Remarks by Susan Mayne, Director of the Center for Food Safety and Applied Nutrition at the National Food Policy Conference - 10/12/2022

(Remarks as prepared for delivery)

Thank you, Dr. Califf. As you highlighted, we are facing an epidemic of diet-related chronic diseases right now. We have known this for some time. But what has changed is the inspiration and commitment to action provided by the White House Conference on Hunger, Nutrition, and Health.

The National Strategy from this conference provides a roadmap of actions the federal government will take to end hunger and reduce diet-related diseases by 2030-all while reducing disparities. This is an opportune time to greatly accelerate efforts to create a healthier food supply.

We heard emphatically at the Conference that we need all of us working together - taking a whole of government and whole of society approach-because the problems of hunger and diet-related disease are multifaceted, requiring multifaceted solutions. Healthy eating is influenced by a number of factors, including access to healthy, safe and affordable foods, as well as consumers' knowledge, attitudes and culture.

Government certainly has a role in getting healthy foods to everybody and in making the healthier choice the easier choice. For example, food labeling can be a powerful tool for change. It empowers consumers with information that they can use to choose healthier foods. I believe that most consumers want this information, but we must make it understandable and easy to find. People want information at their fingertips.

That is why the National Strategy includes updating the definition of the "Healthy" nutrient content claim that consumers can see on the front of food packages. The definition is being updated to align with current nutrition science and the Dietary Guidelines for Americans. For example, current dietary guidelines focus on the importance of healthy dietary patterns and the food groups that comprise them, the type of fat in the diet rather than the total amount of fat consumed, and the amount of sodium and added sugars in the diet. The proposed definition is consistent with this focus.

We are also developing a "Healthy" symbol to accompany the definition so that consumers can quickly find foods that meet the definition. We know that most people's eating patterns do not align with current dietary recommendations so we believe updating the "Healthy" claim and having a symbol could help improve eating patterns.

We also are developing guidance for industry on their use of Dietary Guidance Statements on food labels to help people understand how a food or food group can contribute to a healthy eating pattern. Examples of Dietary Guidance Statements are "make half your grains whole grains," and "eat a variety of vegetables." Our guidance would help with more consistent use of such statements to benefit consumers.

Our work on front-of-package information doesn't stop there. We also are planning to develop a front-of-package-or FOP-labeling system to quickly and easily communicate nutrition information. Use of these schemes has increased dramatically around the world in recent years. FOP systems can promote equitable access to nutrition information and provide consumers with information to make healthier choices.

Online nutrition information is another priority that is part of the National Strategy. Since 2018 we've continued to see a shift in consumer buying patterns as people are increasingly using e-commerce to shop for groceries online. This trend dramatically accelerated during the pandemic. That is why as part of the National Strategy, we will publish a request for information to gather public input regarding industry practices, technology, and current challenges to inform guidance for the food industry on nutrition, ingredient, and allergen information that should be readily available for groceries when shopping online.

Food labeling is powerful in another way. In addition to helping consumers make good choices, it has the potential to make foods healthier because it provides an incentive for food manufacturers to reformulate. Our goal is to create a healthier default so that all food options get healthier.

We know this works. One great success is our influence in virtually eliminating artificial trans fat from the food supply. After trans fat was added to the Nutrition Facts label in 2006, it led to an 80% drop in intake of artificial trans fat - through consumers choosing different options and industry reformulating. The FDA has since taken additional actions and these artificial trans fats have now essentially been removed from the food supply, likely averting tens of thousands of cases of heart disease and stroke.

We've also seen the restaurant and fast-food industries offer lower-calorie options after we required calories on menus and menu boards. As another example, added sugars are now on the Nutrition Facts label. Consumers now have access to that information when they did not even a few years ago. The FDA will begin assessing the evidence for additional ways to reduce added sugar consumption as part of the national strategy.

We have tools in addition to labeling to encourage healthier foods, and our work on sodium is a good example. Too much sodium can increase the risk for developing hypertension, which in turn can raises the risk for heart attacks and strokes.

We know the large majority of sodium in our diets comes from sodium that is added to processed and prepared foods, not sodium added at the table or during cooking. That's why having sodium listed on the Nutrition Facts panel is important, but not enough. Even nutritionally savvy consumers have difficulty following eating patterns with recommended limits of sodium because foods across the board just have too much sodium.

Last year, we issued voluntary short-term targets to reduce sodium in foods.

We see this is a critical first step in a gradual, iterative approach we'll be taking to help reduce sodium to recommended limits over time. Notably, our targets also include goals for restaurants and food service providers, which many other countries' strategies do not have.

If fully implemented, we estimate that average sodium intake in the U.S. would be reduced by 12%; from 3,400mg/day average to around 3,000 mg/day. Although average intakes would still be above recommended limits, we know that even modest improvements made across the population could produce large public health benefits. And we plan to monitor the food supply and develop updated, revised targets in the future.

While our targets are key to our sodium reduction work, we are taking a multi-pronged approach to our sodium reduction efforts. Several other of our initiatives further support and reinforce sodium reduction. For example, we issued guidance in December 2020 on the use of "potassium salt" as an alternate name for potassium chloride on food ingredient labels. Sodium is also a criterion for many of our claims, including "healthy," that a product must meet in order to bear the claim. We're also looking at ways to provide greater flexibility to industry around the use of sodium in standardized foods, such as canned vegetables and breads, to allow industry to produce healthier foods, including lower sodium versions.

Many may not realize that sodium is also part of our menu labeling requirements. Along with disclosing the number of calories in standard menu items, covered establishments are required to provide, upon request, written nutrition information for standard menu items, including sodium.

We recognize that our work complements and amplifies the actions of other federal agencies working to reduce sodium intake, such as our colleagues at the U.S. Department of Agriculture and their work on reducing sodium in school meals.

As we work to improve nutrition, we are keenly aware of the link between nutrition and food safety. Produce is a good example of this intersection. We know that increasing access to, and encouraging, a diet rich in fresh fruits and vegetables can improve health.

However, we also need to ensure that such produce is safe from microbial and chemical contaminants; this is critically important to consumer confidence in fresh produce. We still find ourselves far too often faced with outbreaks and recalls linked to fruits and vegetables. In addition, we know the agricultural community is also faced with the difficult challenge of protecting their crops from non-microbial contamination, such as from PFAS and dangerous levels of elements like arsenic and cadmium which we know occur naturally in our environment.

Fortunately, we have investigated more, we have researched more, and we have advanced our scientific understanding of the microbial contaminants and toxins that can contaminate our food. Our ability to diagnose and detect foodborne illness, our understanding of microbial contamination, and our analytical methods to detect environmental chemical contaminants in food have improved.

These activities are providing us with more data, information and insights into the many factors that affect the safety of the produce we all feed our families.

The prevention strategies we've put in place are an affirmative, deliberate approach to limit or prevent future outbreaks. In 2020, we issued our Leafy Green Action Plan, which outlined multi-faceted steps to reduce Shiga toxin-producing E. coli outbreaks associated with the consumption of leafy greens. And last month, we released the first in a series of Food Safety Prevention Strategies that address commodity-hazard pairings, like Salmonellosis associated with bulb onions.

These strategies are the result of a culmination of information, including lessons learned from outbreak and root cause investigations, our work with industry, regulatory partners, and other stakeholders to identify what may have gone wrong following recent foodborne outbreaks, particularly those that we have seen happen more than once. They build on the advancements we have made to modernize our food system over the last decade by leveraging compliance history, outbreak data and scientific research to strategically target hazards.

Traceability is an essential part of our food safety strategy. It leads to better safety by enabling rapid traceback to the source of contamination, speeding recalls of potentially contaminated foods. Traceability ties into prevention by enabling us to conduct root cause analyses that in turn help us to develop preventive controls.

We are also working to modernize our work around environmental contaminants in our food supply by leveraging advancements in analytical methods, toxicology and research. These advancements are helping us to take new, more targeted approaches such as the Closer to Zero action plan to reduce exposure to toxic levels of elements in foods eaten by young children as much as is possible.

This is an exciting time for all of us committed to eliminating hunger and improving nutrition and overall health. We have our work cut out for us, but having a National Strategy on hunger and nutrition and health helps us to focus and coordinate our work among all of us. I know we will have further conversations on the many initiatives contained in the Strategy and I look forward to engaging with you-2030 is not far away and we have much to accomplish together.

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