrition can have a real impact on our health.

Dr. Susan Mayne: Yes. It's never too early or too late to eat healthy. Thanks for having me on.

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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