Today's session that you've joined is on eating healthy to be healthy, promoting health and preventing disease with the Dietary Guidelines for Americans. It might be a very pertinent topic, but perhaps you've all just come back from lunch. So we welcome you. My name is Jennifer Shevinsky. I am a preventive medicine physician and lifestyle medicine physician by training, and I'm an EIS, or Epidemic Intelligence Service Officer, with the Center for Disease Control and Prevention. And I've been working on the clinical preventive medicine and lifestyle medicine track. This session today, we will have three speakers. We will have Stephanie Fu, who is the Senior Policy Advisor at the U.S. Department of Agriculture Food and Nutrition Service in the Center for Nutrition Policy and Promotion. We also have Marlena Bates, who also works at the U.S. Department of Agriculture Food and Nutrition Services at the Center for Nutrition Policy and Promotion as a Nutrition Evidence Systematic Review Analyst. And we'll also have Darcy Gungor, who is also a Nutrition Evidence Systematic Review Analyst at the U.S. Department of Agriculture Food and Nutrition Service in the Center for Nutrition Policy and Promotion. We feel very fortunate to have them with us here today. They have planned an interactive session for everyone. Please feel free to participate, type in, and I will also be moderating the chat for a question and answer session at the end. So, without further ado, I will pass it on to our speakers, and we look forward to the session. Thank you for joining. Thank you, Jennifer, for your introduction. We're very grateful to be here today. Hello, all, and welcome to our session on Eating Healthy to Be Healthy, Promoting Health and Preventing Disease with the Dietary Guidelines for Americans. By the end of this session, you should be able to describe the rigor of the scientific evidence that underlies the Dietary Guidelines for Americans. And just as a reminder, my name is Marlena Bates, and I'll be presenting that section of the presentation. Next, you should be able to find and download the Dietary Guidelines for Americans online and quickly navigate to the information most relevant to the patients and clients that you serve, as well as use the Dietary Guidelines in real-world settings to help patients or clients improve their dietary pattern. And that section will be presented by Darcy Gungor. And then last, but certainly not least, you should be able to select MyPlate resources to use with or recommend to patients or clients, and that last piece will be presented by Stephanie Foo. And just as a small caveat, if you also may not have patients or clients, you may work in a more research setting. We also have some opportunities there as well with research recommendations, and you may work with a more collaborative team with either nutrition experts or a dietician, and you may be able to appoint those folks in the direct use resources as well. The American College of Preventive Medicine and the Dietary Guidelines for Americans are allies in disease prevention and health promotion. As you can see in our descriptions and mission statements for our organizations, ACPM seeks to reach populations through disease prevention and health promotion, and the Dietary Guidelines seeks to promote health and prevent disease through helping Americans to achieve a nutritionally adequate diet. And we would love to work together with you all to move these guidelines into practice. We're from the USDA Center for Nutrition Policy and Promotion. We're sorry for all of the acronyms. There are a lot in our organization. Our team includes nutrition scientists, analysts, economists, dieticians, public health experts, and nutrition communications specialists. We have teams who support nutrition systematic reviews, which is where Darcy and myself work, and then also other nutrition analyses. This work informs the development of the Dietary Guidelines for Americans. The Center for Nutrition Policy and Promotion is the USDA lead in developing the Dietary Guidelines with our partners over at the Department of Health and Human Services. The Dietary Guidelines are the foundation of nutrition programs across government, including the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, and the National School Lunch Program. The Center also leads the development of the USDA food plans as well as MyPlate and other tools such as the Healthy Eatings. But really all of this is tied together, as you can see here on this slide. Really all of this goes in a huge timeline that works together. Next, we want this to be interactive. So if you can, please open a browser on another screen or device and follow these instructions. You can go to PollEV.com and type in DarcyGungor689, and you can do this on a tablet. If you have a multi-monitor screen set up or on your phone, it's usually how I do it, where you can pull this up. And just as a reminder, if you can pull it up and then leave this up on your phone or on your screen, that way you can continue to use it. We're going to keep throwing up a few questions throughout the presentation, and we'd love to really learn more about you and try to tailor a few of these slides to your experience and your work and just make this really applicable for you all. So help us get to know you. What is your primary type of work? And you can select more than one response. Are you a primary care doctor, a specialist? Do you work more in research or academia? Are you directly in hospital and healthcare systems, the government? Are you a student, trainee, intern, or are you something else? And if you're something else, we're going to ask you on the next slide about that. So don't feel like you're left out. Thanks for all of your responses. It looks like we have quite a variety. A lot of students and trainees. I love it. So if you answered something else, if you don't mind telling us, what do you do or what do you work on? Awesome. Looks like we have legal, residency coordinator, academic. Not applicable. We accept that answer too. Resident. Okay, great. Government. We're right there with you. So it looks like we have quite a variety of all of you. That's awesome. Thank you all for being here today. All right. So USDA and HHS update the dietary guidelines every five years to reflect the body of scientific evidence current at the time. And we take this job very seriously. We establish an advisory committee to conduct an independent review of an incredible amount of science. And then federal staff carefully write, review, revise, and release a new edition of the dietary guidelines. And this is to ensure that the public health focus of the dietary guidelines is based on the ponderance of evidence. And I did want to point out that the members of the 2020 Dietary Guidelines Advisory Committee for this latest cycle that was released in December of this year, that this this is a group of 20 individuals. It's a very multidisciplinary group. So as you can see, there are a lot of MDs, a lot of MPHs that are practicing both in research and clinical settings. So really a very diverse group. And there will show later that there are lots of ways that you can get involved down the line just like these individuals. The committee used three approaches to review scientific evidence. The first of those is data analysis. These analyses included nationally representative data, the U.S. population, and their dietary intake and rates of chronic disease, which helped to answer questions that were of public health interest for the guidelines. Second, food pattern modeling was conducted to evaluate potential changes in the amounts of and types of foods in a dietary pattern and how those changes can affect our population's nutrient needs being met. Finally, systematic reviews were conducted by NESER, the team that Darcy and I are a part of, and dozens of systematic reviews that answered scientific questions informed this most recent cycle of the Dietary Guidelines. It really varies each cycle by which questions are decided to be of most public health importance during that five-year period. I think it's very likely that you're familiar with what systematic reviews are, but we conduct original systematic reviews so that they're designed to be relevant to the development of the Dietary Guidelines. But I'll explain our methodology here just in brief. Our systematic reviews are carefully planned research projects to answer questions on diet and health relationships. So we start with a question first. We put a lot of thought into asking the right questions because the answers to all of these systematic review questions help to inform the recommendations provided in the Dietary Guidelines. Next, we search for and screen studies. We think about what criteria we will apply to identify the best evidence to answer the question, and we conduct a literature search that casts a wide net to find all of the potentially relevant studies and then screen those studies against the eligibility criteria decided upon. Then we extract data from each of the included studies, and we also assess each study's risk and bias. Once we have all of the desired data from each study, we start connecting the dots by synthesizing the extracted data from all of the included studies, and we use this synthesis, this kind of formed information with everything together, to answer the question and then also to grade the strengths, which is a little bit more unique part of our procedure. Sometimes there are gaps in the evidence, and after conducting such a comprehensive review, we're in a good position to point them out and recommend future research. Now, I want to be searching for and screening studies briefly, and the development of inclusion and exclusion criteria, because it's so central to building a useful evidence base for the Dietary Guidelines. So the inclusion and exclusion criteria applied during the systematic review, I'm just going to give a few examples, but they're still to identify the best evidence for the Dietary Guidelines for Americans. So first off, study design, and we include the best evidence, including randomized control trials when they're available, but they're not always appropriate, as I'm sure you can surmise, like breastfeeding studies with a variety of different health outcomes might not be the most ethical or the most appropriate to prescribe a mother how to feed her baby and so forth. Another example of a review that I specifically worked on was dietary patterns in all-cause mortality. Of course, it would not be very moral or ethical to prescribe a diet that might shorten a person's life or end it sooner, so generally there are not a lot of randomized control trials. I believe out of 153 studies that were included, one was a randomized control trial, and only because they looked at all-cause mortality just by chance. So we also include non-randomized control trials and the best observational studies, including prospective control studies, prospective cohort studies, retrospective cohort studies, and nested case control studies. Next, we have health status, which we're really focused on the public health piece and not the treatment piece of health status, but just as a note, we do include folks that are at risk for chronic disease, as well as healthy individuals, and studies that individuals and folks that are also that have chronic disease. So it is not only healthy Americans, but sometimes there's, you know, a little bit of a rumor around that. Next, we look at human development index, is one of our standard inclusion-exclusion criteria, and the reason that we use this scale, this index, is to bring in information that's only generalizable to the U.S. So we do include studies that are in countries outside of the U.S., but only those that are considered developed or very developed on the human development in order to really make that information applicable. You will also note that we do not have any inclusion-exclusion criteria that are based on race, ethnicity, socioeconomic status, education, gender, etc. We do not view that as something that would be helpful, it would not be generalizable to the U.S., and we want to be very inclusive in our work. Next, you can help with the next review of science. So this really brings together everything that we just talked about, and how does this apply to you all? Right now, you can help build the body of evidence for the 2025 systematic reviews and reviews that come out. You can read the research recommendations from the 2020 Dietary Guidelines Advisory Committee, or if you really are interested in specific topics, there are research recommendations that are associated with each of the systematic reviews on NESSER's website, which Darcy will share later in the presentation. If you have access to cohorts that you are, you have been part of, or that you're working on that data, or you're pulling information every few years, and study them. If you can add a nutrition component, that's great. Anything that can be helpful to address those research recommendations from the committee, that would really help the body of evidence, and those would potentially be incorporated in the next cycle of the guidelines. If you have access to collected data that hasn't already been published on, publish it. We love to see new research, and research in very specific areas. So additionally, spreading the word to your colleagues, especially research colleagues or colleagues that are working on different trials, there's lots of ways to get involved with the research piece of things. In 2023, you can nominate researchers for the 2025 Dietary Guidelines Advisory Committee. Lots of our committee members are doctors like yourselves, or soon-to-be doctors like yourselves. Perhaps in the future, we'll even get to work with you or your colleagues. And in 2024 and 2025, while the next committee is conducting its work, you can follow the Review of Science. And I know some of you said that you are illegal, or you might not be positions, or soon-to-be positions, and you can still be involved. You can follow the Review of Science, which is posted online and discussed in public meetings. And you can also, anyone can do this, submit public comments to improve the work, and that's incredibly helpful to our work to hear from the public. And that kind of is the sum up of my section, but I just wanted to throw up a little pain scale for you all. Just check in how you're feeling. Do you feel like you have the information that you need to get involved in the next Dietary Guidelines cycle? And I believe in this poll, you can just tap. It should show up on your screen if you left it open. You can just tap on any of these faces, and it should show up for us as little, as little arrows almost on the little faces. So it should be on that same polling site as before on poll.eb.com, or poll.eb.com. Looks like most of you are feeling pretty good. We're in the middle, but with that, I'm going to pass things over to Darcy Gungor. Great. Thanks, Marlena. So I'm going to talk a little bit about the Dietary Guidelines themselves and try to hit those objectives to help you find them and identify the relevant content and put them into practice in your own lives with your patients and clients. So the Dietary Guidelines for Americans is written for professionals like you. You're really an important target audience for us. We really value you. We're very happy to have this chance to connect. So health professionals like you can use the Guidelines to work with the general public and help them consume a healthy and nutritionally adequate diet, or if you're not working with patients one-on-one, you can be helping to establish policies or services that support healthy dietary patterns. Nutrition policymakers, who are sort of the other target audience, will use the information in the Dietary Guidelines to develop and implement and evaluate federal food and nutrition programs and policies and design federal nutrition education materials. And I mention this because that works actually really relevant for you as well because it impacts your patients. For example, the Dietary Guidelines are used to develop what are called the USDA Food Plans, and those are tiered for different income. And the lowest tier, the Thrifty Food Plan, is used as a basis for the Supplemental Nutrition Assistance Program, or SNAP. So if you have patients with low income, they may rely on SNAP benefits to purchase food at retailers like grocery stores or increasingly at farmer's markets. We have important work to do together. Americans are not following the Dietary Guidelines for Americans. Health is suffering. This figure shows what's called the Healthy Eating Index and the scores for the Healthy Eating Index across life stages. And this index measures how closely food and beverage choices align with the Dietary Guidelines. So a higher score indicates a higher quality diet, and the maximum score is 100. But as you can see here, the average score is actually around a 59. And I'm sure I'm preaching to the choir here, but the connection between diet and health has been well documented. But despite that, 6 in 10 adults are living with more and more diet-related chronic diseases. And this past year, of course, people living with chronic diseases have been at higher risk of severe illness from COVID. It really underscored for us the importance of this work. The good news is that healthy eating across the lifespan can promote health and reduce risk of chronic disease. And this image may be a little small to fully appreciate, but it conveys some of the science underlying the Dietary Guidelines, which found that healthy eating at every stage of life has health benefits, such as a lower risk of obesity, asthma, CBD, diabetes, certain types of cancers like breast cancer. So we have a call to action in the Dietary Guidelines, which is to make every bite count. And now let's take a look at the Guidelines themselves. The 2020-2025 edition of the Guidelines has four overarching Guidelines. So let's start by taking a closer look at Guideline 1, which says to follow a healthy dietary pattern at every life stage. This is the first time that the Dietary Guidelines has provided guidance by stage of life, from birth to older adulthood, including pregnancy and lactation. The edition also emphasizes that it's never too early or too late to eat a healthy diet. So Chapter 2, you can see here, targets information for infants and toddlers. Chapter 3 is for children and adolescents. Chapter 4 is for adults. Chapter 5 is for women during pregnancy and lactation. And Chapter 6 is for older adults. And I'm going to attempt to make a walkthrough here a little bit targeted to what you would like to see. I'm going to try and make this a choose-your-own-adventure novel. So go ahead and turn back to that polling software because I'm going to ask you now, life stage or life stages are most of your patients or clients. And you can select more than one response if you see more than one age group. And whoever comes out as the winner here, we're through of that part of the guidelines. If you need help getting back to this site, if you closed your page by accident, it's PollEv.com forward slash Darcy Gungor 689. It's at the top of here. PollEv.com forward slash Darcy Gungor 689, having trouble. Looks like we're coming out with adults as the winner. Looks like that's where we're settling. Thank you very much for that input. So let's do a walkthrough of that particular of the guidelines. So what I'm going to do now, attempt to be a little bit nimble here, I'm going to go to the Dietary Guidelines website, which is dietaryguidelines.gov. And you'll see that right on the very front page, there's this option to download the PDF of the Dietary Guidelines. I've already gone ahead and downloaded it so that it's faster. So here's what the cover page looks like. Okay. And if you can scroll past the cover page, you'll get to the table of contents. And I want to sort of highlight for you that all of the age, life stage chapters have a similar pattern to them. So that's why we're only going to go through one. So you can see they all start off talking with an introduction, information about what healthy dietary patterns look like, information about cakes in America, and then a section on special considerations, which might be about sort of like sugar sweetened beverages here for children and adolescents, or about nutrients. You can see here in older adults, protein and vitamin B12 are being highlighted. Then there's a section about how to support healthy eating, including this little sub section on accessing a healthy dietary pattern. So I'm going to go ahead and jump to the adult section. Here's our introduction. Every chapter does have a little bit of information about the importance of physical activity, and it does direct readers to the physical activity guidelines, which is another great document, and also has information about overweight and obesity. And they all, in the healthy dietary patterns section, they also include this little section here because we talk so much about consuming nutrient-dense foods and beverages. It gets defined in a little pop-out like this in each of the sections. So this is what the healthy dietary pattern information looks like, and this came about because of the food modeling, which Marlena highlighted as one of the approaches to the science review. So you can see that you've got your calorie levels, and you can estimate your calorie needs. There's an appendix that helps you do that. So if you're a relatively sedentary 40-year-old woman, you should be in about this range here. And then it highlights the food groups, such as vegetables, and the food subgroups, such as dark green vegetables or red and orange vegetables. And for your calories, how many cup equivalents do you need per week? So that is there for every year. Then there's also information about current intakes. So you can see that this here is for ages 19 through 30, and there's another section for adults in the next age group up. And it shows the healthy eating index score, and it also shows, on the basis of some of the analyses that were done, what are the recommended intake ranges, which are shown in this sort of turquoise color, versus what are the average intakes for real, which are these purple spots. And so you can see, for example, total vegetables, the average intake is lower than the recommended intake ranges. There's also similar information that gets to the subgroup level. So if you want to see, well, why are we doing so badly in vegetables? Here's the total vegetables that was on that last image. And you can see here each of the subgroups, so dark green, red, and orange, and so on. So this information is in every chapter. Then the last thing I want to highlight for you, let's scroll through, we have special considerations, which as I said, are targeted towards either foods of interest in that age group or nutrients of interest in that age group, and then how to support healthy eating. And within that supporting healthy eating subsection on accessing a healthy dietary pattern, which does a good job of referring the reader to food programs like SNAP or FDPIR, and so on, dependent on the group. So now I'm going to attempt to get back to my slides. OK, so the second guideline is my favorite focus of the new edition. And I can see this as a guideline that health professionals like yourselves can really help with. It's optimize and enjoy nutrient-dense foods and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations. The guidelines are meant to be adaptable to personal preferences, cultural traditions, and budgetary considerations. The guidelines framework purposefully provides recommendations by food groups and food subgroups, not specific foods and beverages. And that's to avoid being prescriptive. So this framework approach ensures that people can really make it their own. And health professionals like you can help guide your patients with three steps. First, start with personal preferences. That guideline that I just highlighted says to customize and enjoy foods. And we think that enjoyment part is so important to emphasize. Second, think about how to incorporate cultural traditions. And third, help your patients consider budget. And now I'm going to ask you again, what do you think your patients or clients might need help with? And you can choose more than one response. Do you think you should be able to just touch the spot on your screen here? Do you suppose that your patients are going to need help identifying how to customize around their personal preferences? Do you have a relatively diverse practice with patients that maybe have lots of different cultural backgrounds and they might need help figuring out how to translate what they see in the guidelines to the foods that maybe represent their cultural background? Is budget a big concern for our patients? Looks like we're sort of coming in at all three. Yeah. OK. So I'm going to try to show you a page that I think will really help. This is on the dietary guidelines. And we've really expanded the lists of foods that come from each food group and each food subgroup, as you can see here. And so you should be able to help your patients and clients to identify how to operate within their personal preferences. Maybe they have personal preferences, for example, that they don't like consuming dairy. And so we mentioned that this can be with fortified soil alternatives. And there's a whole lot of different choices in here. Hopefully, something on that list is something that is a personal preference that you can start with. Maybe in terms of their cultural traditions, maybe they're from a place that has fruits and vegetables now right on the list. And maybe they weren't previously. These are things that we have here. Mung beans, pigeon peas, jicama, loquat. We've really tried to be more inclusive in the fruit and vegetables and all of the food groups, really, including the imagery that we're using in this edition. Another one that I like over here is for meats. We've got beef, goat, lamb, pork, game meats, including bison, elk, deer. We're trying very hard to make sure that people can see and recognize, oh, these are foods that I might have in my cultural tradition. And in terms of budgetary considerations, we do highlight that all of these can be met in a variety of ways. So for example, vegetables can be very expensive. But all fresh or canned vegetables, all fresh, all frozen, canned, and in some cases, 100% fruit juices can come with a fruit allowance as well. So we should be very mindful that there are a variety of types of foods and ways that you can purchase them that might be more beneficial to a range of budgets. Trying to turn off my laser pointer, and it's not going well. OK, let's. OK, the third dietary guideline is to focus on meeting food group needs with nutrient-dense foods and beverages and to stay within calorie limits. You can help your clients identify shifts to more nutrient-dense foods that they're willing to make because they really add up. So about the pattern of eating, research shows that the ongoing pattern of an individual's eating habits has the greatest impact on their health. And there are resources in the guidelines that show this type of thing, where you can customize what might be a typical burrito bowl and make small shifts, and that it really does add up if you turn that into a nutrient-dense burrito bowl. And fourth, limit foods and higher in added sugars, saturated fats, and sodium, and limit alcoholic beverages. Most Americans are exceeding their limits for added sugars, saturated fats, and sodium, as you can see here. And so the guidelines does have some resources where your patients or clients identify the sources of added sugars, saturated fats, and sodium in their diets. And so this is a graphic that talks about average intakes of sodium, what those sources are. You can see here that the top source of sodium is actually sandwiches, which may be something that occurs to your patients or clients. So now I'm going to check in with you also and see how are you feeling. Do you think you have the information that you need to use the dietary guidelines in your real-world settings where you are to help your patients or your clients improve their dietary patterns? I see a green. That's good. You should be able to just tap your screen. Lots of greens, good. OK, and one yellow. For those of you who are finding that you're not landing on green, I want you to keep track of what more information that you think we could provide to you because we want to be good resources to you. And we'll bring those up again at the end. OK. So one more slide from me, which is just to let you know that these are some resources that we've got for professionals and for the public, which might include your patients. Access the evidence. Medical reviews are available at nesr.usda.gov. We've got data analyses, food pattern modeling, and a report of the most recent committee at dietaryguidelines.gov. I showed you how to get to the dietary guidelines PDF. That's at dietaryguidelines.gov. Also, there are going to be a toolkit of professionals at health.gov coming up sometime soon, and CDC grounds at cdc.gov, which are expected in the fall. And we also have a lot of resources at myplate.gov. And Stephanie is going to be up next to talk about those. And all of these resources are available for free to you and your patients. So with that, I'll turn it over to Stephanie. Thanks so much, Darcy. So we're going to spend a little bit of time on consumer resources now that you can let your clients, patients, customers know about. The first thing that we wanted to go through is just in terms of consumer messaging. So when it comes to consumer messaging, where the call to action for the dietary guidelines is a call to action to professionals like you, we then translate that into a call to action for consumers. And we know that healthy eating is, it takes planning, it takes thought. We're not going to try to sugarcoat it and talk about how easy it is. But we do want to encourage people to start simply. And so we know this isn't quite grammatical, but we do have a campaign that we launched called Start Simple with MyPlate. And the whole purpose of it is to help consumers with incremental change. So we always talk about taking those small steps. And that's what this is about. In terms of the consumer messages, we spent quite a bit of time in the field conducting consumer research across life stages. And so what you see here are the key messages that we have that we then turn into materials to help consumers in making those choices day to day. So these are grounded in MyPlate and rooted in the guidelines. So of course, in terms of the advice, it does go back to the food groups. And there are specific behaviors for each one of the food groups. So you'll see here a message that we often find helpful is to make, pack your plate fruits and vegetables. It helps consumers just kind of visualize and think about the products that they're going to eat. It helps consumers visualize and think about the proportion of the choices that they're making. So I'm not going to go over each one of these. One of them that I did want to point out is as an update that when it comes to dairy, we have tried to be even clearer in this edition of the guidelines and therefore the Consumer MyPlate when we talk about dairy, we include lactose-free dairy and fortified soy versions of milk and yogurt because we realize that a good portion of the population in the US either cannot or chooses not to consume dairy milk. And so we do want to make sure that we're clear about that. There's also a part, we often get the question about other plant-based milks. And if you have that question, we have information in the dietary guidelines about that in the dairy section. In terms of resources, we have a number of resources that we developed to go live concurrently with the dietary guidelines so that as soon as the guidelines were released, professionals would have resources to share with consumers right away. One of those sources, of course, is MyPlate.gov. It is the central portal for all kinds of information and resources, digital tools, downloadable resources. And we're going to go through some of those. So one of those is a MyPlate quiz. And when I go through this list, what I often say is that they're kind of like a menu. You can either choose every course as part of your meal, or you can decide that you only want one or two things. And so this first piece is MyPlate quiz. As soon as you go to MyPlate.gov, it's right there on the home page. And it's meant to be a very simple kind of BuzzFeed style self-assessment. So a person can go in there and plug in their information really quickly. And I'm going to walk through what that looks like. The next piece is a consumer app that's available both in the Apple Store and Google Play. I'll go through some of that as well. And personalized MyPlate plans that offer quantitative information, and then toolkits. So to go through these one by one, first, the quiz is interactive. All of these pieces, we really designed for consumers to be able to personalize to their preferences, to their lifestyle. As Darcy said, that is really important in the guidelines. And we're trying to make that come to life with these tools. So with this quiz, it's 20 questions. It goes really fast. And once you plug in those questions, you get a tailored response. So in this case, this person has taken the quiz. And what it shows is they're doing really great on fruits, grains, and protein foods. And they look like they need a little help in vegetables and dairy. So the results that they get are geared toward those needs. What you'll see as well is in the center of this that it links to the Start Simple with MyPlate app. So once you finish this quiz, the person gets a code. And they can plug it into the Start Simple app, which, let's go to the next slide, is a tool where you've done your self-assessment. Now you can pick goals. And the app is, if you want to find it, you do need to plug into the Search Start Simple with MyPlate, not just MyPlate. If you do MyPlate, you'll get a Livestrong app because they beat us to the name. So do plug in Start Simple with MyPlate. And the point of this is goal setting, but very, very simple, doable goals. So there are things like, if I need to do better in vegetables, you can pick a goal like snack on vegetables or start your day with dairy for the dairy goal. And the reason they're that way is that, for me, snacking on vegetables might mean that I really want a snack on sugar snap peas. But for someone else, they really want to eat baby carrots. So you can make it yours. There is, in the app, the ability to track real-time progress. And then this is, as we are all trying to focus on helping consumers make better choices and change behaviors incrementally, celebrating that success is an important part of that behavior change. So there's an element in here where people can earn badges and celebrate their success by achieving the goals that they set. We also have challenges that we issue probably about quarterly. And then there are some pop-up challenges. And that is also to help folks stay motivated, to try new goals, to keep them going. The new feature is that folks can register to have an account. It's called an eAuth account. It's no different than any other registration where you submit your email address, and then you pick your password. And then that gives you the ability to save things and go back to it. So I talked a little bit earlier about the ability to save or to sync up your quiz results. And in the next slide, what you'll see is that you can plug that in. You'll get this screen, and it will automatically sync up with the app. So it will prompt you to set goals in those areas. You can set goals in anything, but this just is a little bit of a nudge in those areas where you might need a little bit of encouragement. So as I said, you can go to myplate.gov and go to the Start Simple app page for information. But you can also download it from the two locations. The next tool is what we call the MyPlate Plan. And this is for the person in the next stage, where when we tested the app, we tested the quiz in the app. They loved the fact that those two could sync. One of the things that we heard for folks in the app was, two of the things, was they loved that it was very simple, that it was actually not a food diary where they had to measure their food and input exactly what they ate. It was one step removed and really just encouraged them to make those very doable changes one meal at a time one day at a time. The other thing we've heard though is then that it made them curious about well so how much do I actually need to eat which is where my plate plan comes in. So in this you plug the person just plugs in basic information like a BMI calculator you'll see here. It's available in English and Spanish. Once you plug in that information you will get oh I'm sorry it's also available for a number of different audiences. So with the latest guidelines of course women who are pregnant and breastfeeding were an important area of focus. So my plate plan provides information for those stages as well as they have very specific needs. So once you plug in your information this is an the next slide is an example of the results that you'll get. So very specific amounts and then some suggestions on ways to achieve those amounts. And then what you get is you can print out a two-sided front and back piece that will help you it will give your specific amount as a reference. So if you want to you know put it in it to a bulletin board in the kitchen you can do that and again available in both English and Spanish. The other thing that's nice about this widget on our website myplate.gov it's actually one of the most visited pages and one of this is something that might be of interest for you if you want to offer this tool to your your patients or clients. We have a widget so all you do is you embed it onto your website and any if we for example update it for some reason then it automatically updates on your website. So if you embed it it looks like it's coming from you and you can direct your patients to it figure out how much they need to eat if you have recommendations for them or if you want them to find out for themselves. So just a closer look at myplate.gov there are pages specific to life stages and these are some examples of what folks can find. There's also another section that is really popular on our website that is healthy eating on a budget and right now there is very straightforward information. As Darcy mentioned one of the other things that we do is the Thrifty Food Plan which informs this the maximum SNAP allotment and so we're hoping to expand this in the coming year or so. Particularly as we've all been experiencing in serving the public what folks have been going through with the COVID-19 epidemic or pandemic and knowing how much it's affected folks across the board particularly communities who are underserved both in terms of hunger as well as being impacted health-wise even more harshly by the pandemic. We also have a whole range of all kinds of resources that you'll find if you go to the resources page you can search by audience topic or resource type and that search tool is really important and helpful because there is a lot there are lots and lots of resources for consumers all kinds of audiences as well as the MyPlate icon that's available in more than 20 languages. And then finally another aspect that's available on MyPlate.gov is the MyPlate kitchen which is our home base for resources. What we can do is we've provided over a thousand recipes. They come from a number of programs that our Food and Nutrition Services Agency administers and so a number of them are from the SNAP program. There are many many budget-friendly recipes with commonly available ingredients. We have a recipe of the month that we put up there that folks like and then there are also a number of other ways to search such as recipes that are trending, things that are seasonal, recipes that take under 30 minutes which I think a lot of us probably appreciate. And as I mentioned there there are quite a bit of things that you can filter out when you're searching that you might not find in some other on some other recipe websites so you can search on the next slide by cooking equipment, you can search by food group, you can also browse by cost. So we have a range of four cost levels and that's very helpful to a lot of our program participants and folks at the community level. And we also we talked a little bit earlier about how you can register and create your own account and so by doing that with MyPlate kitchen you can create your own online cookbook to come back to for some of your favorite recipes. And as with the MyPlate plan tool this is also available in Spanish, all the recipes and the cookbook capability. This is an example of what you get when you click on a recipe. It's rated, you can share it on social media and there are suggestions for similar recipes. On the next slide what you'll see is the breakdown of nutrients for folks who are interested and then again kind of laddering back to that MyPlate plan if you're if folks are tracking what they're eating this gives you an idea by by food group of how much you're getting from each of the food groups. And I mentioned earlier we had created toolkits and there are toolkits by the different audiences that we serve in the professional world. So for example if you're practicing we have a toolkit for professional organizations. If you a number of folks we know because of the the area that you're in that we're so thankful for you might have a registered dietician or more than one on staff and so there's a toolkit specifically for RDNs. So we invite you to check this out on the website at MyPlate.gov. There's a section for professionals so when you click in there you'll see right away that the toolkits are there for you. It has suggestions on ways that you can incorporate our materials with links to all of those resources so you don't have to go searching all around the website. And then we have a number of resources coming up. We have almost 30 new tip sheets that knock on wood are have been going through clearance. It's government so it takes a little bit longer and those will be coming soon in PDF form so that they're downloadable in English and Spanish. And we're also going to have a tip sheet that is a start simple with MyPlate tip sheet very core to what we do and that will be in 22 languages. We're also expanding our food group gallery so on the website there's a gallery of examples of foods in in each food group to just get people thinking about what all the different options are. There's a lot of variety and the things that you love are things that count and so we're expanding those images particularly to make them more inclusive of cultural diversity that is really important to the work that we're doing. And then also coming up we'll be adding photos that show what a cup of something looks like of different types of foods. We often get questions about you know what's a serving size and we don't really talk about serving sizes anymore because that as a term could be so ambiguous. And so what we use is cups and ounce equivalents and so we're adding photos that will show that in case that's helpful in providing information to the public that you're serving. So if you'd like an update or to stay in touch with us on new resources coming from MyPlate we encourage you to go to our website at myplate.gov scroll down to the bottom and you'll see there sign up for updates. So with that we encourage you to stay connected with us and we really hope that this is a good entree into all the resources that we've developed that you can access for free. And we want to know how we can support you better. So with that I'd like to turn it back for Q&A. Back on. I'm going to bring forward some of the questions in our final two minutes of our session. So one of the questions that we have that came through our panelists is can you speak more to the evidence you found to include animal products. In lifestyle medicine world we are taught that evidence for best health is whole food plant-based eating pattern. So specifically I guess addressing the meat, dairy, animal products. Sure. So you'll see in the dietary guidelines that that there are amounts that are recommended by calorie level. And if I could turn it over to Marlena there was a systematic review conducted specifically on dietary patterns. And so that would that that review provide some insight. Marlena can you address that a little bit? Sure. Yeah our dietary guidelines we looked at eight different questions but I think our probably biggest and most helpful review would be the all-cause mortality review that I mentioned earlier. And really I think the moral of that is that you can you can reach a healthy dietary pattern through a variety of pathways. Be that vegetarian or someone who consumes meat. So I think if you really want to dig into the evidence we can point you to nesr.usda.gov to look a little bit more closely at that review. If you want to reach out I think on our we can we're happy to provide our email addresses. I'd be happy to answer any more direct questions about that specifically. But I know we're short on time so I'll leave it with that for now. Okay and then I guess we'll have one time for one more question. And I see here a question about whether the guidelines are based on what you think Americans may attain or whether it's actually based on the best eating patterns. I guess I could take that one as well since it's about patterns. I think when we have we have our three methods that look at diets you know we look at the analysis and so when we do the dietary pattern modeling that's that's all kind of theoretical and looking at everything. But I'm sorry I know we have 16 seconds so we're running short on time. But we're really looking at these different what the researchers are looking at. What's in the literature and what we have available for those dietary patterns. So again I can point you to those systematic reviews that go really in depth on the index score patterns. Well thank you to our panelists. Thank you for the attendees. And as the panel members mentioned they're happy for you to reach out to my email. Thank you and enjoy the rest of your day. Thank you. you

Dietary Guidelines for Americans

health promotion

disease prevention

scientific evidence

data analysis

food pattern modeling

healthy dietary pattern

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MyPlate.gov

personalized eating habits

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