Part 2 of 2 Response To My 11/18/15 FOIA Request Re: 2015 US DGAC Members Barbara Millen, Alice Lichtenstein, Frank Hu

DEPARTMENT OF HEALTH & HUMAN SERVICES
Program Support Center

Division of FOIA Services
5600 Fishers Lane Rm 19-01

Rockville, Maryland 20857
Phone: 301-443-3403
Fax: 301-480-5862
PSCFileNo.: 16-0040-FOIA; 16-0226-FOIA
May 12,2016
Peter Heimlich
3630 River Hollow Run

Duluth, GA 30096
Dear Mr. Heimlich:
This is our final response to your November 18, 2015 Freedom of Information Act (FOIA)
request. In summary, you requested copies of all correspondence to and from Dr. Millen, Dr.
Lichtenstein and Dr. Hu members of the 2015 Dietary Guidelines Advisory Committee.
A records search was conducted by the Office of the Assistant Secretary for Health (OASH), and
411 pages were located that are responsive to your request. Enclosed you will find 411 pages
released, 330 of which are released in their entirety. I have determined to withhold minor
portions of 81 pages under FOIA Exemptions (b)(6).
Exemption (b)(6) protects information the disclosure of which would constitute a clearly
unwarranted invasion of privacy. The information withheld consists of an individual's personal
information.
Please note that attachments included within emails are drafts of versions that are now public
documents available in the Scientific Report of the 2015 Dietary Guidelines Advisory
Committee at health.gov/dietaryguidelines/, for your convenience I have provided you the link
below.
http://health.HOv/dietarvguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015dietarv-guidelines-advisorv-cornmittee.pdf
http://health.gov/dietaryguidelines/2015/meetings.asp
http://www.nel.gov/categorv.cfm?cid=50
There will be no charges in this instance because the billable costs are less than our threshold of
$25.
If you have reason to believe that the information withheld should not be exempt from
disclosure, you may appeal. Your appeal should be sent within 30 days from the date you
receive this letter to the Director, News Division, Office of the Assistant Secretary for Public
Affairs, U.S. Department of Health and Human Services, Parklawn Building, Room 19-01, 5600
Fishers Lane, Rockville, MD 20857. Clearly mark both the envelope and your letter "'Freedom of
Information Act Appeal."
Sincerely yours,
Denise F.
Wallace-S|i
Denise F. Wallace
FOIA Officer
Freedom of Information Act Services

Enclosure: 411 pages on CD
Casavale, Kellie (OS/OASH)

From:
Sent:
To:
Subject:
Attachments:
Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu>

Monday, February 23, 2015 7:26 AM
FW: Two slide decks: Chapter 5 and PA
image001.png
In case you are interested in the most recent discourse. This is one of many, many e-mails that have
been flying back and forth.
AliceH.Lichtenstein,D.Sc.
GershoffProfessorofNutritionScienceandPolicy
DirectorandSeniorScientist,CardiovascularNutritionLaboratory
TuftsUniversity
JMUSDAHumanNutritionResearchCenteronAging
711WashingtonStreet
Boston,MA02111
phone:6175563127
email:Alice.Lichtenstein@Tufts.edu
From: Siega-riz, Anna Maria [mailto:am_siegariz@unc.edu]
Sent: Monday, February 23, 2015 6:57 AM
To: Mary Story, Ph.D.; Neuhouser, Marian L; Millen, Barbara E; Frank Hu; Siega-riz, Anna Maria
Cc: Nelson, Miriam; Lichtenstein, Alice; Cheryl Anderson, PhD, MS, MPH; Frank Hu, MD, PhD, MPH; J. Thomas Brenna,
PhD, MS; Lucile Adams-Campbell, PhD, MS; Rafael Prez-Escamilla, PhD, MS; Steven Abrams, MD; Steven Clinton, MD,
PhD; Wayne Campbell, PhD, MS; Griffin, Timothy; mhamm@anr.msu.edu; Grossman, Andrea
Subject: Re: Two slide decks: Chapter 5 and PA
Dittoandfurthermoreifyoumakeyourpresentationallatoncethereisverylittleincentiveforfolkstostayforitall.
Anna Maria Siega-Riz, PhD

ProfessorofEpidemiologyandNutrition
and
AssociateDeanforAcademicAffairs
GillingsSchoolofGlobalPublicHealth
2105AMcGavranGreenbergHall,CB7435
ChapelHill,NC27599
Phone:9199665984
1
PSC-HHS-000001
Email:am siegariz@unc.edu
From:"<MaryStory>",'MaryStory<mary.story@duke.edu>
Date:Sunday,February22,2015at5:39PM
To:"Neuhouser,MarianL"<mneuhous@fredhutch.org>,DrPHBarbaraMillen<bmillen@bu.edu>,FrankHu
<nhbfh@channing.harvard.edu>,AnnaSiegaRiz<am siegariz@unc.edu>
Cc:"'Miriam(Mim)E.Nelson"<miriam.nelson@tufts.edu>,AliceLichtenstein<Alice.Lichtenstein@tufts.edu>,
"c1anderson@ucsd.edu"<c1anderson@ucsd.edu>,"frank.hu@channing.harvard.edu"
<frank.hu@channing.harvard.edu>,"'jtb4@cornell.edu'"<jtb4@cornell.edu>,LucileAdamsCampbell
<lla9@georgetown.edu>,RafaelPerezEscamilla<rafael.perezescamilla@yale.edu>,StevenAbrams
<sabrams@bcm.edu>,StevenClinton<steven.clinton@osumc.edu>,WayneCampbell<campbellw@purdue.edu>,
"Griffin,Timothy"<Timothy.Griffin@tufts.edu>,"mhamm@anr.msu.edu"<mhamm@anr.msu.edu>,"Grossman,
Andrea"<Andrea.Grossman@tufts.edu>
Subject:Re:Twoslidedecks:Chapter5andPA
IjustreadMarion'snoteandshemakesgoodpoints.Itwillseemdisjointednottohavethesubcomittee'sreports.
Barbaraitseemslikeitwouldbebestjusttokeeptheagendaaswas.
Mary
From:<Neuhouser>,MarianL<mneuhous@fredhutch.org>
Date:Sunday,February22,20154:16PM
To:"'BarbaraMillen,DrPH,MPH,RD'"<bmillen@bu.edu>,FrankHu<nhbfh@channing.harvard.edu>,"Siegariz,Anna
Maria"<am siegariz@unc.edu>
Cc:"Nelson,Miriam"<Miriam.Nelson@tufts.edu>,MaryStory<mary.story@duke.edu>,"Lichtenstein,Alice"
<Alice.Lichtenstein@tufts.edu>,"CherylAnderson,PhD,MS,MPH"<c1anderson@ucsd.edu>,"FrankHu,MD,PhD,
MPH"<frank.hu@channing.harvard.edu>,"J.ThomasBrenna,PhD,MS"<jtb4@cornell.edu>,"LucileAdamsCampbell,
PhD,MS"<lla9@georgetown.edu>,"RafaelPrezEscamilla,PhD,MS"<rafael.perezescamilla@yale.edu>,"Steven
Abrams,MD"<sabrams@bcm.edu>,"StevenClinton,MD,PhD"<steven.clinton@osumc.edu>,"WayneCampbell,PhD,
MS"<campbellw@purdue.edu>,"Griffin,Timothy"<Timothy.Griffin@tufts.edu>,"mhamm@anr.msu.edu"
<mhamm@anr.msu.edu>,"Grossman,Andrea"<Andrea.Grossman@tufts.edu>
Subject:RE:Twoslidedecks:Chapter5andPA
Hi Barbara
Thanks for sending this around. My first take on this master for your section is that it emphasizes some of the major work
from SC1 and perhaps to too light on some of the work of the other subcommittees and groups. Slides 16-21 are some of
the major results slides shown from SC1, then slide 22 is very general about SC2 then it jumps to placeholders for slides
22 and 24 (which come from SC1 work and we actually do already have slides for this as we showed the three patterns
and some nutrient content in the public meetings). Slides 26-28 are all major content from SC1 (slides we presented),
leaving only a few very general slides for the rest of the work (but no content from the other SCs or other groups).
As most, but not all of the group knows, I will be traveling on Wed (planned months ago) and not able to participate
since I will be on an airplane at the time of the event. Thus, Cheryl will present SC1. It will be very important to
coordinate with Cheryl because I imagine some of the slides in this master are the very ones she planned on presenting.
I'm concerned about overlap and also concerned that the rest of the important topics from the rest of the SCs will not get
their full overview up front.
Marian
From: Millen, Barbara E [bmillen@bu.edu]
Sent: Sunday, February 22, 2015 11:36 AM
To: Frank Hu; Siega-riz, Anna Maria
Cc: Nelson, Miriam; Mary Story, Ph.D.; Lichtenstein, Alice; Cheryl Anderson, PhD, MS, MPH; Frank Hu, MD, PhD, MPH; J.
Thomas Brenna, PhD, MS; Lucile Adams-Campbell, PhD, MS; Neuhouser, Marian L; Rafael Prez-Escamilla, PhD, MS;
2
PSC-HHS-000002
Steven Abrams, MD; Steven Clinton, MD, PhD; Wayne Campbell, PhD, MS; Griffin, Timothy; mhamm@anr.msu.edu;
Grossman, Andrea
Subject: RE: Two slide decks: Chapter 5 and PA
HIEveryone,
FranksCommunicationsOfficerecommendedthatwerevisetheagendaforthesymposiumonWednesday.Themajor
changewouldbetohavemycommentsaddressupfront,ourchargeandevidencebasedmethodsandthemajor
findingsandintegration.Therationaleisthatthosewhocantbethereforthefull2.5hourswouldgetthemessage.I
certainlyexpectthatmanywillstaythefulltimeframebutthisassuresthatourprimary,positivemessagesarenot
lost.Pleasetakealookandletusknowyourcomments.
Mydraftslidesareattached.IwilltweakthemabitasIgothroughthereportandmakemyfinalpresentation
notes.Youwillseetwoplaceholderslides.IaskedKellieandTrishBrittenquitesometimeagotoworkonacoupleof
slidesthatcomparethethreemodeledHealthyDietaryPatternsonfoodgroupaswellasnutrientprofile(TablesD132
and33fromthereport).Myintentistodefusesomeofthecommentwehavebeengetting.Trishwasawayuntilthe
otherdaybutIthinksheisworkingonthemforuseonWednesday.
Byallmeans,commentontherevisedagendaandmyslides.
Iwilltrytotrimbackabitinthenextpassandaskthateveryonethinkaboutdoingasmuchofthataspossible.Ido
agreewithAnnaMariaandFrankthoughthatsomeslideswillhardlytakeaminute.Idida20minutewebinarthisweek
(ontheObesityGuidelines)andused60slides;Iwas2minutesundertheallottedtimeframeanddidntfeelatall
rushed.SoIthinkitscloseasis.Letmeknowifyouwouldrecommendemphasizinganythingelse.
Lookslikewehaveareasonablyconsistentformatacrossslidedecks.IfollowedTomsadviceontheMasterbutyoucan
alsoaccomplishitbytakingthemasterforanotherDGACmembersdeckandinsertyourslides.Presto!
Allthebest,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
From: Frank Hu [mailto:nhbfh@channing.harvard.edu]
Sent: Sunday, February 22, 2015 9:54 AM
To: Siega-riz, Anna Maria
Cc: Nelson, Miriam; Millen, Barbara E; Mary Story, Ph.D.; Lichtenstein, Alice; Cheryl Anderson, PhD, MS, MPH; Frank Hu,
MD, PhD, MPH; J. Thomas Brenna, PhD, MS; Lucile Adams-Campbell, PhD, MS; Marian Neuhouser, PhD, RD; Rafael
Prez-Escamilla, PhD, MS; Steven Abrams, MD; Steven Clinton, MD, PhD; Wayne Campbell, PhD, MS; Griffin, Timothy;
mhamm@anr.msu.edu; Grossman, Andrea
Subject: Re: Two slide decks: Chapter 5 and PA
Anna maria,
The slides Kelly sent are not new ones, but those used in our last public meetings (5-7). For saturated fat, I used
the final slides from last meeting, and added one on methods from meeting 6.
You are right that adherence to time limit is more important than the number of slides. My experience has been
that the actual time I end up talking is typically longer than planned, and this is directly correlated with the
number of slides. Nonetheless, 7-8 slides is a general guide, not a rule. Again, our time is very constrained.
As you may have noticed, there are intense and unprecedented interests on the DGAC report, from all sides.
Hence our symposium is extremely timely and should offer an excellent opportunity for us to describe the
strong science base and present key findings.
3
PSC-HHS-000003
We are fine-tuning the agenda and will send out a slightly revised version tomorrow.
The followings are the website for registration and webcast:
Inordertoattendthissymposium,youmustpreregisteronouronlineform
athttps://harvard.az1.qualtrics.com/jfe/form/SV 7WL0pzPIwAnLIl7.Thewebsiteforthiseventcanbefound
athttp://www.hsph.harvard.edu/dgacsymposium/.Thewebcastcanalsobefoundonthissite.
Frank
On Sun, Feb 22, 2015 at 9:30 AM, Siega-riz, Anna Maria <am siegariz@unc.edu> wrote:
MaybeImissedsomething,didKellysendusnewslides?FrankwhileIknowwearelimitedto8minutessomeoftheslidesdo
nottakeafullminutetodescribesoIwouldnotworrysomuchaboutthenumberbutmoreaboutmakingsurewedontgo
overourtimeallotment.
AMSR
Anna Maria Siega-Riz, PhD

and
ChapelHill,NC27599
Phone:9199665984
From:FrankHu<nhbfh@channing.harvard.edu>
Date:Saturday,February21,2015at6:06PM
To:"'Miriam(Mim)E.Nelson"<miriam.nelson@tufts.edu>
Cc:DrPHBarbaraMillen<bmillen@bu.edu>,'MaryStory<mary.story@duke.edu>,AliceLichtenstein
<Alice.Lichtenstein@tufts.edu>,AnnaSiegaRiz<am siegariz@unc.edu>,"c1anderson@ucsd.edu"
<c1anderson@ucsd.edu>,"frank.hu@channing.harvard.edu"<frank.hu@channing.harvard.edu>,"'jtb4@cornell.edu'"
<jtb4@cornell.edu>,LucileAdamsCampbell<lla9@georgetown.edu>,"mneuhous@fhcrc.org"<mneuhous@fhcrc.org>,
RafaelPerezEscamilla<rafael.perezescamilla@yale.edu>,StevenAbrams<sabrams@bcm.edu>,StevenClinton
<steven.clinton@osumc.edu>,WayneCampbell<campbellw@purdue.edu>,"Griffin,Timothy"
<Timothy.Griffin@tufts.edu>,"mhamm@anr.msu.edu"<mhamm@anr.msu.edu>,"Grossman,Andrea"
<Andrea.Grossman@tufts.edu>
Subject:Re:Twoslidedecks:Chapter5andPA
Dearall,
attachedpleasefindmyslidesonsaturatedfat,slightlymodifiedfromtheslidesKelliesenttousyesterday.Pleaseletme
knowifyouhaveanycomments.
Giventhetimeconstraint,eachofushasonly78minutestospeakandhencethenumberofmyslidesislimitedto7.Itwould
begreatifyoucanlimitthenumberofyourslidestonomorethan8.Iknowthisishard,butitisimportanttokeepupwith
thescheduleandleaveadequatetimeforQ&A.
ItwouldbegreatifyoucansendmeyourfinalslidesbyMonday.
thanks
Frank
OnFri,Feb20,2015at9:20AM,Nelson,Miriam<Miriam.Nelson@tufts.edu>wrote:
4
PSC-HHS-000004
HiFrankandBarbara,
IamattachingthetwoslidedecksthatIhavetopresent.TheseareeditedversionsofwhatwepresentedinDecember.Ihave
cutbackonthenumberofslidesdramatically(andsomeofthewords).
IwasnotascleaverasAnnaMariainthatIwasn'tabletofigureouthowtotakeofftheDecember15threferenceinthetop
right.Cansomeoneelsedothat?
Also,Iamassumingthatourtitleslidesshouldhavethechapternumberandname,notsubcommitteecorrect?
Ifmyfellowsubcommittee/consultantscolleagueshaveanyadditionaledits/suggestionsfortheslides,pleaseletmeknow.
Best,Mim
Miriam E. Nelson, PhD

Associate Dean, Tisch College of Citizenship and Public Service
Professor, Friedman School of Nutrition Science and Policy
Lincoln Filene Hall
10 Upper Campus Road
Tufts University
Medford, MA 02155
Phone: 617-627-4178
Fax: 617-627-3401
www.ActiveCitizen.tufts.edu
www.StrongWomen.org
Twitter: @DrMiriamNelson
From:FrankHu<nhbfh@channing.harvard.edu>
Date:Monday,February2,201512:10PM
To:"Millen,BarbaraE"<bmillen@bu.edu>
Cc:"MaryStory,Ph.D."<mary.story@duke.edu>,AliceLichtenstein<alice.lichtenstein@tufts.edu>,"AnnaMariaSiega
Riz,PhD,MS,RD"<am siegariz@unc.edu>,"CherylAnderson,PhD,MS,MPH"<c1anderson@ucsd.edu>,"FrankHu,MD,
PhD,MPH"<frank.hu@channing.harvard.edu>,"J.ThomasBrenna,PhD,MS"<jtb4@cornell.edu>,Lucille
<lla9@georgetown.edu>,"MarianNeuhouser,PhD,RD"<mneuhous@fhcrc.org>,MiriamNelson
<miriam.nelson@tufts.edu>,PerezEscamillaRafael<rafael.perezescamilla@yale.edu>,"sabrams@bcm.edu"
<sabrams@bcm.edu>,"StevenClinton,MD,PhD"<steven.clinton@osumc.edu>,"WayneCampbell,PhD,MS"
<campbellw@purdue.edu>
Subject:Re:UpdatesDGACSymposium
IshareMary'sconcernsandI'malsoconcernedabouttimeconstraint.Theentiresymposiumis2.5hoursandthe
presentationscaneasilytake1.5hours.Weshouldleaveatleast3045minsforQ&A.
Frank
OnMonday,February2,2015,Millen,BarbaraE<bmillen@bu.edu>wrote:
Very important thought. We are in agreement that we want to have the tone very positive. If we decide to have
the reactors, we can perhaps have them address the report in ways we think will be enhancing of our
5
PSC-HHS-000005
presentation, implications for various settings, areas where policy development might be most helpful, etc.
What do others feel?
Also, apologies for leaving UNC-Chapel Hill off the site list. Anna-Maria is definitely working on this as I
think wveryone is aware from our call.
Barbara
Dr. Barbara E. Millen
bmillen@bu.edu
From: Mary Story, Ph.D. [mailto:mary.story@duke.edu]
Sent: Monday, February 02, 2015 11:33 AM
To: Millen, Barbara E; 'Alice Lichtenstein, DSc, MS'; 'Anna Maria Siega-Riz, PhD, MS, RD'; 'Cheryl Anderson, PhD, MS,
MPH'; 'Frank Hu, MD, PhD, MPH'; 'J. Thomas Brenna, PhD, MS'; 'Lucile Adams-Campbell, PhD, MS'; 'Marian Neuhouser,
PhD, RD'; 'Miriam (Mim) E. Nelson, PhD, MS'; 'Rafael Prez-Escamilla, PhD, MS'; 'Steven Abrams, MD'; 'Steven Clinton,
MD, PhD'; 'Wayne Campbell, PhD, MS'
Subject: Re: Updates DGAC Symposium
Importance: High
Barbara
I have some questions concerns about the reactor panel. I think it is important to have panel members be supporting the DGAC
report and not criticizing anything from the committee report. Of course anyone is free to make critical comments of our
recommendations but in my view this should not be done at this event. Since we cannot control what individuals may say if they
are panel members, I question even having a reactor panel. Depending on who you invite to be a reactor panel this could
backfire.
As an initial speaker I think Jim Marks or Michael McGinnis would be good.
Mary
From: <Millen>, "'Barbara Millen, DrPH, MPH, RD'" <bmillen@bu.edu>

Date: Monday, February 2, 2015 at 10:28 AM
To: "'Alice Lichtenstein, DSc, MS'" <alice.lichtenstein@tufts.edu>, "'Anna Maria Siega-Riz, PhD, MS, RD'"
<am_siegariz@unc.edu>, "'Cheryl Anderson, PhD, MS, MPH'" <c1anderson@ucsd.edu>, "'Frank Hu, MD,
PhD, MPH'" <frank.hu@channing.harvard.edu>, "'J. Thomas Brenna, PhD, MS'" <jtb4@cornell.edu>, "'Lucile
Adams-Campbell, PhD, MS'" <lla9@georgetown.edu>, "'Marian Neuhouser, PhD, RD'"
<mneuhous@fhcrc.org>, "Mary Story, Ph.D." <mary.story@duke.edu>, "'Miriam (Mim) E. Nelson, PhD, MS'"
<miriam.nelson@tufts.edu>, "Rafael Prez-Escamilla, PhD, MS" <rafael.perez-escamilla@yale.edu>, "'Steven
Abrams, MD'" <sabrams@bcm.edu>, "'Steven Clinton, MD, PhD'" <steven.clinton@osumc.edu>, "'Wayne
Campbell, PhD, MS'" <campbellw@purdue.edu>
Subject: Updates DGAC Symposium
Hello Everyone,
Greetings from another white-out here is Boston! Frank and I have heard from many of you about
participating in the February 25th DGAC symposium. As I mentioned on our call, Howard Koh has confirmed
his role as moderator. We seem in agreement that we would use the format from the last two DGAC meetings
are the outline for the symposium (presentations on our charge and evidence-based process, the SCs and WGs,
and Integration). We have to work out the timing of each part of the symposium as plans come together. The
Federal staff will be preparing slides for our use. We have not yet identified any alternative dates; Frank is
checking at HSPH. Things are definitely shaping up in terms of our live satellite sites and ideas for speaker(s)
and panelists.
6
PSC-HHS-000006
At this point, the following locations are considering creating a satellite site pending confirmation of technology
and availability on our date: Cornell, HSPH (host), Purdue, Tufts, UC-San Diego, UW and FHCRC. Others are
certainly welcome. Please let me know.
Quite a few names have been recommended either as an initial speaker (Jim Marks from RWJ) or as a reactor
panelists (Jim Marks, Bob Eckel, Larry Appel, Paul Whelton, Connie Weaver, Bill Dietz, Harvey Fineberg,
Adam Drewnowski, Kathleen Merrigan, Mike McGinnis, Larry Soler, and former Senator Tom Harkin. On our
call, there seemed to be enthusiasm and agreement that Jim Marks would be ideal for opening remarks. I have
asked Howard Koh (who also recommended him) to contact Jim on our behalf.
Would anyone like to recommend any other panelists? I will circulate other names if you provide them. Of
those already identified above, could you let me your top three or four panelists, assuming that Jim Marks
would be one? If you have particular thought about achieving a balance of perspectives on the panel, please
let me know. Lets see if there is consensus on a short list.
Also, it sounds as though a number of you may be planning some introductory remarks or activities in your
respective locations. That is certainly a possibility if you have scheduled time before or after our televised
symposium. I have seen this work very well in other activities of this type so I encourage you to make plans if
you think it would make your local event that much more interesting.
Frank and I will be working on the IT and logistics and will let you know how we thinks evolve.
All the very best,
Barbara
bmillen@bu.edu
From: Millen, Barbara E
Sent: Tuesday, January 27, 2015 4:13 PM
To: 'Alice Lichtenstein, DSc, MS'; 'Anna Maria Siega-Riz, PhD, MS, RD'; 'Cheryl Anderson, PhD, MS, MPH'; 'Frank Hu, MD,
PhD, MPH'; 'J. Thomas Brenna, PhD, MS'; 'Lucile Adams-Campbell, PhD, MS'; 'Marian Neuhouser, PhD, RD'; 'Mary Story,
PhD, MS, RD'; 'Miriam (Mim) E. Nelson, PhD, MS'; 'Rafael Prez-Escamilla, PhD, MS'; 'Steven Abrams, MD'; 'Steven
Clinton, MD, PhD'; 'Wayne Campbell, PhD, MS'
Subject: Follow-up: DGAC Symposium
Many thanks everyone for your participation in todays DGAC call and discussion of the upcoming 2015
DGAC Report Symposium. Here is a summary of the notes from the call and a few things learned in
conversations with DGAC members. Please take a look at the Action Items and get back to Frank and me with
details and any questions you might have.
Date and Time:
Back up Date (mid-March):
Host Location:
Other Live Locations:
others TBD.
Audiences:
Registered webinar audience.
Wednesday, February 25 3:30-6:00 p.m.

TBD
Harvard School of Public Health (HSPH)
UNC-Chapel Hill and to be confirmed, UC San Diego and Purdue;
Invited and registered audience for host and live locations.
7
PSC-HHS-000007
Format:
Televised symposium with live audiences in Host and Satellite
locations. Webinar for registered audience for expanded participation.
Symposium format:
Introduction: Comments by leader from satellite sites and/or
invited guest presenters (foundation leaders, dignitaries, others TBD).
Moderator: Howard Koh
Report Summary: Follow the last two Public Meetings. The DGAC
Evidence-based Process (and Integration Chapter) presented by Chair.
SC and Workgroup leads (if available) will summarize their
chapters. Integration Chapter.
It was recommended that these presentations include a brief summary of
key findings, recommendations and implications,
and the evidence base on which the conclusions are based (a combination
of key text summaries and data slides).
Reactor Panel: recommended experts in the field, perhaps from
participating institutions or outside experts
Q and A: Questions sent at registration and by email or webinar.
ACTION ITEMS:
1. Federalstaffworkingonslidesandgeneralmediamaterials.
2. FrankHuwillcheckandcirculatebackupmidMarchsymposiumdate(s)andtime(s).
3. EachDGACmemberwillconfirmwhethertheyareavailabletoparticipate,wheretheywillparticipate(homeinstitution,
HSPH,oratasatellitesite),
and what satellite arrangements might be possible at their institution.
a. CommunicatethisinformationtoBarbaraandFrank
4. DGACmemberswhoareconsideringhostingalivesatellitelocationshouldconfirmwithBarbaraandFrankassoonas
possible.
ITdetailscanbediscussedwithFrank.
5. Oncefurtherdetailsareset,wewilldevelopcopytopromotetheeventandinviteparticipation.
All the best,

Barbara
bmillen@bu.edu
*******************************************************
FrankB.Hu,MD,PhD
ProfessorofNutritionandEpidemiology
HarvardT.H.ChanSchoolofPublicHealth
ProfessorofMedicine
HarvardMedicalSchool
665Huntingtonave,Boston,MA02115
tel:6174320113fax:6174322435
<http://www.hsph.harvard.edu/faculty/frankhu/>
8
PSC-HHS-000008
http://www.hsph.harvard.edu/faculty/frankhu/
******************************************************
*******************************************************
FrankB.Hu,MD,PhD
ProfessorofNutritionandEpidemiology
HarvardT.H.ChanSchoolofPublicHealth
ProfessorofMedicine
HarvardMedicalSchool
665Huntingtonave,Boston,MA02115
tel:6174320113fax:6174322435
<http://www.hsph.harvard.edu/faculty/frankhu/>
http://www.hsph.harvard.edu/faculty/frankhu/
******************************************************
-*******************************************************
Frank B. Hu, MD, PhD
Professor of Nutrition and Epidemiology
Harvard T.H. Chan School of Public Health
Professor of Medicine
Harvard Medical School
665 Huntington ave, Boston, MA 02115
tel: 617 432 0113 fax: 617 432 2435
<http://www.hsph.harvard.edu/faculty/frank-hu/>
http://www.hsph.harvard.edu/faculty/frank-hu/
******************************************************
PSC-HHS-000009

From:
Sent:
To:
Cc:
Subject:
Millen, Barbara E <bmillen@bu.edu>

Sunday, February 22, 2015 3:25 PM
Olson, Richard (HHS/OASH); 'Rihane, Colette - CNPP' (Colette.Rihane@cnpp.usda.gov)
FW: MIND YOUR OWN BUSINESS
Hithere,
MyITpersonandoneofthestaffforwardedthishateemail.Wecantpleaseanyone.Dontknowwhatyour
experienceiswiththissortofthing.Anythoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
From: Kevin Grinberg [mailto:kevin@activefrequency.com]

Sent: Friday, February 20, 2015 6:19 PM
To: Millen, Barbara E
Subject: Fwd: MIND YOUR OWN BUSINESS
I assume Dolores forwarded you this gem as well. I don't even know what to say...
This nonsense aside, congrats on all the press coverage!
---------- Forwarded message ---------From: "'M C' via Help" <help@millenniumprevention.com>
Date: Feb 20, 2015 3:46 PM
Subject: MIND YOUR OWN BUSINESS
To: "help@healthmain.com" <help@healthmain.com>
Cc:
"The recommendations Thursday from the Dietary Guidelines Advisory Committee also call for
Americans to reduce meat consumption and to take sustainability into account when dining."
Here's a tip.
MIND YOUR OWN DAMN BUSINESS. Frigging Nanny State bastards need to get laid and get a life.
WE wil leat, drink, smoke, and do WHATEVER we damn well please. NO ONE cares what you think.
Tax sweets? Are you morons aware that we can make our own donuts? Pies? Cakes? What are you
Liberal morons going to do? Tax flour?
America will be better off when the last damn Liberal dies.
10
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From:
Sent:
To:
Subject:

Thursday, February 19, 2015 7:35 AM
FW: Your Healthy News
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
From: HealthDay News Service [mailto:HealthNews@HealthDay.com]
Sent: Thursday, February 19, 2015 4:06 AM
To: Lichtenstein, Alice
Subject: Your Healthy News
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Dietary Fiber
and Weight
Loss
HealthDay News
Eating More Fiber Helped People Lose Weight, Researchers
Report
Making one
simple
dietary
change may
help you
lose weight
and improve
your health,
study finds.
Watch
now
Trial comparing simple dietary change to more complicated regimen found

similar health benefits
MONDAY, Feb. 16, 2015 A simple high-fiber diet can provide health benefits while
being easier to stick with than a diet calling for multiple changes in eating habits, a
new clinical trial concludes.
People who only ad... Read the full article
Dark
Chocolate
Surprise?
Health Tip: Getting Nutrition on the Go

What to eat before and after exercise
When you're traveling, especially for an athletic competition, you don't have to rely on
fast food to fuel your body.
Beware:
There may
be milk in
your
favorite
dark
chocolate,
according to
the FDA.
Watch
now
The Academy of Nutrition and Dietetics offers these suggestions for what to eat:
C... Read the full article
Meat-Heavy, High-Acid Diet Poses Risk for Those With

Kidney Disease: Study
Switching to regimen higher in fruits, veggies might help stave off organ
failure, experts say
Coffee and
Endometrial
Cancer Risk
FRIDAY, Feb. 13, 2015 Patients struggling with chronic kidney disease who routinely
consume meat-rich, highly acidic diets may boost their risk for kidney failure, a new
study suggests.
According to the U.S. National ... Read the full article
Coffee may
lower risk of
most
common
cancer of
female
reproductive
system,
study finds.
Watch
now
Mediterranean Diet May Lower Stroke Risk, Study Finds

Researchers say healthy eating plan appears to cut odds of blood clot
THURSDAY, Feb. 12, 2015 A Mediterranean diet may reduce your risk of one type of
stroke, new research suggests.
People who most closely followed the Mediterranean diet were less likely to suffer an
ischemic stroke -- ... Read the full article
HealthDay Living:
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Make
Kitchen
Marvels With
the
Mandoline
Low Vitamin D Levels in Stroke Survivors a Bad Sign, Study

Finds
Turn
veggies into
tasty pasta
substitutes
cookingvideo
Watch
now
Tied to raised risk of a severe stroke, poor recovery, researchers say

THURSDAY, Feb. 12, 2015 Low vitamin D levels are linked to an increased risk of
suffering a severe stroke and poor health in stroke survivors, new research finds.
The study included almost 100 stroke patients who were... Read the full article
How to
Readjust
Calories as
You Lose
Weight
Proposed Dietary Guidelines Not a Green Light to Eat What

You Want
People still need to limit foods with heart-damaging saturated fats and trans
fats, nutritionists say
THURSDAY, Feb. 12, 2015 People who follow a heart-healthy diet won't see much
Make diet
adjustments
to avoid a
plateau
diet-video
Watch
now
change in their eating habits if, as reported, this year's U.S. Dietary Guidelines report
rescinds previous warnings against eating certain cholester... Read the full article
Dehydration Linked to Greater Stroke Damage
A Healthy
and
Romantic
Valentine's
Day Dinner
Thicker blood may be the reason why, study suggests

THURSDAY, Feb. 12, 2015 People who aren't well-hydrated when they have a stroke
are about four times more likely to have a worse outcome than people who've had
more fluids, a new study suggests.
A simple
take on
surf-andturf for your
valentine
cookingvideo
Watch
now
Researchers found that... Read the full article
Health Tip: Avoiding Menopausal Weight Gain

Suggestions to stay trim as you age
Weight gain during and after menopause is common and can have significant health
consequences.
Featured:
The Mayo Clinic says women can help avoid menopausal weight gain by:
Getting plenty of exercise, incorpo... Read the full article
13
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From:
Sent:
To:
Cc:
Subject:

Thursday, February 12, 2015 12:10 PM
Sagon, Candy
RE: new dietary guidelines quote--AARP story
WouldliketocommentbutIcan'tuntilthereportisreleased.
GershoffProfessorofNutritionScienceandPolicyDirectorandSeniorScientist,CardiovascularNutritionLaboratory
TuftsUniversityJMUSDAHumanNutritionResearchCenteronAging
711WashingtonStreet
Boston,MA02111
phone:6175563127
OriginalMessage
From:Sagon,Candy[mailto:CSagon@aarp.org]
Sent:Thursday,February12,201510:56AM
To:Lichtenstein,Alice
Subject:newdietaryguidelinesquoteAARPstory
Dr.Lichtenstein
I'msureyou'veseenthenewsstoriesaboutwhatcouldbemajorshiftinnationaldietaryguidelines'recommendation
aboutcholesterol,andI'mhopingyoucouldcommentforahealthstoryI'mdoingfortheAARPwebsite.
Theproposedreportstatesthatcholesterolisnolongeranutrientofconcern.Doyouthinkthiswastherightmove?
Asanexpertintherelationshipbetweenfatsinthedietandhealth,I'malsohopingyoucouldcommentononepartthat
wasdiscussedinthelengthyWashingtonPoststoryontheguidelinesnamely,thattheywouldbelessrestrictiveabout
thecholesterolineggsandseafood,likelobster,butstillwarnagainstfattymeat,creamandbutter.
Isn'tthesaturatedfatandcholesterolinallthesefoodsthesame?Whywoulditbeoktohaveaneggaday,butnot
butter?
Thankyouforyourhelpwiththis.
CandySagon
CandySagon|AARP
SeniorAssociateEditor,Health
601EStreetNW|Washington,DC20049|Office:2024346065|csagon@aarp.org<mailto:eambrose@aarp.org>
15
PSC-HHS-000015
16
PSC-HHS-000016

From:
Sent:
To:
Subject:

Wednesday, February 11, 2015 8:55 PM
RE: Advisory Panel Considers Changing Recommendations On Cholesterol
Kellie, very much appreciated. Very well stated.

I just had a colleague ask whether the DG were coming out soon and if she promised not to say
anything could she please have a copy. If colleagues dont know the difference between DGAC
report and DG I hate to think what the press is going to do with the stories.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
From: Casavale, Kellie (OS/OASH) [mailto:Kellie.Casavale@hhs.gov]
Sent: Wednesday, February 11, 2015 8:40 PM
Subject: RE: Advisory Panel Considers Changing Recommendations On Cholesterol
;)
KellieO.Casavale,PhD,RD
NutritionAdvisor,DivisionofPreventionScience
CoExecutiveSecretary,2015DietaryGuidelinesAdvisoryCommittee
HHS,OfficeofDiseasePreventionandHealthPromotion
From: Lichtenstein, Alice [mailto:Alice.Lichtenstein@tufts.edu]

To: Casavale, Kellie (OS/OASH)
Interesting. Looked at the Athero paper. They did not appear to correct for age in any
analysis. Were that the case, since age and egg yolk in take were correlated, I dont see how they
could attribute the effect to one factor or the other. Age is a well-established risk factor.
17
PSC-HHS-000017
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'dspence@robarts.ca'
Cc: 'walter.kernan@yale.edu'; Lichtenstein, Alice; 'Neuhouser, Marian L'
Subject: FW: Advisory Panel Considers Changing Recommendations On Cholesterol
Dr.Spence,
Yourcorrespondencebelowwasforwardedtome.Thankyouforyourinterestinthe2015DietaryGuidelinesAdvisory
Committee.InformationabouttheAdvisoryCommitteeandtheprocessthefederalgovernmentusesforupdatingthe
DietaryGuidelinesforAmericansfederalpolicycanbefoundatwww.DietaryGuidelines.gov.AdvisoryCommittee
memberscannotacceptpubliccomments.Publiccommentisanimportantpartofourprocess.Inthecomingweeks,a
FederalRegisternoticewillbepublishedannouncingtheavailabilityoftheCommitteesAdvisoryReport,apublic
commentperiod,andthedateofapublicmeetingforprovidingoralcommentstotheFederalgovernmentonthe
AdvisoryReport.ApubliccommentsdatabasewillopenforthepublictosubmitcommentstotheFederalgovernment
ontheAdvisoryReportwhentheFederalRegisternoticeispublished.Weencourageyoutosubmityourcomments
belowatthattime.YoucancontinuetocheckDietaryGuidelines.govforthemostuptodateinformation.
Pleaseletmeknowifyouhaveanyquestions.
Thanks,
Kellie
From: David Spence [mailto:dspence@robarts.ca]

Sent: Wednesday, February 11, 2015 11:42 AM
To: Kernan, Walter
Cc: Marion Neuhauser (mneuhous@fhcrc.org); Lichtenstein, Alice
DearWalter,
Thankyouforalertingmetothis.Ihavecopiedthismessagetotwoofthechairsofthecommitteeinvolved,inthehope
thatImaydiscussthiswiththembeforethisreportisfinalized.Iwouldbehappytopresenttotheircommitteeifthe
schedulepermits.
18
PSC-HHS-000018

Theincreasinglyprevalentbeliefthatdietarycholesterolisnotimportantistheresultofasustainedandwellfunded
campaignoftheeggindustry,followingtheirconvictionforfalseadvertising,upheldintheSupremeCourt.
TheslidesofmypresentationtotheAHAstrokemeetingtodayareattached,alongwithsomepapers.
Dr.NeuhauserandDr.Lichtenstein,pleaseviewthevideostowhichlinksareprovidedonmylastslide.
Itwouldbeagraveerrortowithdrawthevalidlongstandingrecommendationtolimitcholesterolintake,particularly
amongpatientsatriskofvasculardisease.Dietarycholesterolisnotaboutthefastinglipids(wheretheeggindustry
wouldliketokeepthefocus);itisaboutthepostprandialstate.
Bestregards,
DavidSpence
J.DavidSpenceM.D.,FRCPC,FAHA
ProfessorofNeurologyandClinicalPharmacology
Director,StrokePrevention&AtherosclerosisResearchCentre,
RobartsResearchInstitute,WesternUniversity
1400WesternRoad,London,ONCanadaN6G2V2
Phone15199315731;Fax15199315737
Emaildspence@robarts.cahttp://www.imaging.robarts.ca/SPARC/
From:Kernan,Walter[mailto:walter.kernan@yale.edu]
Sent:February111510:10AM
To:DavidSpence
Subject:FW:AdvisoryPanelConsidersChangingRecommendationsOnCholesterol
Checkoutthefirstarticle.
WalterN.Kernan,MD
ProfessorofMedicine(GeneralMedicine)
YaleSchoolofMedicine
Suite515
2ChurchStreetSouth
NewHaven,CT06519
Phone:2037647000
Fax:2037647552
From:AMAMorningRounds[mailto:MorningRounds@ama.custombriefings.com]
Sent:Wednesday,February11,20158:19AM
To:Kernan,Walter
Subject:AdvisoryPanelConsidersChangingRecommendationsOnCholesterol
If you are using a mobile device or are unable to see the message below, click here to view
19
PSC-HHS-000019
Good Morning Dr. Walter Kernan. Here are today's top stories.
Wednesday, February 11, 2015
Leading the News

Advisory panel considers changing recommendations on cholesterol.
Scott Pelley reported in the CBS Evening News (2/10, story 5, 1:30, Pelley) that according to the Dietary Guidelines Advisory Committee,
a government advisory panel, we dont have to worry so much after all about cholesterol in our diets. Dr. Jon Lapook noted that while
the amount of cholesterol in your blood is still important, the panel found that the amount of cholesterol in your food doesnt necessarily
translate to a higher level of cholesterol in your blood. While the current recommendations say people should have less than 300
milligrams of cholesterol in their diet a day, that number is likely to change when the recommendations come out later this year. Linsey
Davis noted on ABC World News (2/10, story 7, 1:10, Muir) that while the panel said that eating some foods that are high in cholesterol
like eggs and seafood may not be so bad after all, foods like meats and cheeses, because they contain saturated fats, are still on the
list.
The Washington Post (2/11, Whoriskey) reported in its Wonkblog blog that the this does not reverse warnings about high levels of
bad cholesterol in the blood, which have been linked to heart disease, adding that some experts warned that people with particular
health problems, such as diabetes, should continue to avoid cholesterol-rich diets. The blog adds that a group from the American Heart
Association and the American College of Cardiology who looked at the issue in 2013 said there is simply not enough evidence of danger
20
PSC-HHS-000020
to call for limiting cholesterol in diets.

USA Today (2/11, Szabo) reports that the committee will send its final recommendations to the Department of Health and Human
Services and the U.S. Department of Agriculture, which issue the dietary advice. HHS and the USDA are expected to issue Dietary
Guidelines for Americans, 2015 later this year.
The AP (2/11, Jalonick) reports, however, that its unclear if the recommendation will make it into the final guidelines.
Forbes (2/11) contributor Larry Husten writes that the proposed change reflects a major shift in the scientific view of cholesterol that
has taken place in recent years. While serum cholesterol is still considered an important risk factor, cholesterol consumed in food is now
thought to play a relatively insignificant role in determining blood levels of cholesterol. Also covering the story are Reuters (2/11) and
HealthDay (2/11).
Practice News: VA program needs physicians to provide veterans care

After asking for physicians help to enhance care for veterans last November, the U.S. Department of Veterans Affairs
(VA) has released information for physicians interested in delivering care through the Veterans Choice Program. Learn
how you can help improve access to care for veterans. Read more at AMA Wire.
Technology News: Innovators tap physicians for early insights
How would you design your ideal practice environment? What about your ideal electronic health record? With physician
input at the ground level of emerging technologies, practicing medicine could become more satisfyingthats the
thinking behind a new collaboration that will give physical space to innovators who want to transform health care. Read
more at AMA Wire.
AMA Store: Get expert 2015 coding help with new data file
Simplify your coding with the CPT/RVU 2015 Data File, which offers a definitive resource for physicians seeking to
import 2015 relative value units (RVU) and CPT and Healthcare Common Procedure Coding System (HCPCS) codes
and descriptions into existing claims and billing systems. Read more at AMA Wire.
Connect with the AMA online:
or visit AMA Wire Online
Government and Medicine

Administration warns of penalty for failing to enroll in health coverage.
The Washington Times (2/11, Howell) reports that with only a few days left before the deadline to sign up for health insurance under the
ACA, the Obama Administration has begun to spotlight the penalty some Americans could pay for failing to do so. While the
Administration has previously focused on the benefits of coverage, the latest email blasts to customers with HealthCare.gov accounts
warn users to get covered or risk paying a fee.
US News & World Report (2/11, Brecht) adds that the premium subsidy consumers receive is based on projected income and family
size for the year. As such, if you ended up earning more money than expected or had a change in your family in 2014, you could be
responsible for paying back some or all of the subsidies received.
NYTimes examines state efforts to expand Medicaid.

The New York Times (2/11, A16, Goodnough, Subscription Publication) reports on efforts to expand Medicaid in a number of states,
noting just how complicated the politics of expanding Medicaid have become and just how different the results of seeking an
21
PSC-HHS-000021
expansion have been from state to state. In Pennsylvania, for instance, Gov. Tom Wolf (D) is scrapping his Republican predecessors
conservative approach to expanding Medicaid and pursuing a traditional expansion under the ACA. In Tennessee and Wyoming,
however, bills to extend Medicaid to far more low-income residents under the law were quashed by Republican legislators last week,
despite having the support of the states Republican governors. The Times adds that, to date, 28 states have accepted Federal funds to
expand Medicaid eligibility.
Senators back bill to exempt volunteer firefighters from employer mandate.

The Hill (2/11, Ferris) reports that a bipartisan group of senators is relaunching an effort to exempt volunteer firefighters and emergency
responders from an ObamaCare rule requiring employers to offer insurance to full-time employees. The legislation, introduced by Sens.
Mark Warner (D-VA) and Pat Toomey (R-PA), now has more than 20 co-sponsors. While the IRS has already said it will not count
volunteer fire departments or ambulances as employers under the ACAs mandate, the senators warned that the government could still
reverse course without a change to the law.
Health Coverage and Access

Los Angeles County to reduce AIDS/HIV spending due to increased enrollment in insurance,
Medicare, and Medicaid.
The Los Angeles Times (2/10, Sewell) reports that Los Angeles County announced yesterday that it intended to cut $4 million from its
provision of medical care to AIDS and HIV patients, pointing to increased insurance coverage under the Affordable Care Act. AIDS
Healthcare Foundation board Chairwoman Cynthia Davis objected to the proposed cuts, saying that it is necessary to ensure that these
hard-to-reach and medically underserved clients receive the care they need. In response, Mario Perez, head of the countys HIV
response programs, said the number of patients enrolled in Medicare, Medicaid and private insurance has increased, as the ACA has
worked as intended in the county leading to reduced need for the county funds.
CMS official says Florida low income pool funding wont be extended.
The Miami Herald (2/11) reports that Florida lawmakers were scrambling to find $1.3 billion to plug a sudden budget deficit after the
nations Medicaid chief said Tuesday that Florida will lose federal money to help hospitals treat poor and uninsured patients. Eliot
Fishman, director of the Children and Adults Health Programs Group in the Center for Medicaid and CHIP Services at CMS, told
attendees at an Orlando healthcare conference that Federal officials wont extend Floridas Low Income Pool (LIP) program, which
reimburses hospitals that treat large numbers of poor and uninsured patients. The announcement appears to overturn a main premise by
Gov. Rick Scott that the LIP fund would be available next year, thrusting his budget projections into disarray. A spokeswoman for the
governor, however, pointed out that state officials are meeting with CMS on Wednesday to discuss the LIP extension.
Study supports affordability of health insurance for students.

The Los Angeles Times (2/11) reports that a new analysis from California State Universitys Health Insurance Education Project found
that half the approximately 445,000 students in the CSU system are able to purchase health insurance for less than they would have to
pay in fines for remaining uncovered. Officials say the numbers show that buying health insurance makes financial sense, challenging
the idea that the cost of health insurance often cited as the main reason people dont sign up is unaffordable.
Quality and Safety

Report: Patient-safety initiative preventing hospital-acquired infections in Ohios pediatric
hospitals.
The Columbus (OH) Dispatch (2/11, Sutherly) reports that leaders of Ohios pediatric hospitals credit an unprecedented patient-safety
initiative with preventing hospital-acquired infections and other harm in about 230 children they treated between January 2012 and
October 2014. In a newly released interim report...officials with the Ohio Solutions for Patient Safety project said their work has saved
patients families, insurance companies and taxpayers in Ohio nearly $6 million during that period.
Report: Novel doses of old medications used to circumvent cost controls on traditional ones.
On the front of its Business Day section, the New York Times (2/11, B1, Meier, Subscription Publication) reports that since 2013, states
22
PSC-HHS-000022
nationwide have moved to crack down on so-called physician dispensing of prescription drugs, a practice largely limited to doctors who
treat injured workers. However, physicians and companies have responded by exploiting loopholes in those rules and adopting new
strategies to stay one step ahead, recent studies suggest. For example, one workaround has been to create novel dosages of old drugs
to get around cost controls on traditional ones, according to a report issued in January by the Workers Compensation Research Institute.
The study found that along with the 7.5-milligram version of cyclobenzaprine, the muscle relaxant, new dosages of two older painkillers,
tramadol and hydrocodone, that carry far higher prices than the standard versions, have also appeared.
Google search to add illustrations, information on medical conditions.

USA Today (2/11, Cava) reports that Google search will be adding everything from elaborate illustrations to an assessment of how
common the condition may be, to search results for 400 of the most commonly searched medical conditions. The company consulted
with physicians and artists to provide users a better at-a-glance experience. The company intends to add to those. Amit Singhal,
Googles vice president in charge of search, said that the company has had physicians and the Mayo Clinic review the information. He
added that Google is not seeking to replace medical advice, but is hoping to provide a framework for a more informed conversation with
your doctor. Google employed artists to make detailed illustrations.
Reuters (2/11, Tharakan) and TIME (2/10, Kedmey) also report the news.
Public Health
IOM panel says chronic fatigue syndrome is real.
In a segment lasting nearly three minutes, NBC Nightly News (2/10, story 9, 2:50, Holt) reported that on Tuesday, a panel from the
Institute of Medicine declared that chronic fatigue syndrome is not only real, but the vast majority of people who suffer from it havent
even been diagnosed. NBC News correspondent Ann Thompson explained that the IOM issued a new set of symptoms to help doctors
recognize the disease, such as a drop-off in normal activity for more than six months with profound exhaustion, sleep that doesnt
refresh, and symptoms that get worse after physical or mental exertion, plus either cognitive impairment or symptoms that only improve
when patients are lying down.
The New York Times (2/10, Tuller) Well blog reported that chronic fatigue syndrome is also known as myalgic encephalomyelitis,
and many experts now refer to the condition as ME/CFS. However, the IOM panel recommended that the illness be renamed systemic
exertion intolerance disease. The blog also points out that the IOM panel was convened at the request of the Department of Health and
Human Services, the Centers for Disease Control and Prevention, the Food and Drug Administration and other federal agencies.
The Washington Post (2/10, Bernstein) To Your Health blog reported that the IOM panel acknowledged how patients with the
illness struggle, sometimes for years, before finding a health-care provider who diagnoses a disorder. The panel wrote, Seeking and
receiving a diagnosis can be a frustrating process for several reasons, including skepticism of health care providers about the serious
nature of [chronic fatigue syndrome] and the misconception that it is a psychogenic illness or even a figment of the patients imagination.
Currently, less than a third of medical schools include the condition in their curricula and only 40 percent of medical textbooks contain
information on it, the experts said.
The AP (2/11, Neergaard) reports that while physicians may not know how to cure the disorder...there are treatments for individual
symptoms, noted committee member Dr. Lucinda Bateman of the Fatigue Consultation Clinic in Salt Lake City. Meanwhile, the IOM said
theres been a paucity of research into the causes, treatments, even the natural history of the disease to figure out who may get better
over time. The AP adds that the IOM advised the government to develop a toolkit to help doctors diagnose the disease, and to make
sure the disorder is assigned a specific medical billing code.
Napping may help undo negative health effects of a sleepless night.

TIME (2/11) reports that a small study of 11 healthy men published online in the Journal of Clinical Endocrinology & Metabolism
suggests that the negative health effects of a sleepless night can actually be reversed by a good nap. For the study, participants
underwent two laboratory sleep sessions. In the first session, the men only got two hours of sleep and then had their urine and saliva
measured and analyzed for hormonal changes. For the second session, the men once again only got two hours of sleep, but this time
they also took two 30-minute naps the following day. Again, they provide samples of urine and saliva.
HealthDay (2/11, Preidt) reports that after the first session, participants had a 2.5-fold increase in levels of norepinephrine, a stress
hormone that increases heart rate, blood pressure and blood sugar. In addition, the men had lower levels of a protein called interleukin6, which fights viruses. After napping following the second session, the mens norepinephrine and interleukin-6 levels were normal. The
ABC News (2/11, Francis) Medical Unit blog also covers the story.
23
PSC-HHS-000023
Childhood vitamin D deficiency may be tied to hardening of the arteries in middle age.
The New York Times (2/11, Bakalar) Well blog reports that a study published online in the Journal of Clinical Endocrinology &
Metabolism reveals that vitamin D deficiency in childhood may be linked to hardening of the arteries in middle age. The study of 2,148
youngsters ranging in age from three to 18 and followed since 1980 revealed that kids in the lowest one-quarter for vitamin D levels,
about 15 nanograms per milliliter, were nearly twice as likely to have thickening of the carotid artery as those in the other three quarters.
This associated persisted after adjusting for age, sex and other cardiovascular risk factors.
HealthDay (2/11, Preidt) reports that additional studies are needed to learn if low vitamin D levels actually contribute to artery
hardening, but the findings highlight the need to ensure children get adequate levels of vitamin D in their diet, said the studys lead
author.
LGBT kids who come out in school may suffer lower rates of depression, anxiety than those
who do not.
The Chicago Tribune (2/11, Stevens) reports that a study published in the February issue of the American Journal of Orthopsychiatry
suggests that lesbian, gay, bisexual and transgender kids who come out at school suffer lower rates of depression and anxiety and
higher rates of self-esteem, long-term, than those who hide their identity from their peers. The survey of 245 LGBT adults ages 21 to 25
who were asked about their high-school years and how the timing of coming out affected their future life satisfaction, revealed lower
rates of anxiety and depression even if theyre bullied as a result of coming out. Reuters (2/11, Seaman) also covers the study.
Patients with type 2 diabetes who are treated for hypertension may have better outcomes.
Reuters (2/11, Doyle) reports that a review published Feb. 10 in the Journal of the American Medical Association suggests that patients
with type 2 diabetes who are treated for hypertension appear to have longer lives and a decreased risk for heart disease. The review
examined 40 studies encompassing some 100,000 patients with type 2 diabetes.
HealthDay (2/11, Dotinga) reports that people with type 2 diabetes are less likely to suffer heart attacks, strokes or die early when
they take blood pressure medications even if they dont actually have high blood pressure. The review also found that each decrease
of 10 mm Hg in the systolic blood pressure reading...lowered the risk of early death by 13 percent, heart attacks and similar problems by
11 percent, coronary heart disease by 12 percent and stroke by 27 percent. In addition, the risk of albuminuria...and retinopathy
declined by 17 percent and 13 percent, respectively.
MedPage Today (2/11, Brown) reports that an accompanying editorial observed, These findings are timely, clear, and important and
lend support to current guideline recommendations to consider offering patients with type 2 diabetes antihypertensive therapy when their
systolic blood pressure is 140 mmHg or greater.
Surveys: Americans slowly embracing complementary medicine.

TIME (2/11, Sifferlin) reports that people in the US are slowly but surely embracing complementary medicine alternative practices to go
with standard treatment according to new data from the National Center for Health Statistics (NCHS). Data indicate that while the
overall use of complementary health approaches has remained relatively stable over the years at 34%, certain types are rapidly gaining
popularity, especially yoga. The Minneapolis (MN) Star Tribune (2/11, Browning) also covers the story.
Researchers studying genomes of exceptional responders.

In an 1,100-word article, Bloomberg News (2/11) reports that renowned hospitals such as Memorial Sloan-Kettering Cancer Center in
New York and the Dana-Farber Cancer Institute in Boston have begun to process the genomes of some of cancer patients known as
exceptional responders. These patients, because of some combination of genetic makeup...will react favorably to conventional or
experimental medicines and treatments and beat the odds on cancers that defeat most people. These hospitals are hoping to learn
whether they possess gene variations that can help others by leading to new treatments and drugs or even the revival of failed ones.
24
PSC-HHS-000024
Health officials, senators agree on importance of

vaccinations at hearing.
The Hill (2/10, Sullivan) reports that both Republican and Democratic
Senators stressed the importance of vaccinations at a hearing yesterday.
The Senate Health Committees chairman, Sen. Lamar Alexander (R-TN),
said, Too many parents are turning away from sound science. ...Sound
science is this: Vaccines save lives. Sen. Elizabeth Warren (D-MA), asked
Dr. Anne Schuchat, director of the National Center for Immunization at the
CDC if any scientific evidence exists that vaccines cause profound mental
disorders, a controversial phrase Sen. Rand Paul (R-KY) had used.
Schuchat responded, No, adding that some of the diseases themselves
can cause mental disorders. Additionally, both Sen. Barbara Mikulski (DMD) and Sen, Susan Collins (R-ME) not only urged vaccination but raised
concerns about a $50 million proposed cut in President Obamas budget to a
CDC vaccination program.
The Springfield (MA) Republican (2/11) reports on Warrens questions to the witnesses appearing before a meeting of the full
committee on The Reemergence of Vaccine-Preventable Diseases: Exploring the Public Health Successes and Challenges. Her
questions mostly focused on the safety of vaccines, and on questions that have been raised in the media by parents challenging what is
in vaccines, when they should be given and alternatives to them.
Business Journals (2/11, Hoover) notes that the public health officials testifying to Congress yesterday said parents who did not
vaccinate their children are the main reason for this years measles outbreak. Dr. Schuchat stated, Outbreaks can occur in the United
States when unvaccinated groups are exposed to imported measles virus. She said that micro-communities of those who dont vaccinate
are making it difficult to control the spread of measles and are making us vulnerable to having the virus re-establish itself in our country
again. Schuchat added that they put others at risk who cannot get vaccinated because they are too young or they have specific health
conditions.
NBC News (2/10) reports that the doctors at the Senate hearing told the Congressmen that false rumors that frighten parents are
clearly behind the current outbreak of measles linked to Disneyland. However, the attention being focused on the outbreak might turn
around a dangerous trend of opting out of vaccines for philosophical reasons, they said. People are more aware now of the
consequences of their choices.
According to the International Business Times (2/11), During Tuesdays Senate health committee panel, members and panelists
agreed that vaccines are a public health priority and that children should be immunized.
USA Today (2/10, Troyan), the Huffington Post (2/11, Edwards-Levy), and Modern Healthcare (2/11, Subscription Publication) also
all highlight the bipartisan agreement in support of immunization of children against preventable diseases.
Growing number of pediatricians turning away parents who wont vaccinate kids. The Los Angeles Times (2/10,
Mejia) reported that amid the current measles outbreak, an increasing number of pediatricians nationwide are turning away parents
who refuse to vaccinate their children. Dr. Charles Goodman, a pediatrician who turned away the mother of a child she refused to have
vaccinated, said, We decided that the patients who are not vaccinated are presenting a clear and present danger. He believes it isnt
fair for a small number of willfully unvaccinated patients to put those many patients, who either couldnt be vaccinated because theyre
too young or had a weakened immune system, at risk.
In Slate Magazine (2/10), Melinda Wenner Moyer interviewed infectious disease experts about how to protect unvaccinated babies
from the measles.
West Virginia, Mississippi have toughest school vaccination laws. The AP (2/11, Raby, Pettus) reports that states like
Mississippi and West Virginia, which have struggled with health crises, including rampant diabetes and obesity, are the only ones that
refuse to exempt school children from mandatory vaccinations based on their parents personal or religious beliefs. In both states,
barring a significant medical reason, kids who havent been vaccinated cant attend school public or private.
NPR (2/10, Plevin) reported on its All Things Considered program and in its Shots blog that California law allows incoming
kindergartners who have received at least one dose of each required vaccine to enroll as whats known as conditional entrants, and
beyond that, its up to the school to notify a family when the childs next shot is due. Tonya Ross, a registered nurse and director of
nursing services for the Los Angeles Unified School District, says...that follow-up doesnt always happen. Immunization rates must be
reported in the fall, but there is no additional reporting requirement beyond the three percent of kindergartners randomly audited every
25
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third spring.
A second piece from the NPR (2/10, Dembosky) on its Morning Edition program and in its Shots blog considered the question of
whether or not employers have any responsibility to check the vaccination status of their staff, even when theres no imminent outbreak.
Dr. Arthur Reingold, a professor of epidemiology at the School of Public Health at the University of California-Berkeley, said there are
there are three types of companies, including: hospitals, where it makes complete sense to require employees to be vaccinated; an
office environment that doesnt present risks that would justify mandatory vaccination; and a places like Disneyland, where there are
many children and international visitors, but they are healthy.
Obama to withdraw most US troops sent to Africa to contain Ebola.

The New York Times (2/11, Davis, Subscription Publication) reports that according to Administration officials, the President will announce
on Wednesday that he is withdrawing almost all the American troops who were sent to West Africa to help contain the spread of the
Ebola virus. While the expected announcement reflects vindication for Mr. Obama and the administration, whose slow and at times
bungling initial response to the Ebola outbreak raised questions about the presidents ability to handle fast-moving global crises, it also
raises questions about whether Mr. Obama is prematurely claiming success on what he had labeled a national security priority, opening
himself to criticism should Ebola again spiral out of control. The Hill (2/10, Mali) reports that the President will make the announcement
during a White House event at which he will also outline further steps the U.S. is taking to prevent Ebola cases at home.
The Wall Street Journal (2/11, Nissenbaum, Barnes, Subscription Publication) notes there are currently 1,300 American troops
working in West Africa. Rear Adm. John Kirby, the Pentagon press secretary, said Tuesday, Given the success of the U.S. response to
the crisis, the majority of [Defense Department] personnel in West Africa will now return home.
Bloomberg News (2/10, Linskey) reports that according to a statement from the White House, most of the remaining soldiers will
return to the U.S. on April 30, and about 100 personnel will remain after that date.
The AP (2/10) reports USAID Administrator Rajiv Shah stated, Just 10 months since the first U.S. government personnel deployed,
we have delivered extraordinary results. Of the 2,800 troops the US deployed, about 1,500 have already returned home. Those
remaining in West Africa will work with Liberias military, regional partners and U.S. civilians to continue fighting Ebola.
According to the Washington Times (2/10), the American troops deployed to West Africa constructed Ebola Treatment Units, trained
local and international healthcare workers on how to treat those infected with the disease and provided support to humanitarian and
public-health workers who provided care throughout West Africa.
Also reporting the story are Reuters (2/11, Maler), TIME (2/10) and NPR (2/10).
Scientists testing Ebola treatments struggle to find enough Ebola patients. The Washington Post (2/11, Brittain)
reports that scientists racing to find a cure for Ebola by conducting experiments in West Africa are encountering an unexpected
challenge: finding enough Ebola patients as the outbreak recedes. In Liberia, for example, researchers had to abandon a clinical trial in
late January because of a lack of Ebola patients. On Monday, a Belgian-led team in Guinea launched an experiment testing whether
blood plasma of Ebola survivors can save lives. Another trial is expected to begin within weeks to test two vaccines, but both
experiments need scores of patients with the virus in order to produce statistically significant results.
A feature on the Washington Post (2/11) website examines the two promising Ebola vaccines that have begun clinical trials in West
Africa. The chimp adenovirus vaccine, from GlaxoSmithKline; and VSV-Zebov, made by NewLink and Merck, have both started testing in
parts of Liberia.
World leaders say Ebola outbreak exposed need for better crisis response. The AP (2/10) reports that a trio of world
leaders says the devastating Ebola outbreak exposed the weakness of international crisis response and is seeking a solution. German
Chancellor Angela Merkel, Norwegian Prime Minister Erna Solberg and Ghanaian President John Mahama have asked UN SecretaryGeneral Ban Ki-moon to create a high-level panel and commission a report on how the international community can better respond to
such crises. The letter calls for better approaches to mobilizing funding and resources, strengthening basic health care systems and the
development of vaccines and treatments for neglected tropical diseases.
Meanwhile, Bloomberg News (2/11) reports that Britains reaction to the Ebola outbreak cost lives and money, according to a U.K.
parliamentary report that criticized the international response to the contagion as totally inadequate. The outbreak could have been
contained had the Department for International Development recognized the risk of the disease sooner, the House of Commons Public
Accounts Committee said Wednesday.
Visit the AMA Ebola Resource Center for expert resources for physicians and the public.
Health and Diet

26
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Health benefits of alcohol consumption may be more limited than previously thought.
The Los Angeles Times (2/11, Healy) reports that a study published Feb. 10 in the journal BMJ Open suggests that the health benefits of
alcohol consumption are more limited than previously thought. The study found that for women over age 65, the health benefits of
alcohol are not enormous, but drinkers were less likely to die during a follow-up period of between six and 10 years. However, those
health benefits did not significantly vary with the amount women drank: those who claimed they drank two or fewer drinks per month were
just as protected against death from any cause as those who drank 15 or even 20 units of alcohol per week.
HealthDay (2/11) reports that overall, the review of nearly 53,000 British people found little to no health benefit linked to alcohol
consumption, once the results were adjusted for a range of personal, social, economic and lifestyle factors. The studys lead author said,
Based on the findings from this study, alcohol consumption appears to confer little to no protection against mortality [death] in most agesex groups.
Pharma & Device Update

Promising malaria vaccine unable to secure funding.
Newsweek (2/11, Conaway) reports on a malaria vaccine developed by a company called Sanaria that announced in 2013 that its
vaccine proved to be 100 perfect effective in preventing malaria caused by plasmodium falciparum by far the most deadly of the five
malaria-causing parasites and responsible for almost all of the estimated 600,000 deaths per year. Despite the promising results,
Sanaria cant get support from other researchers in the field and hasnt been able to secure as much funding as its rivals have.
Newsweek adds that Sanaria got its start 11 years ago in an 800-square-foot facility and with a $550,000 Small Business Innovation
Research grant from the National Institute of Allergy and Infectious Diseases.
Tuesday's Lead Stories

Study: HPV vaccine does not lead to risky sexual behaviors in teen girls.
Pennsylvania governor moves toward traditional Medicaid expansion.
Quest Diagnostics, Myriad Genetics settle dispute over cancer gene tests.
HHS: Average ACA monthly premium after tax credits is $105.
Analysis: Clinical trials with violations often make no mention of issues in final report.
Measles outbreak grows to 166 cases across 18 states, DC.
Energy drinks associated with greater hyperactivity, inattention risk in middle-school kids.
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28
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From:
Sent:
To:
Subject:

RE: Advisory Panel Considers Changing Recommendations On Cholesterol
Interesting. Looked at the Athero paper. They did not appear to correct for age in any
analysis. Were that the case, since age and egg yolk in take were correlated, I dont see how they
could attribute the effect to one factor or the other. Age is a well-established risk factor.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'dspence@robarts.ca'
Cc: 'walter.kernan@yale.edu'; Lichtenstein, Alice; 'Neuhouser, Marian L'
Subject: FW: Advisory Panel Considers Changing Recommendations On Cholesterol
Dr.Spence,
Yourcorrespondencebelowwasforwardedtome.Thankyouforyourinterestinthe2015DietaryGuidelinesAdvisory
Committee.InformationabouttheAdvisoryCommitteeandtheprocessthefederalgovernmentusesforupdatingthe
DietaryGuidelinesforAmericansfederalpolicycanbefoundatwww.DietaryGuidelines.gov.AdvisoryCommittee
memberscannotacceptpubliccomments.Publiccommentisanimportantpartofourprocess.Inthecomingweeks,a
FederalRegisternoticewillbepublishedannouncingtheavailabilityoftheCommitteesAdvisoryReport,apublic
commentperiod,andthedateofapublicmeetingforprovidingoralcommentstotheFederalgovernmentonthe
AdvisoryReport.ApubliccommentsdatabasewillopenforthepublictosubmitcommentstotheFederalgovernment
ontheAdvisoryReportwhentheFederalRegisternoticeispublished.Weencourageyoutosubmityourcomments
belowatthattime.YoucancontinuetocheckDietaryGuidelines.govforthemostuptodateinformation.
Pleaseletmeknowifyouhaveanyquestions.
Thanks,
Kellie
29
PSC-HHS-000029

To: Kernan, Walter
DearWalter,
schedulepermits.
Bestregards,
DavidSpence
Phone15199315731;Fax15199315737
To:DavidSpence
WalterN.Kernan,MD
30
PSC-HHS-000030
Suite515
2ChurchStreetSouth
NewHaven,CT06519
Phone:2037647000
Fax:2037647552
To:Kernan,Walter
Leading the News

31
PSC-HHS-000031

list.
HealthDay (2/11).

more at AMA Wire.

32
PSC-HHS-000032





33
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Quality and Safety

hospitals.

Public Health
34
PSC-HHS-000034

author.
who do not.

35
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conditions.
from the measles.
36
PSC-HHS-000036
third spring.

parts of Liberia.
37
PSC-HHS-000037
Health and Diet



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39
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From:
Sent:
To:
Subject:
Attachments:

FW: Advisory Panel Considers Changing Recommendations On Cholesterol
Spence AHA SC 2015 Effect of Dietary Cholesterol and Egg Consumption
REGARDS.pdf; Atherosclerosis 2012 Egg yolk plaque.pdf; Atherosclerosis 2012 Reply to
letters on egg yolk and plaque.pdf; Can J Cardiol 2010 Cholesterol and egg yolk Copy.pdf; Can J Cardiol 2011 reply to letters to the Editor on egg yolk - Copy.pdf; Can J
Cardiol Carrot in snowman with warning - Copy.pdf; IAS Commentary Eggs Athero.org
2013.pdf
FYI, see below.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Kernan, Walter
DearWalter,
schedulepermits.
40
PSC-HHS-000040
Bestregards,
DavidSpence
Phone15199315731;Fax15199315737
To:DavidSpence
WalterN.Kernan,MD
Suite515
2ChurchStreetSouth
NewHaven,CT06519
Phone:2037647000
Fax:2037647552
To:Kernan,Walter
41
PSC-HHS-000041
Leading the News

list.
42
PSC-HHS-000042
HealthDay (2/11).

more at AMA Wire.



43
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Quality and Safety

hospitals.

44
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Public Health

45
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author.
who do not.


46
PSC-HHS-000046

conditions.
from the measles.
47
PSC-HHS-000047
third spring.

parts of Liberia.
Health and Diet

48
PSC-HHS-000048


Subscriber Tools

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49
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50
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From:
Sent:
To:
Cc:

Saturday, January 31, 2015 12:56 PM
Britten, Patricia - CNPP
mneuhous@fhcrc.org; sabrams@bcm.edu; c1anderson@ucsd.edu;
mary.story@duke.edu; alice.lichtenstein@tufts.edu; jconnor@fhcrc.org;
lhimes@bcm.edu; lauren.bailey@tufts.edu; Yamini, Essie (FDA/CFSAN); Kuczynski, Kevin
- CNPP; Essery, Eve - CNPP; Wong, Yatping - CNPP; Bowman, Shanthy; Casavale, Kellie
(OS/OASH); Rihane, Colette - CNPP; Olson, Richard (HHS/OASH); Krebs-Smith, Sue
(NIH/NCI) [E]; Reedy, Jill (NIH/NCI) [E]; (b) (6)
Subject:
Re: DGAC followup: Potential journal articles from Subcommittee 1's work
HiTrish,sincethererelatetooneofmyareasofcareerlongresearchIwouldlovetohelpinanywaypossible.Barbara
SentfrommyiPhone
OnJan30,2015,at12:35PM,"Britten,PatriciaCNPP"<Patricia.Britten@cnpp.usda.gov>wrote:
HiAll,
FeelsgoodtousemySC1emaillistagain
AsImentionedonthisweeksDGACadministrativecall,Ihavecollectedideasforafewpotentialarticles
thatSC1membersandstaffindicatedtheywereinterestedinpursuing.Iknowfromexperiencethat
havingpublicationsbasedonourdataanalysesandmodelingworkcanbeveryimportantandvery
rewarding.Ialsoknowthateacharticlebecomesquitetimeconsuming.So,Iwanttopursuethose
articlesthatarehighestpriorityfirst,andthenlookatadditionalarticlesthatarealsoofinterest.Hereis
abeginninglist:
Quantificationofthefoodgroupcompositionofdietarypatternswithhealthbenefits
PossibleAuthors:NadineBraunstein(shehasindicatedshewouldliketotaketheleadonthis),
MiyukiShimizu,Marian,Cheryl,Trish,others?
FoodgroupdensitybypointofpurchasecomparedtoHEIfoodgroupstandards
PossibleAuthors:Mary,WenyenJuan,SueKS,JillReedy,Trish,others?
Foodgroupandenergyintakerecommendationsincomparisontousualintakedistributions
PossibleAuthors:Trish,Marian,Sueand/orJill,others?
NOTE:InthemodelinganalysisonadequacyoftheUSDAFoodPatterns,wereferencedthat,for
thefirsttime,allfoodgrouprecommendationswerecomparedtousualintakedistributionsina
systematicway.Wewerenotabletopresentallofthedetailsofthisanalysisinthemodeling
reportanditwouldbegoodtohaveitdocumentedintheliterature.Wediddothisanalysisfor
vegetablesubgroupsin2010,andintheJANDarticleontheFoodPatternsupdate,thatpartof
themanuscriptwasofhighestinteresttothereviewers.
TherearealsopossibilitiesofdraftingadditionalmanuscriptstodocumentandexpandontheSCswork,
suchasthefollowing:
51
PSC-HHS-000051
Thecontributionoffoodcategoriestonutrientandfoodgroupintakes,overallandbyage/sex
group(wehavedatafornutrientsandfoodgroupsthatwerenotpresented,anddatafor
age/sexgroupsthatwasonlysummarized)
ThedevelopmentoftheVegetarianandMedstylePatterns
ThecontributionsofeachfoodgrouptooverallnutrientintakeintheUSDAFoodPatterns,in
comparisontotheircontributionsbasedoncurrentintakelevels.
Pleaseletmeknowyourthoughtsoneachoftheseideas,ifyouhaveadditionalideasformanuscripts,if
youwouldliketobeinvolvedinanyoftheseorothermanuscripts,orifyouarejustenjoyingnothaving
DGACdeadlineshangingoveryourheadatthemoment
Best,
Trish
This electronic message contains information generated by the USDA solely for the intended
recipients. Any unauthorized interception of this message or the use or disclosure of the
information it contains may violate the law and subject the violator to civil or criminal penalties.
If you believe you have received this message in error, please notify the sender and delete the
email immediately.
52
PSC-HHS-000052

From:
Sent:
To:
Cc:
Subject:

Monday, January 26, 2015 2:07 PM
Lichtenstein, Alice; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH)
Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; 'Anne Rodgers'
RE: Final approval of edits: Chapter 6: Cross-Cutting Topics
Iapprovethisrevisionaswell.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Monday, January 26, 2015 1:51 PM
To: Essery, Eve - CNPP; Millen, Barbara E; Casavale, Kellie (OS/OASH)
Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; 'Anne Rodgers'
Subject: RE: Final approval of edits: Chapter 6: Cross-Cutting Topics
It was my error, I must have been on overload last week. Very sorry about that.
The revised version looks correct to me.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
From: Essery, Eve - CNPP [mailto:Eve.Essery@fns.usda.gov]
To: Lichtenstein, Alice; Millen, Barbara E; Casavale, Kellie (OS/OASH)
Hi Alice,
The text originally said better sodium and potassium balance and you edited it to say ratio. Rather than put that into a
balance/ratio statement, do you just want to recommend lowering sodium? Hows this?...
The Committee encourages the food industry to continue reformulating and making changes to
certain foods to improve their nutrition profile. Examples of such actions include lowering sodium and
added sugars content, achieving better saturated fat to polyunsaturated fat ratio, and reducing portion
sizes in retail settings (restaurants, food outlets, and public venues, such as professional sports
stadiums and arenas). The Committee also encourages the food industry to market these improved
products to consumers.
53
PSC-HHS-000053

I dont approve. According to the predominance of evidence the critical issue is to reduce the Na
content of food. The issue of Na/K ratio is still emerging and the implication that just taking a K
supplement on top of a high Na diet will improve outcomes cannot be supported by the science. The
Na/K concept has emerged from certain dietary patterns naturally low in Na and high in K, e.g., those
high in F&V.
I am sorry not to have caught this earlier. Improving the SFA/PUFA ratio is appropriate.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hi Barbara and Alice,

Weve done some editing of your statement for clarity and readability. Do you approve this version of the statement for
inclusion in the Cross-Cutting Chapter and the Integration Chapter?
Thanks!
Eve
certain foods to improve their nutrition profile. Examples of such actions include achieving better
sodium to potassium ratio and/or saturated fat to polyunsaturated fat ratio, lowering added sugars
content, and reducing portion sizes in retail settings (restaurants, food outlets, and public venues,
such as professional sports stadiums and arenas). The Committee also encourages the food industry
to market these improved products to consumers.

Sent: Friday, January 23, 2015 3:18 PM
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PSC-HHS-000054
Wow, who would have ever thought that could happen.

The sentence conveys what I was thinking about. Was there a reason to leave out SFA. Could we
treat it as for Na/K? Also, I think it should be sodium to potassium ratio. Just a quick read, you can
decide what is most appropriate.
The Committee also encourages the food industry to continue to reformulate and make changes to
improve the nutrition profile of certain foods to achieve better sodium to potassium ratio, saturated fat
to polyunsaturated fat ratio, lower added sugars content, reduce portion sizes in retail settings
(restaurants, food outlets, and public venues, such as professional sports stadiums and arenas), and
to market them to consumers.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Millen, Barbara E; Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
JustwhenyouthoughttheCrossCuttingChapterwasdone;)
AliceYouhadaskedifastatementcouldbeaddedtothechaptersummarystatingthattheCommitteealsosupports
expandedavailabilityofreducedSFA,Naandaddedsugarproducts.Weinitiallysaidthiswasntpossiblebecauseit
hadntbeenvettedbytheCommittee.However,KellieandIwerewalkingthroughsomethingsintheReport,andshe
rememberedasomewhatsimilarstatementintheIntegrationChapter.BelowistheparagraphwhereAlicemadethe
comment.Wouldyouliketoaddthehighlightedsentencetothischapter?(Thisispossiblesinceitwasalreadyvettedas
partoftheIntegrationChapter.)Pleaseletusknow.
Achievingreductionsinsodium,saturatedfat,andaddedsugars,canallbeaccomplishedandaremoreattainableby
eatingahealthydietarypattern.Forallthreeofthesecomponentsofthediet,policiesandprogramsatlocal,state,and
nationallevelsinboththeprivateandpublicsectorarenecessarytosupportreductionefforts.Similarly,theCommittee
supportseffortsinlabelingandothercampaignstoincreaseconsumerawarenessandunderstandingofsodium,
saturatedfats,andaddedsugarsinfoodsandbeverages.TheCommitteealsoencouragesthefoodindustryto
continuetoreformulateandmakechangestoimprovethenutritionprofileofcertainfoodstoachievebettersodium
andpotassiumbalance,loweraddedsugarscontent,reduceportionsizesinretailsettings(restaurants,foodoutlets,
andpublicvenues,suchasprofessionalsportsstadiumsandarenas),andtomarketthemtoconsumers.
55
PSC-HHS-000055
Thanks!
Eve
From: Millen, Barbara E [mailto:bmillen@bu.edu]

Sent: Wednesday, January 21, 2015 4:16 PM
To: Essery, Eve - CNPP; Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
OK.Westandbyourevidencebase.Itsaninterestingresearchquestion(butImnotsuggestinganyadditions)!
Thankyoufortheclarification.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Barbara To answer your question about why sources of healthy proteins was deleted from the sat fat section of the
cross-cutting chapter, on Sun 12/21/14 @ 9:33am, Frank sent an email with edits to this section, including the one
referenced below. (Both of you, as well as Tom, were included on the email string.) To accompany this edit, Frank
included a note that states, Please note that protein sources are removed from here because none of the trials or
epidemiological studies involved protein as a replacement for saturated fat food sources. His edit was to align more with
the research considered.
Please let me know if youd like me to forward his email.
Eve

Sent: Wednesday, January 21, 2015 7:17 AM
To: Millen, Barbara E; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH)
I agree with Barbara. By bringing the reference forward what are we suggesting, cut dairy
consumption or worse yet switch from fat-free and low-fat to full fat dairy products? That would not
be consistent with our other guidance.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
56
PSC-HHS-000056

To: Lichtenstein, Alice; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH)
ButhereweretalkingaboutsubstitutionforcarbohydratesandCVDriskandlipids.Sodoesreferencehereto
sustainabilitymakesense?Also,Iwouldwonderaboutbringinginliteraturefrommodelingresearchwhenwere
reportingonsaturatedfatandCVD.
Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

My guess is due to sustainability issues according tovan Doreen et al. Is that correct?
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sorry,online4734,whatistherationaleforeliminatingsourcesofhealthyproteins?OtherwiseIamfinewiththe
edits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

57
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HiBarbaraandAlice,
Abriefsummaryofthechangestothecrosscuttingchapterbasedonyourfinalreviewisbelow,withindividual
commentsprovidedinthechapterattached.
KellieUnlesswehearfromBarbaraandAliceotherwise,thischapterisreadytomoveforwardforfinalization.
Thanks!
Eve
LCSschangedtolowcaloriesweetenersthroughout
Line375:Deletedandsimplecookingtechniquesthatmaximizeflavortoparallelchaptersummary.
Line492:AddedCHD(discussedinthereviewofevidence)
Line1019:Switchedordertobebeveragesandfoods
Line1086:Editsmadesothatthesentencereads,Forsodium,emphasisshouldbeplacedonexpanding
industryeffortstoreducethesodiumcontentoffoodsandhelpingconsumersunderstandhowtoflavor
unsaltedfoodswithspicesandherbs.(Thisisclearlystatedinthesodiumsection;thesearejusteditstocarry
thatforwardinthechaptersummary.)
Afewresponsestocomments:
o
Inthestyleguide,itisrequestedthatalowercasenbeusedforn=
Abbreviationsreviewedandedited,whenneeded
Alicehascommentedthatshedoesnotsupportthestatementthataddedsugarsnotbereplacedwith
lowcaloriesweeteners.However,thishasbeenpresentedatpublicmeetings,anditwasnotdecided
thatthiswouldbedeletedorchanged,andthus,thiswouldbeasubstantivechangethatcannotbe
madeatthistime.
AliceaskedifastatementcouldbeaddedtothechaptersummarystatingthattheCommitteealso
supportsexpandedavailabilityofreducedSFA,Naandaddedsugarproducts.However,sincethishas
notbeendiscussedwiththefullCommittee,itisasubstantiveeditthatcannotbemadeatthistime.

To: Millen, Barbara E; Casavale, Kellie (OS/OASH)
Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve - CNPP; 'Anne Rodgers'
I agree with Barbara. All along I thought we were emphasizing the need for the food industry to ramp
down on Na.
TuftsUniversity
711WashingtonStreet
58
PSC-HHS-000058
Boston,MA02111
phone:6175563127
Sent: Monday, January 19, 2015 11:12 AM
To: Casavale, Kellie (OS/OASH); Lichtenstein, Alice
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve - CNPP'; 'Anne Rodgers'
Hieveryone,
Iamapprovingtherecommendededitswithoneexceptiontoeditsinthedocument.Iproposeabitoftweakingon
Lines19814.Aswritten,theemphasisappearstobeoneducatingconsumers(Ithinkbutitsnotclear)toflavor
unsaltedfoodswithherbsandspices.Ithinkwealsowanttoemphasizeexpandingfoodindustryinitiativestolowerthe
sodiumcontentoffoods.Dowewanttomentionanyotherenvironmentalchanges?Ioffersomesuggestedwording
tobemoreconsistentwiththeconclusionstatements.
Aswiththeotherchapters,thiswasapleasuretoread!Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Saturday, January 17, 2015 6:55 PM
To: Millen, Barbara E; 'Lichtenstein, Alice'
Subject: Final approval of edits: Chapter 6: Cross-Cutting Topics
Importance: High
BarbaraandAlice,
Chapter6:CrosscuttingTopicsofPublicHealthImportanceandalogofeditsareattached.Theeditorialchangeswere
accepted.YouwillseethatmosttrackedchangesinthechapteraretoupdatethereferencestorefertotheNHLBI
ReportandAHA/ACCGuidelinepairsaccurately.Thereareafewothersubstantivetrackedchangesthataddress
previouslyestablishedissues.
Pleaserespondbackassoonaspossiblenotingthat
1. Youapprovetheseallbemadeandthechapterconsideredfinal
2. NoteanyeditsthatneedtweakingTOADDRESSTHEORIGINALISSUE
DONOTSUGGESTANYNEWEDITSUNLESSYOUNOTICEABLATANTERROR.
Ifyouhavequestions,pleasereplytothegroup,andEvewillanswerthemforyou.
Manythanks,
Kellie
59
PSC-HHS-000059
1101WoottonPkwy,LL117
Rockville,MD20852
(240)4538252
www.DietaryGuidelines.gov
This electronic message contains information generated by the USDA solely for the intended recipients. Any
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please notify the sender and delete the email immediately.
60
PSC-HHS-000060

From:
Sent:
To:
Cc:
Subject:

Essery, Eve - CNPP; Millen, Barbara E; Casavale, Kellie (OS/OASH)
It was my error, I must have been on overload last week. Very sorry about that.
The revised version looks correct to me.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hi Alice,
The text originally said better sodium and potassium balance and you edited it to say ratio. Rather than put that into a
balance/ratio statement, do you just want to recommend lowering sodium? Hows this?...
certain foods to improve their nutrition profile. Examples of such actions include lowering sodium and
added sugars content, achieving better saturated fat to polyunsaturated fat ratio, and reducing portion
sizes in retail settings (restaurants, food outlets, and public venues, such as professional sports
stadiums and arenas). The Committee also encourages the food industry to market these improved
products to consumers.

61
PSC-HHS-000061
high in F&V.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Thanks!
Eve


62
PSC-HHS-000062
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Thanks!
Eve

63
PSC-HHS-000063
Dr.BarbaraE.Millen
bmillen@bu.edu

Eve

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
64
PSC-HHS-000064
Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
edits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
Thanks!
Eve
65
PSC-HHS-000065
o
madeatthistime.

down on Na.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
66
PSC-HHS-000066
Hieveryone,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
67
PSC-HHS-000067
68
PSC-HHS-000068

From:
Sent:
To:
Cc:
Subject:

high in F&V.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Thanks!
Eve
69
PSC-HHS-000069


TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
70
PSC-HHS-000070
Thanks!
Eve

Dr.BarbaraE.Millen
bmillen@bu.edu

Eve

TuftsUniversity
711WashingtonStreet
Boston,MA02111
71
PSC-HHS-000071

phone:6175563127
Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
edits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
72
PSC-HHS-000072

HiBarbaraandAlice,
Thanks!
Eve
o
madeatthistime.

down on Na.
73
PSC-HHS-000073
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hieveryone,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
74
PSC-HHS-000074
Rockville,MD20852
(240)4538252
75
PSC-HHS-000075

From:
Sent:
To:
Cc:
Subject:

Friday, January 23, 2015 3:49 PM
Britten, Patricia - CNPP; Casavale, Kellie (OS/OASH); 'Barbara E Millen'
Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve CNPP; 'Anne Rodgers'
RE: Final approval of edits: Glossary (and Report Update)
We are then in 100% agreement. What a pleasure.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
From: Britten, Patricia - CNPP [mailto:Patricia.Britten@cnpp.usda.gov]
To: Lichtenstein, Alice; Casavale, Kellie (OS/OASH); 'Barbara E Millen'
Subject: RE: Final approval of edits: Glossary (and Report Update)
Alice,Imeantthistobeacrossreferencetoboththesugarsandaddedsugarsdefinitions,justforgottoputinadded
sugars.Hereiswhatitshouldbe:
SugarsweetenedbeveragesLiquidsthataresweetenedwithvariousformsofaddedsugars(seeAddedSugars
andCarbohydrates:Sugars).Thesebeveragesinclude,butarenotlimitedto,soda,fruitades,andsportsdrinks.Also
calledcaloricallysweetenedbeverages.
Kellie,IthinkwiththisonelastchangeweallagreeandBarbaraandAlicehavebothapprovedtheglossary.
Trish

To: Britten, Patricia - CNPP; Casavale, Kellie (OS/OASH); 'Barbara E Millen'
Great solutions Trish, I agree with them all. Thank you. A hallo is starting to float above all your
heads.
76
PSC-HHS-000076
I do want to clarify one point. For SSB could we not cross reference to the Add Sugars definition or
can we just cross reference to chapters?
See comments in text agreeing with everything and bringing up that point in situ.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Alice,
Thanksforyourreviewandsuggestions.Kellieaskedmetorespondonseveralofyourcommentstoseeifweve
reachedagreementonfinalwording.Majorchangesbelowandallchangesreflectedintheattachment:
SaturatedfattyacidsSaturatedfattyacidshavenodoublebonds.Majorsourcesincludeanimalproductssuch
asmeatanddairyproducts,andtropicaloilssuchascoconutorpalmoils.Ingeneral,fatshighinsaturatedfatty
acidsaresolidatroomtemperature.
transfattyacidsTransfattyacidsareunsaturatedfattyacidsthatcontainoneormoreisolated(i.e.,
nonconjugated)doublebondsinatransconfiguration.Sourcesoftransfattyacidsincludepartially
hydrogenatedvegetableoilsthatarehavebeenusedtomaketraditionalshorteningandsomecommercially
preparedbakedgoods,snackfoods,friedfoods,andtraditionalstickmargarine.Transfattyacidsalsoare
presentinfoodsthatcomefromruminantanimals(e.g.,cattleandsheep)andarecallednaturalorrTFA.Such
foodsincludedairyproducts,beef,andlamb.
OilsFatsthatareliquidatroomtemperature.Oilscomefrommanydifferentplantsandsomefish.Some
commonoilsincludecanola,corn,olive,peanut,safflower,soybean,andsunfloweroils.Anumberoffoodsare
naturallyhighinoils,suchas:nuts,olives,somefish,andavocados.Foodsthataremainlymadeupofoil
includemayonnaise,certainsaladdressings,andsoft(tuborsqueeze)margarinewithnotransfats.Oilsarehigh
inmonounsaturatedorpolyunsaturatedfats,andlowinsaturatedfatsthansolidfats.Afewplantoils,termed
tropicaloils,includingcoconutoil,palmoilandpalmkerneloil,arehighinsaturatedfatsandfornutritional
purposesshouldbeconsideredassolidfats.Partiallyhydrogenatedoilsthatcontaintransfatsshouldalsobe
consideredassolidfatsfornutritionalpurposes.(SeeFats)
SolidfatsFatsthatareusuallynotliquidatroomtemperature.Solidfatsarefoundinanimalfoodsexceptfor
seafood,andcanbemadefromvegetableoilsthroughhydrogenation.Sometropicaloilplants,suchascoconut
andpalm,areconsideredassolidfatsduetotheirfattyacidcomposition.Solidfatscontainmoresaturatedfats
77
PSC-HHS-000077
and/ortransfatsthanliquidoils(e.g.,soybean,canola,andcornoils),withloweramountsof
monounsaturatedorpolyunsaturatedfattyacids.Commonfatsconsideredtobesolidfatsinclude:butterfat,
beeffat(tallow,suet),chickenfat,porkfat(lard),traidionalstickmargarine,traditionalshortening,coconutoil,
palmoilandpalmkerneloil.Foodshighinsolidfatsinclude:butter,fullfatcheeses,creams,wholemilk,full
faticecreams,marbledcutsofmeats,regulargroundbeef,bacon,sausages,poultryskin,andmanybaked
goodsmadeusingtheseproducts(suchascookies,crackers,doughnuts,pastries,andcroissants).Thefat
componentofmilkandcream(butter)issolidatroomtemperature.(SeeFats)
LeanmeatAnymeatwithlessthan10%fatbyweight,orlessthan10gramsoffatper100grams,basedon
USDAandFDAdefinitionsforfoodlabeluse.Examplesinclude95%leangroundbeef,cooked;broiledbeef
steak,leanonlyeaten;bakedporkchop,leanonlyeaten;roastedchickenbreastorleg,noskineaten;and
smoked/curedham,leanonlyeaten.
NOTE:
Crisco Ingredients from the current website:
SOYBEAN OIL, FULLY HYDROGENATED PALM OIL, PARTIALLY HYDROGENATED PALM AND SOYBEAN OILS, MONO AND DIGLYCERIDES, TBHQ AND
CITRIC ACID (ANTIOXIDANTS).
Pleaseletusknowifthisisokaywiththeseedits.
Thanks,
Tris

Sent: Friday, January 23, 2015 9:29 AM
To: Casavale, Kellie (OS/OASH); 'Barbara E Millen'
Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve - CNPP; 'Anne Rodgers'; Britten,
Patricia - CNPP
Generally looks good to me and should be very helpful to the users of the report. See comments
below and in text. Regardless of the decision with regard to these, none are such that the document
should be held up.
Minor comments;
Should have picked this up sooner but BMI z-score should have been listed as its own
separate entry since it is less familiar than BMI and someone may not read down to the bottom
of the BMI entry, especially since reference to BMI z-score is sandwiched in between the text
and table
General comment, the term .Eating out is misleading in the current food environment since it
included prepared outside the home but consumed in the home. Future DRI committees
should rethink the term.
Suggesting further modified to saturated fat;
Ingeneral,fatshighinsaturatedfattyacidsaresolidatroomtemperature,withthenotableexceptionof
tropicaloils.
78
PSC-HHS-000078
Trans fat Should be modified to read Sourcesoftransfattyacidsincludepartiallyhydrogenated

vegetableoilsthatareusedtomaketraditionalshorteningandsomecommerciallypreparedbakedgoods,snack
foods,friedfoods,andtraditionalstickmargarine.
Shortenings like Crisco are now trans-free. There has been a well-documented shift in
commercial prepared baked goods to be trans free likely resulting from the FDA mandate that
TFA needs to be listed on the Nutrients Facts label. The definition as written does not reflect
this shift. It is certainly not accurate for most margarines, even stick margarine for which many
are trans free. Dated definition.
Other comments in text.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'Barbara E Millen'; Lichtenstein, Alice
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve - CNPP'; 'Anne Rodgers'; Britten,
Patricia - CNPP
Subject: Final approval of edits: Glossary (and Report Update)
Importance: High
BarbaraandAlice,
Ithinkthiswillbethelastfileforyoutoapprove,AppendixE5Glossary.Onlyahandfulofadditionsandminortweaks
wereneeded.Explanationsforeachareprovided.
1. Youapprovethesebeacceptedandglossaryconsideredfinal
Ifyouhavequestions,pleasereplytothegroup.IhavecopiedTrishaswell;shewasinvolvedinalmostallofthese
resolutions.
AsanupdateweareVERYclosetomovingallofthefilestotheirfinalform.Weexpectbeingabletosendthemtobe
made508compliantMONDAY.OncetheygotothecontractorNOeditscanbemade.Ifanerrorisfoundthatneeds
tobedocumented,wewillpostanaddendumalongsidethereporttodocumentandcommunicatethese.Becauseof
thefinalityofthisstep,Iwantedtobesureyouwereaware.
TherehasalsobeensomeguidancegiventousfromfaraboveregardingthetimingofthesubmissionoftheReportto
theSecretaries.WewilldescribethatontheAdministrativecallonTuesdaymorning.
79
PSC-HHS-000079
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
80
PSC-HHS-000080

From:
Sent:
To:
Cc:

Lichtenstein, Alice
Britten, Patricia - CNPP; Casavale, Kellie (OS/OASH); Olson, Richard (HHS/OASH);
Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve - CNPP; Anne Rodgers
Re: Final approval of edits: Glossary (and Report Update)
Subject:
Itooapproveandagreethatallofyouareamazing.Barbara
SentfrommyiPhone
OnJan23,2015,at3:35PM,"Lichtenstein,Alice"<Alice.Lichtenstein@tufts.edu>wrote:
Great solutions Trish, I agree with them all. Thank you. A hallo is starting to float above
all your heads.
I do want to clarify one point. For SSB could we not cross reference to the Add Sugars
definition or can we just cross reference to chapters?
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve - CNPP; 'Anne
Rodgers'
Alice,
Thanksforyourreviewandsuggestions.Kellieaskedmetorespondonseveralofyourcommentstosee
ifwevereachedagreementonfinalwording.Majorchangesbelowandallchangesreflectedinthe
attachment:
81
PSC-HHS-000081
SaturatedfattyacidsSaturatedfattyacidshavenodoublebonds.Majorsourcesinclude
animalproductssuchasmeatanddairyproducts,andtropicaloilssuchascoconutorpalmoils.
Ingeneral,fatshighinsaturatedfattyacidsaresolidatroomtemperature.
transfattyacidsTransfattyacidsareunsaturatedfattyacidsthatcontainoneormoreisolated
(i.e.,nonconjugated)doublebondsinatransconfiguration.Sourcesoftransfattyacidsinclude
partiallyhydrogenatedvegetableoilsthatarehavebeenusedtomaketraditionalshortening
andsomecommerciallypreparedbakedgoods,snackfoods,friedfoods,andtraditionalstick
margarine.Transfattyacidsalsoarepresentinfoodsthatcomefromruminantanimals(e.g.,
cattleandsheep)andarecallednaturalorrTFA.Suchfoodsincludedairyproducts,beef,and
lamb.
OilsFatsthatareliquidatroomtemperature.Oilscomefrommanydifferentplantsandsome
fish.Somecommonoilsincludecanola,corn,olive,peanut,safflower,soybean,andsunflower
oils.Anumberoffoodsarenaturallyhighinoils,suchas:nuts,olives,somefish,andavocados.
Foodsthataremainlymadeupofoilincludemayonnaise,certainsaladdressings,andsoft(tub
orsqueeze)margarinewithnotransfats.Oilsarehighinmonounsaturatedorpolyunsaturated
fats,andlowinsaturatedfatsthansolidfats.Afewplantoils,termedtropicaloils,including
coconutoil,palmoilandpalmkerneloil,arehighinsaturatedfatsandfornutritionalpurposes
shouldbeconsideredassolidfats.Partiallyhydrogenatedoilsthatcontaintransfatsshould
alsobeconsideredassolidfatsfornutritionalpurposes.(SeeFats)
SolidfatsFatsthatareusuallynotliquidatroomtemperature.Solidfatsarefoundinanimal
foodsexceptforseafood,andcanbemadefromvegetableoilsthroughhydrogenation.Some
tropicaloilplants,suchascoconutandpalm,areconsideredassolidfatsduetotheirfattyacid
composition.Solidfatscontainmoresaturatedfatsand/ortransfatsthanliquidoils(e.g.,
soybean,canola,andcornoils),withloweramountsofmonounsaturatedorpolyunsaturated
fattyacids.Commonfatsconsideredtobesolidfatsinclude:butterfat,beeffat(tallow,suet),
chickenfat,porkfat(lard),traidionalstickmargarine,traditionalshortening,coconutoil,palm
oilandpalmkerneloil.Foodshighinsolidfatsinclude:butter,fullfatcheeses,creams,whole
milk,fullfaticecreams,marbledcutsofmeats,regulargroundbeef,bacon,sausages,poultry
skin,andmanybakedgoodsmadeusingtheseproducts(suchascookies,crackers,doughnuts,
pastries,andcroissants).Thefatcomponentofmilkandcream(butter)issolidatroom
temperature.(SeeFats)
LeanmeatAnymeatwithlessthan10%fatbyweight,orlessthan10gramsoffatper100
grams,basedonUSDAandFDAdefinitionsforfoodlabeluse.Examplesinclude95%lean
groundbeef,cooked;broiledbeefsteak,leanonlyeaten;bakedporkchop,leanonlyeaten;
roastedchickenbreastorleg,noskineaten;andsmoked/curedham,leanonlyeaten.
NOTE:
SOYBEAN OIL, FULLY HYDROGENATED PALM OIL, PARTIALLY HYDROGENATED PALM AND SOYBEAN OILS, MONO AND
DIGLYCERIDES, TBHQ AND CITRIC ACID (ANTIOXIDANTS).
82
PSC-HHS-000082
Thanks,
Tris

Rodgers'; Britten, Patricia - CNPP
Generally looks good to me and should be very helpful to the users of the report. See
comments below and in text. Regardless of the decision with regard to these, none are
such that the document should be held up.
Minor comments;
Should have picked this up sooner but BMI z-score should have been listed as its
own separate entry since it is less familiar than BMI and someone may not read
down to the bottom of the BMI entry, especially since reference to BMI z-score is
sandwiched in between the text and table
General comment, the term .Eating out is misleading in the current food
environment since it included prepared outside the home but consumed in the
home. Future DRI committees should rethink the term.
Ingeneral,fatshighinsaturatedfattyacidsaresolidatroomtemperature,withthenotable
exceptionoftropicaloils.
Trans fat Should be modified to read Sourcesoftransfattyacidsincludepartially

hydrogenatedvegetableoilsthatareusedtomaketraditionalshorteningandsome
commerciallypreparedbakedgoods,snackfoods,friedfoods,andtraditionalstickmargarine.
Shortenings like Crisco are now trans-free. There has been a well-documented
shift in commercial prepared baked goods to be trans free likely resulting from
the FDA mandate that TFA needs to be listed on the Nutrients Facts label. The
definition as written does not reflect this shift. It is certainly not accurate for most
margarines, even stick margarine for which many are trans free. Dated
definition.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
83
PSC-HHS-000083

Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve - CNPP'; 'Anne
Rodgers'; Britten, Patricia - CNPP
Importance: High
BarbaraandAlice,
Ithinkthiswillbethelastfileforyoutoapprove,AppendixE5Glossary.Onlyahandfulofadditions
andminortweakswereneeded.Explanationsforeachareprovided.
Ifyouhavequestions,pleasereplytothegroup.IhavecopiedTrishaswell;shewasinvolvedinalmost
alloftheseresolutions.
AsanupdateweareVERYclosetomovingallofthefilestotheirfinalform.Weexpectbeingableto
sendthemtobemade508compliantMONDAY.OncetheygotothecontractorNOeditscanbemade.
Ifanerrorisfoundthatneedstobedocumented,wewillpostanaddendumalongsidethereportto
documentandcommunicatethese.Becauseofthefinalityofthisstep,Iwantedtobesureyouwere
aware.
Therehasalsobeensomeguidancegiventousfromfaraboveregardingthetimingofthesubmission
oftheReporttotheSecretaries.WewilldescribethatontheAdministrativecallonTuesdaymorning.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
email immediately.
84
PSC-HHS-000084
<17 Appendix E-5 Glossary_SEMI-FINAL_tracked changes_1-22-15 AHL TB 1-23-15

AHL.docx>
85
PSC-HHS-000085

From:
Sent:
To:
Cc:
Subject:
Attachments:

17 Appendix E-5 Glossary_SEMI-FINAL_tracked changes_1-22-15 AHL TB 1-23-15
AHL.docx
Great solutions Trish, I agree with them all. Thank you. A hallo is starting to float above all your
heads.
I do want to clarify one point. For SSB could we not cross reference to the Add Sugars definition or
can we just cross reference to chapters?
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Alice,
Thanksforyourreviewandsuggestions.Kellieaskedmetorespondonseveralofyourcommentstoseeifweve
reachedagreementonfinalwording.Majorchangesbelowandallchangesreflectedintheattachment:
SaturatedfattyacidsSaturatedfattyacidshavenodoublebonds.Majorsourcesincludeanimalproductssuch
asmeatanddairyproducts,andtropicaloilssuchascoconutorpalmoils.Ingeneral,fatshighinsaturatedfatty
acidsaresolidatroomtemperature.
transfattyacidsTransfattyacidsareunsaturatedfattyacidsthatcontainoneormoreisolated(i.e.,
nonconjugated)doublebondsinatransconfiguration.Sourcesoftransfattyacidsincludepartially
hydrogenatedvegetableoilsthatarehavebeenusedtomaketraditionalshorteningandsomecommercially
86
PSC-HHS-000086
preparedbakedgoods,snackfoods,friedfoods,andtraditionalstickmargarine.Transfattyacidsalsoare
presentinfoodsthatcomefromruminantanimals(e.g.,cattleandsheep)andarecallednaturalorrTFA.Such
foodsincludedairyproducts,beef,andlamb.
OilsFatsthatareliquidatroomtemperature.Oilscomefrommanydifferentplantsandsomefish.Some
commonoilsincludecanola,corn,olive,peanut,safflower,soybean,andsunfloweroils.Anumberoffoodsare
naturallyhighinoils,suchas:nuts,olives,somefish,andavocados.Foodsthataremainlymadeupofoil
includemayonnaise,certainsaladdressings,andsoft(tuborsqueeze)margarinewithnotransfats.Oilsarehigh
inmonounsaturatedorpolyunsaturatedfats,andlowinsaturatedfatsthansolidfats.Afewplantoils,termed
tropicaloils,includingcoconutoil,palmoilandpalmkerneloil,arehighinsaturatedfatsandfornutritional
purposesshouldbeconsideredassolidfats.Partiallyhydrogenatedoilsthatcontaintransfatsshouldalsobe
consideredassolidfatsfornutritionalpurposes.(SeeFats)
SolidfatsFatsthatareusuallynotliquidatroomtemperature.Solidfatsarefoundinanimalfoodsexceptfor
seafood,andcanbemadefromvegetableoilsthroughhydrogenation.Sometropicaloilplants,suchascoconut
andpalm,areconsideredassolidfatsduetotheirfattyacidcomposition.Solidfatscontainmoresaturatedfats
and/ortransfatsthanliquidoils(e.g.,soybean,canola,andcornoils),withloweramountsofmonounsaturated
orpolyunsaturatedfattyacids.Commonfatsconsideredtobesolidfatsinclude:butterfat,beeffat(tallow,
suet),chickenfat,porkfat(lard),traidionalstickmargarine,traditionalshortening,coconutoil,palmoiland
palmkerneloil.Foodshighinsolidfatsinclude:butter,fullfatcheeses,creams,wholemilk,fullfaticecreams,
marbledcutsofmeats,regulargroundbeef,bacon,sausages,poultryskin,andmanybakedgoodsmadeusing
theseproducts(suchascookies,crackers,doughnuts,pastries,andcroissants).Thefatcomponentofmilkand
cream(butter)issolidatroomtemperature.(SeeFats)
LeanmeatAnymeatwithlessthan10%fatbyweight,orlessthan10gramsoffatper100grams,basedon
USDAandFDAdefinitionsforfoodlabeluse.Examplesinclude95%leangroundbeef,cooked;broiledbeef
steak,leanonlyeaten;bakedporkchop,leanonlyeaten;roastedchickenbreastorleg,noskineaten;and
smoked/curedham,leanonlyeaten.
NOTE:
SOYBEAN OIL, FULLY HYDROGENATED PALM OIL, PARTIALLY HYDROGENATED PALM AND SOYBEAN OILS, MONO AND DIGLYCERIDES, TBHQ AND
CITRIC ACID (ANTIOXIDANTS).
Thanks,
Tris

Patricia - CNPP
87
PSC-HHS-000087
should be held up.
Minor comments;
and table
tropicaloils.

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Patricia - CNPP
Importance: High
BarbaraandAlice,
88
PSC-HHS-000088
resolutions.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
89
PSC-HHS-000089

From:
Sent:
To:
Cc:
Subject:


TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
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PSC-HHS-000090
saturatedfats,andaddedsugarsinfoodsandbeverages.TheCommitteealsoencouragesthefoodindustrytocontinue
toreformulateandmakechangestoimprovethenutritionprofileofcertainfoodstoachievebettersodiumand
potassiumbalance,loweraddedsugarscontent,reduceportionsizesinretailsettings(restaurants,foodoutlets,and
publicvenues,suchasprofessionalsportsstadiumsandarenas),andtomarketthemtoconsumers.
Thanks!
Eve

Dr.BarbaraE.Millen
bmillen@bu.edu

Eve

91
PSC-HHS-000091
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
edits.Barbara
92
PSC-HHS-000092

Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
Thanks!
Eve
o
madeatthistime.

down on Na.
93
PSC-HHS-000093

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hieveryone,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
94
PSC-HHS-000094

Manythanks,
Kellie
Rockville,MD20852
(240)4538252
95
PSC-HHS-000095

From:
Sent:
To:
Cc:
Subject:

Essery, Eve - CNPP
Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Olson, Richard (HHS/OASH); Rihane,
Colette - CNPP; Bowman, Shanthy; Anne Rodgers
Re: Final approval of edits: Chapter 6: Cross-Cutting Topics
Ilikeitandapprovetheaddition.Barbara
SentfrommyiPhone
OnJan23,2015,at3:01PM,"Essery,EveCNPP"<Eve.Essery@fns.usda.gov>wrote:
AliceYouhadaskedifastatementcouldbeaddedtothechaptersummarystatingthattheCommittee
alsosupportsexpandedavailabilityofreducedSFA,Naandaddedsugarproducts.Weinitiallysaidthis
wasntpossiblebecauseithadntbeenvettedbytheCommittee.However,KellieandIwerewalking
throughsomethingsintheReport,andsherememberedasomewhatsimilarstatementinthe
IntegrationChapter.BelowistheparagraphwhereAlicemadethecomment.Wouldyouliketoaddthe
highlightedsentencetothischapter?(Thisispossiblesinceitwasalreadyvettedaspartofthe
IntegrationChapter.)Pleaseletusknow.
Achievingreductionsinsodium,saturatedfat,andaddedsugars,canallbeaccomplishedandaremore
attainablebyeatingahealthydietarypattern.Forallthreeofthesecomponentsofthediet,policiesand
programsatlocal,state,andnationallevelsinboththeprivateandpublicsectorarenecessaryto
supportreductionefforts.Similarly,theCommitteesupportseffortsinlabelingandothercampaignsto
increaseconsumerawarenessandunderstandingofsodium,saturatedfats,andaddedsugarsinfoods
andbeverages.TheCommitteealsoencouragesthefoodindustrytocontinuetoreformulateandmake
changestoimprovethenutritionprofileofcertainfoodstoachievebettersodiumandpotassium
balance,loweraddedsugarscontent,reduceportionsizesinretailsettings(restaurants,foodoutlets,
Thanks!
Eve

OK.Westandbyourevidencebase.Itsaninterestingresearchquestion(butImnotsuggestingany
additions)!
Dr.BarbaraE.Millen
bmillen@bu.edu
96
PSC-HHS-000096

Barbara To answer your question about why sources of healthy proteins was deleted from the sat fat
section of the cross-cutting chapter, on Sun 12/21/14 @ 9:33am, Frank sent an email with edits to this
section, including the one referenced below. (Both of you, as well as Tom, were included on the email
string.) To accompany this edit, Frank included a note that states, Please note that protein sources are
removed from here because none of the trials or epidemiological studies involved protein as a
replacement for saturated fat food sources. His edit was to align more with the research considered.
Eve

I agree with Barbara. By bringing the reference forward what are we suggesting, cut
dairy consumption or worse yet switch from fat-free and low-fat to full fat dairy
products? That would not be consistent with our other guidance.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

ButhereweretalkingaboutsubstitutionforcarbohydratesandCVDriskandlipids.Sodoesreference
heretosustainabilitymakesense?Also,Iwouldwonderaboutbringinginliteraturefrommodeling
researchwhenwerereportingonsaturatedfatandCVD.
Otherthoughts?
Barbara
97
PSC-HHS-000097
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Sorry,online4734,whatistherationaleforeliminatingsourcesofhealthyproteins?OtherwiseIam
finewiththeedits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
Abriefsummaryofthechangestothecrosscuttingchapterbasedonyourfinalreviewisbelow,with
individualcommentsprovidedinthechapterattached.
KellieUnlesswehearfromBarbaraandAliceotherwise,thischapterisreadytomoveforwardfor
finalization.
Thanks!
Eve
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PSC-HHS-000098
Line375:Deletedandsimplecookingtechniquesthatmaximizeflavortoparallelchapter
summary.
Line1086:Editsmadesothatthesentencereads,Forsodium,emphasisshouldbeplacedon
expandingindustryeffortstoreducethesodiumcontentoffoodsandhelpingconsumers
understandhowtoflavorunsaltedfoodswithspicesandherbs.(Thisisclearlystatedinthe
sodiumsection;thesearejusteditstocarrythatforwardinthechaptersummary.)
o
Alicehascommentedthatshedoesnotsupportthestatementthataddedsugarsnot
bereplacedwithlowcaloriesweeteners.However,thishasbeenpresentedatpublic
meetings,anditwasnotdecidedthatthiswouldbedeletedorchanged,andthus,this
wouldbeasubstantivechangethatcannotbemadeatthistime.
Aliceaskedifastatementcouldbeaddedtothechaptersummarystatingthatthe
CommitteealsosupportsexpandedavailabilityofreducedSFA,Naandaddedsugar
products.However,sincethishasnotbeendiscussedwiththefullCommittee,itisa
substantiveeditthatcannotbemadeatthistime.

Rodgers'
I agree with Barbara. All along I thought we were emphasizing the need for the food
industry to ramp down on Na.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Rodgers'
99
PSC-HHS-000099

Hieveryone,
Iamapprovingtherecommendededitswithoneexceptiontoeditsinthedocument.Iproposeabitof
tweakingonLines19814.Aswritten,theemphasisappearstobeoneducatingconsumers(Ithinkbut
itsnotclear)toflavorunsaltedfoodswithherbsandspices.Ithinkwealsowanttoemphasize
expandingfoodindustryinitiativestolowerthesodiumcontentoffoods.Dowewanttomentionany
otherenvironmentalchanges?Ioffersomesuggestedwordingtobemoreconsistentwiththe
conclusionstatements.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Rodgers'
Importance: High
BarbaraandAlice,
Chapter6:CrosscuttingTopicsofPublicHealthImportanceandalogofeditsareattached.The
editorialchangeswereaccepted.Youwillseethatmosttrackedchangesinthechapteraretoupdate
thereferencestorefertotheNHLBIReportandAHA/ACCGuidelinepairsaccurately.Thereareafew
othersubstantivetrackedchangesthataddresspreviouslyestablishedissues.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
100
PSC-HHS-000100
email immediately.
101
PSC-HHS-000101

From:
Sent:
To:
Cc:
Subject:

Trish, you are absolutely correct on the coconut oil. I dont know why liquid stuck in my head, must
be the most refined form, which is not what is currently available. Now I picture all those jars of
coconut oil on Trader Joes shelves (with a shudder).
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
HiAlice,
InresponsetoyoursuggestionforthesaturatedfatdefinitionIwouldhesitatetoaddanexceptionfortropical
oils.Coconutoilisquitesolidatroomtemperature,andwhileIcantfindmeltingpointsrightaway,somewebimages
ofredpalmoilandpalmkerneloil(injarsforcommercialsale)lookfairlysolidatleastopaqueaswell.Wedosayin
generalatthebeginningofthesentence,soIhopethatwillbesufficient.
Isupportyoureditstothetransfatdefinitiontherehasbeenarecentdramaticshift.Ievensuggestsayingthat
havebeenusedtomakeratherthanthatareusedtomake
Thanksforyourquickreviewoftheglossary!
Trish

Patricia - CNPP
102
PSC-HHS-000102
should be held up.
Minor comments;
and table
tropicaloils.

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Patricia - CNPP
Importance: High
BarbaraandAlice,
103
PSC-HHS-000103
resolutions.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
104
PSC-HHS-000104

From:
Sent:
To:
Cc:
Subject:

Britten, Patricia - CNPP; Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
IapprovedtherecommendededitthatTrishmadeandsupportleavingthesaturatedfatdefinitionasisasTrish
recommends.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Millen, Barbara E
HiAlice,
InresponsetoyoursuggestionforthesaturatedfatdefinitionIwouldhesitatetoaddanexceptionfortropical
oils.Coconutoilisquitesolidatroomtemperature,andwhileIcantfindmeltingpointsrightaway,somewebimages
ofredpalmoilandpalmkerneloil(injarsforcommercialsale)lookfairlysolidatleastopaqueaswell.Wedosayin
generalatthebeginningofthesentence,soIhopethatwillbesufficient.
Isupportyoureditstothetransfatdefinitiontherehasbeenarecentdramaticshift.Ievensuggestsayingthat
havebeenusedtomakeratherthanthatareusedtomake
Thanksforyourquickreviewoftheglossary!
Trish

Patricia - CNPP
should be held up.
Minor comments;
and table
105
PSC-HHS-000105
tropicaloils.

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Patricia - CNPP
Importance: High
BarbaraandAlice,
resolutions.
106
PSC-HHS-000106
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
107
PSC-HHS-000107

From:
Sent:
To:
Cc:
Subject:
Attachments:

Friday, January 23, 2015 9:29 AM
Casavale, Kellie (OS/OASH); 'Barbara E Millen'
Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve - CNPP';
'Anne Rodgers'; Britten, Patricia - CNPP
17 Appendix E-5 Glossary_SEMI-FINAL_tracked changes_1-22-15 AHL.docx
should be held up.
Minor comments;
and table
Ingeneral,fatshighinsaturatedfattyacids aresolidatroomtemperature,withthenotableexceptionof
tropicaloils.

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
108
PSC-HHS-000108

Patricia - CNPP
Importance: High
BarbaraandAlice,
resolutions.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
109
PSC-HHS-000109

From:
Sent:
To:
Cc:
Subject:

Thursday, January 22, 2015 7:15 AM
Lichtenstein, Alice
RE: DGAC SYmposium
Alice,
Thankyouforyourhonesty.IhavetriedtobeverycarefulaboutconveyingtotheDGACthattherewereconcerns
aboutaneventlikethis,someofwhichIhavepersonally,butthatwithcarefulplanningwecanminimizethem.Iopted
inmyemailtotheDGACmemberstostatethiscarefullyandwithoutgettingintothespecificdetails.Itisgenerally
agreedthatthesymposiumwouldhighlightourfindings,oursystematic,evidencebasedapproach,andour
recommendations.Everyonewishesaverypositiveapproach.Ithinkwecancarefullymanageit.Iwastryingtosenda
carefulmessagethatthiswasanimportanteventbutacomplexone,andnotonewithoutrisksthathavetobe
minimized.Ialsothoughttheideaofmultisitelocationswouldgiveotherinstitutionstheclearopportunityto
participate(ifDGACmemberspreferrednottotraveltoBostonbuttotieinfromtheiracademicbase),makingita
dynamicandclearlymultiinstitutionalevent.SeveralDGACmembersasyouknowarealreadylookingintothis
possibility.
AsImentionedbefore,Ididntinterpretyourcommentsasbeingopposedtothesymposium.Itrulyapologizefor
indicatingtherewasmoreenthusiasmthanappearswarranted.Mytendencyistowardsthepositiveand,inthiscase,
withanattempttoconveythatthiseventneedscarefulplanningandmanagementsoourreportanditsstrongevidence
basecomesishighlightedinthemostpositivelight.Ithinkwecanandhopewewill.
Idolookforwardtoothercollaborationsgoingforward.
Allthebest,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Thursday, January 22, 2015 3:21 AM
Cc: Casavale, Kellie (OS/OASH)
Subject: RE: DGAC SYmposium
Barbara:
Got your phone message late in the day and am now just going through my e-mails.
I was not personally offended by your actions. As indicated in our phone conversation when you first
told me you had met with Walt and Frank about a symposium I laid out my concerns. Those
concerns has not abated, hence, I had decided not to participate in the symposium. Officially, I have
a conflict.
110
PSC-HHS-000110
During the whole DGAC process I think we brought complementary skills to the process. I see no
reason for that not to continue into the future.
Alice
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Alice,
Ileftyouavoicemailmessageandrespectyourdecision.Ihopetohaveachancetotalkwithyoubrieflywhenits
convenientforyou.
Lookingforwardtosigningoffonthereporttogetherandcontinuetoenjoythecollaborationtremendously.
Manythanks,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Barbara, given the concerns I raised when we first spoke I have decided not to participate in the
symposium. Not necessary for me to be involved in calls.
Thanks for giving me the opportunity to make the decision.
111
PSC-HHS-000111
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Tuesday, January 20, 2015 9:14 AM
Subject: Re: DGAC SYmposium
WillyouparticipateintheDGACadministrativecallaboutthesymposium?Barbara
SentfrommyiPhone
OnJan20,2015,at7:39AM,"Lichtenstein,Alice"<Alice.Lichtenstein@tufts.edu>wrote:
Barbara, as I indicated to you from the start I have moderate, at best, enthusiasm for
the meeting. Please dont send anything further out suggesting I am involved or
supportive. At this point I will sit on the sidelines.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Subject: DGAC SYmposium
HiAlice,
HowardKohcheckedhisscheduleandwithfederalstaffandemailedmeandFranktoindicatethatheis
freetomoderatethesymposium.IthinkhewillbebalancedandknowsverywellfromhisWashington
experience,whatthepotentialisandhowtonavigate.Hehasofferedtomakecallsonourbehalftoget
adignitary(ies)involvedandotherswhowemaywishtoincludeinsomefashion.Ithankedhimand
askedthathewaituntilweengagetheDGACinanadministrativecalltogettheirinput.Heunderstands
andwilldefertous.
ShouldyouandIhaveacalltotalkabitaboutyourandMariansthoughts?IemailedMarianasasked
thatshelookathertravelscheduleandtrytoparticipateifpossible.Yourthoughts?
112
PSC-HHS-000112
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
113
PSC-HHS-000113

From:
Sent:
To:
Cc:
Subject:

Wednesday, January 21, 2015 4:16 PM
Essery, Eve - CNPP; Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
Dr.BarbaraE.Millen
bmillen@bu.edu

Eve

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
114
PSC-HHS-000114
Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
edits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

115
PSC-HHS-000115

HiBarbaraandAlice,
Thanks!
Eve
o
madeatthistime.

down on Na.
TuftsUniversity
116
PSC-HHS-000116
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hieveryone,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
117
PSC-HHS-000117
Rockville,MD20852
(240)4538252
118
PSC-HHS-000118

From:
Sent:
To:
Subject:

Wednesday, January 21, 2015 7:44 AM
FW: DGACFollow-up Please Hold Wednesday Feb 25
This was the response I got back to the first e-mail I sent you where I took my name out of the text.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Sunday, January 18, 2015 5:17 PM
Cc: Neuhouser, Marian L; Casavale, Kellie (OS/OASH)
Subject: Re: DGACFollow-up Please Hold Wednesday Feb 25
Alice,
Ididnotsenditindrafttoyou.ItwasacopyofwhathadalreadygonetotheremainderofourDGACwithcopiestothe
SRSCandworkgroupleads.IindicatedinourcallwiththefederalstaffthatIwouldbegettinginformationouttothem
andthoughtIhadeveryone'sgoaheadincludingyours.
Ididnotseeyouremailuntillaterthisafternoon.
Barbara
SentfrommyiPhone
Marian, I made the same comment and took my name out of the text. I did not realize
even a draft went out with my name in it.
TuftsUniversity
119
PSC-HHS-000119
711WashingtonStreet
Boston,MA02111
phone:6175563127
From: Neuhouser, Marian L [mailto:mneuhous@fredhutch.org]

Cc: Lichtenstein, Alice
Barbara
IthinkIwasprettyclearthatIsupportedaneventbutIwasnotatallsupportiveoftheideayou
previouslypresented.Youremailbelowsaysallchairswereenthusiasticbutthatisnotthecaseatleast
withme.Iamdeeplydisappointed.
Marian
SentfrommyiPhone
OnJan18,2015,at8:46AM,Millen,BarbaraE<bmillen@bu.edu>wrote:
HiMarian,
Apologiesthatthisisabitformalandperhapssomewhatrepetitive.Iwanttobesure
everyonehasthesameinformation.Thisistheemailcontent(below)nowsenttothe
remainingmembersoftheDGACafterconfirmingdateswiththeSRSCandWorkgroup
leadsandaconversationwithKellie,Rick,ColetteandEve.BTW,thelateJanuarydate
willnolongerbepossible.Thereporteditingistakingabitlongerthanexpectedsowe
wereadvisedthatiswouldbesafertogowiththemostavailablelaterFebruarydate.I
hopethatitmightbepossibleforyoutoworkwiththedate.Iamtravelingtoofor
meetingsonFridaythe27th.LogisticswillbeabitcomplicatedbutIwantedtowork
withthedatemostontheSRSCandourworkgroupleadswerefree.
Iwantedtobringyoufurtheruptodateonsomeplanningthatisunderwaytopublicize
the2015DGACreportonceitisofficiallypublishedintheFederalregister.Aswe
approachedourfinalpublicmeeting,severalmembersoftheSRSCandDGAC
mentionedaninterestindoingsomepublicizingofourwork.TheSRSCdiscusseditin
ourfinalcallsandwereinagreementtoworktodevelopaplan.Afterourfinalmeeting,
AliceandIconferredwithKellie,RickandColetteandthereisagreementthatis
reasonabletoassumethereportwillbepublishedlaterinFebruary.Ialsometwith
HowardKoh,whoasyourecallconductingourswearingintotheDGAC.Youmayalso
recallthatitwasannouncedthathereturnedtotheHarvardSchoolofPublicHealththis
pastsummer.HewasenthusiasticaboutpublicizingtheDGACreportandofferedto
assistwherepossible.IalsometwithWalterWillett,ChairoftheNutritionDepartment,
andhespontaneouslyofferedtohostatelevisedsymposiumonthereportonce
published.HesuggestedthattheirtechnologyallowslivesatellitesitessoIthoughtI
120
PSC-HHS-000120
wouldraisethepossibilitythatourDGACmembershostinstitutions,wherepossible,
mighthostasatellitesitewithaliveaudience(andpossiblypresenter).
IpolledtheSRSCandchapterleadsandtheworkgroupleadersabouttheideaand
aboutdatesinlateFebruarythatmightworkintheirschedules.Itlookslike
WednesdayFebruary25thisthedatethatmostarefree.Ihopethismightworkinyour
scheduleaswell.EveryoneIhavespokentothusonourCommitteeisenthusiastic
abouttheidea.Itisgenerallyagreedthatthesymposiumwouldhighlightourfindings,
oursystematic,evidencebasedapproach,andourrecommendations.Everyonewishes
averypositiveapproach.Ithinkwecancarefullymanageit.AliceandIhadafollowup
callwithRick,KellieandColettetogettheirinput.Theyweresupportive,recognizethat
thiswouldberathernovel(sinceotherDGACshavenotdonethisbefore)and
suggestedwemighttakeaudiencequestionsinadvancetoprepare.
IwillbesendingaDoodlepolltogetanAdministrativeDGACcalltogetherwithallDGAC
memberssowecantalkfurtherabouttheformat,contentandlogisticsofthe
symposium.Duringourplanningprocessanduntilwesendoutinvitations,pleasehold
thisplanningprocessreasonablyconfidential.Iunderstandthatyoumaywishtotalk
withyourinstitutionalITaboutyourabilitytohostasiteonlocation.
Ifyouwishtotalkaboutthisidea,pleaseletmeknow.Icanbereachedat(b) (6)
(cellisbestincaseImtraveling).
AlltheverybestandHappyNewYear!Thisisawonderfulopportunity.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
(b) (6)
121
PSC-HHS-000121

From:
Sent:
To:
Subject:

I dont remember this being discussed with me.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Neuhouser, Marian L
Marian,
Iamsorryforyourreactionandhadhopedthatyoumightbeabletoworkaroundthe25th.WhentheSRSCand
workgroupleadswerepolledfortheavailabledates,the25thwastheonlydatewhenmosteveryonewasfree.The
federalstaffadvisedagainsttheearliestdateandIdidaskHSPHforearlieralternativedateinFebruarybutKellie
suggestedtheywouldnotberealisticintermsofthetimingofthereport'spublication.Itoowillbetravelingright
afterwardstorepresentusandthe25thwillnotbeeasy.WhenwespoketothefederalstaffIdidshareyourconcerns
andalsodiscussedthemwithFrank(notreferencingyou)andwithAlice.HeunderstandsasdoesHowardandWalter
thatwewanttobeinclusiveandpositiveandnothavethisleadtocontroversy.Itisimportanttohavepresentationof
ourreportandourverysoundprocess.
Nospecificaspectsofthesymposiumhavebeensetexceptadateandtimingatthispoint.ThenextstepasImentioned
wasouradministrativecall.Ihopeyouwillparticipateonsettingthisupinawaythatweareallascomfortableas
possible.
MyapologiesifyoufeelImisrepresentedanythingorwasnotasopenaspossible.Itriedveryseriouslytoincludeour
leadershipfromtheoutsetandtheonlyafterdiscussingthingswithfederalstaff,movetoscheduletheadministrative
call.SincewearetechnicallystillinourtermasDGAC,IwasadvisedtohandlecommunicationwiththeSRSCand
workgroupleadsoneonone.Afterthegenerallypositiveresponsesfromourleadership,thefederalstaffrecommended
theDGACcall.
IfyouwouldliketocharfurtherIwouldbehappytodoso.Iamconcernedandwouldliketoresolveitifatallpossible.
122
PSC-HHS-000122
Sincerely,
Barbara
SentfrommyiPhone
OnJan18,2015,at12:56PM,"Neuhouser,MarianL"<mneuhous@fredhutch.org>wrote:
Barbara
Ialsodonotunderstandwhytheemailsays'dateswereconferredwiththeSRSC'whenIspecifically
saidIwasnotavailablefortheFebdatessinceIamrepresentingtheDGACataneventinWashDCsince
bothyouandAlicewerenotavailable.Inotedthisinmypreviousreplyearlierthismonthwhenyou
proposedthisideaandIprettystronglydidnotsupportit.
Iamreallyquitedistressedaboutboththisprocessandtheresult
Marian
SentfrommyiPhone
OnJan18,2015,at9:11AM,Neuhouser,MarianL<mneuhous@fredhutch.org>wrote:
Barbara
IthinkIwasprettyclearthatIsupportedaneventbutIwasnotatallsupportiveofthe
ideayoupreviouslypresented.Youremailbelowsaysallchairswereenthusiasticbut
thatisnotthecaseatleastwithme.Iamdeeplydisappointed.
Marian
SentfrommyiPhone
HiMarian,
Apologiesthatthisisabitformalandperhapssomewhatrepetitive.I
wanttobesureeveryonehasthesameinformation.Thisistheemail
content(below)nowsenttotheremainingmembersoftheDGACafter
confirmingdateswiththeSRSCandWorkgroupleadsanda
conversationwithKellie,Rick,ColetteandEve.BTW,thelateJanuary
datewillnolongerbepossible.Thereporteditingistakingabitlonger
thanexpectedsowewereadvisedthatiswouldbesafertogowiththe
mostavailablelaterFebruarydate.Ihopethatitmightbepossiblefor
youtoworkwiththedate.IamtravelingtooformeetingsonFriday
the27th.LogisticswillbeabitcomplicatedbutIwantedtoworkwith
thedatemostontheSRSCandourworkgroupleadswerefree.
123
PSC-HHS-000123
Iwantedtobringyoufurtheruptodateonsomeplanningthatis
underwaytopublicizethe2015DGACreportonceitisofficially
publishedintheFederalregister.Asweapproachedourfinalpublic
meeting,severalmembersoftheSRSCandDGACmentionedaninterest
indoingsomepublicizingofourwork.TheSRSCdiscusseditinourfinal
callsandwereinagreementtoworktodevelopaplan.Afterourfinal
meeting,AliceandIconferredwithKellie,RickandColetteandthereis
agreementthatisreasonabletoassumethereportwillbepublished
laterinFebruary.IalsometwithHowardKoh,whoasyourecall
conductingourswearingintotheDGAC.Youmayalsorecallthatitwas
announcedthathereturnedtotheHarvardSchoolofPublicHealththis
pastsummer.HewasenthusiasticaboutpublicizingtheDGACreport
andofferedtoassistwherepossible.IalsometwithWalterWillett,
ChairoftheNutritionDepartment,andhespontaneouslyofferedto
hostatelevisedsymposiumonthereportoncepublished.He
suggestedthattheirtechnologyallowslivesatellitesitessoIthoughtI
wouldraisethepossibilitythatourDGACmembershostinstitutions,
wherepossible,mighthostasatellitesitewithaliveaudience(and
possiblypresenter).
IpolledtheSRSCandchapterleadsandtheworkgroupleadersabout
theideaandaboutdatesinlateFebruarythatmightworkintheir
schedules.ItlookslikeWednesdayFebruary25thisthedatethatmost
arefree.Ihopethismightworkinyourscheduleaswell.EveryoneI
havespokentothusonourCommitteeisenthusiasticabouttheidea.It
isgenerallyagreedthatthesymposiumwouldhighlightourfindings,our
systematic,evidencebasedapproach,andour
recommendations.Everyonewishesaverypositiveapproach.Ithink
wecancarefullymanageit.AliceandIhadafollowupcallwithRick,
KellieandColettetogettheirinput.Theyweresupportive,recognize
thatthiswouldberathernovel(sinceotherDGACshavenotdonethis
before)andsuggestedwemighttakeaudiencequestionsinadvanceto
prepare.
IwillbesendingaDoodlepolltogetanAdministrativeDGACcall
togetherwithallDGACmemberssowecantalkfurtheraboutthe
format,contentandlogisticsofthesymposium.Duringourplanning
processanduntilwesendoutinvitations,pleaseholdthisplanning
processreasonablyconfidential.Iunderstandthatyoumaywishtotalk
Ifyouwishtotalkaboutthisidea,pleaseletmeknow.Icanbereached
at(b) (6)
AlltheverybestandHappyNewYear!Thisisawonderful
opportunity.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
124
PSC-HHS-000124

From:
Sent:
To:
Subject:

When I received this e-mail I asked my name be taken out and modified the text accordingly. She
responded by saying she had already sent it out. The following sentences struck me as egregious
since I was not supportive and certainly not enthusiastic Everyone I have spoken to thus on our
Committee is enthusiastic about the idea. It is generally agreed that the symposium would highlight
our findings, our systematic, evidence-based approach, and our recommendations.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Sunday, January 18, 2015 11:48 AM
Subject: FW: DGACFollow-up Please Hold Wednesday Feb 25
HiAlice,
ThisiswhatIamintheprocessofsendingtoallremainingDGACmembersandalsototheSRSCandworkgroupleadsso
thateveryonehasthesameinformation.Hopeyouretakingabreak!
Iwantedtobringyoufurtheruptodateonsomeplanningthatisunderwaytopublicizethe2015DGACreportonceitis
officiallypublishedintheFederalregister.Asweapproachedourfinalpublicmeeting,severalmembersoftheSRSCand
DGACmentionedaninterestindoingsomepublicizingofourwork.TheSRSCdiscusseditinourfinalcallsandwerein
agreementtoworktodevelopaplan.Afterourfinalmeeting,AliceandIconferredwithKellie,RickandColetteand
thereisagreementthatisreasonabletoassumethereportwillbepublishedlaterinFebruary.IalsometwithHoward
Koh,whoasyourecallconductingourswearingintotheDGAC.Youmayalsorecallthatitwasannouncedthathe
returnedtotheHarvardSchoolofPublicHealththispastsummer.HewasenthusiasticaboutpublicizingtheDGAC
reportandofferedtoassistwherepossible.IalsometwithWalterWillett,ChairoftheNutritionDepartment,andhe
spontaneouslyofferedtohostatelevisedsymposiumonthereportoncepublished.Hesuggestedthattheirtechnology
allowslivesatellitesitessoIthoughtIwouldraisethepossibilitythatourDGACmembershostinstitutions,where
possible,mighthostasatellitesitewithaliveaudience(andpossiblypresenter).
125
PSC-HHS-000125
IpolledtheSRSCandchapterleadsandtheworkgroupleadersabouttheideaandaboutdatesinlateFebruarythat
mightworkintheirschedules.ItlookslikeWednesdayFebruary25thisthedatethatmostarefree.Ihopethismight
workinyourscheduleaswell.EveryoneIhavespokentothusonourCommitteeisenthusiasticabouttheidea.Itis
generallyagreedthatthesymposiumwouldhighlightourfindings,oursystematic,evidencebasedapproach,andour
recommendations.Everyonewishesaverypositiveapproach.Ithinkwecancarefullymanageit.AliceandIhada
followupcallwithRick,KellieandColettetogettheirinput.Theyweresupportive,recognizethatthiswouldberather
novel(sinceotherDGACshavenotdonethisbefore)andsuggestedwemighttakeaudiencequestionsinadvanceto
prepare.
IwillbesendingaDoodlepolltogetanAdministrativeDGACcalltogetherwithallDGACmemberssowecantalkfurther
abouttheformat,contentandlogisticsofthesymposium.Duringourplanningprocessanduntilwesendout
invitations,pleaseholdthisplanningprocessreasonablyconfidential.Iunderstandthatyoumaywishtotalkwithyour
institutionalITaboutyourabilitytohostasiteonlocation.
traveling).
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
126
(cellisbestincaseIm
PSC-HHS-000126

From:
Sent:
To:
Cc:
Subject:

Millen, Barbara E; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH)
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

127
PSC-HHS-000127
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
edits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
Thanks!
Eve
o
128
PSC-HHS-000128
madeatthistime.

down on Na.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hieveryone,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
129
PSC-HHS-000129

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
130
PSC-HHS-000130

From:
Sent:
To:
Cc:
Subject:

Otherthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
edits.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
131
PSC-HHS-000131

HiBarbaraandAlice,
Thanks!
Eve
o
madeatthistime.

down on Na.
132
PSC-HHS-000132
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hieveryone,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
133
PSC-HHS-000133
Rockville,MD20852
(240)4538252
134
PSC-HHS-000134

From:
Sent:
To:
Cc:
Subject:

Tuesday, January 20, 2015 9:16 AM
De Jesus, Janet M (NIH/NHLBI) [E]
'alice.lichtenstein@tufts.edu' (alice.lichtenstein@tufts.edu); Casavale, Kellie (OS/OASH);
Olson, Richard (HHS/OASH); Colette Rihane; Shanthy Bowman; Essery, Eve - CNPP;
Anne Rodgers; Mcgrane, Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)
Re: Final approval of edits: Chapter 5 (SC 5)
Soundsgoodandweshouldcheckperhapsagainstwhatspectrumsaremodeledintheresearchwearereportingon.
Doesthatseemreasonable?Barbara
SentfrommyiPhone
OnJan20,2015,at8:49AM,"DeJesus,JanetM(NIH/NHLBI)[E]"<dejesusjm@nhlbi.nih.gov>wrote:
Regardingthemodelling:thehealthvegetarianpatternis34%totalfatand8%saturatedfatsimilarto
theUSandMediterraneanpatterns.
<image003.png>

To: De Jesus, Janet M (NIH/NHLBI) [E]
Cc: Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Olson, Richard (HHS/OASH); Colette Rihane;
Shanthy Bowman; Essery, Eve - CNPP; Anne Rodgers; Mcgrane, Mary - CNPP
(Mary.Mcgrane@cnpp.usda.gov)
Subject: Re: Final approval of edits: Chapter 5 (SC 5)
Thankyou.Thecomparisonstatementdoesn'tworkacrosstheentirespectrumofvegetarian.Ihopewe
canfindareasonablesolution.Barbara
SentfrommyiPhone
HiBarbaraandAlice,
MollyreviewedthestudiesagainyesterdayinresponsetoBarbarasoriginalcomment.
Shesuggestedremovinglowfatbecausethecomparatorcanvary.Sheshouldbeable
torespondwithmoreinformationfromthestudies.Wecanalsocheckonthe
vegetariandietthatwasmodelledinSC1.
Thanks,
Janet

To: Millen, Barbara E; De Jesus, Janet M (NIH/NHLBI) [E]; Casavale, Kellie (OS/OASH)
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve 135
PSC-HHS-000135
CNPP'; 'Anne Rodgers'; Mcgrane, Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)

Subject: RE: Final approval of edits: Chapter 5 (SC 5)
This is an important point and confounder. We should remember, we are

not recommending a low fat diet of any type, rather a moderate fat diet,
due to the risk of dyslipidemia.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: De Jesus, Janet M (NIH/NHLBI) [E]; Casavale, Kellie (OS/OASH); Lichtenstein, Alice
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve CNPP'; 'Anne Rodgers'; Mcgrane, Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)
Manythanks.Asyouarepreparingtheedits,canyouchecksomethingformeonthe
comparatorissue,line431.MyunderstandingfromSCdiscussionsandmyreadofthe
aspectofthereportisthatthedietcontainingsomemeat(lowerRPM)mayhave
somewhatbetterenvironmentalimpact(andcertainlyhealthimpact).Whencompared
toaspectrumofvegetariandiets,itoutperformsthehighfatvegetariandietonland
use(i.e.itcanfeedmorepeople).So,wecantusevegetariandietasthecomparator
inthestatementonline431+;thecorrectcomparatorwouldseemtobethehighfat
vegetariandiet.Itstrickybecausethiswasamodelingexercise.Technically,notall
vegetariandiets(highfatinparticular)outperformdietscontainingsomeRPM.The
bestresult,asIunderstandit,wasachievedwhenRPMintakewasloweredandmore
peopleweremodeledasvegetarians.Thatsuggestifwecanincreasetheproportionof
(lowerfat)vegetariansinthepopulationandgenerallygetpeopletofollowthelower
RPMdietweareadvocating,wearelikelytoachievebetterenvironmentalandhealth
outcomes.Isthevegetariandietweremodelinginthereporttechnicallyalowerfat
versionasmodeledinthesestudies.Imnotsure.WemightwanttocheckSotoo,we
havetobesurewearecapturingtheresultscorrectlyintheChaptersectionanddraw
thecorrectconclusionhere.
Thanksforchecking.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
From: De Jesus, Janet M (NIH/NHLBI) [E] [mailto:dejesusjm@nhlbi.nih.gov]

136
PSC-HHS-000136
To: Millen, Barbara E; Casavale, Kellie (OS/OASH); 'Lichtenstein, Alice'

Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve CNPP'; 'Anne Rodgers'; Mcgrane, Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)
HiBarbaraandAlice,
Thanksforthehelpfulcomments.WeaddressedallofyourcommentsinChapter5and
theresolutionisdescribedinredbelow:
Barbara:
Line121Clarifywherewedefineseafood.Thecommentheresoundslikewereonly
addressingfish(finfish)inthereportwhenweextendtoseafood,particularlywhenwe
definenutrientcompositionbutalso(insomecases)whenweexaminediet/dietary
patternandhealthorenvironmentaloutcomes.Wemaywanttoclarifybothterms
hereorelsewhereintheintroduction.Goodcatch.Wechangedthefishinthislineto
seafood.Seafoodisdefinedintheglossaryasincludingfinfishandshellfish.Chapter5
onlyusesthetermfishwhenitisreferringtofinfishandthisisdefinedinafootnote
whenitisusedthefirsttime.
Line144Isnovelreallytheintendedtermforthenewareasofevaluation?We
deletedandnovel
Line431Checkthecomparator.Theremaybeanerror.Ithoughtthecontrastwasbeing
discussedinrelationshiptoahighfatvegetariandiet?Wedeletedlowfat.
Alice:
Line187:Thisisaverystrongterm,notcertainwecouldsubstantiate.Isuspecta
numberofgroupseachhavedifferentconceptsofstateoftheart.Wedeletedstate
oftheart
Line336:Whyjustfederal?Wouldwenotwantitincorporatedintoallfeeding
programsandpersonalchoices?Wesuggestaddingandlocal.Anotheroptionisto
deletefederal.
Iwillsendanupdatedversionofthechaptertomorrow.
Thanks,
Janet
Janet M. de Jesus, M.S., R.D.
Public Health Advisor

CenterforTranslationResearchandImplementationScience(CTRIS)
NationalHeart,Lung,andBloodInstitute
NationalInstitutesofHealth
6705RockledgeDrive
Rockledge1Building;Room6189,MSC7960
Bethesda,MD20817
3014965344
dejesusjm@mail.nih.gov

To: Casavale, Kellie (OS/OASH); 'Lichtenstein, Alice'
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve CNPP'; 'Anne Rodgers'; De Jesus, Janet M (NIH/NHLBI) [E]
137
PSC-HHS-000137

Hiall,
IapprovethelogofeditsforSectionD.Chapter5.Herearemycommentsothe
chapter.Liketheothers,itisreallyawonderfulnewchapter,verywelldoneandhighly
informative.IhighlightedwhereIsawtheneedforsomepossibleminoreditorial
changes.Hopefully,thesearefine:
Lines110and341paragraphspacingneeded
Line121Clarifywherewedefineseafood.Thecommentheresoundslikewereonly
addressingfish(finfish)inthereportwhenweextendtoseafood,particularlywhenwe
definenutrientcompositionbutalso(insomecases)whenweexaminediet/dietary
patternandhealthorenvironmentaloutcomes.Wemaywanttoclarifybothterms
hereorelsewhereintheintroduction.
Line144Isnovelreallytheintendedtermforthenewareasofevaluation?
Line431Checkthecomparator.Theremaybeanerror.Ithoughtthecontrastwasbeing
discussedinrelationshiptoahighfatvegetariandiet?
Line1245Typorecognized.
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Thursday, January 15, 2015 4:13 PM
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve CNPP'; 'Anne Rodgers'; De Jesus, Janet M (NIH/NHLBI) [E]
Subject: Final approval of edits: Chapter 5 (SC 5)
Importance: High
BarbaraandAlice,
Chapter5:FoodSustainabilityandSafetyandashortlogofeditsareattached.Mostof
theeditsinthechapteraretochangefishtoseafoodwhereappropriateandsome
additionstothedescriptionofthemethodologyforthetopicofDPandSustainability.
IwillbeoutoftownFridayandTuesday,butlookforwardtoreturningwithaninboxfull
ofapprovals!Ifyouhavequestions,pleasereplytothegroupandEveandJanetwill
answerthemforyou.
Manythanks,
Kellie
138
PSC-HHS-000138
Rockville,MD20852
(240)4538252
139
PSC-HHS-000139

From:
Sent:
To:
Cc:
Subject:

De Jesus, Janet M (NIH/NHLBI) [E]
Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Olson, Richard (HHS/OASH); Colette
Rihane; Shanthy Bowman; Essery, Eve - CNPP; Anne Rodgers; Mcgrane, Mary - CNPP
(Mary.Mcgrane@cnpp.usda.gov)
Thankyou.Thecomparisonstatementdoesn'tworkacrosstheentirespectrumofvegetarian.Ihopewecanfinda
reasonablesolution.Barbara
SentfrommyiPhone
HiBarbaraandAlice,
MollyreviewedthestudiesagainyesterdayinresponsetoBarbarasoriginalcomment.Shesuggested
removinglowfatbecausethecomparatorcanvary.Sheshouldbeabletorespondwithmore
informationfromthestudies.WecanalsocheckonthevegetariandietthatwasmodelledinSC1.
Thanks,
Janet

Rodgers'; Mcgrane, Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)
This is an important point and confounder. We should remember, we are not

recommending a low fat diet of any type, rather a moderate fat diet, due to the risk of
dyslipidemia.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
140
PSC-HHS-000140

Manythanks.Asyouarepreparingtheedits,canyouchecksomethingformeonthecomparatorissue,
line431.MyunderstandingfromSCdiscussionsandmyreadoftheaspectofthereportisthatthediet
containingsomemeat(lowerRPM)mayhavesomewhatbetterenvironmentalimpact(andcertainly
healthimpact).Whencomparedtoaspectrumofvegetariandiets,itoutperformsthehighfat
vegetariandietonlanduse(i.e.itcanfeedmorepeople).So,wecantusevegetariandietasthe
comparatorinthestatementonline431+;thecorrectcomparatorwouldseemtobethehighfat
vegetariandiet.Itstrickybecausethiswasamodelingexercise.Technically,notallvegetariandiets
(highfatinparticular)outperformdietscontainingsomeRPM.Thebestresult,asIunderstandit,was
achievedwhenRPMintakewasloweredandmorepeopleweremodeledasvegetarians.Thatsuggestif
wecanincreasetheproportionof(lowerfat)vegetariansinthepopulationandgenerallygetpeopleto
followthelowerRPMdietweareadvocating,wearelikelytoachievebetterenvironmentalandhealth
outcomes.Isthevegetariandietweremodelinginthereporttechnicallyalowerfatversionasmodeled
inthesestudies.Imnotsure.WemightwanttocheckSotoo,wehavetobesurewearecapturingthe
resultscorrectlyintheChaptersectionanddrawthecorrectconclusionhere.
Thanksforchecking.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
Thanksforthehelpfulcomments.WeaddressedallofyourcommentsinChapter5andtheresolutionis
describedinredbelow:
Barbara:
Line121Clarifywherewedefineseafood.Thecommentheresoundslikewereonlyaddressingfish
(finfish)inthereportwhenweextendtoseafood,particularlywhenwedefinenutrientcompositionbut
also(insomecases)whenweexaminediet/dietarypatternandhealthorenvironmentaloutcomes.We
maywanttoclarifybothtermshereorelsewhereintheintroduction.Goodcatch.Wechangedthe
fishinthislinetoseafood.Seafoodisdefinedintheglossaryasincludingfinfishandshellfish.
Chapter5onlyusesthetermfishwhenitisreferringtofinfishandthisisdefinedinafootnotewhenit
isusedthefirsttime.
Line144Isnovelreallytheintendedtermforthenewareasofevaluation?Wedeletedandnovel
Line431Checkthecomparator.Theremaybeanerror.Ithoughtthecontrastwasbeingdiscussedin
relationshiptoahighfatvegetariandiet?Wedeletedlowfat.
141
PSC-HHS-000141
Alice:
Line187:Thisisaverystrongterm,notcertainwecouldsubstantiate.Isuspectanumberofgroups
eachhavedifferentconceptsofstateoftheart.Wedeletedstateoftheart
Line336:Whyjustfederal?Wouldwenotwantitincorporatedintoallfeedingprogramsandpersonal
choices?Wesuggestaddingandlocal.Anotheroptionistodeletefederal.
Thanks,
Janet

6705RockledgeDrive
Bethesda,MD20817
3014965344

Rodgers'; De Jesus, Janet M (NIH/NHLBI) [E]
Hiall,
IapprovethelogofeditsforSectionD.Chapter5.Herearemycommentsothechapter.Likethe
others,itisreallyawonderfulnewchapter,verywelldoneandhighlyinformative.IhighlightedwhereI
sawtheneedforsomepossibleminoreditorialchanges.Hopefully,thesearefine:
Line121Clarifywherewedefineseafood.Thecommentheresoundslikewereonlyaddressingfish
(finfish)inthereportwhenweextendtoseafood,particularlywhenwedefinenutrientcompositionbut
also(insomecases)whenweexaminediet/dietarypatternandhealthorenvironmentaloutcomes.We
maywanttoclarifybothtermshereorelsewhereintheintroduction.
Line431Checkthecomparator.Theremaybeanerror.Ithoughtthecontrastwasbeingdiscussedin
relationshiptoahighfatvegetariandiet?
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

142
PSC-HHS-000142

Rodgers'; De Jesus, Janet M (NIH/NHLBI) [E]
Importance: High
BarbaraandAlice,
Chapter5:FoodSustainabilityandSafetyandashortlogofeditsareattached.Mostoftheeditsinthe
chapteraretochangefishtoseafoodwhereappropriateandsomeadditionstothedescriptionof
themethodologyforthetopicofDPandSustainability.
IwillbeoutoftownFridayandTuesday,butlookforwardtoreturningwithaninboxfullofapprovals!If
youhavequestions,pleasereplytothegroupandEveandJanetwillanswerthemforyou.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
143
PSC-HHS-000143

From:
Sent:
To:
Cc:
Subject:

De Jesus, Janet M (NIH/NHLBI) [E]; Millen, Barbara E; Casavale, Kellie (OS/OASH)
'Anne Rodgers'; Mcgrane, Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)
RE: Final approval of edits: Chapter 5 (SC 5)
I agree with removing low-fat. I would also suggest the document be searched to determine whether
there are any other places where the term low-fat occurs, just in case we missed something.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve - CNPP'; 'Anne Rodgers'; Mcgrane,
Mary - CNPP (Mary.Mcgrane@cnpp.usda.gov)
HiBarbaraandAlice,
MollyreviewedthestudiesagainyesterdayinresponsetoBarbarasoriginalcomment.Shesuggestedremovinglow
fatbecausethecomparatorcanvary.Sheshouldbeabletorespondwithmoreinformationfromthestudies.Wecan
alsocheckonthevegetariandietthatwasmodelledinSC1.
Thanks,
Janet

This is an important point and confounder. We should remember, we are not recommending a low fat
diet of any type, rather a moderate fat diet, due to the risk of dyslipidemia.
144
PSC-HHS-000144
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Manythanks.Asyouarepreparingtheedits,canyouchecksomethingformeonthecomparatorissue,line431.My
understandingfromSCdiscussionsandmyreadoftheaspectofthereportisthatthedietcontainingsomemeat(lower
RPM)mayhavesomewhatbetterenvironmentalimpact(andcertainlyhealthimpact).Whencomparedtoaspectrum
ofvegetariandiets,itoutperformsthehighfatvegetariandietonlanduse(i.e.itcanfeedmorepeople).So,wecant
usevegetariandietasthecomparatorinthestatementonline431+;thecorrectcomparatorwouldseemtobethe
highfatvegetariandiet.Itstrickybecausethiswasamodelingexercise.Technically,notallvegetariandiets(highfat
inparticular)outperformdietscontainingsomeRPM.Thebestresult,asIunderstandit,wasachievedwhenRPMintake
wasloweredandmorepeopleweremodeledasvegetarians.Thatsuggestifwecanincreasetheproportionof(lower
fat)vegetariansinthepopulationandgenerallygetpeopletofollowthelowerRPMdietweareadvocating,wearelikely
toachievebetterenvironmentalandhealthoutcomes.Isthevegetariandietweremodelinginthereporttechnicallya
lowerfatversionasmodeledinthesestudies.Imnotsure.WemightwanttocheckSotoo,wehavetobesureweare
capturingtheresultscorrectlyintheChaptersectionanddrawthecorrectconclusionhere.
Thanksforchecking.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
Thanksforthehelpfulcomments.WeaddressedallofyourcommentsinChapter5andtheresolutionisdescribedinred
below:
Barbara:
Line121Clarifywherewedefineseafood.Thecommentheresoundslikewereonlyaddressingfish(finfish)inthe
reportwhenweextendtoseafood,particularlywhenwedefinenutrientcompositionbutalso(insomecases)whenwe
145
PSC-HHS-000145
examinediet/dietarypatternandhealthorenvironmentaloutcomes.Wemaywanttoclarifybothtermshereor
elsewhereintheintroduction.Goodcatch.Wechangedthefishinthislinetoseafood.Seafoodisdefinedinthe
glossaryasincludingfinfishandshellfish.Chapter5onlyusesthetermfishwhenitisreferringtofinfishandthisis
definedinafootnotewhenitisusedthefirsttime.
Line431Checkthecomparator.Theremaybeanerror.Ithoughtthecontrastwasbeingdiscussedinrelationshiptoa
highfatvegetariandiet?Wedeletedlowfat.
Alice:
Line187:Thisisaverystrongterm,notcertainwecouldsubstantiate.Isuspectanumberofgroupseachhavedifferent
conceptsofstateoftheart.Wedeletedstateoftheart
Line336:Whyjustfederal?Wouldwenotwantitincorporatedintoallfeedingprogramsandpersonalchoices?We
suggestaddingandlocal.Anotheroptionistodeletefederal.
Thanks,
Janet

6705RockledgeDrive
Bethesda,MD20817
3014965344

Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Shanthy Bowman'; 'Essery, Eve - CNPP'; 'Anne Rodgers'; De Jesus,
Janet M (NIH/NHLBI) [E]
Hiall,
IapprovethelogofeditsforSectionD.Chapter5.Herearemycommentsothechapter.Liketheothers,itisreallya
wonderfulnewchapter,verywelldoneandhighlyinformative.IhighlightedwhereIsawtheneedforsomepossible
minoreditorialchanges.Hopefully,thesearefine:
elsewhereintheintroduction.
highfatvegetariandiet?
Manythanks.
146
PSC-HHS-000146

Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
Chapter5:FoodSustainabilityandSafetyandashortlogofeditsareattached.Mostoftheeditsinthechapterareto
changefishtoseafoodwhereappropriateandsomeadditionstothedescriptionofthemethodologyforthetopicof
DPandSustainability.
IwillbeoutoftownFridayandTuesday,butlookforwardtoreturningwithaninboxfullofapprovals!Ifyouhave
questions,pleasereplytothegroupandEveandJanetwillanswerthemforyou.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
147
PSC-HHS-000147

From:
Sent:
To:
Cc:
Subject:

Millen, Barbara E; De Jesus, Janet M (NIH/NHLBI) [E]; Casavale, Kellie (OS/OASH)
This is an important point and confounder. We should remember, we are not recommending a low fat
diet of any type, rather a moderate fat diet, due to the risk of dyslipidemia.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Thanksforchecking.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
148
PSC-HHS-000148

HiBarbaraandAlice,
below:
Barbara:
Alice:
Thanks,
Janet

6705RockledgeDrive
Bethesda,MD20817
3014965344

Hiall,
149
PSC-HHS-000149

Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
150
PSC-HHS-000150
Rockville,MD20852
(240)4538252
151
PSC-HHS-000151

From:
Sent:
To:
Cc:
Subject:

De Jesus, Janet M (NIH/NHLBI) [E]; 'Millen, Barbara E'; Casavale, Kellie (OS/OASH)
Regarding the following, either adding local or deleting federal is fine with me.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'Millen, Barbara E'; Casavale, Kellie (OS/OASH); Lichtenstein, Alice
HiBarbaraandAlice,
below:
Barbara:
152
PSC-HHS-000152

Alice:
Thanks,
Janet

6705RockledgeDrive
Bethesda,MD20817
3014965344

Hiall,
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
153
PSC-HHS-000153

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
154
PSC-HHS-000154

From:
Sent:
To:
Cc:
Subject:

De Jesus, Janet M (NIH/NHLBI) [E]; Casavale, Kellie (OS/OASH); 'Lichtenstein, Alice'
Also,intermsoftherecommendededitsforAlicescomments,Ipreferaddingandlocal(line336)andapprovethe
deletionofstateoftheartandrecommenddeletinguniqueonline188.Itseemsredundantwhenweuseitonline
191.
Best,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
below:
Barbara:
Alice:
155
PSC-HHS-000155
Thanks,
Janet

6705RockledgeDrive
Bethesda,MD20817
3014965344

Hiall,
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
156
PSC-HHS-000156

Manythanks,
Kellie
Rockville,MD20852
(240)4538252
157
PSC-HHS-000157

From:
Sent:
To:
Cc:
Subject:

De Jesus, Janet M (NIH/NHLBI) [E]; Casavale, Kellie (OS/OASH); 'Lichtenstein, Alice'
Thanksforchecking.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

HiBarbaraandAlice,
below:
Barbara:
(b) (5)
Line144Isnovelreallytheintendedtermforthenewareasofevaluation?(b) (5)
highfatvegetariandiet?(b) (5)
158
PSC-HHS-000158

Alice:
conceptsofstateoftheart.(b) (5)
Line336:Whyjustfederal?Wouldwenotwantitincorporatedintoallfeedingprogramsandpersonalchoices?(b) (5)
(b) (5)
Thanks,
Janet

6705RockledgeDrive
Bethesda,MD20817
3014965344

Hiall,
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
159
PSC-HHS-000159

Importance: High
BarbaraandAlice,
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
160
PSC-HHS-000160

From:
Sent:
To:
Cc:
Subject:
Attachments:

Monday, January 19, 2015 8:44 AM
Casavale, Kellie (OS/OASH); 'Lichtenstein, Alice'
'Anne Rodgers'; De Jesus, Janet M (NIH/NHLBI) [E]
SC 5_Lof of edits_1 15 15.docx; 10 Part D_Chapter 5 Food Sustainability and
Safety_SEMI-FINAL_changes for BEM AHL approval_1-15-15 bem 1 19 2015.docx; 10.
Part D_Chapter 5 Food Sustainability and Safety_SEMI-FINAL_changes for BEM AHL
approval_1-15-15.docx
Hiall,
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Importance: High
BarbaraandAlice,
161
PSC-HHS-000161
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
162
PSC-HHS-000162

From:
Sent:
To:
Cc:
Subject:

Sunday, January 18, 2015 5:27 PM
Lichtenstein, Alice
Re: DGACFollow-up Please Hold Wednesday Feb 25
AliceIdidnotseeyouremailasImentioneduntilashortwhileago.Communicationshadallgoneout.Atthispoint
nothingspecificisplanned.Ihadunderstoodyouwerewithdrawingyourconcernsasyouindicatedinourlastcall.I
understandthereservationsyouinitiallyraisedandIhopewecanmakethisarestsymposium.Ithinkweneedtoget
theadmin.CallscheduletoclarifythatihopetheDGACwillsettheplanandcreateanumberifsitestomakethisa
meetingwithparticipationacrossthecountry.
Ifyouwanttochat,pleaseletmeknow.
Barbara
SentfrommyiPhone
OnJan18,2015,at11:57AM,"Lichtenstein,Alice"<Alice.Lichtenstein@tufts.edu>wrote:
Reasonable e-mail and very generous to include my name given I have not been
involved with the planning. Please leave my name out, I am still ambivalent and at this
point far from enthusiastic. See modified e-mail, below.
Iwantedtobringyoufurtheruptodateonsomeplanningthatisunderwaytopublicizethe2015DGAC
reportonceitisofficiallypublishedintheFederalregister.Asweapproachedourfinalpublicmeeting,
severalmembersoftheSRSCandDGACmentionedaninterestindoingsomepublicizingofour
work.TheSRSCdiscusseditinourfinalcallsandwereinagreementtoworktodevelopaplan.After
ourfinalmeeting,IconferredwithKellie,RickandColetteandthereisagreementthatisreasonableto
assumethereportwillbepublishedlaterinFebruary.IalsometwithHowardKoh,whoasyourecall
conductingourswearingintotheDGAC.Youmayalsorecallthatitwasannouncedthathereturnedto
theHarvardSchoolofPublicHealththispastsummer.HewasenthusiasticaboutpublicizingtheDGAC
reportandofferedtoassistwherepossible.IalsometwithWalterWillett,ChairoftheNutrition
Department,andhespontaneouslyofferedtohostatelevisedsymposiumonthereportonce
published.HesuggestedthattheirtechnologyallowslivesatellitesitessoIthoughtIwouldraisethe
possibilitythatourDGACmembershostinstitutions,wherepossible,mighthostasatellitesitewitha
liveaudience(andpossiblypresenter).
IpolledtheSRSCandchapterleadsandtheworkgroupleadersabouttheideaandaboutdatesinlate
Februarythatmightworkintheirschedules.ItlookslikeWednesdayFebruary25thisthedatethat
mostarefree.Ihopethismightworkinyourscheduleaswell.EveryoneIhavespokentothusonour
Committeeisenthusiasticabouttheidea.Itisgenerallyagreedthatthesymposiumwouldhighlightour
findings,oursystematic,evidencebasedapproach,andourrecommendations.Everyonewishesavery
positiveapproach.Ithinkwecancarefullymanageit.IhadafollowupcallwithRick,Kellieand
Colettetogettheirinput.Theyweresupportive,recognizethatthiswouldberathernovel(sinceother
DGACshavenotdonethisbefore)andsuggestedwemighttakeaudiencequestionsinadvanceto
prepare.
163
PSC-HHS-000163
IwillbesendingaDoodlepolltogetanAdministrativeDGACcalltogetherwithallDGACmemberssowe
cantalkfurtherabouttheformat,contentandlogisticsofthesymposium.Duringourplanningprocess
anduntilwesendoutinvitations,pleaseholdthisplanningprocessreasonablyconfidential.I
understandthatyoumaywishtotalkwithyourinstitutionalITaboutyourabilitytohostasiteon
location.
caseImtraveling).
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
(cellisbestin

HiAlice,
ThisiswhatIamintheprocessofsendingtoallremainingDGACmembersandalsototheSRSCand
workgroupleadssothateveryonehasthesameinformation.Hopeyouretakingabreak!
ourfinalmeeting,AliceandIconferredwithKellie,RickandColetteandthereisagreementthatis
reasonabletoassumethereportwillbepublishedlaterinFebruary.IalsometwithHowardKoh,who
asyourecallconductingourswearingintotheDGAC.Youmayalsorecallthatitwasannouncedthathe
returnedtotheHarvardSchoolofPublicHealththispastsummer.Hewasenthusiasticaboutpublicizing
theDGACreportandofferedtoassistwherepossible.IalsometwithWalterWillett,Chairofthe
NutritionDepartment,andhespontaneouslyofferedtohostatelevisedsymposiumonthereportonce
164
PSC-HHS-000164
positiveapproach.Ithinkwecancarefullymanageit.AliceandIhadafollowupcallwithRick,Kellie
andColettetogettheirinput.Theyweresupportive,recognizethatthiswouldberathernovel(since
otherDGACshavenotdonethisbefore)andsuggestedwemighttakeaudiencequestionsinadvanceto
prepare.
location.
caseImtraveling).
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
165
(cellisbestin
PSC-HHS-000165

From:
Sent:
To:
Cc:
Subject:

Lichtenstein, Alice
InlightiftheemailexchangethisafternoonIwantedthetwoofyoutobeawarethatMary,WayneandLucillehavealso
emailedtosayitis"exciting","terrific"anda"wonderfulopportunity".Ilookforwardtotheadministrationcall.Please
beawarethatotherthanadatethecontentifthesymposiumisnotsetaswediscussedinourcall.Wedidnotethat
HowardKohwasgoingtobeaskedwhetherhemightintroducethesymposiumandIbelievethathasbeendoneandhe
ischecking.Otherwiseitisthecommittee'sroletorecommendideasfortheplan.
Barbara
SentfrommyiPhone
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Barbara
Marian
SentfrommyiPhone
166
PSC-HHS-000166

HiMarian,
167
PSC-HHS-000167

Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
168
PSC-HHS-000168

From:
Sent:
To:
Cc:
Subject:

Lichtenstein, Alice
Neuhouser, Marian L; Casavale, Kellie (OS/OASH)
Alice,
Ididnotsenditindrafttoyou.ItwasacopyofwhathadalreadygonetotheremainderofourDGACwithcopiestothe
SRSCandworkgroupleads.IindicatedinourcallwiththefederalstaffthatIwouldbegettinginformationouttothem
andthoughtIhadeveryone'sgoaheadincludingyours.
Ididnotseeyouremailuntillaterthisafternoon.
Barbara
SentfrommyiPhone
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Barbara
169
PSC-HHS-000169
Marian
SentfrommyiPhone
HiMarian,
170
PSC-HHS-000170
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
171
PSC-HHS-000171

From:
Sent:
To:
Cc:
Subject:

Neuhouser, Marian L; Millen, Barbara E
RE: DGACFollow-up Please Hold Wednesday Feb 25
Marian, I made the same comment and took my name out of the text. I did not realize even a draft
went out with my name in it.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Barbara
IthinkIwasprettyclearthatIsupportedaneventbutIwasnotatallsupportiveoftheideayoupreviouslypresented.
Youremailbelowsaysallchairswereenthusiasticbutthatisnotthecaseatleastwithme.Iamdeeplydisappointed.
Marian
SentfrommyiPhone
HiMarian,
Apologiesthatthisisabitformalandperhapssomewhatrepetitive.Iwanttobesureeveryonehasthe
sameinformation.Thisistheemailcontent(below)nowsenttotheremainingmembersoftheDGAC
afterconfirmingdateswiththeSRSCandWorkgroupleadsandaconversationwithKellie,Rick,Colette
andEve.BTW,thelateJanuarydatewillnolongerbepossible.Thereporteditingistakingabitlonger
thanexpectedsowewereadvisedthatiswouldbesafertogowiththemostavailablelaterFebruary
date.Ihopethatitmightbepossibleforyoutoworkwiththedate.Iamtravelingtooformeetingson
Fridaythe27th.LogisticswillbeabitcomplicatedbutIwantedtoworkwiththedatemostontheSRSC
andourworkgroupleadswerefree.
172
PSC-HHS-000172

ourfinalmeeting,AliceandIconferredwithKellie,RickandColetteandthereisagreementthatis
reasonabletoassumethereportwillbepublishedlaterinFebruary.IalsometwithHowardKoh,who
asyourecallconductingourswearingintotheDGAC.Youmayalsorecallthatitwasannouncedthathe
returnedtotheHarvardSchoolofPublicHealththispastsummer.Hewasenthusiasticaboutpublicizing
theDGACreportandofferedtoassistwherepossible.IalsometwithWalterWillett,Chairofthe
NutritionDepartment,andhespontaneouslyofferedtohostatelevisedsymposiumonthereportonce
positiveapproach.Ithinkwecancarefullymanageit.AliceandIhadafollowupcallwithRick,Kellie
andColettetogettheirinput.Theyweresupportive,recognizethatthiswouldberathernovel(since
otherDGACshavenotdonethisbefore)andsuggestedwemighttakeaudiencequestionsinadvanceto
prepare.
location.
caseImtraveling).
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
173
(cellisbestin
PSC-HHS-000173

From:
Sent:
To:
Cc:
Subject:

Sunday, January 18, 2015 11:57 AM
Millen, Barbara E
RE: DGACFollow-up Please Hold Wednesday Feb 25
Reasonable e-mail and very generous to include my name given I have not been involved with the
planning. Please leave my name out, I am still ambivalent and at this point far from
enthusiastic. See modified e-mail, below.
agreementtoworktodevelopaplan.Afterourfinalmeeting,IconferredwithKellie,RickandColetteandthereis
agreementthatisreasonabletoassumethereportwillbepublishedlaterinFebruary.IalsometwithHowardKoh,who
asyourecallconductingourswearingintotheDGAC.Youmayalsorecallthatitwasannouncedthathereturnedtothe
HarvardSchoolofPublicHealththispastsummer.HewasenthusiasticaboutpublicizingtheDGACreportandofferedto
assistwherepossible.IalsometwithWalterWillett,ChairoftheNutritionDepartment,andhespontaneouslyoffered
tohostatelevisedsymposiumonthereportoncepublished.Hesuggestedthattheirtechnologyallowslivesatellite
sitessoIthoughtIwouldraisethepossibilitythatourDGACmembershostinstitutions,wherepossible,mighthosta
satellitesitewithaliveaudience(andpossiblypresenter).
recommendations.Everyonewishesaverypositiveapproach.Ithinkwecancarefullymanageit.Ihadafollowupcall
withRick,KellieandColettetogettheirinput.Theyweresupportive,recognizethatthiswouldberathernovel(since
otherDGACshavenotdonethisbefore)andsuggestedwemighttakeaudiencequestionsinadvancetoprepare.
traveling).
(cellisbestincaseIm
TuftsUniversity
174
PSC-HHS-000174
711WashingtonStreet
Boston,MA02111
phone:6175563127
HiAlice,
ThisiswhatIamintheprocessofsendingtoallremainingDGACmembersandalsototheSRSCandworkgroupleadsso
thateveryonehasthesameinformation.Hopeyouretakingabreak!
agreementtoworktodevelopaplan.Afterourfinalmeeting,AliceandIconferredwithKellie,RickandColetteand
thereisagreementthatisreasonabletoassumethereportwillbepublishedlaterinFebruary.IalsometwithHoward
Koh,whoasyourecallconductingourswearingintotheDGAC.Youmayalsorecallthatitwasannouncedthathe
returnedtotheHarvardSchoolofPublicHealththispastsummer.HewasenthusiasticaboutpublicizingtheDGAC
reportandofferedtoassistwherepossible.IalsometwithWalterWillett,ChairoftheNutritionDepartment,andhe
spontaneouslyofferedtohostatelevisedsymposiumonthereportoncepublished.Hesuggestedthattheirtechnology
allowslivesatellitesitessoIthoughtIwouldraisethepossibilitythatourDGACmembershostinstitutions,where
possible,mighthostasatellitesitewithaliveaudience(andpossiblypresenter).
recommendations.Everyonewishesaverypositiveapproach.Ithinkwecancarefullymanageit.AliceandIhada
followupcallwithRick,KellieandColettetogettheirinput.Theyweresupportive,recognizethatthiswouldberather
novel(sinceotherDGACshavenotdonethisbefore)andsuggestedwemighttakeaudiencequestionsinadvanceto
prepare.
traveling).
Barbara
Dr.BarbaraE.Millen
175
(cellisbestincaseIm
PSC-HHS-000175
bmillen@bu.edu
176
PSC-HHS-000176

From:
Sent:
To:
Cc:
Subject:

Saturday, January 17, 2015 6:22 AM
Casavale, Kellie (OS/OASH); 'Lichtenstein, Alice'
Olson, Richard (HHS/OASH); Colette Rihane; Shanthy Bowman; 'Essery, Eve - CNPP';
Anne Rodgers
RE: Final: Part C. Methodology
Manythanks.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Cc: Olson, Richard (HHS/OASH); Colette Rihane; Shanthy Bowman; 'Essery, Eve - CNPP'; Anne Rodgers
Subject: Final: Part C. Methodology
BarbaraandAlice,
Hereisasupereasyoneforyou!ThereareonlyacoupleofveryminoreditorialchangesinPartC.Methodology.Itis
attached.YoudonotneedtoapprovetheseeditssincetheyarenottheresultofsubstantivedecisionsbytheDGAC.The
documentisattachedasanFYI.Noresponseneeded.
Thanks,
Kellie
Rockville,MD20852
(240)4538252
177
PSC-HHS-000177

From:
Sent:
To:
Cc:
Subject:

Essery, Eve - CNPP; Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Olson, Richard
(HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Anne Rodgers
ThankyouTrish.Ithinkwehaveallfoundthecategoriesveryimportantanduseful.IwasclarifyingintheExecsummary
whereIthoughtinclusionofthetermswiththefoodsbeingdiscussedwouldbehelpful.Iwasnotadvocatingachange.
Hopethat'sclear.AlsoIwasclarifyingthatweprovidethedefinitionsofthecategoriesinourglossary.Ithinksomeof
therecentcommentsreflectabitofconfusionsinceothersmaynotbefamiliarwiththedistinctions.
ThanksagainandhappyNewYear.
Barbara
SentfrommyiPhone
OnJan16,2015,at3:25PM,"Britten,PatriciaCNPP"<Patricia.Britten@cnpp.usda.gov>wrote:
HiBarbara,
HappyNewYear!
EveaskedmetorespondsincethesetermscomefromSubcommittee1schapter.
Iimaginethatthedistinctionbetweenthetermnutrientandtheothertermsisclear.Foodgroups
andfoodcategoriesbothareUSDAdefinedterms.Foodcomponentsisamoregeneraltermthatcan
be,andhasbeen,usedwithclarifyingexamplesinseveralways.
FoodGroups:ForpurposesoftheUSDAFoodPatterns,inSubcommittee1schapterthefoodgroups
aredefinedasfruits,vegetables,grains,dairy,andproteinfoods.Someofthesegroups(vegetables,
grains,proteinfoods)aredividedintosubgroupsthatareexplicitlyidentifiedwithintakegoalsorlimits
intheFoodPatterns.
FoodCategories:ThistermwasagreeduponbyajointgroupofARS/FSRGandCNPPstaffwhen
planningandexecutingtheWWEIAFoodCategoriesanalysis,todistinguishfoodsasconsumedfromthe
USDAFoodGroups.Categoriesareidentifiedasfoodsasconsumed,andformanyfoods,thesediffer
greatlyfromfoodgroups.Forexample,asyouremember,theDGACrequestedthatfoodsconsumedas
sandwichesandsaladsbereanalyzedbyFSRGtomaketheircategoriesfitthisdefinitionmore
closely.ThisdifferenceisexplicitlynotedinSubcommittee1schapterandintheExecutivesummary.
FoodComponents:ThisisageneraltermthathasbeenusedinSubcommittee1schaptertodescribea
collectionofitems,whicharethenspecifiedthroughalistorexamples.Iseethistermasusefulwhen
theitem(s)beingdiscussedareneitherfoodgroupsnornutrients,orareamixoftypesofitems.Itis
intendedtobegeneralforflexibleuse,butspecifiedineachindividualuseoftheterm.Thismeansthat
insomecases(whenspecified),foodcomponentscouldincludefoodsubgroupsornutrientsinaddition
tootheritemsthatareneither.Thetermisusefulbecauseitisflexible.
178
PSC-HHS-000178
ThetermisusedthreetimesinSubcommittee1schapter,andineachcaseitisfollowedbythespecific
itemsthatitisintendedtoinclude.Twiceitisinthesentencewehavebeeneditinginthisemail
stringitwasaddedtothissentence(whichappearsbothinthequestion5implicationsandinthe
chaptersummary)toclarifythedifferencebetweenthecomponentsofrefinedgrains,solidfats,and
addedsugars,andoverconsumednutrients.
Theonlyotheruseofthisterminsubcommittee1schapterisinastatementbeginningonline1606:
Ontheotherhand,severalofthesesubcategories,notablydessertsandsweetsnacksand
sugarsweetenedbeverages,tendtocontributetoenergyintakewithlittlecontributionto
underconsumedfoodgroupsandnutrients,butmajorcontributionstooneormore
overconsumedfoodcomponents(seeQuestion11:Whatarethetopfoodscontributingto
sodium,saturatedfat,andaddedsugarsintakeintheU.S.population?)
Inthiscase,thereferencetoquestion11providesthespecificsforthetermfoodcomponents.
ThetermfoodcomponentsisalsousedintheExecutiveSummary,withaclarifyinglist,inseveral
places.Ibelieveyou(Barbara)haveinsertedithereforclarityredtextiswhatyouhaveadded.
Line64:Furthermore,populationintakeistoohighfortwofoodcomponents,refinedgrains
andaddedsugars.
Line71:andtolowerpopulationintakeofthenutrients,sodiumandsaturatedfat,andthe
foodcomponents,refinedgrains.Improvedbeverageselectionsthatlimitorremovesugar
sweetenedbeveragesandplacelimitsonsweetsanddessertswouldhelplowerintakesofthe
foodcomponent,addedsugars.
Line77:TheDGACfoundthatalthoughdietqualityvariessomewhatbythesettingwherefood
isobtained,overall,nomatterwherethefoodisobtained,thedietqualityoftheU.S.
populationdoesnotmeetrecommendationsforvegetables,fruit,dairy,orwholegrains,and
exceedsrecommendations,leadingtooverconsumption,forthenutrientssodiumandsaturated
fatandthefoodcomponentsrefinedgrains,solidfats,andaddedsugars.
Thetermsfoodgroups,foodcategories,andfoodcomponentsaredefinedwhentheyareusedinboth
Subcommittee1schapterandintheexecutivesummary,usuallythroughexamples.EveandIhave
discussedtheinstancesandthinkthattheircurrentuseisthereforeclear.
Hopethisishelpful,
Trish

Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Anne Rodgers; Britten,
Patricia - CNPP
Eve,
179
PSC-HHS-000179
SorrybutIamgoingbacknowtodofinaleditsontheExec.Summary,etc.andwonderifyoucanexplain
whywehavefoodgroups(oftheUSDApatternslikefruitsandvegetables),foodcomponents(ones
weretargetingforchangelikerefinedgrains),nutrientsandfoodcategories(foods(isaseaten
correct?)likeburgers).Itmaybeconfusingwithoutconsistentuse/clarificationandavailable
definitions,.Theexistenceofthesebucketsseemstohavetodowithhowweapproachtheanalysisof
populationdietaryintake.Wewillhavetobeclearinourexplanation.
Canyouletmeknow.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Anne Rodgers; Britten,
Patricia - CNPP
HiAlice,
Thanksforyourquickreviewofchapter1.KellieaskedTrishandItorespondtoyourconcernabout
solidfatsandsaturatedfatsinthefollowingparagraph.
Followingtherecommendedfoodintakepatternincreasesintakesofwholegrains,vegetables,fruits,
andfatfree/lowfatdairyandthusincreasethelikelihoodofmeetingrecommendationsforthesefood
groupswhiledecreasingintakeoffoodcomponentsrefinedgrains,solidfats,andaddedsugars,andthe
nutrientssodiumandsaturatedfat.
ThissentencewasrevisedaftertheDecembermeetinginresponsetothequestionsraisedbyyouand
FrankHu.Trishexplainedduringthemeetingthatsolidfatisconsideredafood,andsaturatedfata
nutrient,andtheyarenottotallysynonymous.Thesaturatedfatcontentofvarioussolidfatsranges
fromabout30%oftotalfat(chickenfat)toabout90%(coconutoil).TheUSDAFoodPatternstreatthem
astwoseparateitemsoneafoodcomponentandoneanutrient.
InthePatterns,solidfatsaretreatedasafoodcomponenttolimit,andthePatternsindicatespecific
maximumamountsofsolidfatforeachcalorielevel.Saturatedfatispartofthenutrientgoalsand
limitsforthePatterns,andamountsofsaturatedfatinthePatternsarereportedinthenutrientcontent
tables.
Theeditwemadeinthesentenceabovewastoclarifythatthereare3foodcomponentsthatare
decreasedwhenfollowingtheUSDAFoodPatterns(refinedgrains,solidfat,andaddedsugars)and2
nutrientsthataredecreased(sodiumandsaturatedfat).Wethoughtthattheeditclarifiedthatthere
were2lists,notone.Marianreviewedthiswordingafterthemeetingandnotedtherevisionwasfine
withher.Ifitwouldbehelpfultofurtherclarifythattherearetwolists,wecouldmakeafurthereditso
thatthelistsareinseparatesentences.Suggestion:
Followingtherecommendedfoodintakepatternincreasesintakesofwholegrains,vegetables,fruits,
andfatfree/lowfatdairyandthusincreasethelikelihoodofmeetingrecommendationsforthesefood
groupswhiledecreasingintakeoffoodcomponentsrefinedgrains,solidfats,andadded
180
PSC-HHS-000180
sugars.Followingtherecommendedpatternalsodecreasesintakeofthenutrientssodiumand
saturatedfat
Pleaseletusknowhowyoudliketoproceedkeepitasis,edititassuggestedabove,orsuggest
anotheredit.
Thanks!
EveandTrish

To: Casavale, Kellie (OS/OASH); Barbara E Millen
Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve - CNPP; Anne
Rodgers; Britten, Patricia - CNPP
I went through whole chapter so I could see the changes, in situ. My only problem is
with listing solid fat and saturated fat in the same list. We discussed the issue
extensively and I thought agreed to not do it. However, that was my memory, which
may be biased. I certainly could not defend listing both together. See my note.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: Barbara E Millen; Lichtenstein, Alice
Cc: Olson, Richard (HHS/OASH); Colette Rihane; Shanthy Bowman; 'Essery, Eve - CNPP'; Anne Rodgers;
Importance: High
BarbaraandAlice,
Chapter1:FoodandNutrientIntakes,andHealth:CurrentStatusandTrendsandalogoffive
substantiveeditsareattached.Fortimeefficiency,youmayprefertoreviewthelog,sinceitisonlya
littlemorethanapage.(ThefiguresarealsoattachedasaPDFforreferenceonly.Therearenoteditsto
them.)
181
PSC-HHS-000181
IwillbeoutoftownFridayandTuesday,butlookforwardtoreturningwithaninboxfullofapprovals!If
youhavequestions,pleasereplytothegroupandEveandTrishwillanswerthemforyou.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
email immediately.
182
PSC-HHS-000182

From:
Sent:
To:
Cc:
Subject:

Essery, Eve - CNPP; Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Anne Rodgers;
Eve,
SorrybutIamgoingbacknowtodofinaleditsontheExec.Summary,etc.andwonderifyoucanexplainwhywehave
foodgroups(oftheUSDApatternslikefruitsandvegetables),foodcomponents(onesweretargetingforchangelike
refinedgrains),nutrientsandfoodcategories(foods(isaseatencorrect?)likeburgers).Itmaybeconfusingwithout
consistentuse/clarificationandavailabledefinitions,.Theexistenceofthesebucketsseemstohavetodowithhowwe
approachtheanalysisofpopulationdietaryintake.Wewillhavetobeclearinourexplanation.
Canyouletmeknow.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Anne Rodgers; Britten, Patricia - CNPP
HiAlice,
Thanksforyourquickreviewofchapter1.KellieaskedTrishandItorespondtoyourconcernaboutsolidfatsand
saturatedfatsinthefollowingparagraph.
Followingtherecommendedfoodintakepatternincreasesintakesofwholegrains,vegetables,fruits,andfatfree/low
fatdairyandthusincreasethelikelihoodofmeetingrecommendationsforthesefoodgroupswhiledecreasingintakeof
foodcomponentsrefinedgrains,solidfats,andaddedsugars,andthenutrientssodiumandsaturatedfat.
ThissentencewasrevisedaftertheDecembermeetinginresponsetothequestionsraisedbyyouandFrankHu.Trish
explainedduringthemeetingthatsolidfatisconsideredafood,andsaturatedfatanutrient,andtheyarenottotally
synonymous.Thesaturatedfatcontentofvarioussolidfatsrangesfromabout30%oftotalfat(chickenfat)toabout
90%(coconutoil).TheUSDAFoodPatternstreatthemastwoseparateitemsoneafoodcomponentandonea
nutrient.
InthePatterns,solidfatsaretreatedasafoodcomponenttolimit,andthePatternsindicatespecificmaximumamounts
ofsolidfatforeachcalorielevel.SaturatedfatispartofthenutrientgoalsandlimitsforthePatterns,andamountsof
saturatedfatinthePatternsarereportedinthenutrientcontenttables.
183
PSC-HHS-000183
Theeditwemadeinthesentenceabovewastoclarifythatthereare3foodcomponentsthataredecreasedwhen
followingtheUSDAFoodPatterns(refinedgrains,solidfat,andaddedsugars)and2nutrientsthataredecreased
(sodiumandsaturatedfat).Wethoughtthattheeditclarifiedthattherewere2lists,notone.Marianreviewedthis
wordingafterthemeetingandnotedtherevisionwasfinewithher.Ifitwouldbehelpfultofurtherclarifythatthere
aretwolists,wecouldmakeafurthereditsothatthelistsareinseparatesentences.Suggestion:
foodcomponentsrefinedgrains,solidfats,andaddedsugars.Followingtherecommendedpatternalsodecreases
intakeofthenutrientssodiumandsaturatedfat
Pleaseletusknowhowyoudliketoproceedkeepitasis,edititassuggestedabove,orsuggestanotheredit.
Thanks!
EveandTrish

Cc: Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Essery, Eve - CNPP; Anne Rodgers; Britten,
Patricia - CNPP
I went through whole chapter so I could see the changes, in situ. My only problem is with listing solid
fat and saturated fat in the same list. We discussed the issue extensively and I thought agreed to not
do it. However, that was my memory, which may be biased. I certainly could not defend listing both
together. See my note.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Cc: Olson, Richard (HHS/OASH); Colette Rihane; Shanthy Bowman; 'Essery, Eve - CNPP'; Anne Rodgers; Britten, Patricia
- CNPP
Importance: High
BarbaraandAlice,
Chapter1:FoodandNutrientIntakes,andHealth:CurrentStatusandTrendsandalogoffivesubstantiveeditsare
attached.Fortimeefficiency,youmayprefertoreviewthelog,sinceitisonlyalittlemorethanapage.(Thefiguresare
alsoattachedasaPDFforreferenceonly.Therearenoteditstothem.)
184
PSC-HHS-000184

questions,pleasereplytothegroupandEveandTrishwillanswerthemforyou.
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
185
PSC-HHS-000185

From:
Sent:
To:
Cc:
Subject:

IagreewithAliceandliketheseparatesentencesthatEveprepared.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); Millen, Barbara E
The revised text addresses my concern. I understood the issue of food vs nutrient, however, it took
explanation and did not come through with the original wording.
Following the recommended food intake pattern increases intakes of whole grains, vegetables, fruits,
and fat-free/low fat dairy and thus increase the likelihood of meeting recommendations for these food
groups while decreasing intake of food components refined grains, solid fats, and added
sugars. Following the recommended pattern also decreases intake of the nutrients sodium and
saturated fat.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Barbara E Millen
HiAlice,
186
PSC-HHS-000186
nutrient.
Thanks!
EveandTrish

Patricia - CNPP
TuftsUniversity
711WashingtonStreet
187
PSC-HHS-000187
Boston,MA02111
phone:6175563127
- CNPP
Importance: High
BarbaraandAlice,
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
188
PSC-HHS-000188

From:
Sent:
To:
Cc:
Subject:

Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); Barbara E Millen
The revised text addresses my concern. I understood the issue of food vs nutrient, however, it took
explanation and did not come through with the original wording.
Following the recommended food intake pattern increases intakes of whole grains, vegetables, fruits,
and fat-free/low fat dairy and thus increase the likelihood of meeting recommendations for these food
groups while decreasing intake of food components refined grains, solid fats, and added
sugars. Following the recommended pattern also decreases intake of the nutrients sodium and
saturated fat.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Lichtenstein, Alice; Casavale, Kellie (OS/OASH); Barbara E Millen
HiAlice,
nutrient.
189
PSC-HHS-000189

Thanks!
EveandTrish

Patricia - CNPP
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
- CNPP
Importance: High
190
PSC-HHS-000190
BarbaraandAlice,
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
191
PSC-HHS-000191

From:
Sent:
To:
Cc:
Subject:
Attachments:

Thursday, January 15, 2015 4:47 PM
Casavale, Kellie (OS/OASH); 'Barbara E Millen'
'Anne Rodgers'; De Jesus, Janet M (NIH/NHLBI) [E]
10 Part D_Chapter 5 Food Sustainability and Safety_SEMI-FINAL_changes for BEM AHL
approval_1-15-15 AHL.docx
I approve all the edits. Inserted comments #1 and 2 just for consideration by the group for potential
modification.
The snow is starting to fly in Boston, big lovely snowflakes.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Importance: High
BarbaraandAlice,
192
PSC-HHS-000192
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
193
PSC-HHS-000193

From:
Sent:
To:
Cc:
Subject:
Attachments:

Thursday, January 15, 2015 1:58 PM
Casavale, Kellie (OS/OASH); Barbara E Millen
Anne Rodgers; Britten, Patricia - CNPP
06 Part D_Chapter 1 Food and Nutrient Intakes SEMI-FINAL_changes for approaval by
BEM AHL_1-15-15 AHL.docx
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
- CNPP
Importance: High
BarbaraandAlice,
194
PSC-HHS-000194
Manythanks,
Kellie
Rockville,MD20852
(240)4538252
195
PSC-HHS-000195

From:
Sent:
To:
Cc:
Subject:

Wednesday, January 14, 2015 3:45 PM
Casavale, Kellie (OS/OASH); Barbara E Millen
Anne Rodgers
RE: Final: Part C. Methodology
I approve all edits, the few there are.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Cc: Olson, Richard (HHS/OASH); Colette Rihane; Shanthy Bowman; 'Essery, Eve - CNPP'; Anne Rodgers
Subject: Final: Part C. Methodology
BarbaraandAlice,
Hereisasupereasyoneforyou!ThereareonlyacoupleofveryminoreditorialchangesinPartC.Methodology.Itis
attached.YoudonotneedtoapprovetheseeditssincetheyarenottheresultofsubstantivedecisionsbytheDGAC.The
documentisattachedasanFYI.Noresponseneeded.
Thanks,
Kellie
Rockville,MD20852
(240)4538252
196
PSC-HHS-000196

From:
Sent:
To:
Cc:
Subject:

Thursday, January 08, 2015 7:59 AM
Millen, Barbara E; Casavale, Kellie (OS/OASH)
Colette Rihane; Olson, Richard (HHS/OASH); Shanthy Bowman; Essery, Eve - CNPP;
Anne Rodgers
RE: Final Edits for BEM/AHL Review: Executive Summary
Having thought about dairy a bit more I have additional thoughts. First, as Barbara and Kellie have
indicated, we cant change what the committee agreed on. Second, I am concerned about singling
out dairy as a major source of Na and SFA because it is not the leading source. Dairy products,
particularly non- and low-fat dairy, are outstanding sources of high quality protein, particularly
important since we recommend limiting red and processed meat; is more affordable than fish or meat;
and except for milk has a relatively long shelf life and needs minimal, if any, preparation. In all cases,
particularly for older adult, these are very important issues. The issue of lactose intolerance is no
longer much of an issue due to the availability of low lactose forms. From what I can remember
concerns about dairy intake are from observational studies. These are important to consider but as
we learned with beta-carotene, folate and vit E, not what we should be basing policy on.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Cc: Lichtenstein, Alice; Colette Rihane; Olson, Richard (HHS/OASH); Shanthy Bowman; Essery, Eve - CNPP; Anne
Rodgers
Subject: Re: Final Edits for BEM/AHL Review: Executive Summary
Understand.Thisisacomplicatedtimeofyearforeveryoneandeditsweremoredifficultthanusual.Hopefullymyedits
arereasonable.Theremainingnigglingissueseemstobewordingarounddairy...agoodsourceofunderconsumedand
overconsumednutrients.WonderhowbesttohandleitsoIofferedsomethoughts.I'mavailableifacallwouldbe
helpful.Barbara
SentfrommyiPad
OnJan5,2015,at7:41AM,"Casavale,Kellie(OS/OASH)"<Kellie.Casavale@hhs.gov>wrote:
Thankyou,BarbaraandAlice.Wewillreviewyournotesandgetbackintouchonthem.The
CommitteesworkisatthepointcurrentlywhereonlytheissuesdiscussedonDec.15thleadtochanges
197
PSC-HHS-000197
inthereport.Noothersubstantivechangescanbemade.Sowhenwereviewtheedits,somemaynot
beabletobeconsideredunlesstheyareresolvingissuesdiscussedinthepublicmeeting.Tomy
knowledgeallofthoseissuesareresolved,wejustneedyourconfirmationofthat.Iambeginningtobe
veryconcernedaboutthetimingofsubmittingthereport.IttooktheCommitteeaboutaweeklonger
thanexpectedtoresolvetheveryshortlistofissuesthatwereidentifiedonDec.15th.
Barbara,justforclarification,theUnderSecretariesdonotreviewyourcoverletter.TheCoExecutive
Secretariesarereviewingit.ItwillgothroughtheUnderSecretariesandtheActingASHonitswaytothe
Secretarythough.
Iwillbeintouchwiththenextpiecesassoonaspossible.
Manythanks!
Kellie

To: Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
Cc: Colette Rihane; Olson, Richard (HHS/OASH); Shanthy Bowman; Essery, Eve - CNPP; Anne Rodgers
Subject: RE: Final Edits for BEM/AHL Review: Executive Summary
Hieveryone,
Alicesandmyreviewsoverlappedandherearemythoughts.Havingjustcompletedthedraftletterto
SecretariesthattheUnderSecretariesarereviewing,Ihavebeentryingtosharpentheclarityof
messages.Ithoughtsomeofourkeypointscouldbeemphasizedabitmore.Also,Ithoughtwehave
toresolvedairy.Ourhealthypatternshavelowfatdairy(andalternatives)andweknowthatdairyas
currentlyconsumedbyAmericansnotonlyprovidesagoodsourceofsomeoftheunderconsumed
nutrientsofpublichealthconcernbutalsothosethatareoverconsumed,notablysodium(particularly
cheeses)andsaturatedfat(fullfatandevenlowerfattypes).So,Ididsometweakingfor
consideration.Imavailableifweneedtotalkatall.
Best,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Casavale, Kellie (OS/OASH); Millen, Barbara E
My grant with the Jan 2 deadline was submitted. On vacation this week with my
family. Will keep up in morning and evenings.
198
PSC-HHS-000198
See comments, in red. When I read text, I always think, can we defend it if challenged?
For the most part, yes.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Sent: Saturday, January 03, 2015 1:23 AM
To: Millen, Barbara E; Lichtenstein, Alice
Subject: Final Edits for BEM/AHL Review: Executive Summary
Importance: High
BarbaraandAlice,
WeareinthelastphasesoffinalizingthereporttogototheSecretariesnextweek.Attachedisthe
ExecutiveSummarytoreviewanddetermineiftheeditscanbeaccepted.Thegreatnewsisthatdespite
howlongittookmetoreviewthecomments,alleditsareresolved!Youjustneedtotakealookand
givemethegreenlighttoacceptthechangesandconsiderthisfinal.
Iwillmovethrougheachchapterinasimilarway.Onceyouhaveapprovedtheeditsforallchapters,I
willsendcleancopiestoyouinoneemailwithaformforeachofyoutosigntogiveusofficialapproval
tosubmitittotheSecretaries.
ExecutiveSummary
Ideletedafewcommentsthatwereoldnews.However,Ileftthecommentstringsonthelines
listedbelowthatprovidedfollowupthatconfirmedtheyareresolvedifyouagreetothe
trackedchangesprovided.
o Lines1115
o Lines5456
o Line59AttheendofFrankscommentthereisfollowupfromTrishthatprovidesthe
rationalefornotmakinganedithere.Commentisresolvedifyouagree.
o Line66
o Line76
o Line81
o Lines8889
o Lines107108
o Lines114116BecauseSC2updatedtheirlanguageanditdoesnotmentionleanmeat,
Barbararequestedasentencebeincludetoacknowledgethatleanmeatcanbepartof
ahealthydiet.Eveaddressedthisneedhere,suggestingwordingtoaddasafootnote.
o Lines113134Editedtomakethedescriptionofhealthydietarypatternsmatchthe
updatesintheSC2chapter.
199
PSC-HHS-000199
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Lines142144
Lines155156
Line173SeefollowupcommentstoAlicefromMaryandRafael.
Lines179181
Lines182183
Line213219
Line228
Lines236237
Line250
Line272273
Lines285288
Line293AliceseefollowupfromMim.
Line294
Lines319320
Line321AliceseefollowupfromJanetonyourquestion.
Lines334357Barbaranotedthatthereisasentenceaboutsaturatedfatandone
aboutaddedsugars,butnotoneaboutsodium.TheCCchaptersummaryalsodoesnot
haveacongruentsentence.EvesuggestedasentenceCherylapprovedfortheSWG
whichhasbeenadded.
Line347
355357NochangeifAliceisagreeablewithMariansresponse.
368
392396
404408
TheIntroductionandtheIntegrationchapterswillcomenext,followedbytheScienceBasechapters.
Thanks!
Kellie
Rockville,MD20852
(240)4538252
200
PSC-HHS-000200

From:
Sent:
To:
Subject:

Fwd: contact for Dr. Millen
FYI. Will you please contact the NY Times? Many thanks. Barbara
Sent from my iPhone
Begin forwarded message:
From: Kevin Grinberg <kevin@millenniumprevention.com>
Date: January 5, 2015 at 4:07:45 PM EST
To: "Millen, Barbara E" <bmillen@bu.edu>
Cc: "dwolongevicz@millenniumprevention.com" <dwolongevicz@millenniumprevention.com>
Subject: Fwd: contact for Dr. Millen
Barbara, see below (this came in to help@healthmain.com)
Dolores may have forwarded it already (since she sees help@healthmain messages), but I figured
I'd send it along as well.
---------- Forwarded message ---------From: Lapidos, Juliet <juliet.lapidos@nytimes.com>
Date: Mon, Jan 5, 2015 at 4:04 PM
Subject: contact for Dr. Millen
To: help@healthmain.com
To whom it may concern:
I'm on the editorial board of The New York Times.
I'd like to speak with Barbara Millen as soon as possible about the Dietary Guidelines Review Committee's
recommendations for the 2015 dietary guidelines. I'd like to discuss, specifically, the apparent move to address
environmental concerns in the guidelines.
Thanks and best,
Juliet Lapidos
212 556 5953
201
PSC-HHS-000201

From:
Sent:
To:
Cc:
Subject:

Lichtenstein, Alice; Colette Rihane; Olson, Richard (HHS/OASH); Shanthy Bowman;
Essery, Eve - CNPP; Anne Rodgers
Re: Final Edits for BEM/AHL Review: Executive Summary
Understand.Thisisacomplicatedtimeofyearforeveryoneandeditsweremoredifficultthanusual.Hopefullymyedits
arereasonable.Theremainingnigglingissueseemstobewordingarounddairy...agoodsourceofunderconsumedand
overconsumednutrients.WonderhowbesttohandleitsoIofferedsomethoughts.I'mavailableifacallwouldbe
helpful.Barbara
SentfrommyiPad
Secretarythough.
Manythanks!
Kellie

Hieveryone,
202
PSC-HHS-000202
Best,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Importance: High
BarbaraandAlice,
203
PSC-HHS-000203
ExecutiveSummary
o Lines1115
o Lines5456
o Line66
o Line76
o Line81
o Lines8889
o Lines107108
o Lines142144
o Lines155156
o Line173SeefollowupcommentstoAlicefromMaryandRafael.
o Lines179181
o Lines182183
o Line213219
o Line228
o Lines236237
o Line250
o Line272273
o Lines285288
o Line293AliceseefollowupfromMim.
o Line294
o Lines319320
o Line321AliceseefollowupfromJanetonyourquestion.
o Lines334357Barbaranotedthatthereisasentenceaboutsaturatedfatandone
whichhasbeenadded.
o Line347
o 355357NochangeifAliceisagreeablewithMariansresponse.
o 368
o 392396
o 404408
Thanks!
Kellie
204
PSC-HHS-000204

Rockville,MD20852
(240)4538252
205
PSC-HHS-000205

From:
Sent:
To:
Subject:

Re: Final Edits for BEM/AHL Review: Executive Summary
OK.Idon'tthinkthechangesweresubstantiveunlessthequeryraisedondairyposesapotentialproblem.Itisa
nigglingissue.Barbara
SentfrommyiPad
Secretarythough.
Manythanks!
Kellie

Hieveryone,
206
PSC-HHS-000206
Best,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Importance: High
BarbaraandAlice,
ExecutiveSummary
207
PSC-HHS-000207
o Lines1115
o Lines5456
o Line66
o Line76
o Line81
o Lines8889
o Lines107108
o Lines142144
o Lines155156
o Lines179181
o Lines182183
o Line213219
o Line228
o Lines236237
o Line250
o Line272273
o Lines285288
o Line294
o Lines319320
o Lines334357Barbaranotedthatthereisasentenceaboutsaturatedfatandone
whichhasbeenadded.
o Line347
o 355357NochangeifAliceisagreeablewithMariansresponse.
o 368
o 392396
o 404408
Thanks!
Kellie
208
PSC-HHS-000208
Rockville,MD20852
(240)4538252
209
PSC-HHS-000209

From:
Sent:
To:
Cc:
Subject:
Attachments:

Lichtenstein, Alice; Casavale, Kellie (OS/OASH)
Anne Rodgers
02 Part A_Executive Summary_SEMI-FINAL_for BEM AHL final review_1-3-15 bem
edits.docx
Hieveryone,
Alicesandmyreviewsoverlappedandherearemythoughts.HavingjustcompletedthedraftlettertoSecretariesthat
theUnderSecretariesarereviewing,Ihavebeentryingtosharpentheclarityofmessages.Ithoughtsomeofourkey
pointscouldbeemphasizedabitmore.Also,Ithoughtwehavetoresolvedairy.Ourhealthypatternshavelowfat
dairy(andalternatives)andweknowthatdairyascurrentlyconsumedbyAmericansnotonlyprovidesagoodsourceof
someoftheunderconsumednutrientsofpublichealthconcernbutalsothosethatareoverconsumed,notablysodium
(particularlycheeses)andsaturatedfat(fullfatandevenlowerfattypes).So,Ididsometweakingfor
Best,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

My grant with the Jan 2 deadline was submitted. On vacation this week with my family. Will keep up
in morning and evenings.
See comments, in red. When I read text, I always think, can we defend it if challenged? For the most
part, yes.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
210
PSC-HHS-000210
Importance: High
BarbaraandAlice,
WeareinthelastphasesoffinalizingthereporttogototheSecretariesnextweek.AttachedistheExecutiveSummary
toreviewanddetermineiftheeditscanbeaccepted.Thegreatnewsisthatdespitehowlongittookmetoreviewthe
comments,alleditsareresolved!Youjustneedtotakealookandgivemethegreenlighttoacceptthechangesand
considerthisfinal.
Iwillmovethrougheachchapterinasimilarway.Onceyouhaveapprovedtheeditsforallchapters,Iwillsendclean
copiestoyouinoneemailwithaformforeachofyoutosigntogiveusofficialapprovaltosubmitittotheSecretaries.
ExecutiveSummary
Ideletedafewcommentsthatwereoldnews.However,Ileftthecommentstringsonthelineslistedbelowthat
providedfollowupthatconfirmedtheyareresolvedifyouagreetothetrackedchangesprovided.
o Lines1115
o Lines5456
o Line59AttheendofFrankscommentthereisfollowupfromTrishthatprovidestherationalefornot
makinganedithere.Commentisresolvedifyouagree.
o Line66
o Line76
o Line81
o Lines8889
o Lines107108
o Lines114116BecauseSC2updatedtheirlanguageanditdoesnotmentionleanmeat,Barbara
requestedasentencebeincludetoacknowledgethatleanmeatcanbepartofahealthydiet.Eve
addressedthisneedhere,suggestingwordingtoaddasafootnote.
o Lines113134EditedtomakethedescriptionofhealthydietarypatternsmatchtheupdatesintheSC2
chapter.
o Lines142144
o Lines155156
o Lines179181
o Lines182183
o Line213219
o Line228
o Lines236237
o Line250
o Line272273
o Lines285288
o Line294
o Lines319320
211
PSC-HHS-000211
o
o
o
o
o
o
Lines334357Barbaranotedthatthereisasentenceaboutsaturatedfatandoneaboutaddedsugars,
butnotoneaboutsodium.TheCCchaptersummaryalsodoesnothaveacongruentsentence.Eve
suggestedasentenceCherylapprovedfortheSWGwhichhasbeenadded.
Line347
368
392396
404408
Thanks!
Kellie
Rockville,MD20852
(240)4538252
212
PSC-HHS-000212

From:
Sent:
To:
Cc:
Subject:
Attachments:

Casavale, Kellie (OS/OASH); Millen, Barbara E
Anne Rodgers
02 Part A_Executive Summary_SEMI-FINAL_for BEM AHL final review_1-3-15 AHL.docx
My grant with the Jan 2 deadline was submitted. On vacation this week with my family. Will keep up
in morning and evenings.
See comments, in red. When I read text, I always think, can we defend it if challenged? For the most
part, yes.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Importance: High
BarbaraandAlice,
WeareinthelastphasesoffinalizingthereporttogototheSecretariesnextweek.AttachedistheExecutiveSummary
toreviewanddetermineiftheeditscanbeaccepted.Thegreatnewsisthatdespitehowlongittookmetoreviewthe
comments,alleditsareresolved!Youjustneedtotakealookandgivemethegreenlighttoacceptthechangesand
considerthisfinal.
Iwillmovethrougheachchapterinasimilarway.Onceyouhaveapprovedtheeditsforallchapters,Iwillsendclean
copiestoyouinoneemailwithaformforeachofyoutosigntogiveusofficialapprovaltosubmitittotheSecretaries.
ExecutiveSummary
Ideletedafewcommentsthatwereoldnews.However,Ileftthecommentstringsonthelineslistedbelowthat
providedfollowupthatconfirmedtheyareresolvedifyouagreetothetrackedchangesprovided.
o Lines1115
o Lines5456
213
PSC-HHS-000213
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Line59AttheendofFrankscommentthereisfollowupfromTrishthatprovidestherationalefornot
makinganedithere.Commentisresolvedifyouagree.
Line66
Line76
Line81
Lines8889
Lines107108
Lines114116BecauseSC2updatedtheirlanguageanditdoesnotmentionleanmeat,Barbara
requestedasentencebeincludetoacknowledgethatleanmeatcanbepartofahealthydiet.Eve
addressedthisneedhere,suggestingwordingtoaddasafootnote.
Lines113134EditedtomakethedescriptionofhealthydietarypatternsmatchtheupdatesintheSC2
chapter.
Lines142144
Lines155156
Line173SeefollowupcommentstoAlicefromMaryandRafael.
Lines179181
Lines182183
Line213219
Line228
Lines236237
Line250
Line272273
Lines285288
Line293AliceseefollowupfromMim.
Line294
Lines319320
Line321AliceseefollowupfromJanetonyourquestion.
Lines334357Barbaranotedthatthereisasentenceaboutsaturatedfatandoneaboutaddedsugars,
butnotoneaboutsodium.TheCCchaptersummaryalsodoesnothaveacongruentsentence.Eve
suggestedasentenceCherylapprovedfortheSWGwhichhasbeenadded.
Line347
368
392396
404408
Thanks!
Kellie
Rockville,MD20852
(240)4538252
214
PSC-HHS-000214

From:
Sent:
To:
Cc:
Subject:

Thursday, December 25, 2014 8:10 AM
Frank Hu
Tom Brenna; Lichtenstein, Alice; Essery, Eve - CNPP; Anne Rodgers; Casavale, Kellie
(OS/OASH)
Re: dietary fat adn cholesterol
We didn't review data on cholesterol and CVD risk which makes the second point, while valid, a bit
problematical. Not sure how best to resolve it. Barbara
Sent from my iPhone
On Dec 24, 2014, at 10:01 AM, "Frank Hu" <nhbfh@channing.harvard.edu> wrote:
I'm thinking about several justifications for not carrying forward the 2010 cholesterol
recommendation.
1. The main approach of 2015 DGAC is food-based and pattern-based recommendations. Dietary
cholesterol intake is not considered by the DGAC as a major area of public health concern in
developing recommendations based on healthy dietary patterns.
2. There is little scientific evidence to support the 300 mg/day limit. Dietary cholesterol has only
small effects on serum cholesterol, and in prospective cohort studies, dietary cholesterol intake
was not associated with long-term CVD risk. Consumption of eggs (a major source of dietary
cholesterol) was not associated with CVD risk either. The consumption of red meats/process
meats, another major dietary source of dietary cholesterol, is recommended to be reduced in all
the major healthy dietary patterns reviewed by the DGAC.
3. Current level of cholesterol intake in the US population is xxx, well below 300 mg/day.
Average egg consumption is xxx.
4. Regarding seafood, my impression is that the structure of cholesterol in seafood is somewhat
different from that in meats and eggs. Several RCTs showed that seafood cholesterol did not
increase blood cholesterol. It is probably not a good idea to lump cholesterol from meats/eggs
together with that from seafood.
Frank
On Tue, Dec 23, 2014 at 5:40 PM, Millen, Barbara E <bmillen@bu.edu> wrote:
215
PSC-HHS-000215
Whatdoothersfeelaboutclarifyingwhywearenotcarryingforwardthe2010cholesterol
recommendation.Itmightbesuitabletocommentfurtheronthatcurrentmeanpopulationintake
achievesthepriorcholesteroltarget(under300mg)butalsotonotethatafurtheremphasison
cholesterolmightmaketheseafoodrecommendationconfusingsincesomeseafood,suchasshellfish
arehigherincholesterol.Wedowanttopromoteallseafoodincludingshellfish.
Whatareothersthoughts?
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Tuesday, December 23, 2014 5:28 PM
To: Tom Brenna
Cc: Lichtenstein, Alice; Millen, Barbara E; Essery, Eve - CNPP; Anne Rodgers; Casavale, Kellie (OS/OASH)
Subject: Re: dietary fat
Dear All,
I was alerted that we were silent on trans fat at our public meeting presentation. So I added the
following sentence to the implications of saturated fat-CVD section. Please let me know what
you think. If you agree with the wording, I think it should be also added to the Executive
Summary and Integration Chapter.
Trans fat from partially hydrogenated vegetable oils should be avoided.
Happy Holidays!
Frank
216
PSC-HHS-000216
On Mon, Dec 22, 2014 at 6:41 AM, Tom Brenna <jtb4@cornell.edu> wrote:
It's fine with me.
Tom
On Sun, Dec 21, 2014 at 9:33 AM, Frank Hu <nhbfh@channing.harvard.edu> wrote:

Alice,
attached please see my edits/comments on Chapters 2 and 6, in response to your comments.
For SFA, the Mensink and Katan 2003 MA (60 RCTs) included the DELTA trial, and thus, this
provides the strongest overall evidence on the effects of replacing SFA with other macronutrients
on blood lipids. The lipid effects in DASH were not primary outcomes and the results should be
interpreted in the context of the overall dietary pattern rather than as a low-fat diet. I have
consolidated the section on SFA replacement and blood lipids in the cross-cutting chapter and i
think it is now more coherent and stronger.
Please let me know if you have any questions.
Frank
On Sat, Dec 20, 2014 at 5:33 PM, Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu> wrote:
Frank, I can see your point. I was too quick to criticize but dont really have a good
solution.
I have added comments to the integration chapter as well as chapter 2 (more minor
points). Perhaps expressing the data in terms of a 5%E difference in dietary
217
PSC-HHS-000217
composition will provide a stronger argument. We do need to consider Marians

statement that reading the text, the data dont appear strong.
I am interested in what approach you would suggest taking.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Sent: Saturday, December 20, 2014 4:08 PM
no. Based on your last email, I thought you were sending us something since you "don't agree". I
was waiting for your revision.
Are you still planning to send out a revised version today?
218
PSC-HHS-000218

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Sent: Friday, December 19, 2014 12:37 PM
Cc: Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); Anne Rodgers
I would prefer to keep at least some evidence summary on blood lipids in the chapter because
this is part of conclusion statements. As Eve mentioned, we can specify the study populations
(e.g. individuals with high cholesterol) when describing the findings from the AHA/ACC report.
Although many of the studies summarized by Mensink and Katan are old, the general
conclusions regarding the effects of replacing saturated fat with PUFA, MUFA, and carbs are
solid and broadly consistent with more recent studies.
I will try to make some adjustment to this section today or tomorrow.
frank
On Thu, Dec 18, 2014 at 8:11 PM, Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu> wrote:
I can live with almost anything now. However, it will be unfortunate if we retain the text
about the old Katan analyses and DELTA and DASH studies copied directly from the
AHA/ACC report because they were both predicated on low fat diets, something we no
longer recommend and have to fight an uphill battle to remind people we dont
219
PSC-HHS-000219
recommend them. Retaining the text in the 2015 DGAC report is just undermining our
message, in my opinion.
------------------------------------------------------------------------------Alice H. Lichtenstein, D.Sc.

Gershoff Professor of Nutrition Science and Policy
Director and Senior Scientist, Cardiovascular Nutrition Laboratory
Tufts University
JM USDA Human Nutrition Research Center on Aging
711 Washington Street
Boston, MA 02111
phone: 617 556 3127

e-mail: Alice.Lichtenstein@Tufts.edu

Sent: Thursday, December 18, 2014 1:59 PM
To: Frank Hu; Lichtenstein, Alice
Cc: Casavale, Kellie (OS/OASH); 'Anne Rodgers'
Subject: RE: dietary fat
Frank and Alice,

Kellie forwarded me the email string on dietary fat since I am compiling the edits to the cross-cutting
chapter. Im not sure if I have the full email string Frank Can you send me the final decision on the
edits to the saturated fat section?
Alice To your point about how the AHA/ACC Guidelines are specifically for those who would benefit
from cholesterol-lowering, I just wanted to note that the sodium section has a similar situation (the
AHA/ACC Guidelines are for those who would benefit from blood pressure lowering); however, Cheryl just
made this point in her write-up. Could this be resolved by just stating clearly that the AHA/ACC Guidelines
were limited to those with high cholesterol?
220
PSC-HHS-000220
Just let me know what is decided so that I can get it into the final!
THANKS!!
Eve

Sent: Wednesday, December 17, 2014 2:06 PM
Cc: Anne Brown Rodgers (b) (6)
Alice,
After your deletions (AHA/ACC, Mensink and Katan, and Hooper), we don't have any evidence
summary on blood lipids to support the following conclusion statement. Dary's paper did not
specifically summarize the lipid effects. Instead, it used lipid effects (TC to LDL ratio) from
Mensink and Katan to project the magnitude of CHD reduction by replacing saturated fat with
PUFA, carbs, or mono.
Strong and consistent evidence from RCTs shows that replacing SFA with unsaturated
fats, especially PUFA, significantly reduces total and LDL cholesterol. Replacing SFA with
carbohydrates (sources not defined) also reduces total and LDL cholesterol, but
significantly increases triglycerides and reduces HDL cholesterol.

Sent: Wednesday, December 17, 2014 7:24 AM
To: Frank Hu (nhbfh@channing.harvard.edu)
Subject: dietary fat
Not certain whether I actually attached/sent my suggested changes.
------------------------------------------------------------------------------221
PSC-HHS-000221
Alice H. Lichtenstein, D.Sc.

Tufts University
Boston, MA 02111
phone: 617 556 3127

From: Anne Rodgers (b) (6)

To: Lichtenstein, Alice; 'Casavale, Kellie (OS/OASH)'
Subject: RE: integration and exec summary
Yes, you commented on the Executive Summary this morning and on the Integration chapter just
before it went into the semi-final draft.
Anne Brown Rodgers

Science Writer
(b) (6)

222
PSC-HHS-000222
To: Casavale, Kellie (OS/OASH); Anne Brown Rodgers (b) (6)

Subject: integration and exec summary
Final chapters, according to my records I have commented on both. If this is not the
case please let me know. I am aware there is still one outstanding issue other
committee members were queried about.

Tufts University
Boston, MA 02111
phone: 617 556 3127

email immediately.
-*******************************************************
223
PSC-HHS-000223

Harvard School of Public Health
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
224
PSC-HHS-000224
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
225
PSC-HHS-000225

From:
Sent:
To:
Cc:
Subject:
Attachments:

Sunday, December 21, 2014 3:52 PM
Frank Hu; bmillen@bu.edu; Essery, Eve - CNPP; Tom Brenna; Anne Rodgers
RE: dietary fat
11 Part D_Chapter 6 Cross-cutting Topics_SEMI-FINAL_12-10-14 AHL v2 FH AHL.docx;
07 Part D_Chapter 2 Dietary Patterns_SEMI-FINAL_12-10-14 AHL v3 FH AHL.docx
Put in a few notes of agreement. No additional comments.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Sunday, December 21, 2014 9:33 AM
To: Lichtenstein, Alice; bmillen@bu.edu; Essery, Eve - CNPP; Tom Brenna; Anne Rodgers
Alice,
attached please see my edits/comments on Chapters 2 and 6, in response to your comments.
For SFA, the Mensink and Katan 2003 MA (60 RCTs) included the DELTA trial, and thus, this provides the
strongest overall evidence on the effects of replacing SFA with other macronutrients on blood lipids. The lipid
effects in DASH were not primary outcomes and the results should be interpreted in the context of the overall
dietary pattern rather than as a low-fat diet. I have consolidated the section on SFA replacement and blood
lipids in the cross-cutting chapter and i think it is now more coherent and stronger.
Please let me know if you have any questions.
Frank
Frank, I can see your point. I was too quick to criticize but dont really have a good solution.
226
PSC-HHS-000226
I have added comments to the integration chapter as well as chapter 2 (more minor points). Perhaps
expressing the data in terms of a 5%E difference in dietary composition will provide a stronger
argument. We do need to consider Marians statement that reading the text, the data dont appear
strong.
I am interested in what approach you would suggest taking.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

no. Based on your last email, I thought you were sending us something since you "don't agree". I was waiting
for your revision.
Are you still planning to send out a revised version today?
227
PSC-HHS-000227

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Cc: Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); Anne Rodgers
I would prefer to keep at least some evidence summary on blood lipids in the chapter because this is part of
conclusion statements. As Eve mentioned, we can specify the study populations (e.g. individuals with high
cholesterol) when describing the findings from the AHA/ACC report. Although many of the studies
summarized by Mensink and Katan are old, the general conclusions regarding the effects of replacing saturated
fat with PUFA, MUFA, and carbs are solid and broadly consistent with more recent studies.
I will try to make some adjustment to this section today or tomorrow.
frank
On Thu, Dec 18, 2014 at 8:11 PM, Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu> wrote:
I can live with almost anything now. However, it will be unfortunate if we retain the text about the old
Katan analyses and DELTA and DASH studies copied directly from the AHA/ACC report because
they were both predicated on low fat diets, something we no longer recommend and have to fight an
228
PSC-HHS-000228
uphill battle to remind people we dont recommend them. Retaining the text in the 2015 DGAC report
is just undermining our message, in my opinion.

Tufts University
Boston, MA 02111
phone: 617 556 3127


Frank and Alice,

Kellie forwarded me the email string on dietary fat since I am compiling the edits to the cross-cutting chapter. Im not
sure if I have the full email string Frank Can you send me the final decision on the edits to the saturated fat section?
Alice To your point about how the AHA/ACC Guidelines are specifically for those who would benefit from cholesterollowering, I just wanted to note that the sodium section has a similar situation (the AHA/ACC Guidelines are for those who
would benefit from blood pressure lowering); however, Cheryl just made this point in her write-up. Could this be resolved
by just stating clearly that the AHA/ACC Guidelines were limited to those with high cholesterol?
229
PSC-HHS-000229
THANKS!!
Eve

Alice,
After your deletions (AHA/ACC, Mensink and Katan, and Hooper), we don't have any evidence summary on
blood lipids to support the following conclusion statement. Dary's paper did not specifically summarize the lipid
effects. Instead, it used lipid effects (TC to LDL ratio) from Mensink and Katan to project the magnitude of
CHD reduction by replacing saturated fat with PUFA, carbs, or mono.
Strong and consistent evidence from RCTs shows that replacing SFA with unsaturated fats, especially
PUFA, significantly reduces total and LDL cholesterol. Replacing SFA with carbohydrates (sources not
defined) also reduces total and LDL cholesterol, but significantly increases triglycerides and reduces
HDL cholesterol.


230
PSC-HHS-000230

Tufts University
Boston, MA 02111
phone: 617 556 3127


Yes, you commented on the Executive Summary this morning and on the Integration chapter just before it went
into the semi-final draft.
Anne Brown Rodgers

Science Writer
(b) (6)

231
PSC-HHS-000231
Final chapters, according to my records I have commented on both. If this is not the case please let
me know. I am aware there is still one outstanding issue other committee members were queried
about.

Tufts University
Boston, MA 02111
phone: 617 556 3127

-*******************************************************
232
PSC-HHS-000232

tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
233
PSC-HHS-000233

From:
Sent:
To:
Cc:
Subject:

Thursday, December 18, 2014 8:11 PM
Essery, Eve - CNPP; Frank Hu
Casavale, Kellie (OS/OASH); 'Anne Rodgers'
RE: dietary fat
I can live with almost anything now. However, it will be unfortunate if we retain the text about the old
Katan analyses and DELTA and DASH studies copied directly from the AHA/ACC report because
they were both predicated on low fat diets, something we no longer recommend and have to fight an
uphill battle to remind people we dont recommend them. Retaining the text in the 2015 DGAC report
is just undermining our message, in my opinion.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Frank and Alice,

Kellie forwarded me the email string on dietary fat since I am compiling the edits to the cross-cutting chapter. Im not
sure if I have the full email string Frank Can you send me the final decision on the edits to the saturated fat section?
Alice To your point about how the AHA/ACC Guidelines are specifically for those who would benefit from cholesterollowering, I just wanted to note that the sodium section has a similar situation (the AHA/ACC Guidelines are for those who
would benefit from blood pressure lowering); however, Cheryl just made this point in her write-up. Could this be resolved
by just stating clearly that the AHA/ACC Guidelines were limited to those with high cholesterol?
THANKS!!
Eve
234
PSC-HHS-000234
Alice,
Afteryourdeletions(AHA/ACC,MensinkandKatan,andHooper),wedon'thaveanyevidencesummaryonbloodlipids
tosupportthefollowingconclusionstatement.Dary'spaperdidnotspecificallysummarizethelipideffects.Instead,it
usedlipideffects(TCtoLDLratio)fromMensinkandKatantoprojectthemagnitudeofCHDreductionbyreplacing
saturatedfatwithPUFA,carbs,ormono.
StrongandconsistentevidencefromRCTsshowsthatreplacingSFAwithunsaturatedfats,especiallyPUFA,
significantlyreducestotalandLDLcholesterol.ReplacingSFAwithcarbohydrates(sourcesnotdefined)alsoreduces
totalandLDLcholesterol,butsignificantlyincreasestriglyceridesandreducesHDLcholesterol.

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Yes,youcommentedontheExecutiveSummarythismorningandontheIntegrationchapterjustbeforeitwentintothe
semifinaldraft.
AnneBrownRodgers
ScienceWriter
(b) (6)

235
PSC-HHS-000235
Final chapters, according to my records I have commented on both. If this is not the case please let
me know. I am aware there is still one outstanding issue other committee members were queried
about.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
236
PSC-HHS-000236

From:
Sent:
To:

Casavale, Kellie (OS/OASH); Anne Brown Rodgers (b) (6)
Subject:
RE: a few more edits: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC
Chairs
Sounds like a good plan to me.

Ignoring e-mails during the day to focus on my grant. However, catching up now.
The Food and Nutrition Board had an outstanding session on public/private partnerships. I think we
will hear more about it in the year to come.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Thursday, December 18, 2014 11:02 AM
To: 'Millen, Barbara E'; Nelson, Miriam; 'Perez-Escamilla, Rafael'; 'Neuhouser, Marian L'; 'Siega-riz, Anna Maria'; Mary
Story, Ph.D.; Lichtenstein, Alice
Cc: Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Essery, Eve - CNPP'; Britten, Patricia - CNPP; Piercy, Katrina
(HHS/OASH); Rahavi, Elizabeth - CNPP; De Jesus, Janet M (NIH/NHLBI) [E]; Anne Rodgers
Subject: RE: a few more edits: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
AnneandImetthismorning,andtheissuesareresolvingasdiscussedinthepublicmeeting.Thus,Iwouldrecommend
thatwefollowthepreestablishedprotocolandhaveBarbaraandAlicesignoffonfinalchanges.YourDGMTleadshave
beeninvolvedineveryeditthatinvolvesyourSCandwillbeinthelooptotheveryend.Soyoushouldfeelquite
confidentthattheyareingoodhands.Wewillofcoursebeintouchwithanychair(orothermembers)ifwe(orBarbara
orAlice)haveanyquestionsorfeelsomethingwasnotclearlyresolved.
WhenAnnehasmergedandaddressedthecommentstotheextentshecan,shewillsendtheExecutiveSummaryand
ALLoftheothersectionsoftheDGACReporttome.IwillreviewtheeditsandprepareasummaryforBarbaraandAlice.
ThetrackedchangesandthesummarywillgotoBarbaraandAliceforfinalsignoffonbehalfoftheDGAC.Inthisstep
theyapprovethattheeditsmadedoinfactreflectthedecisionsmadeatthefinalmeetingandthatnootherchanges
havebeenmadethatdonotreflectthedecisionsofthefullDGAC.Iwillthenmovethefilesintotheirfinalform,
completetheremainingadministrativeworkonthem,andHHSandUSDAwillprepareforthedualsubmissiontothe
Secretaries.
237
PSC-HHS-000237
Pleaseletmeknowifyouhaveanyquestionsorifthereareanyissuesthatyouareconcernedabout.
Thanks,
Kellie

To: Anne Rodgers; De Jesus, Janet M (NIH/NHLBI) [E]; 'Nelson, Miriam'; 'Perez-Escamilla, Rafael'; 'Neuhouser, Marian L';
Casavale, Kellie (OS/OASH); 'Siega-riz, Anna Maria'; Mary Story, Ph.D.
Cc: 'Lichtenstein, Alice'; Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Essery, Eve - CNPP'
Anne,
Whenyouhavemergedandaddressedthecommentstotheextentyoucan,willyoubecirculatingitbacktoAliceand
me.Whataboutothers?Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Anne Rodgers; 'De Jesus, Janet M (NIH/NHLBI) [E]'; 'Nelson, Miriam'; 'Perez-Escamilla, Rafael'; 'Neuhouser, Marian
L'; 'Casavale, Kellie (OS/OASH)'; 'Siega-riz, Anna Maria'
Cc: Millen, Barbara E; 'Lichtenstein, Alice'; 'Olson, Richard (HHS/OASH)'; 'Colette Rihane'; 'Essery, Eve - CNPP'
Subject: Re: a few more edits: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Hi
IhadnotcompletedmycommentsfortheExecutiveSummary.Imadetheseadditionalchangesontheversionthat
Rafaelhadsentthismorning.HeusedtheversionIhadsentyesterdaymorning.
Mary
From:AnneRodgers(b) (6)
Date:Wednesday,December17,20149:35AM
To:"'DeJesus,JanetM(NIH/NHLBI)[E]'"<dejesusjm@nhlbi.nih.gov>,"'Nelson,Miriam'"<Miriam.Nelson@tufts.edu>,
"RafaelPrezEscamilla,PhD,MS"<rafael.perezescamilla@yale.edu>,MaryStory<mary.story@duke.edu>,
"'Neuhouser,MarianL'"<mneuhous@fredhutch.org>,"'Casavale,Kellie(OS/OASH)'"<Kellie.Casavale@hhs.gov>,
"'Siegariz,AnnaMaria'"<am siegariz@unc.edu>
Cc:"'BarbaraMillen,DrPH,MPH,RD'"<bmillen@bu.edu>,"'Lichtenstein,Alice'"<Alice.Lichtenstein@tufts.edu>,
"'Olson,Richard(HHS/OASH)'"<Richard.Olson@hhs.gov>,'ColetteRihane'<colette.rihane@cnpp.usda.gov>,"'Essery,
EveCNPP'"<Eve.Essery@fns.usda.gov>
Subject:RE:afewmoreedits:CONFIDENTIAL:DraftSemiFinal2015DGACReportDGACChairs
ThanksJanet.
Illincorporatethisinformation.
238
PSC-HHS-000238
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)

To: Anne Rodgers; 'Nelson, Miriam'; 'Perez-Escamilla, Rafael'; 'Mary Story, Ph.D.'; 'Neuhouser, Marian L'; Casavale, Kellie
(OS/OASH); 'Siega-riz, Anna Maria'
Cc: 'Millen, Barbara E'; 'Lichtenstein, Alice'; Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Essery, Eve - CNPP'
HiAnneandMim,
ThefollowingtextshouldclarifythecommentsforSC5.
p.8,line242.ThetextfromtheSC5chapterthatcanbeincorporated:However, it should be noted that coffee as it is

normally consumed can contain added calories from cream, milk, and added sugars. Care should be taken to minimize
these caloric additions."
p.8,line336
HighcaffeineintheSC5chapterisdefinedas(>400mg/dayforadults;undeterminedforchildrenandadolescents)
Best,
Janet
Janet M.de Jesus, M.S., R.D.

Center for Translation Research and Implementation Science (CTRIS)
National Heart, Lung, and Blood Institute
National Institutes of Health
6705 Rockledge Drive
Rockledge 1 Building; Room 6189, MSC 7960
Bethesda, MD 20817
301-496-5344

To: 'Nelson, Miriam'; 'Perez-Escamilla, Rafael'; 'Mary Story, Ph.D.'; 'Neuhouser, Marian L'; Casavale, Kellie (OS/OASH);
'Siega-riz, Anna Maria'
Cc: 'Millen, Barbara E'; 'Lichtenstein, Alice'; Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Essery, Eve - CNPP'; De Jesus,
Thanks,Mim.
Janet,canyousendmetheanswerstoMimsquestionsandIlladdthemtothecompileddraft?Thanks.
239
PSC-HHS-000239

Anne
AnneBrownRodgers
ScienceWriter
(b) (6)
From: Nelson, Miriam [mailto:Miriam.Nelson@tufts.edu]

To: Perez-Escamilla, Rafael; Mary Story, Ph.D.; Neuhouser, Marian L; Casavale, Kellie (OS/OASH); 'Siega-riz, Anna Maria'
Cc: 'Millen, Barbara E'; Lichtenstein, Alice; Anne Rodgers; Olson, Richard (HHS/OASH); Colette Rihane; 'Essery, Eve CNPP'
Subject: a few more edits: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Anne, Kellie and Janet,

Here are my edits on top of everyone else's. Janet, I also have two quick questions in the margins regarding accuracy.
Many thanks! Mim
MiriamE.Nelson,PhD
AssociateDean,TischCollegeofCitizenshipandPublicService
Professor,FriedmanSchoolofNutritionScienceandPolicy
LincolnFileneHall
10UpperCampusRoad
TuftsUniversity
Medford,MA02155
Phone:6176274178
Fax:6176273401
www.StrongWomen.org
www.ChildObesity180.org
Twitter:@DrMiriamNelson
From: Perez-Escamilla, Rafael [rafael.perez-escamilla@yale.edu]
To: Mary Story, Ph.D.; Neuhouser, Marian L; Casavale, Kellie (OS/OASH); Nelson, Miriam; 'Siega-riz, Anna Maria'
Subject: RE: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
I have added my comments to Mary's version:

lines 80, 112, 148, 166, 174 and 368.
best,
Rafael Perez-Escamilla, PhD
Professor of Epidemiology & Public Health
Department of Chronic Disease Epidemiology
Director, Office of Public Health Practice
Director, Global Health Concentration
Yale School of Public Health
240
PSC-HHS-000240
135 College Street, Suite 200 (room 216)

New Haven CT 06510
email: rafael.perez-escamilla@yale.edu
phone: (203) 737-5882
fax: (203) 737-4591
IOM Food and Nutrition Board member
President, International Society for Research in Human Milk and Lactation (ISRHML)
From: Mary Story, Ph.D. [mary.story@duke.edu]
Sent: Tuesday, December 16, 2014 11:47 AM
To: Neuhouser, Marian L; Casavale, Kellie (OS/OASH); Perez-Escamilla, Rafael; 'Miriam (Mim) E. Nelson, PhD, MS';
Cc: 'Millen, Barbara E'; 'Lichtenstein, Alice'; Anne Rodgers; Olson, Richard (HHS/OASH); Colette Rihane; 'Essery, Eve CNPP'
Subject: Re: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Afewcommentsadded.Pleaseseecommentonpage2aboutaddedsugars.
Date:Tuesday,December16,20149:51AM
To:"Casavale,Kellie(OS/OASH)"<Kellie.Casavale@hhs.gov>,"RafaelPrezEscamilla,PhD,MS"<rafael.perez
escamilla@yale.edu[mailto]>,"'Miriam(Mim)E.Nelson,PhD,MS'"<miriam.nelson@tufts.edu[mailto]>,"'Siegariz,Anna
Maria'"<am siegariz@unc.edu[mailto]>,MaryStory<mary.story@duke.edu[mailto]>
Cc:"'BarbaraMillen,DrPH,MPH,RD'"<bmillen@bu.edu[mailto]>,"'Lichtenstein,Alice'"
<Alice.Lichtenstein@tufts.edu[mailto]>,AnneRodgers<abrodgers@verizon.net>,"Olson,Richard(HHS/OASH)"
<Richard.Olson@hhs.gov>,ColetteRihane<colette.rihane@cnpp.usda.gov>,"'Essery,EveCNPP'"
<Eve.Essery@fns.usda.gov>
Subject:RE:CONFIDENTIAL:DraftSemiFinal2015DGACReportDGACChairs
There were a few places where I tried to answer some of Alice's questions and also made a few other minor suggestions.
Marian
From: Casavale, Kellie (OS/OASH) [Kellie.Casavale@hhs.gov]
To: 'Rafael Prez-Escamilla, PhD, MS'; 'Miriam (Mim) E. Nelson, PhD, MS'; Neuhouser, Marian L; 'Siega-riz, Anna Maria';
'Mary Story, Ph.D.'
Subject: FW: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
SCChairs,
BarbaraandAliceaskedmetosharetheattachedcommentsfromAliceontheExecutiveSummaryandtheemailfrom
Barbarabelow.BarbarasuggestsacceptingAlicessuggestions,buttheyrequestyourinputontheonenotedbelow.
Pleasereplytoall.
Thanks,
Kellie
241
PSC-HHS-000241
IagreewithallofAlicescommentsexcept16.IbelievethattheRCTsexaminedintheliteraturereviewsweretesting
protocolsthatcouldbestandardizedinhealthcareandpublichealthsettingsandscaledup.Itwasimportantto
standardizeandtestthecounselingandmultidisciplinaryactivitiesagainstusualcare(inmanycase)todeterminetheir
effectiveness.Aprobleminclinicalpracticethesedaysisthelackofserviceavailabilityand,whereavailable,no
consistencyinitsprovision.Iadvocatekeepingtheparagraphandperhapsstatingsomethingaboutscalingit.Noteto
thatmanyoftheprotocolsusedgraduateassistants(professionalsintraining)whichwouldfurtheraddtocost
efficienciesinpracticeifinternsandotherscouldbetrainedtoparticipate.
LookingforwardtoseeingtherevisionsoftheIntroduction,Exec.SummaryandIntegrationchaptersaswellasthe
(hopefully)fewtweaksthatremainfromthecrossreviewsand/ormeetingrecommendationssaturatedfat,etc.).
Barbara
PSIsleptalittlelaterformethismorning!
Dr.BarbaraE.Millen
From: Lichtenstein, Alice [mailto:Alice.Lichtenstein@tufts.edu[mailto]]

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu[mailto]); Barbara Millen,
DrPH, MPH, RD (bmillen@bu.edu[mailto]); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD;
Rafel Perez-Escamilla (b) (6)
Nelson, Miriam
Cc: Casavale, Kellie (OS/OASH); Rihane, Colette; Essery, Eve - CNPP (Eve.Essery@fns.usda.gov); Bowman, Shanthy;
'amfiguer@email.unc.edu[mailto]'; Bailey, Lauren A.; 'jconnor@fhcrc.org'; 'anjuli.bodyk@yale.edu[mailto]';
(b) (6)
Comments on exec summary.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
email:Alice.Lichtenstein@Tufts.edu[mailto]
From: Olson, Richard (HHS/OASH) [mailto:Richard.Olson@hhs.gov]

To: Lichtenstein, Alice; Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu[mailto]); Barbara Millen, DrPH, MPH,
RD (bmillen@bu.edu[mailto]); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel
Perez-Escamilla (b) (6)
Nelson, Miriam
242
PSC-HHS-000242
(b) (6)
Subject: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
DGACmembers,
Whatajourneyyouhavemade.Iamdelightedtobesendingyouthecompletesemifinaldraftofthe2015DGAC
Report.Thereareanumberofimportantdetailsoutlinedbelow.
CONFIDENTIALTheseareinternalandconfidentialdocuments.Itisessentialtotheintegrityofyourworkthat
colleaguesandthepublicingeneralhaveequalaccess;thus,pleasetreatthesefilesashighlysensitiveand
confidential.
REVIEWThecrossreviewoftheDGACreportwasverysuccessful.Thankyouforyourthoughtfulandtimely
inputtoyourcolleagues.Tothatend,youhavethoroughlyreviewedthechaptersforthegroupsonwhichyou
serveandforthechapter(s)youcrossreviewed.Inthefilesattachedpleasepayspecialattentionto:
o PartA.ExecutiveSummaryYouhavenotyetreviewedthischapter.Itprimarilyprovidescontentfrom
yourotherchapters;however,pleasepayparticularattentiontothesectionsthatrelatetoyour
subcommittee(s)orworkinggroup(s).
o PartB.1IntroductionYouhavenotyetreviewedthischapter.Itdescribestheworkofeachgroupand
includestheconceptualmodelanditssupplementarytable(whichyouhavereviewed).
o PartB.2IntegrationThischapterwassenttoyoupreliminarilyMonday.Thosecommentswere
addressed,aspossible.Pleasereviewthischapterandprovidecommentsifneeded.
o PartC.MethodologyThischapterwascrossreviewed;however,pleaseprovidecommentsifyouhave
them.
o PartD.ScienceBasePleasereviewanychaptersyoudidnotcoauthororcrossreviewifpossible.
o Appendicesyoumayneedtoreviewinclude
APPENDIXE1:NeedsforFutureResearch(acompiledlistofallresearchrecommendationsfrom
yourScienceBasechapters)
APPENDIXE2:GlossaryofTerms
o CommentsfromanyadditionalreviewyoudowillbethefocusofthediscussiononyourSRSCcallthis
Friday,Dec.12thfrom9:45am11am.
o Pleaseprovidecomments(toAnneandccKellie)beforeMonday,December15thordiscussthose
changeswithyourCommitteeinthepublicmeeting.Acopyofthisdraftreportwillbeprovidedfor
eachofyouatthemeeting.Ifyouwouldliketowriteeditsdirectlyonpagesduringthemeeting,
initialthatpageandleaveitbehindwithstaffwhowillgivethemtoKellietocompile.Wewillrecycle
thesereportsafterthemeeting(andarereusingnotebookstotemporarilyhousethem).
Whatsnext?!AftertheDGACmeetingMonday:
Workingwiththestaffandyouasneeded,KelliewillincorporatethechangestheCommitteeagreedtoasa
groupatthepublicmeetinganddocumentthem.BarbaraandAlicewillsignoffonthosefinalchangesonbehalf
ofthefullCommittee.
BarbarawilldraftaLettertotheSecretariesasthecoverletterforyourreport.
StaffwillcompleteanyfinalformattingandpreparethefinalreportforsubmissiontotheSecretaries.
WhenthereportissubmittedtotheSecretaries(goalfirstweekofJanuary),wewillnotifyyou.Atthattimethe
DGACdisbands.However,pleaserefrainfromparticipatingininterviewsorpresentationsontheDGACReport
untilitispostedonDietaryGuidelines.govforthepublic(goalendofJanuary,about3weekstoformatforthe
internet).
Wewillcoordinateanadministrativeconferencecallwithyouearlyinthenewyeartodescribetheactivities
in2015andansweranyquestionsyouhave.
Pleaseletusknowifyouhaveanyquestions.Welookforwardtoseeingyoutogetherasagrouponelasttimeon
Monday.Itwillbebittersweettobothseethisworkcometofruitionbutbeonthevergeoftheconclusionofworkingso
243
PSC-HHS-000243
closelywithyoueveryday.Thankyouagainforyourcommitmenttothiswork,notonlyintheselastdays,butoverthe
lastyearandahalf!
Rick
244
PSC-HHS-000244

From:
Sent:
To:
Cc:
Subject:

Anne Rodgers; De Jesus, Janet M (NIH/NHLBI) [E]; 'Nelson, Miriam'; 'Perez-Escamilla,
Rafael'; 'Neuhouser, Marian L'; Casavale, Kellie (OS/OASH); 'Siega-riz, Anna Maria'; Mary
Story, Ph.D.
'Lichtenstein, Alice'; Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Essery, Eve - CNPP'
RE: a few more edits: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC
Chairs
Anne,
Whenyouhavemergedandaddressedthecommentstotheextentyoucan,willyoubecirculatingitbacktoAliceand
me.Whataboutothers?Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Anne Rodgers; 'De Jesus, Janet M (NIH/NHLBI) [E]'; 'Nelson, Miriam'; 'Perez-Escamilla, Rafael'; 'Neuhouser, Marian
L'; 'Casavale, Kellie (OS/OASH)'; 'Siega-riz, Anna Maria'
Cc: Millen, Barbara E; 'Lichtenstein, Alice'; 'Olson, Richard (HHS/OASH)'; 'Colette Rihane'; 'Essery, Eve - CNPP'
Hi
Mary
ThanksJanet.
Anne
AnneBrownRodgers
ScienceWriter
245
PSC-HHS-000245
(b) (6)

HiAnneandMim,

p.8,line336
Best,
Janet

Bethesda, MD 20817
301-496-5344

Thanks,Mim.
Anne
AnneBrownRodgers
246
PSC-HHS-000246
ScienceWriter
(b) (6)


Many thanks! Mim
MiriamE.Nelson,PhD
LincolnFileneHall
10UpperCampusRoad
TuftsUniversity
Medford,MA02155
Phone:6176274178
Fax:6176273401
www.StrongWomen.org

lines 80, 112, 148, 166, 174 and 368.
best,
New Haven CT 06510
phone: (203) 737-5882
247
PSC-HHS-000247
fax: (203) 737-4591

<Alice.Lichtenstein@tufts.edu[mailto]>,AnneRodgers(b) (6)
"Olson,Richard(HHS/OASH)"
Marian
'Mary Story, Ph.D.'
SCChairs,
Pleasereplytoall.
Thanks,
Kellie
248
PSC-HHS-000248
Barbara
Dr.BarbaraE.Millen

Nelson, Miriam
(b) (6)
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Nelson, Miriam
(b) (6)
249
PSC-HHS-000249
DGACmembers,
confidential.
them.
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
250
PSC-HHS-000250
251
PSC-HHS-000251

From:
Sent:
To:
Cc:
Subject:

Nelson, Miriam; Neuhouser, Marian L; Mary Story, Ph.D.; Anne Rodgers; De Jesus, Janet
M (NIH/NHLBI) [E]; 'Perez-Escamilla, Rafael'; Casavale, Kellie (OS/OASH); 'Siega-riz,
Anna Maria'; Tom Brenna
Lichtenstein, Alice; Olson, Richard (HHS/OASH); 'Colette Rihane'; 'Essery, Eve - CNPP';
Griffin, Timothy; mhamm@anr.msu.edu
RE: Regarding fish...: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Iconcuraswell.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Neuhouser, Marian L; Mary Story, Ph.D.; Anne Rodgers; 'De Jesus, Janet M (NIH/NHLBI) [E]'; 'Perez-Escamilla,
Rafael'; 'Casavale, Kellie (OS/OASH)'; 'Siega-riz, Anna Maria'; Tom Brenna
Cc: Millen, Barbara E; Lichtenstein, Alice; 'Olson, Richard (HHS/OASH)'; 'Colette Rihane'; 'Essery, Eve - CNPP'; Griffin,
Timothy; mhamm@anr.msu.edu
Subject: Regarding fish...: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Tom provided a response to Marian's question that I thought others might be interested in (and I concur).
Best, Mim
Response:
Mim, Marian,
It is a correct and important point for sure but I think it is covered, or at least that was our intention.
We do acknowledge that programs are in place to stabilize and make sustainable fisheries, emerging for instance from
the Magnuson Act. At least as relevant is the closing of the South American anchovy fishery early this year, which has
caused a substantial disruption in fish oil supplies but is intended to preserve the fishery. All fisheries change season to
season, a reason why they are monitored and reported upon every year and next year is no different in that regard.
The newspaper article is about a particular fishery off the coast of Alaska. Our comment is a general matter about all
fisheries supported by the plot showed Monday that the global wild catch plateaued in 1990 and has been stable; that
plot implies that fisheries go up and down but on average are stable.
Chapter 5, lines 570-577: "Currently, seafood production is in the midst of rapid expansion to meet growing worldwide
demand, but the collapse of some fisheries due to overfishing in past decades raises concerns about the ability to produce
safe and affordable seafood to supply the U.S. population and meet current dietary intake recommendations of at least 8
ounces per week.20, 56. Capture fisheries (wild caught) production has leveled-off as a proportion of fully exploited
stocks, and this is due in part to national and international efforts to fish sustainably (e.g., the U.S. Magnuson-Stevens
Fishery Conservation and Management Act (2006) mandating annual catch limits, managed by the U.S. National
Oceanographic and Atmospheric Administration)."
I honestly think this covers it, and will be pleased to look at language to be added if thought useful based on this
newspaper article.
Cheers,
252
PSC-HHS-000252
Tom
Miriam E. Nelson, PhD
Associate Dean, Tisch College of Citizenship and Public Service
Professor, Friedman School of Nutrition Science and Policy

Lincoln Filene Hall
10 Upper Campus Road
Tufts University
Medford, MA 02155
Phone: 617-627-4178
Fax: 617-627-3401
www.StrongWomen.org
Twitter: @DrMiriamNelson
From: Neuhouser, Marian L [mneuhous@fredhutch.org]
To: Mary Story, Ph.D.; Anne Rodgers; 'De Jesus, Janet M (NIH/NHLBI) [E]'; Nelson, Miriam; 'Perez-Escamilla, Rafael';
'Casavale, Kellie (OS/OASH)'; 'Siega-riz, Anna Maria'
Cc: 'Millen, Barbara E'; Lichtenstein, Alice; 'Olson, Richard (HHS/OASH)'; 'Colette Rihane'; 'Essery, Eve - CNPP'
Inoticedsomequestionsaboutthestatementre:thewildcaughtfisheriesbeingfullyexploited.Hereissomenew
informationthatwaspublishedtoday.Theinformationherewouldnotbeconsistentwithastatementthatthewild
caughtfisheriesareexploitedordepleted
http://seattletimes.com/html/localnews/2025250190 bristolbayxml.html
Marian L. Neuhouser, PhD, RD

Cancer Prevention Program
Fred Hutchinson Cancer Research Center
1100 Fairview Avenue North, M4B402
Seattle, WA 98109-1024
Tel: 206-667-4797
Fax: 206-667-7850
Email: mneuhous@fredhutch.org

To: Anne Rodgers; 'De Jesus, Janet M (NIH/NHLBI) [E]'; 'Nelson, Miriam'; 'Perez-Escamilla, Rafael'; Neuhouser, Marian L;
'Casavale, Kellie (OS/OASH)'; 'Siega-riz, Anna Maria'
Cc: 'Millen, Barbara E'; 'Lichtenstein, Alice'; 'Olson, Richard (HHS/OASH)'; 'Colette Rihane'; 'Essery, Eve - CNPP'
Hi
Mary
253
PSC-HHS-000253
ThanksJanet.
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)

HiAnneandMim,

p.8,line336
Best,
Janet

Bethesda, MD 20817
301-496-5344
254
PSC-HHS-000254

Thanks,Mim.
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)


Many thanks! Mim
MiriamE.Nelson,PhD
LincolnFileneHall
10UpperCampusRoad
TuftsUniversity
Medford,MA02155
Phone:6176274178
Fax:6176273401
www.StrongWomen.org
255
PSC-HHS-000255

lines 80, 112, 148, 166, 174 and 368.
best,
New Haven CT 06510
phone: (203) 737-5882
fax: (203) 737-4591
<Alice.Lichtenstein@tufts.edu[mailto]>,AnneRodgers(b) (6)
"Olson,Richard(HHS/OASH)"
Marian
'Mary Story, Ph.D.'
SCChairs,
256
PSC-HHS-000256

Pleasereplytoall.
Thanks,
Kellie
Barbara
Dr.BarbaraE.Millen

Nelson, Miriam
(b) (6)
TuftsUniversity
257
PSC-HHS-000257
711WashingtonStreet
Boston,MA02111
phone:6175563127

Nelson, Miriam
(b) (6)
DGACmembers,
confidential.
them.
ofthefullCommittee.
258
PSC-HHS-000258
internet).
lastyearandahalf!
Rick
259
PSC-HHS-000259

From:
Sent:
To:
Cc:
Subject:

Tuesday, December 16, 2014 5:47 PM
Siega-riz, Anna Maria; Neuhouser, Marian L; Casavale, Kellie (OS/OASH); 'Rafael PrezEscamilla, PhD, MS'; Nelson, Miriam; 'Mary Story, Ph.D.'
'Millen, Barbara E'; Anne Rodgers; Olson, Richard (HHS/OASH); Colette Rihane; 'Essery,
Eve - CNPP'
RE: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Anna Maria, do they specify white potatoes? If so, we should add the word white, if not, the text
should stay as written.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
From: Siega-riz, Anna Maria [mailto:am_siegariz@unc.edu]
To: Neuhouser, Marian L; Casavale, Kellie (OS/OASH); 'Rafael Prez-Escamilla, PhD, MS'; Nelson, Miriam; 'Mary Story,
Ph.D.'
IhavereadoverAliceseditsandquestionsalongwithMiriamsreposes.TheonlyadditionisthatinregardstoFFQsand
potatoeswhatIhaveseenisthattheFFQsaskaboutfriedpotatoesseparatelyfromboiledormashedpotatoes.The
friedarethenexcludedfromthevegetablecategory.
AnnaMariaSiegaRiz,PhD
and
ChapelHill,NC27599
Phone:9199665984(Epi)or9199626120(CPC)newasof6/18/14;
Date:Tuesday,December16,2014at9:51AM
260
PSC-HHS-000260
To:KellieCasavale<Kellie.Casavale@hhs.gov>,RafaelPerezEscamilla<rafael.perezescamilla@yale.edu>,"'Miriam
(Mim)E.Nelson"<miriam.nelson@tufts.edu>,AnnaSiegaRiz<am siegariz@unc.edu>,'MaryStory
<mary.story@duke.edu>
Cc:DrPHBarbaraMillen<bmillen@bu.edu>,AliceLichtenstein<Alice.Lichtenstein@tufts.edu>,AnneRodgers
(b) (6)
RichardOlson<Richard.Olson@hhs.gov>,ColetteRihane<Colette.Rihane@cnpp.usda.gov>,
EveEssery<Eve.Essery@fns.usda.gov>
Marian
'Mary Story, Ph.D.'
SCChairs,
Pleasereplytoall.
Thanks,
Kellie
Barbara
261
PSC-HHS-000261
Dr.BarbaraE.Millen

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu); Barbara Millen, DrPH, MPH,
RD (bmillen@bu.edu); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel PerezEscamilla (b) (6)
Nelson, Miriam
'amfiguer@email.unc.edu'; Bailey, Lauren A.; 'jconnor@fhcrc.org'; 'anjuli.bodyk@yale.edu'; (b) (6)
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: Lichtenstein, Alice; Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu); Barbara Millen, DrPH, MPH, RD
(bmillen@bu.edu); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel Perez-Escamilla
(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
262
PSC-HHS-000262
them.
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
263
PSC-HHS-000263

From:
Sent:
To:
Cc:
Subject:

Tuesday, December 16, 2014 10:22 AM
Neuhouser, Marian L; Casavale, Kellie (OS/OASH); 'Rafael Prez-Escamilla, PhD, MS';
Nelson, Miriam; 'Siega-riz, Anna Maria'; 'Mary Story, Ph.D.'
'Millen, Barbara E'; Anne Rodgers; Olson, Richard (HHS/OASH); Colette Rihane; 'Essery,
Eve - CNPP'
Agree with wording changes and need to clarification regarding potatoes. I should have included a
question mark after white.
Thanks for the quick review Marian.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Casavale, Kellie (OS/OASH); 'Rafael Prez-Escamilla, PhD, MS'; Nelson, Miriam; 'Siega-riz, Anna Maria'; 'Mary Story,
Ph.D.'
Marian
'Mary Story, Ph.D.'
SCChairs,
Pleasereplytoall.
264
PSC-HHS-000264

Thanks,
Kellie
Barbara
Dr.BarbaraE.Millen

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am_siegariz@unc.edu); Barbara Millen, DrPH, MPH,
RD (bmillen@bu.edu); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel PerezEscamilla (b) (6)
Nelson, Miriam
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
265
PSC-HHS-000265

(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
them.
ofthefullCommittee.
internet).
266
PSC-HHS-000266
lastyearandahalf!
Rick
267
PSC-HHS-000267

From:
Sent:
To:
Cc:
Subject:

Millen, Barbara E; Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD
(am_siegariz@unc.edu); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary
Story, PhD, MS, RD; Rafel Perez-Escamilla (b) (6)
Nelson, Miriam
Casavale, Kellie (OS/OASH); Rihane, Colette; Essery, Eve - CNPP
(Eve.Essery@fns.usda.gov); Bowman, Shanthy; 'amfiguer@email.unc.edu'; Bailey, Lauren
A.; 'jconnor@fhcrc.org'; 'anjuli.bodyk@yale.edu'; (b) (6)
Agreed. When the studies were done as noted in the text from the AHA/ACC the emphasis was on
low fat diets. That is not consistent with recommendations since 2000.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Lichtenstein, Alice; Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am_siegariz@unc.edu); Marian
Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel Perez-Escamilla
(b) (6)
Nelson, Miriam
Thequestioniswhattoreplaceitwithinsupportoftherecommendationstoremoveemphasisontotalfat,emphasize
replacedofSFAwithPUFA,anddeemphasizecarbohydrates.AsMarionnotedatthemeeting,thefeedingstudiesdont
provideevidenceofdramaticdifferencesintheeffectsofmacronutrientreplacementsonTGandHDL.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu); Millen, Barbara E; Marian
(b) (6)
Nelson, Miriam
268
PSC-HHS-000268
I reviewed the section in chapter 6 that Marian raised at the meeting. The material was taken directly
from the AHA/ACC report which is dated. In addition, the AHA/ACC report made their
recommendations specifically for people with elevated LDL-C and had a SFA recommendation of 56%E. Given the inconsistency with our report and the different population of interest I am suggesting
we delete the material from the AHA/ACC report for dietary SFA as I publically stated at our meeting
yesterday.
Looking forward to hearing other comments on the issue.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: Lichtenstein, Alice; Anna Maria Siega-Riz, PhD, MS, RD (am_siegariz@unc.edu); Barbara Millen, DrPH, MPH, RD
(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
them.
269
PSC-HHS-000269
o
o
o
o
PartD.ScienceBasePleasereviewanychaptersyoudidnotcoauthororcrossreviewifpossible.
Appendicesyoumayneedtoreviewinclude
CommentsfromanyadditionalreviewyoudowillbethefocusofthediscussiononyourSRSCcallthis
Pleaseprovidecomments(toAnneandccKellie)beforeMonday,December15thordiscussthose
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
270
PSC-HHS-000270

From:
Sent:
To:
Cc:
Subject:

Lichtenstein, Alice; Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD
(am_siegariz@unc.edu); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary
Story, PhD, MS, RD; Rafel Perez-Escamilla (b) (6)
Nelson, Miriam
Thequestioniswhattoreplaceitwithinsupportoftherecommendationstoremoveemphasisontotalfat,emphasize
replacedofSFAwithPUFA,anddeemphasizecarbohydrates.AsMarionnotedatthemeeting,thefeedingstudiesdont
provideevidenceofdramaticdifferencesintheeffectsofmacronutrientreplacementsonTGandHDL.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am_siegariz@unc.edu); Millen, Barbara E; Marian
(b) (6)
Nelson, Miriam
yesterday.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
271
PSC-HHS-000271

(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
them.
ofthefullCommittee.
internet).
272
PSC-HHS-000272
lastyearandahalf!
Rick
273
PSC-HHS-000273

From:
Sent:
To:
Cc:
Subject:

Millen, Barbara E
(Eve.Essery@fns.usda.gov); Bowman, Shanthy; (b) (6)
(HHS/OASH)
RE: AHL Exec Summary Revisions
Olson, Richard
This e-mail should be distributed to the other SC leads and we should get additional input. I will go
with the majority sentiment.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
(b) (6)
Olson, Richard (HHS/OASH)
Subject: AHL Exec Summary Revisions
Barbara
Dr.BarbaraE.Millen
274
PSC-HHS-000274
bmillen@bu.edu

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu); Millen, Barbara E; Marian
(b) (6)
Nelson, Miriam
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
them.
275
PSC-HHS-000275
o
o
o
o
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
276
PSC-HHS-000276

From:
Sent:
To:
Cc:
Subject:
Attachments:

Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD
(am_siegariz@unc.edu); Barbara Millen, DrPH, MPH, RD (bmillen@bu.edu); Marian
Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel PerezEscamilla (b) (6)
Nelson, Miriam
11. Part D_Chapter 6 Cross-cutting Topics_SEMI-FINAL_12-10-14 AHL.docx
yesterday.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
277
PSC-HHS-000277
them.
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
278
PSC-HHS-000278

From:
Sent:
To:
Cc:
Subject:

Lichtenstein, Alice
(Eve.Essery@fns.usda.gov); Bowman, Shanthy; (b) (6)
(HHS/OASH)
AHL Exec Summary Revisions
Olson, Richard
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD (am_siegariz@unc.edu); Millen, Barbara E; Marian
(b) (6)
Nelson, Miriam
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
279
PSC-HHS-000279

(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
them.
ofthefullCommittee.
internet).
280
PSC-HHS-000280
lastyearandahalf!
Rick
281
PSC-HHS-000281

From:
Sent:
To:
Cc:
Subject:
Attachments:

Olson, Richard (HHS/OASH); Anna Maria Siega-Riz, PhD, MS, RD
(am_siegariz@unc.edu); Barbara Millen, DrPH, MPH, RD (bmillen@bu.edu); Marian
Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel PerezEscamilla (b) (6)
Nelson, Miriam
02. Part A_Executive Summary_SEMI-FINAL_12-10-14 AHL.docx
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
282
PSC-HHS-000282
o
o
o
o
o
o
o
PartB.1IntroductionYouhavenotyetreviewedthischapter.Itdescribestheworkofeachgroupand
PartB.2IntegrationThischapterwassenttoyoupreliminarilyMonday.Thosecommentswere
PartC.MethodologyThischapterwascrossreviewed;however,pleaseprovidecommentsifyouhave
them.
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
283
PSC-HHS-000283

From:
Sent:
To:
Subject:

Re: CONFIDENTIAL: Draft Semi-Final 2015 DGAC Report- DGAC Chairs
Justgotn.WillreviewtheintegrationslidesonemoretimewhenI'msettledandgetthemtoyou.Wanttobesurethe
pointsandmycommentsgetasspecificaspossible.WanttoaddresstheconcernsAlicehasmademanytimes,thatwe
don'tjustputplatitudesbuthaveactionablerecommendations.
Barbara
SentfrommyiPhone
OnDec14,2014,at3:20PM,"Casavale,Kellie(OS/OASH)"<Kellie.Casavale@hhs.gov>wrote:
Alice,
Youshouldbeabletoeditthefiles.Perhapsyouneedtosaveitwithanewnameandthenaddthem.
I'veaddedAnnetothisemailstring.
I'veprovidedafewfollowupnotesbelowincasetheyarehelpfulasyouputtogetheryourcomments:
Regardingfoodsafety,IagreethatfoodsafetyintermsoftheDietaryGuidelinestypicallymeansfood
safetyforthepreventionoffoodborneillness.However,SC5didaddressthistopiccomprehensively.
Theypulledforwardallofthetablesfromthe2010DGACreportandthenupdatedthembasedon
federalfoodsafetypolicyadvancementsofFSISandCFSANsince2010.
Regardingunintendedconsequencesofaddedsugars,SC5onlyaddressedaspartameandprimarily
relatedtosafety,buttheaddedsugarsworkinggroupbuiltonthatwithasectiononlowcalorie
sweeteners.SoIthinkwheretheyareaddressedrelatedtounintendedconsequencesismainlyinthe
crosscuttingchapterandSC5wasthinkingmostlyaboutsafety.
SC5alsoaddressedcontaminantsinseafood(butnotcontaminantsinthefoodsupplybroadly).
I'mnotsureifI'minterpretingyourcommentcorrectly.IfyoufeelthescopeofSC5isnotdescribedwell
bythetitleofthechapterorthewayitissetupwithinthereport,perhapsyouwanttocommenton
that.
IdowanttoemailtheDGMTleadsandSCchairsthiseveningtogivethemanupdateonanycomments
thathavecomein.Ofcourse,folksmightbeplanningtobringthingsuptomorrowthatwemaynotbe
awareofinadvance.SofaryourcommentsandafewthoughtsfromBarbaraaretheonlyothers
received(otherthanthosefromWayneandAnnaMariaearlierintheweek).
Kellie
SentfrommyiPhone
OnDec14,2014,at1:46PM,"Lichtenstein,Alice"<Alice.Lichtenstein@tufts.edu>wrote:
284
PSC-HHS-000284
I just spent a tremendous amount of time reviewing the executive

summary. I now find that although I intentionally saved the file I cant
seem to have actually saved. I then did a test save and got the same
result. . Is that the intent of what was sent out, that it is not modifiable or
is there something I am doing wrong? There seems to be no way to
recover the file I worked on.
I only had one major concern that came up - .the chapter on sustainability
and food safety. As indicated before, we did not review food safety. We
reviewed caffeine and aspartame. The latter we state we did mainly
because we were concerned about an unintended consequence of
reducing added sugar. In the mind of the public and most of us food safety
refers to food borne illness and contaminants. I think in this case there is
no truth in the label and we are setting up expectations that will not be
met.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: Lichtenstein, Alice; Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu);
Barbara Millen, DrPH, MPH, RD (bmillen@bu.edu); Marian Neuhouser, PhD, RD
(mneuhous@fhcrc.org); Mary Story, PhD, MS, RD; Rafel Perez-Escamilla
(b) (6)
Nelson, Miriam
Cc: Casavale, Kellie (OS/OASH); Rihane, Colette; Essery, Eve - CNPP
(Eve.Essery@fns.usda.gov); Bowman, Shanthy; 'amfiguer@email.unc.edu'; Bailey,
Lauren A.; 'jconnor@fhcrc.org'; 'anjuli.bodyk@yale.edu'; (b) (6)
DGACmembers,
Whatajourneyyouhavemade.Iamdelightedtobesendingyouthecompletesemi
finaldraftofthe2015DGACReport.Thereareanumberofimportantdetailsoutlined
below.
CONFIDENTIALTheseareinternalandconfidentialdocuments.Itisessentialto
theintegrityofyourworkthatcolleaguesandthepublicingeneralhaveequal
access;thus,pleasetreatthesefilesashighlysensitiveandconfidential.
REVIEWThecrossreviewoftheDGACreportwasverysuccessful.Thankyou
foryourthoughtfulandtimelyinputtoyourcolleagues.Tothatend,youhave
thoroughlyreviewedthechaptersforthegroupsonwhichyouserveandforthe
chapter(s)youcrossreviewed.Inthefilesattachedpleasepayspecialattention
to:
285
PSC-HHS-000285
o
o
o
o
o
o
o
PartA.ExecutiveSummaryYouhavenotyetreviewedthischapter.It
primarilyprovidescontentfromyourotherchapters;however,please
payparticularattentiontothesectionsthatrelatetoyour
PartB.1IntroductionYouhavenotyetreviewedthischapter.It
describestheworkofeachgroupandincludestheconceptualmodel
anditssupplementarytable(whichyouhavereviewed).
PartB.2IntegrationThischapterwassenttoyoupreliminarily
Monday.Thosecommentswereaddressed,aspossible.Pleasereview
thischapterandprovidecommentsifneeded.
PartC.MethodologyThischapterwascrossreviewed;however,please
providecommentsifyouhavethem.
PartD.ScienceBasePleasereviewanychaptersyoudidnotcoauthor
orcrossreviewifpossible.
APPENDIXE1:NeedsforFutureResearch(acompiledlistofall
researchrecommendationsfromyourScienceBasechapters)
Commentsfromanyadditionalreviewyoudowillbethefocusofthe
discussiononyourSRSCcallthisFriday,Dec.12thfrom9:45am11
am.
Pleaseprovidecomments(toAnneandccKellie)beforeMonday,
December15thordiscussthosechangeswithyourCommitteeinthe
publicmeeting.Acopyofthisdraftreportwillbeprovidedforeachof
youatthemeeting.Ifyouwouldliketowriteeditsdirectlyonpages
duringthemeeting,initialthatpageandleaveitbehindwithstaffwho
willgivethemtoKellietocompile.Wewillrecyclethesereportsafter
themeeting(andarereusingnotebookstotemporarilyhousethem).
Workingwiththestaffandyouasneeded,Kelliewillincorporatethechanges
theCommitteeagreedtoasagroupatthepublicmeetinganddocumentthem.
BarbaraandAlicewillsignoffonthosefinalchangesonbehalfofthefull
Committee.
BarbarawilldraftaLettertotheSecretariesasthecoverletterforyour
report.
Staffwillcompleteanyfinalformattingandpreparethefinalreportfor
submissiontotheSecretaries.
WhenthereportissubmittedtotheSecretaries(goalfirstweekofJanuary),we
willnotifyyou.AtthattimetheDGACdisbands.However,pleaserefrainfrom
participatingininterviewsorpresentationsontheDGACReportuntilitisposted
onDietaryGuidelines.govforthepublic(goalendofJanuary,about3weeksto
formatfortheinternet).
Wewillcoordinateanadministrativeconferencecallwithyouearlyinthe
newyeartodescribetheactivitiesin2015andansweranyquestionsyouhave.
Pleaseletusknowifyouhaveanyquestions.Welookforwardtoseeingyoutogetheras
agrouponelasttimeonMonday.Itwillbebittersweettobothseethisworkcometo
fruitionbutbeonthevergeoftheconclusionofworkingsocloselywithyoueveryday.
Thankyouagainforyourcommitmenttothiswork,notonlyintheselastdays,butover
thelastyearandahalf!
286
PSC-HHS-000286
Rick
287
PSC-HHS-000287

From:
Sent:
To:
Cc:
Subject:

Olson, Richard (HHS/OASH); Millen, Barbara E (bmillen@bu.edu); Anne Brown Rodgers
Thanks for your explanations. I will mention again about my concern that the title of SC5 can be open
to misinterpretation. However, before that I will review the chapter.
I tried saving the summary chapter until a new name, that worked. Unfortunately, lost all my
comments. Will try to recreate on while on the plane.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Sunday, December 14, 2014 3:20 PM
Cc: Olson, Richard (HHS/OASH); Millen, Barbara E (bmillen@bu.edu); Anne Brown Rodgers
Alice,
Youshouldbeabletoeditthefiles.Perhapsyouneedtosaveitwithanewnameandthenaddthem.I'veaddedAnne
tothisemailstring.
I'veprovidedafewfollowupnotesbelowincasetheyarehelpfulasyouputtogetheryourcomments:
Regardingfoodsafety,IagreethatfoodsafetyintermsoftheDietaryGuidelinestypicallymeansfoodsafetyforthe
preventionoffoodborneillness.However,SC5didaddressthistopiccomprehensively.Theypulledforwardallofthe
tablesfromthe2010DGACreportandthenupdatedthembasedonfederalfoodsafetypolicyadvancementsofFSISand
CFSANsince2010.
Regardingunintendedconsequencesofaddedsugars,SC5onlyaddressedaspartameandprimarilyrelatedtosafety,
buttheaddedsugarsworkinggroupbuiltonthatwithasectiononlowcaloriesweeteners.SoIthinkwheretheyare
addressedrelatedtounintendedconsequencesismainlyinthecrosscuttingchapterandSC5wasthinkingmostlyabout
safety.
SC5alsoaddressedcontaminantsinseafood(butnotcontaminantsinthefoodsupplybroadly).
288
PSC-HHS-000288
I'mnotsureifI'minterpretingyourcommentcorrectly.IfyoufeelthescopeofSC5isnotdescribedwellbythetitleof
thechapterorthewayitissetupwithinthereport,perhapsyouwanttocommentonthat.
IdowanttoemailtheDGMTleadsandSCchairsthiseveningtogivethemanupdateonanycommentsthathavecome
in.Ofcourse,folksmightbeplanningtobringthingsuptomorrowthatwemaynotbeawareofinadvance.Sofaryour
commentsandafewthoughtsfromBarbaraaretheonlyothersreceived(otherthanthosefromWayneandAnnaMaria
earlierintheweek).
Kellie
SentfrommyiPhone
OnDec14,2014,at1:46PM,"Lichtenstein,Alice"<Alice.Lichtenstein@tufts.edu>wrote:
I just spent a tremendous amount of time reviewing the executive summary. I now find
that although I intentionally saved the file I cant seem to have actually saved. I then did
a test save and got the same result. . Is that the intent of what was sent out, that it is
not modifiable or is there something I am doing wrong? There seems to be no way to
recover the file I worked on.
I only had one major concern that came up - .the chapter on sustainability and food
safety. As indicated before, we did not review food safety. We reviewed caffeine and
aspartame. The latter we state we did mainly because we were concerned about an
unintended consequence of reducing added sugar. In the mind of the public and most of
us food safety refers to food borne illness and contaminants. I think in this case there is
no truth in the label and we are setting up expectations that will not be met.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: Lichtenstein, Alice; Anna Maria Siega-Riz, PhD, MS, RD (am siegariz@unc.edu); Barbara Millen,
DrPH, MPH, RD (bmillen@bu.edu); Marian Neuhouser, PhD, RD (mneuhous@fhcrc.org); Mary Story, PhD,
MS, RD; Rafel Perez-Escamilla (b) (6)
Nelson, Miriam
Cc: Casavale, Kellie (OS/OASH); Rihane, Colette; Essery, Eve - CNPP (Eve.Essery@fns.usda.gov);
Bowman, Shanthy; 'amfiguer@email.unc.edu'; Bailey, Lauren A.; 'jconnor@fhcrc.org';
'anjuli.bodyk@yale.edu'; (b) (6)
DGACmembers,
289
PSC-HHS-000289
Whatajourneyyouhavemade.Iamdelightedtobesendingyouthecompletesemifinaldraftofthe
2015DGACReport.Thereareanumberofimportantdetailsoutlinedbelow.
CONFIDENTIALTheseareinternalandconfidentialdocuments.Itisessentialtotheintegrityof
yourworkthatcolleaguesandthepublicingeneralhaveequalaccess;thus,pleasetreatthese
filesashighlysensitiveandconfidential.
REVIEWThecrossreviewoftheDGACreportwasverysuccessful.Thankyouforyour
thoughtfulandtimelyinputtoyourcolleagues.Tothatend,youhavethoroughlyreviewedthe
chaptersforthegroupsonwhichyouserveandforthechapter(s)youcrossreviewed.Inthe
filesattachedpleasepayspecialattentionto:
o PartA.ExecutiveSummaryYouhavenotyetreviewedthischapter.Itprimarily
providescontentfromyourotherchapters;however,pleasepayparticularattentionto
thesectionsthatrelatetoyoursubcommittee(s)orworkinggroup(s).
o PartB.1IntroductionYouhavenotyetreviewedthischapter.Itdescribestheworkof
eachgroupandincludestheconceptualmodelanditssupplementarytable(whichyou
havereviewed).
o PartB.2IntegrationThischapterwassenttoyoupreliminarilyMonday.Those
commentswereaddressed,aspossible.Pleasereviewthischapterandprovide
commentsifneeded.
o PartC.MethodologyThischapterwascrossreviewed;however,pleaseprovide
commentsifyouhavethem.
o PartD.ScienceBasePleasereviewanychaptersyoudidnotcoauthororcrossreview
ifpossible.
APPENDIXE1:NeedsforFutureResearch(acompiledlistofallresearch
recommendationsfromyourScienceBasechapters)
o Commentsfromanyadditionalreviewyoudowillbethefocusofthediscussionon
yourSRSCcallthisFriday,Dec.12thfrom9:45am11am.
o Pleaseprovidecomments(toAnneandccKellie)beforeMonday,December15thor
discussthosechangeswithyourCommitteeinthepublicmeeting.Acopyofthisdraft
reportwillbeprovidedforeachofyouatthemeeting.Ifyouwouldliketowriteedits
directlyonpagesduringthemeeting,initialthatpageandleaveitbehindwithstaff
whowillgivethemtoKellietocompile.Wewillrecyclethesereportsafterthe
meeting(andarereusingnotebookstotemporarilyhousethem).
Workingwiththestaffandyouasneeded,KelliewillincorporatethechangestheCommittee
agreedtoasagroupatthepublicmeetinganddocumentthem.BarbaraandAlicewillsignoff
onthosefinalchangesonbehalfofthefullCommittee.
Staffwillcompleteanyfinalformattingandpreparethefinalreportforsubmissiontothe
Secretaries.
WhenthereportissubmittedtotheSecretaries(goalfirstweekofJanuary),wewillnotifyyou.
AtthattimetheDGACdisbands.However,pleaserefrainfromparticipatingininterviewsor
presentationsontheDGACReportuntilitispostedonDietaryGuidelines.govforthepublic(goal
endofJanuary,about3weekstoformatfortheinternet).
Wewillcoordinateanadministrativeconferencecallwithyouearlyinthenewyearto
describetheactivitiesin2015andansweranyquestionsyouhave.
Pleaseletusknowifyouhaveanyquestions.Welookforwardtoseeingyoutogetherasagroupone
lasttimeonMonday.Itwillbebittersweettobothseethisworkcometofruitionbutbeonthevergeof
290
PSC-HHS-000290
theconclusionofworkingsocloselywithyoueveryday.Thankyouagainforyourcommitmenttothis
work,notonlyintheselastdays,butoverthelastyearandahalf!
Rick
291
PSC-HHS-000291

From:
Sent:
To:
Subject:

Olson, Richard (HHS/OASH); Casavale, Kellie (OS/OASH); Millen, Barbara E
(bmillen@bu.edu)
I just spent a tremendous amount of time reviewing the executive summary. I now find that although I
intentionally saved the file I cant seem to have actually saved. I then did a test save and got the
same result. . Is that the intent of what was sent out, that it is not modifiable or is there something I
am doing wrong? There seems to be no way to recover the file I worked on.
I only had one major concern that came up - .the chapter on sustainability and food safety. As
indicated before, we did not review food safety. We reviewed caffeine and aspartame. The latter we
state we did mainly because we were concerned about an unintended consequence of reducing
added sugar. In the mind of the public and most of us food safety refers to food borne illness and
contaminants. I think in this case there is no truth in the label and we are setting up expectations that
will not be met.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
(b) (6)
Nelson, Miriam
DGACmembers,
confidential.
292
PSC-HHS-000292
them.
ofthefullCommittee.
internet).
lastyearandahalf!
Rick
293
PSC-HHS-000293

From:
Sent:
To:
Cc:
Subject:
Attachments:

Monday, December 08, 2014 7:37 AM
Essery, Eve - CNPP
Anne Rodgers; Casavale, Kellie (OS/OASH); Rihane, Colette - CNPP
RE: Barbara: Cross-cutting chapter
Part D Ch 6_DRAFT_Edited+ABR+RPE+AHL+SA bem 12 8 2015.docx
Eve,
Thisisawonderful,elegantchapter.Imadeafeweditorialcomments.OneisthatAlicehasrecommendedwestayaway
fromthetermnutrientdense.Wehavedonesointheintegrationchapter.Wemaywish,ashasbeendiscussed,to
retainitintheSCandcrosscuttingchaptersbutImentionitinmycomments.AlsoIdidaslightrewordingofthe
saturatedfatrecommendationaboutsubstitutions.Sincewedidntlookextensivelyatallformsofreplacement,I
thoughtmakingitsimplerwasbetter.Thechaptersfutureresearchneedscallsforadditionalresearchondetermining
whetherrefinedandnonrefinedcarbohydrateshavesimilareffectsonTGandotherlipidsornot.Finally,Ithoughtthe
conclusionsweretoretainthe2400mgsodiumrecommendationbutthesummaryhas2300.Iknowtheliteratureisnot
consistentonthistopicbutweoughttobeconsistentintheconclusions,implicationsandsummary.PerhapsCheryland
youcantakealook.PerhapsImisinterpretedthisbutitshouldnttakelongtocheck.
Manythanksagainforyourpatience.BTW<therecommendationsforactionarewonderfulandwemaywanttouse
moreofthischapterslanguageintheintegrationchapter.Also,youaddressdentalcarieswhichatthemomentisnot
mentionedintheintegrationchapter.Annemaywishtomakeaplaceholderforitandalsomakeanotethatweought
totrytostrengthentherecommendationsforindividualandpopulationlevelactionwiththewordingaspresented
here.Perhapstheworkgroupsmemberswillmakerecomemndationsintheirreviewsoftheintegrationchaptertoday.
Allthebest,
Barbara
BarbaraE.Millen
bmillen@bu.edu

Cc: Anne Rodgers; 'Kellie Casavale'; Rihane, Colette - CNPP
Subject: FW: Barbara: Cross-cutting chapter
Hi Barbara,
The cross-cutting chapter leads are ready to finalize the chapter once they receive your input. Can you let me know when
you might be able to review the chapter? Please review the attached version because it has everyone elses comments in
one place.
THANK YOU!!
Eve
From: Essery, Eve - CNPP

294
PSC-HHS-000294

Cc: 'Anne Rodgers'; Casavale, Kellie (OS/OASH); Rihane, Colette - CNPP
Subject: Barbara: Cross-cutting chapter
Hi Barbara,
Attached is the edited version of the cross-cutting chapter with comments from Alice, Rafael, Steve A, and Anne
combined. If you have comments or edits, it would be great to add them to this file! Thanks so much!
Eve
Eve Essery Stoody, PhD
Nutritionist | Center for Nutrition Policy and Promotion | USDA
3101 Park Center Drive, Room 1034 | Alexandria, VA 22302
Eve.Essery@cnpp.usda.gov | Office: 703-305-2563 | Fax: 703-305-3300
www.DietaryGuidelines.gov | www.ChooseMyPlate.gov | www.NEL.gov
295
PSC-HHS-000295

From:
Sent:
To:
Cc:
Subject:
Attachments:

Monday, December 08, 2014 6:25 AM
Anne Rodgers
Casavale, Kellie (OS/OASH); Braunstein, Nadine (OS/OASH); Eve.Essery@fns.usda.gov;
Nadinebraunstein@aol.com; alice.lichtenstein@tufts.edu
Revised Integration Chapter
Integrated OVERARCHING THEMES and Recommendations with popultion added bem
12 6 2014 (5).docx
Hieveryone,
Attachedistherevisedintegrationchapter.IhaveincludedEssiesnewinformationonthechronicdiseaseratesand
havetriedtothebestofmyeffortstoaddressAlicesmostrecentcommentsandthoseoftheDGACandstaff.Ihope
thethemesandrecommendationsareasclearlywrittenanddirectaspossible.Itriedtoreachabalancebetween
brevityandenoughspecificityandtomakethethemesandrecommendationsasmeaningfulaspossibleandtoavoid
rhetoric.Ihopethebalancemeetswithyourapproval.
IthinktheplanatthispointisforAnneandKellietoreviewtherevisionsandtoputtogetherascleanadocumentfor
DGACreviewasearlytodayaspossible.IthinkitstillmakessensetoaskforurgentturnaroundbyEOBorlatetoday.I
willbeavailabletoreviewcompiledreactionsandtohelpwithanyrevisionsbeforetheentirereportgoestothe
committeetomorrow.Whenisthereportgoingouttomorrow.Willwehavetimetocompilecommentsfromanyone
thatasksforgraceuntilearlytomorrow?
Allthebest,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Nadinebraunstein@aol.com; Millen, Barbara E
Cc: Kellie.Casavale@hhs.gov; Nadine.Braunstein@hhs.gov; Eve.Essery@fns.usda.gov
Subject: RE: Revised availability this weekend
Ok,thanksNadine.Imtakingabreakforawhilenow.
AnneBrownRodgers
ScienceWriter
(b) (6)
From: (b) (6)

To: bmillen@bu.edu; (b) (6)
Cc: Kellie.Casavale@hhs.gov; Nadine.Braunstein@hhs.gov; Eve.Essery@fns.usda.gov
Subject: Re: Revised availability this weekend
296
PSC-HHS-000296
Thanks for your time this afternoon.

FYI - I have some additional changes that I planned to include that Barbara asked me to do beyond her version. I already
had the life course/life span change as well as the Healthy instead of optimal.
More later. I will work with Barbara's, Anne's and my updates.
Thanks to everyone!
Nadine
In a message dated 12/7/2014 6:23:40 P.M. Eastern Standard Time, bmillen@bu.edu writes:
Hiall,
PleasegoaheadandworkwithNadineontheintroductionIsentinmyearlieremailandgetitouttotheDGAC
assoonaspossible.Letthemknowtheintegrationchapterwillcomeinalateremail.Bothwillneedtocome
backbyendofbusinesstomorrow.Ifyouprefer,wecansendthembothfirstthinginthemorningandwecan
takeabitoftimeinthemorningtomakefinalrevisions.Ihaveanearlymeetingat8:15andexpecttoget
thingsbacktoyoulatertonight.However,youmayneedtimeinthemorningtomakefinaleditsandreview
mine.
IhavetoheadoutnowandwilltakethefinalrevisionstointegrationchapterwhenIreturnlaterthisevening.I
wontbeabletofinishmyreviewofthecrosscuttingchapteruntiltheneither.Ihavehadsomuchtoreview
andworkonthisweekend,IhavetotakeabreakrightnowandresumewhenIcan.
SorrythatIcantmarathonrightthoughtitbutIneedtobreak.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
From: Millen, Barbara E

To: 'Nadine'; Anne Rodgers
Cc: Casavale, Kellie (OS/OASH); Braunstein, Nadine (OS/OASH)
Nadine,
297
PSC-HHS-000297

Hereisthecopyweworkedon.ItincludestheeditsImadeinresponsetoAnnesandKelliesrevisions.Please
forwarditandcopymewhenyouredonewithyourfinaledits.
Manythanks!
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
From: Nadine (b) (6)

To: Millen, Barbara E; Anne Rodgers
Hi Barbara!
8 am works for me! I have till about 9 am.
If Kellie and Anne will participate then perhaps Kellie can arrange a conference call line for us.
Thanks!
Nadine
Sent from my Verizon Wireless 4G LTE smartphone
-------- Original message -------298
PSC-HHS-000298
From: "Millen, Barbara E"

Date:12/06/2014 5:29 PM (GMT-05:00)
To: Anne Rodgers
Cc: "Casavale, Kellie (OS/OASH)" ,Nadine ,"Braunstein, Nadine (OS/OASH)"
Prefer starting reasonably early, does 8 work for conceptual model. and them move on to the intro and
integration. Let me know and thanks mellow for alerting Alice if she's available. Barbara
Sent from my iPhone
On Dec 6, 2014, at 3:21 PM, "Anne Rodgers" (b) (6)
wrote:
Imanearlyriseraswell.ThewholedayisfreeformesoIcanmeetanytime.
AnneBrownRodgers
ScienceWriter
(b) (6)

Cc: 'Nadine'; Braunstein, Nadine (OS/OASH); Anne Rodgers
Barbara,
299
PSC-HHS-000299
Illbeupby7amImsureaswell.Herearesomeoptions,justletusknowwhatworksforyou.(
IthinkAnneandIarebothflexibleallday.)
Wecouldstartwiththeconceptualmodelfirstsometimebefore8:45amandthenmoveonto
theothers.OrdiscussiontheotherssomeothertimeSunday,wheneveryoudlike.Nadine
doesntneedtobeonforIntroandIntegration,althoughsheiscertainlywelcome.
WecoulddiscusstheIntroandIntegrationanytimeyoupreferandthentheconceptualmodel
after4pm.
WecanletAliceknowthetimewearemeetingincaseshewantstotakeabreakfromher
grantwork.
Kellie

To: Braunstein, Nadine (OS/OASH); Millen, Barbara E
Subject: Revised availability this weekend
Hi again, Barbara!
My weekend plans have changed. I will be available tonight (Sat) after 5 pm. Tomorrow
I will be available after 4.
I know that you are a morning person. I could also do Sunday morning from 7-8:45.
300
PSC-HHS-000300
Thanks,
Nadine
-------- Original message -------From: "Braunstein, Nadine (OS/OASH)"

Date:12/05/2014 10:21 PM (GMT-05:00)
To: "Millen, Barbara E" ,(b) (6)
Cc: "Casavale, Kellie (OS/OASH)"
Subject: RE: introduction and Integration
Hi Barbara!
Sorry for the late reply. I was out of the office today. I won't be available till Saturday evening.
But Sunday is open most of the day (except around 3-4 pm).
Please let me know if you have any time on Sunday.
Looking forward to completing this part of the DGAC report with you.
If you 'reply all' I will get the info on my cell phone while I'm out on Saturday.
Thanks,
Nadine
301
PSC-HHS-000301

Cc: Casavale, Kellie (OS/OASH); Anne Rodgers; Braunstein, Nadine (OS/OASH)
Subject: introduction and Integration
HI Alice,
The big outstanding items from the morning SRSC call are the completion of the
introduction and integration chapters and the conceptual model. It was proposed that
you and I work over the weekend with Kellie and Anne to prepare the chapters in draft
and then circulate them on Monday to the DGAC with a very short turnaround deadline
so they can go out on Tuesday to the DGAC with the rest of the report. We want to be
sure we have covered the overarching themes and recommendations and resolved
outstanding issues from the previous reviews. I will work with Nadine if shes available
to review things that remain on the conceptual model. Not sure if you have had the time
to review the revisions I did on the integration chapter but your input would be very
much appreciated.
Is there a time over the weekend that you have up to an hour to review the current draft
of the integration chapter and introduction. Both are attached for your review. The only
time I am definitely not available is noon or about 3 tomorrow.
Nadine, can you let me know your availability too?
Many thanks.
Barbara

bmillen@bu.edu

To: Anne Rodgers; 'Perez-Escamilla, Rafael'; 'Abrams, Steven A'; Millen, Barbara E;
frank.hu@channing.harvard.edu; Eve.Essery@cnpp.usda.gov
Cc: 'Casavale, Kellie (OS/OASH)'; Richard.Olson@hhs.gov; colette.rihane@cnpp.usda.gov;
302
PSC-HHS-000302
'Bodyk, Anjuli'; lhimes@bcm.edu; Bailey, Lauren A.; PBROWN@hsph.harvard.edu

Subject: RE: REVISED SATURATED FAT IMPLICATION FOR YOUR REVIEW
Looks fine to me, just one word change.

Tufts University
Boston, MA 02111
phone: 617 556 3127


To: 'Perez-Escamilla, Rafael'; 'Abrams, Steven A'; 'Millen, Barbara E'; Lichtenstein, Alice;
Cc: 'Casavale, Kellie (OS/OASH)'; Richard.Olson@hhs.gov; colette.rihane@cnpp.usda.gov;
'Bodyk, Anjuli'; lhimes@bcm.edu; Bailey, Lauren A.; PBROWN@hsph.harvard.edu
Subject: REVISED SATURATED FAT IMPLICATION FOR YOUR REVIEW
All,
Based on very recent comments from Barbara and Alice, Frank has revised the saturated
fat implications statement. Please review this and send any comments to me and Kellie
by Friday, December 5.
303
PSC-HHS-000303
Thanks very much,

Anne
Anne Brown Rodgers

Science Writer
(b) (6)
304
PSC-HHS-000304

From:
Sent:
To:
Cc:
Subject:
Attachments:

Nadine; Anne Rodgers
Casavale, Kellie (OS/OASH); Braunstein, Nadine (OS/OASH)
RE: Revised availability this weekend
Part B Chapter 1_Introduction_v3_12-7-14 bem NB edits 12 7 2014.doc
Nadine,
Hereisthecopyweworkedon.ItincludestheeditsImadeinresponsetoAnnesandKelliesrevisions.Pleaseforward
itandcopymewhenyouredonewithyourfinaledits.
Manythanks!
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Hi Barbara!
Thanks!
Nadine
-------- Original message -------From: "Millen, Barbara E"

Date:12/06/2014 5:29 PM (GMT-05:00)
To: Anne Rodgers
305
PSC-HHS-000305
Sent from my iPhone

wrote:
AnneBrownRodgers
ScienceWriter
(b) (6)

Barbara,
Illbeupby7amImsureaswell.Herearesomeoptions,justletusknowwhatworksforyou.(Ithink
AnneandIarebothflexibleallday.)
after4pm.
WecanletAliceknowthetimewearemeetingincaseshewantstotakeabreakfromhergrantwork.
Kellie

Hi again, Barbara!
My weekend plans have changed. I will be available tonight (Sat) after 5 pm. Tomorrow I will be
available after 4.
Thanks,
306
PSC-HHS-000306
Nadine

Date:12/05/2014 10:21 PM (GMT-05:00)
Hi Barbara!
Sorry for the late reply. I was out of the office today. I won't be available till Saturday evening. But
Sunday is open most of the day (except around 3-4 pm).
Thanks,
Nadine
HI Alice,
The big outstanding items from the morning SRSC call are the completion of the introduction
and integration chapters and the conceptual model. It was proposed that you and I work over the
weekend with Kellie and Anne to prepare the chapters in draft and then circulate them on
Monday to the DGAC with a very short turnaround deadline so they can go out on Tuesday to
the DGAC with the rest of the report. We want to be sure we have covered the overarching
themes and recommendations and resolved outstanding issues from the previous reviews. I will
work with Nadine if shes available to review things that remain on the conceptual model. Not
sure if you have had the time to review the revisions I did on the integration chapter but your
input would be very much appreciated.
Is there a time over the weekend that you have up to an hour to review the current draft of the
integration chapter and introduction. Both are attached for your review. The only time I am
definitely not available is noon or about 3 tomorrow.
307
PSC-HHS-000307
Many thanks.
Barbara

bmillen@bu.edu

Cc: 'Casavale, Kellie (OS/OASH)'; Richard.Olson@hhs.gov; colette.rihane@cnpp.usda.gov; 'Bodyk, Anjuli';
lhimes@bcm.edu; Bailey, Lauren A.; PBROWN@hsph.harvard.edu

Tufts University
Boston, MA 02111
phone: 617 556 3127

308
PSC-HHS-000308

All,
Based on very recent comments from Barbara and Alice, Frank has revised the saturated fat
implications statement. Please review this and send any comments to me and Kellie by Friday,
December 5.
Thanks very much,

Anne
Anne Brown Rodgers

Science Writer
(b) (6)
309
PSC-HHS-000309

From:
Sent:
To:
Cc:
Subject:

Sunday, December 07, 2014 8:14 AM
Anne Rodgers; Casavale, Kellie (OS/OASH); 'Nadine'; 'Millen, Barbara E'
'Colette Rihane'; Olson, Richard (HHS/OASH); 'Essery, Eve - CNPP'
RE: Revised availability this weekend
Since we did not formally synthesize the evidence for the chapter, I dont think that should be part of
the title. First part of first title looks appropriate to me.
Regarding second title, I think recommendations is too strong a word given there are so many ways
of interpreting it, particularly since the title of our Committee includes the word.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'Casavale, Kellie (OS/OASH)'; 'Nadine'; 'Millen, Barbara E'
Cc: 'Colette Rihane'; 'Olson, Richard (HHS/OASH)'; 'Essery, Eve - CNPP'; Lichtenstein, Alice
Goodmorningall,
WhenwegettotheIntegrationchapter,canwesettleonthetitle?Thecurrenttitleis:Overarching Themes and
Integrated Recommendations: Synthesizing the Evidence
Whenshereviewedthissection,Mimsuggested:Integrated Recommendations: Synthesizing the Evidence.
Shewascomfortablewithkeepingalltheotherchaptertitlesasis.
Thanks,
AnneBrownRodgers
ScienceWriter
(b) (6)
310
PSC-HHS-000310

To: 'Nadine'; Millen, Barbara E; Anne Rodgers
Cc: Braunstein, Nadine (OS/OASH); Colette Rihane; Olson, Richard (HHS/OASH); Essery, Eve - CNPP; 'Lichtenstein, Alice'
Soundslikeaplan!Ialreadysenttheconferenceline,buthereitisagainandIwillsenditinOutlookaswell:(b) (6)
IhavecopiedAliceincaseshecanbreakfromthegrantandpapersforanypartofthis.ImalsocopyingColette,Rick,
andEveincasetheyareabletojoin.
Sunday,December7th
8am:ConceptualModel(1st),thentheIntroductionandIntegration
Wedonothaveawebinarwiththisline.Barbara,pleasesendtheversionsofyourdraftsthatyouwouldlikeustohave
infrontofus.
Thanks,
Kellie
From: Nadine [mailto:(b) (6)

Hi Barbara!
Thanks!
Nadine
-------- Original message -------From: "Millen, Barbara E"

Date:12/06/2014 5:29 PM (GMT-05:00)
To: Anne Rodgers
311
PSC-HHS-000311
Sent from my iPhone
wrote:
AnneBrownRodgers
ScienceWriter
(b) (6)

Barbara,
Illbeupby7amImsureaswell.Herearesomeoptions,justletusknowwhatworksforyou.(Ithink
AnneandIarebothflexibleallday.)
after4pm.
WecanletAliceknowthetimewearemeetingincaseshewantstotakeabreakfromhergrantwork.
Kellie

Hi again, Barbara!
My weekend plans have changed. I will be available tonight (Sat) after 5 pm. Tomorrow I will be
available after 4.
312
PSC-HHS-000312
Thanks,
Nadine

Date:12/05/2014 10:21 PM (GMT-05:00)
Hi Barbara!
Sorry for the late reply. I was out of the office today. I won't be available till Saturday evening. But
Sunday is open most of the day (except around 3-4 pm).
Thanks,
Nadine
HI Alice,
The big outstanding items from the morning SRSC call are the completion of the introduction
and integration chapters and the conceptual model. It was proposed that you and I work over the
weekend with Kellie and Anne to prepare the chapters in draft and then circulate them on
Monday to the DGAC with a very short turnaround deadline so they can go out on Tuesday to
the DGAC with the rest of the report. We want to be sure we have covered the overarching
themes and recommendations and resolved outstanding issues from the previous reviews. I will
work with Nadine if shes available to review things that remain on the conceptual model. Not
sure if you have had the time to review the revisions I did on the integration chapter but your
input would be very much appreciated.
313
PSC-HHS-000313
Is there a time over the weekend that you have up to an hour to review the current draft of the
integration chapter and introduction. Both are attached for your review. The only time I am
definitely not available is noon or about 3 tomorrow.
Many thanks.
Barbara

bmillen@bu.edu


Tufts University
314
PSC-HHS-000314
Boston, MA 02111
phone: 617 556 3127


All,
Based on very recent comments from Barbara and Alice, Frank has revised the saturated fat
implications statement. Please review this and send any comments to me and Kellie by Friday,
December 5.
Thanks very much,

Anne
Anne Brown Rodgers

Science Writer
(b) (6)
315
PSC-HHS-000315

From:
Sent:
To:
Subject:

Friday, December 05, 2014 8:22 AM
RE: For review: 12.5.14 SRSC Meeting 59 Agenda.docx
ThanksKellie,
MycalendarnotessayaJetBlueflightat4:14onSundaythe14threturningIbelieveonthe8somethinglightonthe
15th.IdontknowiftheBostoncrewoptedforearlierflightsbutIhavetendedtobookthelatestflightbackandthentry
foranearlierflightonceattheairportifwearriveearlier.Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Friday, December 05, 2014 7:55 AM
Cc: Anne Rodgers
Subject: RE: For review: 12.5.14 SRSC Meeting 59 Agenda.docx
Yes,thatsoundslikeaverygoodplan.Onthecallthismorningletsaskforavailability.YouwillgettheIntroduction
fromAnnetoday;however,Nadinestillneedstoworkwithyouontheconceptualmodel.Todaywouldbehelpful,
althoughknowyouareswamped.
Kellie

IwasthinkingthatAliceneededtogivesomeinitialreactiontothefirsttwopartsIrewrote.Thatwastheplan.The,we
couldtalkaboutthepopulationlevelchanges.Wecouldalsoconsiderwhatmorewewantedintheintroductionbut
onlyafterAnnehashadthetimetodoherdraft.Whenthinkingaboutanothercall,Iwashopingtohaveitwiththe
SRSCandtoscheduleitbeforethefulldocumentwenttotheDGAC.SothatwouldmeanhavingarevisedIntegration
chaptertotheSRSCbyendofSundayandacallonMonday.Isthatfeasible?IfAliceisfreelateinthedayor
(preferably)tomorrowmorning,IcanmakeitIprobablywontbebackinBostonuntilverylateinthedayifnotdinner
time.ItwilldependupontrafficoutofNewYork.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu
316
PSC-HHS-000316

ThankyouBarbara,asfollowup.Ithinkyouarerightabouttheworktofinalizetheothersectionsleavinglittleroomfor
worktohaveprogressontheIntegrationrecommendationsandtheconceptualmodel.However,thatdoesntchange
thatthesestillneedtoCOMPLETE(notjustupdateddrafts,butcompletestarttofinish)nolaterthanMonday.The
membersneedtoseethem.Weneedaplantomakethathappenbetweentoday,tomorrow,andSunday.
Iaddedthehealthcareconsiderationsintotheactionitemsforthenotesandtodaysmeetingtoreview.
IreorderedtheDGACReportagendaitemsfororderofimportanceandflow.
Iveaddedareviewofthecrosscuttingchapterstatusofrecommendationstotodaysagenda
IntegrationchapterWecanscheduleanothercall.Whendoyouwantit.Thisreallyshouldbedonetoday,
althoughyoumentionedtheweekendisbetter.DoyouwantfeedbackfromAliceFIRSToronthecall?
ConceptualModelNadineismanagingthoseeditsandupdates.Shehasbeenemailingyouwithconsolidated
commentsandquestionsandneedstotalkwithyou.Sheneedsmorefeedbacktobeabletoresolvethe
commentsshehasgotten.Pleasefollowupwithher.ThisneedstogetfinalizedbyCOBSundaysothatitcango
throughcrossreviewwithintheIntroduction.ItneedstobefinallyformattedbytheCNPPgraphicsartist(not
yours),andtheyneedallnexttimetodothat.
FinalMeetingPresentationsTheyshouldtellthestoryoftheFINALrecommendations.Therewillnotbetimeto
talkabouttheprogressionoverthepasttwoyears.
Letsdeviseaplanforcompletion!Imhere!
Kellie

HiKelly,
Herearethedocumentsfortodayscall.Seemynotesandeditsfromtheminutesofourlastcall.Letsputhealthcare
ontotheagendafortodayscall(justanupdateonwhatcameofthefinalreviewsontherecommendationthatwetry
toframeourevidencesoastohelpthoseinHHSandhealthcarerelatedpositiontoconsiderthereportanduseitin
policy/programdevelopment.Thiswouldparticularlyentailtheevidenceonpopulationhealthrisksanddisparities,links
betweendietarypatternsandhealthoutcomes,andevidenceonwhatworksatindividualandpopulationlevelsto
changebehaviorforhealthpromotionanddiseaseprevention).
IhavenothadanyfeedbackontherevisedthemeorindividualrecommendationsthatIcirculatedsinceourcall.Ithink
Aliceisverybusykeepingtrackoftheiterationsonsaturatedfatandthecrosscuttingtopicsandmaynothavehada
chancetoiterate.ImfeelingthatitisprematuretocirculateanythingtothefullDGACandwemaynothaveanything
untilEOBMondayandthen,onlyifAlice,SRSCandotherscanprovidefeedback.TimingisverytightandIthinkwemay
alsoneedtosandwichinanotherSRSCcallmidweektoreviewthemodel,theintegrationchapterandthe
introduction.Yourthoughts?
317
PSC-HHS-000317
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Subject: FW: For review: 12.5.14 SRSC Meeting 59 Agenda.docx
Importance: High
BarbaraIdontseethatIhaveheardbackonthisagendaforSRSCtomorrow.Icansenditinthemorning.Butdohavea
fewquestionsinitforyoubeforeIcangetitoutthedoor.Thanks!
Kellie
From: Casavale, Kellie (OS/OASH)

To: bmillen@bu.edu
Subject: For review: 12.5.14 SRSC Meeting 59 Agenda.docx
Importance: High
BarbaraAdraftagendaisattachedforSRSCFridayforyourreview.Afewquestionsforyouinit.Ihaveanallday
meetingtomorrowsoIwillsendthisafterCOB/5:30pm.Draftnotesareattachedaswell.
Thanks,
Kellie
318
PSC-HHS-000318

From:
Sent:
To:
Cc:
Subject:
Attachments:

Anne Rodgers; 'Perez-Escamilla, Rafael'; 'Abrams, Steven A'; 'Millen, Barbara E';
Casavale, Kellie (OS/OASH); Olson, Richard (HHS/OASH);
colette.rihane@cnpp.usda.gov; 'Bodyk, Anjuli'; lhimes@bcm.edu; Bailey, Lauren A.;
PBROWN@hsph.harvard.edu
RE: REVISED SATURATED FAT IMPLICATION FOR YOUR REVIEW
SFA and PUFA jtb fh clean AHL-2 HU 12 4 clean AHL.docx
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'Perez-Escamilla, Rafael'; 'Abrams, Steven A'; 'Millen, Barbara E'; Lichtenstein, Alice; frank.hu@channing.harvard.edu;
Eve.Essery@cnpp.usda.gov
All,
BasedonveryrecentcommentsfromBarbaraandAlice,Frankhasrevisedthesaturatedfatimplications
statement.PleasereviewthisandsendanycommentstomeandKelliebyFriday,December5.
Thanksverymuch,
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)
319
PSC-HHS-000319

From:
Sent:
To:
Cc:
Subject:

Wednesday, December 03, 2014 8:28 PM
Frank Hu
Tom Brenna; Anne Rodgers; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH);
bmillen@bu.edu
RE: DGAC CROSS-CUTTING TOPICS CHAPTER FOR YOUR REVIEW
Lets get federal guidance on this. It is not something fall on a sword over.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Cc: Tom Brenna; Anne Rodgers; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); bmillen@bu.edu
Subject: Re: DGAC CROSS-CUTTING TOPICS CHAPTER FOR YOUR REVIEW
Alice,
These are implications, rather than conclusion statements (which should be evidence-based). My understanding
is that the implication statements can be developed for practical purpose, potential policy initiatives (e.g., added
sugar nutrition labeling), and generic guidance for individuals.
Frank
On Wed, Dec 3, 2014 at 8:20 PM, Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu> wrote:
I stand by my statement. If we dont have the data from our NEL SR we cant qualify with the word
refined.
320
PSC-HHS-000320
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

To: Tom Brenna
Cc: Anne Rodgers; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); Lichtenstein, Alice; bmillen@bu.edu
Thanks, Tom, for your thoughtful comments. I have no objection to restore the word "refined" before "tropical
oils".
Frank
On Wed, Dec 3, 2014 at 7:50 PM, Tom Brenna <jtb4@cornell.edu> wrote:

Health conscious American consumers, particularly some wishing to use more non-animal products, are
choosing virgin coconut oil as culinary fats and articles on it appear regularly in the press. To my knowledge,
the existing human studies, insofar as they isolate coconut oil effects at all, do not address VCO. On that basis
there is no evidence to make an unqualified statement capturing all of these oils regardless of production
method. As to evidence, ecological studies of populations that consume most of their fat as coconut (= virgin
coconut oil) have low, not high, CVD. These are concordant with animal data replicated in more than one lab
that show VCO lowers LDL while refined deodorized bleached (RDB) CO raises it in the same study - these are
not hydrogenated oils and they have identical fatty acid profiles showing that it is not the fatty acids. This is
also concordant with widespread understanding that cocoa butter, a saturated tropical oil, is non-atherogenic and
in fact cocoa butter (chocolate) is nearly always prepared as a virgin oil.
321
PSC-HHS-000321
I'll state again that I have no doubt that refined coconut oil and palm kernal oil (always refined) are to be
avoided.
I probably would not support an unqualified statement without seeing direct evidence that I suppose I may have
missed. It is likely to drive consumers away from VCO for no good reason. This sat fat recommendation is
going to generate enough bile without going there. I'd like to see the word "refined" restored.
Tom
On Wed, Dec 3, 2014 at 7:29 PM, Frank Hu <nhbfh@channing.harvard.edu> wrote:

Tom,
In the last version, Alice commented "This implies unrefined tropical oils are recommended. I dont think we
have the evidence to support that implication."
Do we have evidence to distinguish refined and unrefined tropical oils in terms of nutrient profile or health
effects?
How much of the tropical oils in the market is refined vs. unrefined? If the vast majority is refined, then it may
not be useful to qualify the types of tropical oils.
We could add a research question on refined vs. unrefined oils ??
Frank

FRank,
322
PSC-HHS-000322
The word "refined" disappeared in this version in this sentence.
"In practice, non-hydrogenated vegetable oils that are high in unsaturated fats and relatively low in SFA (e.g.,
soybean, corn, olive, and canola oils) instead of animal fats (e.g., butter, cream, beef tallow, and lard) or tropical
oils (e.g., palm, palm kernel, and coconut oils) should be recommended as the primary source of dietary fat."
I support "In practice, non-hydrogenated vegetable oils that are high in unsaturated fats and relatively low in
SFA (e.g., soybean, corn, olive, and canola oils) instead of animal fats (e.g., butter, cream, beef tallow, and lard)
or refined tropical oils (e.g., palm, palm kernel, and coconut oils) should be recommended as the primary source
of dietary fat."
and thought we settled on that (apologies for missing the recent call). Please advise.
Tom

Hi Anne,
Based on Alice's and Babara's comments today, i have revised the implication section for saturated fat. Can you
replace the current version of the implication (page 11) with the text from the attached file? Would you mind
sending the revised document with the new text on saturated fat to the group again for comments?
Thanks
323
PSC-HHS-000323
Frank
On Wed, Dec 3, 2014 at 6:38 PM, Anne Rodgers (b) (6)
wrote:
Rafael and Steve, Barbara and Alice,
On behalf of the Cross-cutting Topics Working Group, attached please find their chapter for your cross-review.
Please return any comments to me and Kellie by Friday, December 5 and I will pass them on to the Working
Group and relevant staff.
A couple of notes to keep in mind as you review:
When you review, please focus on substantive issues (e.g., major omissions, questions, or differences
with other chapters), not on editorial issues or minor points of content. We hope that this approach will
help you review the chapter within the short time period available.
If you have any comments or questions about references, please note them in marginal comments, not
directly in the text. The references are in EndNotes and any changes to them may disturb the formatting.
Thanks very much for your review of this chapter, and please let me know if you have any questions.
Anne
Anne Brown Rodgers
Science Writer
(b) (6)
324
PSC-HHS-000324
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
325
PSC-HHS-000325
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
326
PSC-HHS-000326

From:
Sent:
To:
Cc:
Subject:

Wednesday, December 03, 2014 8:21 PM
Frank Hu; Tom Brenna
Anne Rodgers; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); bmillen@bu.edu
RE: DGAC CROSS-CUTTING TOPICS CHAPTER FOR YOUR REVIEW
I stand by my statement. If we dont have the data from our NEL SR we cant qualify with the word
refined.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Tom Brenna
Cc: Anne Rodgers; Essery, Eve - CNPP; Casavale, Kellie (OS/OASH); Lichtenstein, Alice; bmillen@bu.edu
Thanks, Tom, for your thoughtful comments. I have no objection to restore the word "refined" before "tropical
oils".
Frank
Health conscious American consumers, particularly some wishing to use more non-animal products, are
choosing virgin coconut oil as culinary fats and articles on it appear regularly in the press. To my knowledge,
the existing human studies, insofar as they isolate coconut oil effects at all, do not address VCO. On that basis
there is no evidence to make an unqualified statement capturing all of these oils regardless of production
method. As to evidence, ecological studies of populations that consume most of their fat as coconut (= virgin
coconut oil) have low, not high, CVD. These are concordant with animal data replicated in more than one lab
that show VCO lowers LDL while refined deodorized bleached (RDB) CO raises it in the same study - these are
not hydrogenated oils and they have identical fatty acid profiles showing that it is not the fatty acids. This is
also concordant with widespread understanding that cocoa butter, a saturated tropical oil, is non-atherogenic and
in fact cocoa butter (chocolate) is nearly always prepared as a virgin oil.
I'll state again that I have no doubt that refined coconut oil and palm kernal oil (always refined) are to be
avoided.
327
PSC-HHS-000327
I probably would not support an unqualified statement without seeing direct evidence that I suppose I may have
missed. It is likely to drive consumers away from VCO for no good reason. This sat fat recommendation is
going to generate enough bile without going there. I'd like to see the word "refined" restored.
Tom
Tom,
In the last version, Alice commented "This implies unrefined tropical oils are recommended. I dont think we
have the evidence to support that implication."
Do we have evidence to distinguish refined and unrefined tropical oils in terms of nutrient profile or health
effects?
How much of the tropical oils in the market is refined vs. unrefined? If the vast majority is refined, then it may
not be useful to qualify the types of tropical oils.
We could add a research question on refined vs. unrefined oils ??
Frank
FRank,
The word "refined" disappeared in this version in this sentence.
"In practice, non-hydrogenated vegetable oils that are high in unsaturated fats and relatively low in SFA (e.g.,
soybean, corn, olive, and canola oils) instead of animal fats (e.g., butter, cream, beef tallow, and lard) or tropical
oils (e.g., palm, palm kernel, and coconut oils) should be recommended as the primary source of dietary fat."
I support "In practice, non-hydrogenated vegetable oils that are high in unsaturated fats and relatively low in
SFA (e.g., soybean, corn, olive, and canola oils) instead of animal fats (e.g., butter, cream, beef tallow, and lard)
or refined tropical oils (e.g., palm, palm kernel, and coconut oils) should be recommended as the primary source
of dietary fat."
and thought we settled on that (apologies for missing the recent call). Please advise.
Tom

Hi Anne,
328
PSC-HHS-000328
Based on Alice's and Babara's comments today, i have revised the implication section for saturated fat. Can you
replace the current version of the implication (page 11) with the text from the attached file? Would you mind
sending the revised document with the new text on saturated fat to the group again for comments?
Thanks
Frank
On Wed, Dec 3, 2014 at 6:38 PM, Anne Rodgers (b) (6)
wrote:
Rafael and Steve, Barbara and Alice,
On behalf of the Cross-cutting Topics Working Group, attached please find their chapter for your cross-review.
Please return any comments to me and Kellie by Friday, December 5 and I will pass them on to the Working
Group and relevant staff.
A couple of notes to keep in mind as you review:
When you review, please focus on substantive issues (e.g., major omissions, questions, or differences
with other chapters), not on editorial issues or minor points of content. We hope that this approach will
help you review the chapter within the short time period available.
If you have any comments or questions about references, please note them in marginal comments, not
directly in the text. The references are in EndNotes and any changes to them may disturb the formatting.
Thanks very much for your review of this chapter, and please let me know if you have any questions.
Anne
Anne Brown Rodgers
Science Writer
(b) (6)
329
PSC-HHS-000329
(b) (6)
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
330
PSC-HHS-000330

tel: 617 432 0113 fax: 617 432 2435
******************************************************
331
PSC-HHS-000331

From:
Sent:
To:
Cc:
Subject:
Attachments:

Wednesday, December 03, 2014 9:24 AM
Frank Hu; Essery, Eve - CNPP
Millen, Barbara E; (b) (6)
frank.hu@channing.harvard.edu;
PBROWN@hsph.harvard.edu; Casavale, Kellie (OS/OASH)
RE: DGAC: Saturated fat
SFA and PUFA jtb fh clean AHL.docx
Attached, with comments. Frank, thanks for turning around so quickly.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Essery, Eve - CNPP
Cc: Millen, Barbara E; Lichtenstein, Alice; (b) (6)
PBROWN@hsph.harvard.edu; Casavale, Kellie (OS/OASH)
Subject: Re: DGAC: Saturated fat
frank.hu@channing.harvard.edu;
It was a good call today. Based on our discussions, I tweaked the implication statement for saturated
fat. Attached please find a clean version and a tracked version.
Please free feel to edit.
Thanks
frank
On Tue, Dec 2, 2014 at 10:47 AM, Essery, Eve - CNPP <Eve.Essery@fns.usda.gov> wrote:
When:Tuesday,December02,20141:10PM2:00PM(UTC05:00)EasternTime(US&Canada).
Where:(b) (6)
Note:TheGMToffsetabovedoesnotreflectdaylightsavingtimeadjustments.
*~*~*~*~*~*~*~*~*~*
Ill open the line at 1:10pm. Im not sure if youll need until 2, but I put it on your calendar.
(b) (6)
332
PSC-HHS-000332
For discussion 10% quantitative recommendation on saturated fat.

Please see DRAFT cross-cutting chapter attached. The saturated fat section begins on page 9. Thanks!
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
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333
PSC-HHS-000333

From:
Sent:
To:
Cc:
Subject:
Attachments:

Sunday, November 30, 2014 7:28 PM
Essery, Eve - CNPP; Millen, Barbara E; Frank Hu
frank.hu@channing.harvard.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH)
RE: DGAC: Saturated Fat and CVD
SFA and PUFA.docx
See attached for my suggested comments.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Sunday, November 30, 2014 6:38 PM
To: Millen, Barbara E; Lichtenstein, Alice; Frank Hu
Cc: frank.hu@channing.harvard.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH)
Subject: RE: DGAC: Saturated Fat and CVD
Frankandall,
Thankyouverymuchforyourresponsesaboutthequantitativerecommendationforsaturatedfat.Iaskedthisquestion
becauseweknowthe10%recommendationisusedinanumberofFederalfoodassistanceprograms,andwellbeasked
aboutthisdirectly.Doyouthinkitwouldbepossibletostatethisinyourreport,possiblyinyourimplications?Ive
includedtwodraftoptionsforastatement(highlightedbelow).Preference,edits,additions,ordeletionstothis
statement?THANKYOU!!!
Eve
Implications
Recommendations on SFA intake should specify replacement macronutrients and emphasize PUFA and should
be based on food and overall dietary patterns. Individuals should consume a dietary pattern that is low in
saturated fat and emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products,
poultry, fish, legumes, non-tropical vegetable oils and nuts; and limits intake of sweets, sugar-sweetened
beverages and red and processed meats. The Committee recommends that emphasis be taken off the quantitative
recommendation of 10%; however, the 10% upper limit could be used as a general guide. ---OR--- The
Committee recommends that the 10% quantitative recommendation be discontinued; however, the 10% upper
limit could be used as a general guide. Non-hydrogenated vegetable oils that are high in unsaturated fats and
relatively low in SFA (such as soybean, corn, olive, and canola oils) instead of animal fats (such as butter,
cream, lard) or refined tropical oils rich in SFA such as palm and coconut oils should be recommended as the
primary source of culinary fat. Although a healthy dietary pattern is relatively low in SFA, it can include lean
334
PSC-HHS-000334
meats and non- and low-fat dairy products consistent with the USDA Food Patterns. Simply reducing saturated
or total fat in the diet by replacing it with any type of carbohydrates is not effective in reducing risk of CVD,
and thus dietary advice should put more emphasis on types of fat rather than the total amount of fat. The
carbohydrates sources in the dietary pattern should be primarily fiber-rich whole grains, legumes, fruits, and
vegetables and should minimize the amount of refined grains and added sugars. The consumption of low-fat
or nonfat products with high amounts of refined grains and added sugars should be discouraged.

Sent: Saturday, November 22, 2014 5:08 PM
To: Lichtenstein, Alice; Frank Hu; Essery, Eve - CNPP
Cc: frank.hu@channing.harvard.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH)
Iwouldagree.
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Frank Hu; Essery, Eve - CNPP
Cc: frank.hu@channing.harvard.edu; jtb4@cornell.edu; Millen, Barbara E; Casavale, Kellie (OS/OASH)
I agree with dropping 10% SFA and encouraging replacement of SFA with unsaturated fat,
particularly PUFA.
I dont think the issue of dairy should be bundled in with this issue. It should be explored and
addressed separately.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Friday, November 21, 2014 11:28 AM
Cc: frank.hu@channing.harvard.edu; Lichtenstein, Alice; jtb4@cornell.edu; bmillen@bu.edu; Casavale, Kellie (OS/OASH)
Subject: Re: DGAC: Saturated Fat and CVD
Eve,
Please see my response to your questions. I'd love to hear others' comments as well.
335
PSC-HHS-000335
On Fri, Nov 21, 2014 at 9:21 AM, Essery, Eve - CNPP <Eve.Essery@fns.usda.gov> wrote:
HiFrank,
IjusttobesureweclearlyunderstandwhattheDGACisrecommendingaroundsaturatedfat,particularlysincethereis
currentlyakeyrecommendationforsaturatedfatinthe2010DGA.Canyoureviewthestatementsandquestions
below?THANKS!
The2010DGArecommendationforsaturatedfatstates,Consumelessthan10percentofcaloriesfromsaturatedfatty
acidsbyreplacingthemwithmonounsaturatedandpolyunsaturatedfattyacids.
TheSaturatedFatWorkingGrouphasacknowledgedthathighsaturatedfatintakeisstillofconcern.Youhavealso
recommendedconsumingahealthydietarypatternlowinsaturatedfat.
Areyourecommendingthatthe10%quantitativerecommendationbediscontinued,remain,orthatit(orsomeother
percentorrangeofintake)beusedasageneralguide(butnotasakeyrecommendation)?
SINCE WE ARE FOCUSING ON OVERALL DIETARY PATTERNS/DIET QUALITY, I WOULD

RECOMMEND THAT THE 10% QUANTITATIVE RECOMMENDATION BE DISCONTINUED, ALONG
WITH OTHER NUMBERS (SUCH AS 35% TOTAL FAT, OR 3 CUPS OF DAIRY/PER DAY). THESE
NUMBERS, WHICH ARE ARBITRARY, HAVE CAUSED A LOT OF CONFUSION IN THE GENERAL
PUBLIC. NONETHELESS, 10% UPPER LIMIT COULD BE USED A GENERAL GUIDE.
Intermsofreplacement,wouldyourecommendthattheguidanceplacemoreemphasisonPUFAsthanMUFAsorCHO
fromhealthiersources(becausetheevidenceismorelimitedaroundMUFAsandhealthiersourcesofCHO)?
SATURATED FAT SHOULD BE REPLACED BY UNSATURATED FATS, WITH MORE EMPHASIS ON

PUFAs. IN PRACTICE, SINCE MANY FOOD SOURCES OF UNSATURATED FATS SUCH AS
VEGETABLE OILS AND NUTS INCLUDE A BLEND OF MUFAs and PUFAs, THERE IS NO NEED TO
GIVE THE EXACT PROPORTION OF MUFAs and PUFAs IN THE DIET, ESPECIALLY CONSIDERING
THAT THE MED-STYLE DIET WHICH IS RICH IN OLIVE OIL IS CONSIDERED A HEALTHY
DIETARY PATTERN IN SC2. IF INDIVIDUALS CHOOSE TO REPLACE SOME OF SATS WITH CHOs,
THEY SHOULD CHOOSE HEALTHY SOURCES OF CHO SUCH AS WHOLE GRAINS, LEGUMES,
AND F/V.
ON THE OTHER SIDE OF THE COIN, WHEN WE RECOMMEND PEOPLE TO CUT BACK ON
REFINED CHO/ADDED SUGAR, THEY SHOULD REPLACE THEM WITH HEALTHY SOURCES OF
CHOs AND FATS RATHER THAN SATURATED FAT.
336
PSC-HHS-000336

Thankyou!
Eve

Sent: Tuesday, November 18, 2014 8:36 AM
Cc: frank.hu@channing.harvard.edu; alice.lichtenstein@tufts.edu; jtb4@cornell.edu; bmillen@bu.edu; Casavale, Kellie
(OS/OASH); Obbagy, Julie - CNPP; Fisher, Rachel (NIH/NIDDK) [E]; McDowell, Margaret (NIH/NIDDK) [E]
Hi Eve,
attached please find a revised version of the saturated fat-CVD section. I have added an
introduction/background on this section and brief rationales for key research questions.
I look forward to everyone's comments/suggestions.
Frank
On Sat, Nov 15, 2014 at 9:39 PM, Essery, Eve - CNPP <Eve.Essery@fns.usda.gov> wrote:
Hi Frank,
Your saturated fat section of the report is almost complete. As indicated in the attached, please:
1. Add an introduction to the saturated fat section.
2. Finalize the research recommendations.
3. Make any needed changes following the DGAC public meeting (brief notes and action items from the meeting are
attached thanks Rachel!).
Once your changes have been made, Ill add this section to the Cross-Cutting chapter. As you know, we are now on a
tight timeline. Can you review and edit this by Thurs, Nov 20? If this is not possible, please let me know what will work
with your schedule.
337
PSC-HHS-000337
Thank you!
Eve

law and subject the violator to civil or criminal penalties. If you believe you have received this message in
error, please notify the sender and delete the email immediately.
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
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-338
PSC-HHS-000338
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tel: 617 432 0113 fax: 617 432 2435
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339
PSC-HHS-000339

From:
Sent:
To:
Cc:
Subject:
Attachments:

Sunday, November 30, 2014 5:32 PM
Anne Rodgers; 'Millen, Barbara E'
Casavale, Kellie (OS/OASH); Eve.Essery@cnpp.usda.gov
RE: CHAPTERS FOR YOUR CROSS-REVIEW
Part D Ch X_DRAFT_SC3 Chapter_Final for cross-review_11-20 AHL.docx
Not certain I was supposed to review SC3 chapter at this point, however, I started to I did. Please
forward to appropriate individuals, if appropriate.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: 'Millen, Barbara E'; Lichtenstein, Alice
Cc: 'Casavale, Kellie (OS/OASH)'; Eve.Essery@cnpp.usda.gov
Subject: RE: CHAPTERS FOR YOUR CROSS-REVIEW
HiBarbaraandAlice,
Imsorryiftheprocesshasbeenconfusingforyou.Hereisachartthatsummarizesallthereviewdates.Thechapters
thathavealreadygoneoutforcrossreviewarehighlightedinyellow.YouhavebothalreadyreviewedthePhysical
Activitychapter,soyoudonotneedtoreaditagain.PleasedoreviewtheSC1,3,and4chaptersandreturnthemto
meandKelliewithanycommentsbytheduedatesindicated.Iamattachingthosechaptershereforyourconvenience.
Acoupleofnotes:
SC1:ThischapterhastwopiecesafilewiththetextandaPDFwiththeaccompanyingfigures.
SC4:Thischapterincludesallofitssectionsexceptforworksites.Youhavealreadyreviewedthefoodaccess
andECEsectionsatanearlierstage;schoolsistheonlynewsectionforyou.Theworksitessectionisstillbeing
finalizedandwillgooutforcrossreviewonMonday12/1.
ThechaptersforSC2andSC5willgooutforcrossreviewtoday.Wouldyoulikemetoincludeyouontheemailtothe
crossreviewersorwouldyoupreferthatIsendbothchapterstoyouinaseparateemail?
SCIENCEBASECHAPTERS
Reviewers
Datesentout
Draftduebackto
AnneandKellie
Subcommittee1
AnnaMaria,Wayne Monday11/24
Tuesday12/1
340
PSC-HHS-000340
Subcommittee2
Subcommittee3
Subcommittee4
SteveA,Mim
Mary,Frank
Tom,SteveC
Subcommittee5
PhysicalActivity
CrosscuttingTopics
(sodium,addedsugars,
lowcaloriesweeteners,
saturatedfat)
OTHERSECTIONS
Section
Marian,Rafael
Cheryl,Lucile
Rafael,SteveA
Tuesday11/25
Friday11/21
Monday11/24(allbut
worksites);Worksites
willbesentMonday
12/1)
Tuesday11/25
Monday11/17
TBD
Reviewers
Datesent
ExecutiveSummary
ReportIntroduction
Integrationchapter
AllDGACmembers
AllDGACmembers
AllDGACmembers
Research
Recommendations
Methods
AllDGACmembers
Marian,Anna
Maria,Wayne
Wednesday12/3
Monday12/1
Monday12/1(allbut
worksites);Worksites
due12/2
Tuesday12/2
Monday11/24
Draftduebackto
AnneandKellie
TBD
TBD
Prelim:Monday11/24 Sat11/29
Final:Wed12/3
Friday12/5
TBD(discussedby
SRSC11/21)
Monday11/24
Tuesday12/2
PleaseletmeknowhowIcanmakethingsaseasyforyouaspossible.
Thanks,
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)

To: Anne Rodgers
Subject: Re: DGAC SC 1 CHAPTER FOR YOUR CROSS-REVIEW
Thatwasn'tclear.Ithoughtwesaweverything.
I'mgoingtoneedyoutosendthemtomeinoneemailwithdates.I'mintransitthroughthe30thandwilldothebestI
can.IthinkIhaveoverlookedsomealready.Pleaseresend.Barbara
SentfrommyiPhone
wrote:
OnNov25,2014,at1:40PM,"AnneRodgers"(b) (6)
HiBarbara,
341
PSC-HHS-000341

Pleasedoyourreviewsofthechaptersnow,concurrentlywiththecrossreviewers.Mostofthereviews
areduenextMonday(12/1)orTuesday(12/2)andtheSCswillbespendingtherestoftheweek
incorporatingthosecommentsandputtingthefinaltouchesontheirchapterssothatallthepiecescan
cometomebyFriday12/5.ThatmeansthereisnttimeforyouandAlicetoreviewthemafterthe
crossreviews.
Ihopeyourmeetingisgoingwell.Thanks,
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)

To: Anne Rodgers; alice.lichtenstein@tufts.edu
Cc: 'Kellie Casavale'
Subject: RE: DGAC SC 1 CHAPTER FOR YOUR CROSS-REVIEW
Justtoreview,werelookingatitoncethecrossreviewisdone.Correct?Orarewetolookatthis
point?IthoughtoncetheSCchairshandlethecrossreviewcommentsbutpleaseletmeknow.
Manythanks.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Monday, November 24, 2014 7:57 PM
To: Millen, Barbara E; alice.lichtenstein@tufts.edu
Cc: 'Kellie Casavale'
Subject: FW: DGAC SC 1 CHAPTER FOR YOUR CROSS-REVIEW
HiBarbaraandAlice,
IapologizeIneglectedtoincludeyouontheSC1crossreviewemail.Hereistheirchapter.
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)
342
PSC-HHS-000342

To: 'am siegariz@unc.edu'; 'campbellw@purdue.edu'
Cc: 'kellie.casavale@hhs.gov'; 'Richard.Olson@hhs.gov'; 'colette.rihane@cnpp.usda.gov'; Neuhouser,
Marian L; 'Patricia.Britten@cnpp.usda.gov'; 'amfiguer@email.unc.edu'; 'jgoyett@purdue.edu'
Subject: DGAC SC 1 CHAPTER FOR YOUR CROSS-REVIEW
HiAnnaMariaandWayne,
OnbehalfofSubcommittee1,attachedpleasefindtheirdraftchapterforyourcrossreview.Please
returnanycommentstomeandKelliebyTuesday,December2andIwillpassthemontoMarianand
relevantstaff.
IrealizethatIvealsojustsentyoutheMethodssectionforcrossreview.Ihopethatsectionwillnot
takeyoutoolongtoreviewasitisverystraightforwardandfamiliartoyou.
Acoupleofnotestokeepinmindasyoureview:
Whenyoureview,pleasefocusonsubstantiveissues(e.g.,majoromissions,questions,or
differenceswithotherchapters),notoneditorialissuesorminorpointsofcontent.Iwillbe
editingthechapterwhileyouaredoingyoursubstantivereview.Wehopethatthisapproach
willhelpyoureviewthechapterwithintheshorttimeperiodavailable.
Ifyouhaveanycommentsorquestionsaboutreferences,pleasenotetheminmarginal
comments,notdirectlyinthetext.ThereferencesareinEndNotesandanychangestothem
maydisturbtheformatting.
Thanksverymuchforyourreviewofthischapter,andpleaseletmeknowifyouhaveanyquestions.
Anne
AnneBrownRodgers
ScienceWriter
(b) (6)
343
PSC-HHS-000343

From:
Sent:
To:
Cc:
Subject:

Saturday, November 22, 2014 5:08 PM
Lichtenstein, Alice; Frank Hu; Essery, Eve - CNPP
frank.hu@channing.harvard.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH)
Iwouldagree.
Dr.BarbaraE.Millen
bmillen@bu.edu

Cc: frank.hu@channing.harvard.edu; jtb4@cornell.edu; Millen, Barbara E; Casavale, Kellie (OS/OASH)
particularly PUFA.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Eve,
HiFrank,
344
PSC-HHS-000344

below?THANKS!


AND F/V.
Thankyou!
345
PSC-HHS-000345

Eve

Hi Eve,
Frank
Hi Frank,
with your schedule.
Thank you!
Eve
346
PSC-HHS-000346

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tel: 617 432 0113 fax: 617 432 2435
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347
PSC-HHS-000347
tel: 617 432 0113 fax: 617 432 2435
******************************************************
348
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From:
Sent:
To:
Cc:
Subject:

Saturday, November 22, 2014 4:40 PM
frank.hu@channing.harvard.edu; jtb4@cornell.edu; bmillen@bu.edu; Casavale, Kellie
(OS/OASH)
particularly PUFA.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Eve,
HiFrank,
below?THANKS!
349
PSC-HHS-000349


AND F/V.
Thankyou!
Eve
350
PSC-HHS-000350

Hi Eve,
Frank
Hi Frank,
with your schedule.
Thank you!
Eve

351
PSC-HHS-000351

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tel: 617 432 0113 fax: 617 432 2435
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tel: 617 432 0113 fax: 617 432 2435
352
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******************************************************
353
PSC-HHS-000353

From:
Sent:
To:
Cc:
Subject:

Friday, November 21, 2014 11:45 AM
frank.hu@channing.harvard.edu; alice.lichtenstein@tufts.edu; jtb4@cornell.edu;
WhileIagreethatthecutpointsmaybearbitrary,itisalsohelpfultohaveguidestomakepointsclearforconsumers
andclinicians.ItwouldbealsohelpfultoknowhowachangemightimpactthemodelingworkTrishisdoingforSC1.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Cc: frank.hu@channing.harvard.edu; alice.lichtenstein@tufts.edu; jtb4@cornell.edu; Millen, Barbara E; Casavale, Kellie
(OS/OASH)
Eve,
HiFrank,
below?THANKS!
354
PSC-HHS-000354


AND F/V.
Thankyou!
Eve

Hi Eve,
355
PSC-HHS-000355
Frank
Hi Frank,
with your schedule.
Thank you!
Eve

356
PSC-HHS-000356
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tel: 617 432 0113 fax: 617 432 2435
******************************************************
-*******************************************************
tel: 617 432 0113 fax: 617 432 2435
******************************************************
357
PSC-HHS-000357

From:
Sent:
To:
Cc:
Subject:

Tuesday, November 11, 2014 7:14 AM
Britten, Patricia - CNPP; Neuhouser, Marian L
Casavale, Kellie (OS/OASH); Yamini, Essie (FDA/CFSAN)
RE: nutrients of concern
Very helpful to put in perspective. I am playing the role of the devils advocate here, given the topic is
so charged this year and trying to anticipate the critics. Coming through the AHA/ACC process has
been bruising.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
To: Neuhouser, Marian L; Lichtenstein, Alice
Cc: Casavale, Kellie (OS/OASH); Yamini, Essie
Subject: RE: nutrients of concern
HiMarianandAlice,
InreferencetothequestionAliceraised:Whilea1%differencedoesntsoundlikemuch,youneedtorememberthat
theentirerangeofsaturatedfatintakesisonlyfrom8%to15%(5thto95thpercentilesseeattached.).Further,only
29%ofthepopulationconsumeslessthan10%ofenergyassaturatedfat.Sotomeitseemslegitimatetocallsaturated
fatanoverconsumednutrient.Withanintakerangeof7percentagepoints,averageintakesare14%abovethe
recommendedlimit(1/7th)and71%ofthepopulationdoesntmeettherec.
Justmy2cents
Trish

Cc: Casavale, Kellie (OS/OASH); Britten, Patricia - CNPP
AllofSC1areavailableforacallthisweeksoletsputitontheagendatodiscuss
358
PSC-HHS-000358

Cc: Casavale, Kellie (OS/OASH); Britten, Patricia - CNPP (Patricia.Britten@cnpp.usda.gov)
Probably worth a discussion at some point. Traditionally we have linked SFA to %E of whole
diet. However, given we have recommended different total fat intakes over the years I am wondering
whether that is a good approach. We got in a bind with the AHA/ACC guidelines because we only
had low fat studies to base our recommendation on (~25% E) and they fed 5%-6% SFA. That may
be fine for a 25%E fat diet and is possible, as Trish so ability demonstrated, but difficult for a 30%35% fat diet.
Currently some people are above and some below the 10%E goal. On average the nation is
impressively close. I dont want to get criticized for just repeating what other committees have
said. Not certain whether there is a good solution but I figured I would bring it up.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Cc: Casavale, Kellie (OS/OASH); Britten, Patricia - CNPP (Patricia.Britten@cnpp.usda.gov); Neuhouser, Marian L
HiAlice
Thisisanexcellentquestionandwedoneedyourcontinuedinputonthisimportanttopic.Thankyouforbringingthis
up
Amongtheentirepopulationage2andoverthemedianintakeofSFAis11.1%oftotalenergy.Therearenumerous
subgroups,however,forwhomonlyafractionarebelow10%.AswiththeotherNOCwehavetakentheapproachthat
ifareasonablesubgrouparebelowtheEARoronlyareasonablefractionwereabovetheAIthenitwasnotedasa
nutrientofunderconsumption(shortfall)oranutrientofoverconsumption.Nutrientsforwhichwehadbiomarkerdata
and/ornutrientsthatposedhealthriskswerefurtherclassifiedasnutrientsofpublichealthconcern(NOC)
IfweconsistentlyusethisapproachthenSFAiscategorizedasanNOCbecauselargefractionsofsubgroupsdonotmeet
therecommendation(seeattached,page7).Forexampleamongmenandwomen>50yearsofage,only32%and31%
respectivelyarelessthan10%.Whenwelookattheoverallmedianitdoesnotgiveagoodrepresentationofthis.Given
this,IamcomfortableclassifyingSFAasanNOC,butnowisthetimetodiscussiftheexpertsinthisareaseeit
differently.
359
PSC-HHS-000359
Trishanythingtoadd?
Best,
Marian

Subject: nutrients of concern
I am still cogitating over our virtual meeting on Friday. I remain concerned about SFA being listed as
a nutrient of concern for overconsumption if we end up recommending 10%E since we are now at
11%E, very close. Might look like the assessment was a hold-over from 1980.
Marian, any thoughts?
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
360
PSC-HHS-000360

From:
Sent:
To:
Subject:
Attachments:

Friday, November 07, 2014 8:16 AM
RE: Public Meeting Slides and Reminders: DGAC Meeting 6
13. INTEGRATION and NEXT STEPS bem edits 11 7 2014.pptx
OK.Justsoyouhavethefinaldeck.OnlythenotesonSlide8havechanged.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Subject: RE: Public Meeting Slides and Reminders: DGAC Meeting 6
NotheyhaventaslongasyouprintedtheoneswhereIaddedthenamesandpicturesoftheSC/Wgchairsforthe
Integrationpresentation.ThatwasthelastchangeImadetoanyofthemGoingtoloadthemonthecomputernow.
Kellie

Subject: RE: Public Meeting Slides and Reminders: DGAC Meeting 6
Kellie,Haveminechangedatallfromlastnight?IprintedthosealreadyandwonderifIshoulddosoagain?Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

To: Alice Lichtenstein, DSc, MS; Anna Maria Siega-Riz, PhD, MS, RD; Millen, Barbara E; Cheryl Anderson, PhD, MS, MPH;
Frank Hu, MD, PhD, MPH; J. Thomas Brenna, PhD, MS; Lucile Adams-Campbell, PhD, MS; Marian Neuhouser, PhD, RD;
Mary Story, PhD, MS, RD; Miriam (Mim) E. Nelson, PhD, MS; Rafael Prez-Escamilla, PhD, MS; Steven Abrams, MD;
Steven Clinton, MD, PhD; Wayne Campbell, PhD, MS
Cc: Angelica Figueroa; Bailey, Lauren A.; Brianna.Knight@osumc.edu; Jennifer Connor; Ms. Lejuana Himes; Patrice
Brown ; Tidings Chan ; anjuli.bodyk@yale.edu; jgoyett@purdue.edu; Olson, Richard (HHS/OASH); Colette Rihane;
McPeak, Holly (HHS/OASH); Mosher, Amber (OS/OASH); Britten, Patricia - CNPP; Essery, Eve - CNPP; Piercy, Katrina
(HHS/OASH); Rahavi, Elizabeth - CNPP; De Jesus, Janet M (NIH/NHLBI) [E]
Subject: Public Meeting Slides and Reminders: DGAC Meeting 6
361
PSC-HHS-000361
DGACMembers,
Thecurrentversionsofyourslidesfortodayareattached.Ifyouhavenotdonesoalready,pleaseprepareyourwork
space:
Phoneline:Dialinginthroughalandlineispreferredoveracellphoneorthroughacomputer.Aheadsetconnectedtoa
phoneprovidesthebestsoundquality.
Computer:YouwillbewatchingthroughtheNIHwebcast(thesameviewasthepublic),butdialinginthroughyour
phone.Testyourcomputerwiththelinksbelow:
Testyourbrowserusingthistestpageathttp://videocast.nih.gov/browsertest/
(Therearenolivewebcastsuntiloursthismorningifyouwereunabletotestwatchaliveeventbeforetoday.)
Jointhemeetingat9:30amET(6:30amPT)forasoundcheckandreviewofprocedures.Thelivewebcastbeginsat10
amET(7amPT).Wewilldoanalphabeticalrollcalltocheckthequalityofyourphonesoundat9:30am.
WebcastLink:videocast.nih.gov
*Turnthesoundoffofyourcomputerspeakers.Yoursoundwillcomefromyourphone.
Callin:(b) (6)
LeaderPasscode:(b) (6)
*Afterenteringthepasscode,arecordingwillpromptyoutopress*0.
Press*0fortheoperatortojoinyoutothecall.
Attachments
Agenda
IntroductiontoSubcommitteeReports(Millen)
SC1
SC2
SC3
SC4
(SC5isnotpresenting;noslides)
IntroductiontotheCrosscuttingTopicsofDietaryGuidanceandPublicHealthImportance(Millen)
SodiumWG
AddedSugarsWG
SaturatedFatWG
IntegrationofFindings(Millen,SC/WGChairs/Leads)
Pleaseletusknowifyouhaveanyquestions.Thanks!
Kellie
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From:
Sent:
To:
Subject:
Attachments:

Thursday, November 06, 2014 6:56 AM
Essery, Eve - CNPP; Casavale, Kellie (OS/OASH)
RE: DGAC: Sat Fat and CVD
Lichtenstein head shot 2014.pptx
In future please use cropped photo, attached. Thanks.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Wednesday, November 05, 2014 7:54 PM
To: Lichtenstein, Alice; Frank Hu
Cc: bmillen@bu.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP; 'McDowell, Margaret
(NIH/NIDDK) [E]'; 'rachel.fisher@nih.hhs.gov'
Subject: RE: DGAC: Sat Fat and CVD
Hi Frank,
Attached are draft slides for your presentation on Friday. You will have 15 minutes to briefly discuss saturated fat and
CVD as part of the larger session on Cross-Cutting Topics of Dietary Guidance and Public Health Importance. The Added
Sugars Working Group and Sodium Working Group will also be presenting, and your slides are parallel to their
presentations. You can flip through the first few slides pretty quickly. Since you presented this question at the last public
meeting, I only included very brief introductory information. You can state that a more thorough review of the evidence
was presented at the last public meeting and that you are just re-presenting the draft conclusions and implications for
further discussion.
I know there was additional discussion on your implications statement during the SRSC call. Please update the slides with
how youd like to address the quantitative recommendation.
Let me know if you have any questions. Thanks for all you work!
Eve

Sent: Wednesday, November 05, 2014 1:04 PM
Cc: bmillen@bu.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP
Giving the matter more thought I wonder whether we can give a range of recommended SFA
intake. There is no magic/data for the 10% number or 7% number that has been used
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PSC-HHS-000363
previously. The AHA/ACC 5% to 6% range is based on two studies using a lower total fat diet
intakes, 26%-27%, the bottom of what we currently recommend.
I dont have strong feeling on to actual SFA cut point. Probably would be better to tie to percent of
SFA to total fat. Ten% SFA within the context of a 40% fat diet is very different than 10% SFA within
the context of a 25% fat diet. From an implementation perspective it has profound effects.
Regarding up to 10% PUFA I am aware of no organization that is currently recommending
that. Frank, which are you thinking of? If we are limiting SFA and PUFA to 10% each that is
20%. Are the data strong enough to recommend the balance be MUFA?
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Sent: Wednesday, November 05, 2014 11:21 AM
Cc: bmillen@bu.edu; Lichtenstein, Alice; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP
Subject: Re: DGAC: Sat Fat and CVD
Hi Eve,
attached please find my edits on saturated fat conclusion statements and implications based on Alice's and
Barbara's comments. It would be great we can we discuss these on SC2's call.
Shall we include specific cutpoints for saturated fat (<10% calories)? This is a question asked by a lot of people.
I think it is reasonable to include based on current evidence and population average (11-12%). I think this is a
realistic goal compared to 6-7%.
For PUFA, most organizations recommend up to 10% calories, which is also sensible.
Please let me know your thoughts.
frank
On Wed, Nov 5, 2014 at 10:44 AM, Essery, Eve - CNPP <Eve.Essery@fns.usda.gov> wrote:
Hi Frank,
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PSC-HHS-000364
Im pulling together your draft slides on saturated fat and CVD. Alice and Barbara provided comments on your draft
conclusions and implications in the attached. Can you send me your updated conclusions and implications to include in
the slides?
There isnt a sat fat call before the public meeting. However, if you need a minute to discuss this on SC2s call, I can ask
Anna Maria if we can include this on the agenda
THANKS!
Eve

Sent: Friday, October 31, 2014 6:43 AM
Cc: jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP; Anna Maria Siega-Riz
Verynicesummary!Iaddedafewcommentsandadvocatedthatweclarifytheconclusionsforconsistencywithour
dietarypatternlanguageinSC1andSC2andalsotofinetunethemainmessages.Ialsoaddedaresearch
recommendation
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Wednesday, October 29, 2014 9:23 AM
Cc: Millen, Barbara E; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP; Anna Maria Siega-Riz
I added some comments.
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TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Sent: Tuesday, October 28, 2014 8:07 AM
Cc: Lichtenstein, Alice; Millen, Barbara E; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP; Anna
Maria Siega-Riz
attached file.
On Tue, Oct 28, 2014 at 8:06 AM, Frank Hu <nhbfh@channing.harvard.edu> wrote:

Dear all,
attached please find a draft of the evidence summary on saturated fat and CVD. I would appreciate your
comments.
One question is whether we should say something about major food sources of saturated fat, considering that
the DGAC puts more emphasis on foods/patterns than individual nutrients.
Regards
366
PSC-HHS-000366
Frank
On Sat, Sep 13, 2014 at 10:11 PM, Frank Hu <nhbfh@channing.harvard.edu> wrote:

Eve,
Thanks. Attached are draft conclusion statement and implications for saturated fat and CVD. It would be great
if I can get feedback from Alice, Barbara, Tom, and Ana Maria before Monday's discussion at SC2 meeting.
The conclusion statements are longer than usual due to complexity of the evidence base and practical
implications in multiple dimensions.
I look forward to your comments.
Frank
On Sat, Sep 13, 2014 at 5:13 PM, Essery, Eve - CNPP <Eve.Essery@fns.usda.gov> wrote:
Hi Frank,
Yes, Ill send you the webinar and call-in information to join the SC2 meeting on Monday. The SC2 slides I sent last night
include a few slides on saturated fat, and the slides can be built out based on your discussion on Monday. I think if you
are ready to draft conclusions and implications, please do so! I plan to send out the draft agenda and attachments to
SC2 mid-day tomr. Unless I hear from you otherwise, Ill include this document as an attachment.
THANKS and talk soon,
Eve

Sent: Saturday, September 13, 2014 7:23 AM
Cc: Millen, Barbara E; Essery, Eve - CNPP; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP; Anna
Maria Siega-Riz

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Alice, Tom, and Barbara,
Thanks for your helpful comments. I have tried to incorporate them in the revised version as much as possible.
Some issues need to be discussed. Unfortunately I will not be at the meeting in person on Monday (will fly
there tuesday morning). I assume I can join the discussion via tel or Skype?
Eve, what's the next step? do we need to develop conclusion statement, implications? Do we plan to present
this section at the public meeting on Tuesday?
Frank
On Fri, Sep 12, 2014 at 8:19 AM, Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu> wrote:
Very nice job Frank. I added my comments to Barbaras.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
368
PSC-HHS-000368

Sent: Friday, September 12, 2014 5:43 AM
Cc: Lichtenstein, Alice; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP
Hereyougo.Verynicesummarywithstrongquantifiableoutcomes.Iwouldadvocateacoupleofthingsasnotedin
mycomments,inparticularsomeclarificationonmethodsandmodesofinterventionthataresuccessfulinachieve
theseresults,whatlevelofPUFAandSFAarerealistictoachieve(basedonthetrialevidenceandpossiblyPCs)sand
whetherthereareanyaddedbenefitsoftotalfatreductionwithPUFAsubstitutionforSFAand/orweightloss.
ManythanksEveandFrankforthisgreatworksoquickly.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Thursday, September 11, 2014 11:41 PM
Cc: alice.lichtenstein@tufts.edu; Millen, Barbara E; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP
Dear All,
attached is a draft key trend document. I'd appreciate your comments and suggestions.
Frank
On Tue, Sep 9, 2014 at 12:43 PM, Essery, Eve - CNPP <Eve.Essery@fns.usda.gov> wrote:
Hi Alice, Frank, Tom, and Barbara,
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PSC-HHS-000369
Attached are the materials we reviewed on Thursdays call for your question on saturated fat and CVD. Per your request,
we have added Jakobsen, which was not identified in the original search because it was not tagged as a meta-analysis.
We also added Skeaff, 2009 per Toms request. Skeaff was also not identified in the original search because it did not
include saturated in the title or abstract (no abstract available).
Please see the following attached:

1. Include/exclude list Please review and let us know if you think something was incorrectly excluded or is missing.
2. Evidence table
3. Reference overlap
4. PDFs of included articles
5. Key trends document Please provide brief responses to the questions to help inform your synthesis and
development of conclusions.
Does one of you want to take the lead and do a first pass and then do a round robin with the group?
Let me know if you need anything else.

Eve

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From:
Sent:
To:
Cc:
Subject:

Wednesday, November 05, 2014 1:04 PM
bmillen@bu.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP
Giving the matter more thought I wonder whether we can give a range of recommended SFA
intake. There is no magic/data for the 10% number or 7% number that has been used
previously. The AHA/ACC 5% to 6% range is based on two studies using a lower total fat diet
intakes, 26%-27%, the bottom of what we currently recommend.
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hi Eve,
374
PSC-HHS-000374
frank
Hi Frank,
the slides?
THANKS!
Eve

recommendation
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

375
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TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Maria Siega-Riz
attached file.

Dear all,
comments.
376
PSC-HHS-000376
Regards
Frank

Eve,
Frank
Hi Frank,
Eve
377
PSC-HHS-000377

Maria Siega-Riz
Frank
TuftsUniversity
711WashingtonStreet
378
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Boston,MA02111
phone:6175563127

Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Dear All,
379
PSC-HHS-000379
Frank

2. Evidence table

Eve

380
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From:
Sent:
To:
Cc:
Subject:

Wednesday, November 05, 2014 11:30 AM
bmillen@bu.edu; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Hi Eve,
frank
384
PSC-HHS-000384
Hi Frank,
the slides?
THANKS!
Eve

recommendation
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

385
PSC-HHS-000385
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

Maria Siega-Riz
attached file.

Dear all,
comments.
Regards
386
PSC-HHS-000386
Frank

Eve,
Frank
Hi Frank,
Eve

Maria Siega-Riz
387
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Frank
TuftsUniversity
711WashingtonStreet
Boston,MA02111
388
PSC-HHS-000388
phone:6175563127

Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Dear All,
Frank
389
PSC-HHS-000389

2. Evidence table

Eve

390
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From:
Sent:
To:
Subject:
Attachments:

Tuesday, November 04, 2014 7:24 AM
RE: Draft Slides- Millen
INTEGRATION and NEXT STEPS 11 2 14 bem edits 11 4 2014.pptx; INTRO to Crosscutting Topics MILLEN 11 2 14 bem edits 11 4 2014.pptx; INTRO to SC Reports MILLEN
11 2 14b bem edits 11 4 2014.pptx
Hereyougo.Pleasetakealookatthese.Ididntmakemanychangestotheslidesthemselvesbutdidinthenotesin
someplaces.Unfortunatelynoteeditsdonothighlight.Inparticular,pleaselookatSlides2,6,7and8intheIntro
presentationandthenslides346andnewslide11intheIntegrationdeck.Hopefully,thiscapturewhatyouwere
hopingfor.IwantedtoleavethegroupwithabitofinspirationandhopeIdidinSlide11.Letmeknow.
Theseideasforintegrationandfinalrecommendationarebeginningtosharpeninmymind.Lookingforwardtoour
discussionsandmeetings.
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Subject: Draft Slides- Millen
Importance: High
Barbara,
Threeslidedecksareattachedasastartingplaceforyourremarks!Ihopeitwillbeverynicetobeinthecomfortsof
yourhomeratherthanbehindapodiumthistimeAttachedpleasefind:
1. IntrotoSCReports(20min)Thispresentationisalmostidenticaltothepastcouplemeetings.Youprobably
haveitmemorizedbynow!Iupdatedthecommentaryabittobetimelytowhereyouarecurrentlyinthe
process.Thereisaplaceholderontheconceptualmodelsothatwecandiscusstomorrowwhatyoumightlike
toincludehere.
2. IntrotoCrosscuttingTopicsIntheafternoon,beforetheSodium,AddedSugars,andSaturatedFatWorking
Groupspresent,youhave10minutestosetthestageforwhytheDGACcreatedworkinggroups.Itsashort
slidedeck,andyoucanelaborateontherationalefortheimportanceofthesetopicsasCrosscuttingtopicsof
DietaryGuidanceandPublicHealthImportance.
3. IntegrationandNextstepsThereis20minutesforpresentation/discussiononIntegratingFindingsand10
minutesforyoutoreviewNextStepsbeforeRickadjournsthemeeting.Ijustincludedtheslidesfromthe
IntrotoSCremarksthathighlighttheoverarchingthemes,crosscuttingissues,andtopicscopesforthe5SCs
and4WGsasjustastartingplacetothinkaboutwhatwouldbemostusefultostateforthememberstoprovide
someinsightthatyoumightfindusefulinfleshingouttheoutlinefortheintegrationchapter.Wecaneditthese
tobewhateveryouwouldfindmostuseful.
394
PSC-HHS-000394
4. InternalAgendaLast,IattachedtheupdatedinternalagendathatIwillsendtotheentireDGACsothatyoucan
seeonthelasttwopageshowthesepresentationsoccurwithinthefullmeeting.Ihaveyettoaddthecallin
infoforFriday,butwillbeforeIcirculateit.
LetmeknowifyouhavequestionsorwhatIcanhelpyouwithfurther.WeneedyourfinalslidesbyThursdaynight.
Thanks!
Kellie
Rockville,MD20852
(240)4538252
395
PSC-HHS-000395

From:
Sent:
To:
Cc:
Subject:
Attachments:

Friday, October 31, 2014 6:43 AM
Lichtenstein, Alice; Frank Hu; Essery, Eve - CNPP
jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP; Anna Maria SiegaRiz
Evidence Summary CVD and Sat Fat 10 28 Frankhu AHL BEM.docx
recommendation
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Maria Siega-Riz
attached file.
Dear all,
396
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comments.
Regards
Frank
Eve,
Frank
Hi Frank,
Eve

Maria Siega-Riz

397
PSC-HHS-000397
Frank
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
398
PSC-HHS-000398

Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Dear All,
Frank
399
PSC-HHS-000399

2. Evidence table

Eve

400
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402
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From:
Sent:
To:
Cc:
Subject:
Attachments:

Thursday, October 30, 2014 5:32 AM
Essery, Eve - CNPP; 'Siega-Riz, Anna Maria'; 'alice.lichtenstein@tufts.edu';
'c1anderson@ucsd.edu'; 'jtb4@cornell.edu'; 'steven.clinton@osumc.edu';
'frank.hu@channing.harvard.edu'; 'mneuhous@fhcrc.org'; 'rafael.perezescamilla@yale.edu'
Olson, Richard (HHS/OASH); Rihane, Colette - CNPP; Bowman, Shanthy; Obbagy, Julie CNPP; Fisher, Rachel (NIH/NIDDK) [E]; McDowell, Margaret (NIH/NIDDK) [E]; Wong,
Yatping - CNPP; 'Anne Rodgers'; Casavale, Kellie (OS/OASH);
'PBROWN@hsph.harvard.edu'; 'jconnor@fhcrc.org'; 'Bailey, Lauren A.'; 'Knight, Brianna';
'Angelica Figueroa'; Fu, Stephenie - CNPP; Psota, Tricia - CNPP; anjuli.bodyk@yale.edu
RE: DGAC SC2: Call TOMR @ 11am ET (8am PT) - DRAFT chapter for review!
DGAC SC2_Compiled Chapter_SC review_10-27-14 bem edits 10 28 2014.docx
Hiall,
Congratulationsonthechapter!Itiscomingtogetherverywell.Itookquiteabitoftimetoreviewitinsomewhat
greaterdetail.Hopefullythiswillmakethenextlevelofrevieweasier.Afewoverallpoints.Itwillbeimportantto
reviewtheconsistencyacrossSCchaptersinthewordingofandemphasisinthedietarypatternstatements.Forthis
review,IsuggestedwordingthatwediscussedinthelastSC2call.YourwordingisveryclosebutyouwillnotethatIam
recommendingsomeslightediting.Also,thewhatworkscouldcomethroughabitstrongerbasedontheevidence,
particularlyasrelatedtoweightmanagement.IamsuggestingthattheAHA/ACCreviewofRCTsprecedethe
prospectivecohortliteratureinthatsectionofthechapter.Itthinkthismaybetterreflectthehighlevelofconcernover
ingrained,veryhighratesofoverweightandobesityinourpopulationandthemoderatetostrongevidenceonhow
besttomanageit.Also,InoticedthattheLookAheadDiabetestrialwasnotaddressedandthinkwecanusethe
AHA/ACCreportsforthatpurpose.ThoseinthefieldconsideritprettydefinitivesoIthinktheconclusionsandevidence
summaryonDMfromtheexistingreportsneedtobedrawnupontoaddtoourDMsection.Itwasnotuntilthecancer
sectionthattherewasmentionthatthecohortliteratureoftenonlydefinesdietaryexposures(orotherexposures)at
baselineandmaynotconsiderallrelevantpotentialconfounders.Youmaywishtoincludethisinthebriefdiscussionof
limitationsinthedietaryassessmentmethodsinyourintroduction.Ididthoughsoftenthewordinghereabit.Idont
thinkwewanttobesostronginourcritiqueofthesemethodsthatwetakeawayfromourconclusions.Thekeythingis
thatthelimitationswilladdtothebiastowardsthenullandmaytherebymakeourmoderatetostrongconclusions
whereweseethemthatmuchmoreimportant.
Ifyouhaveanyquestions,pleaseletmeknow.
Best,
Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Sent: Monday, October 27, 2014 5:46 PM
To: 'Siega-Riz, Anna Maria'; 'alice.lichtenstein@tufts.edu'; 'c1anderson@ucsd.edu'; 'jtb4@cornell.edu';
'steven.clinton@osumc.edu'; 'frank.hu@channing.harvard.edu'; 'mneuhous@fhcrc.org'; 'rafael.perez-escamilla@yale.edu';
Millen, Barbara E
403
PSC-HHS-000403
Cc: 'Olson, Richard (HHS/OASH)'; Rihane, Colette - CNPP; Bowman, Shanthy; Obbagy, Julie - CNPP; 'Fisher, Rachel
(NIH/NIDDK) [E]'; 'margaret.mcdowell@nih.gov'; Wong, Yatping - CNPP; 'Anne Rodgers'; 'Casavale, Kellie (OS/OASH)';
'PBROWN@hsph.harvard.edu'; 'jconnor@fhcrc.org'; 'Bailey, Lauren A.'; 'Knight, Brianna'; 'Angelica Figueroa'; Fu,
Stephenie - CNPP; Psota, Tricia - CNPP; anjuli.bodyk@yale.edu
Subject: DGAC SC2: Call TOMR @ 11am ET (8am PT) - DRAFT chapter for review!
Attached is the DRAFT compiled SC2 chapter (congrats!!). Anna Maria has requested that for tomorrows discussion, you
focus your review on the Chapter Introduction, Methodology, and Summary and come prepared to discuss your
comments, particularly related to any potential gaps in those sections. We will also talk about next steps for the chapter
review. Thanks and talk soon!
Eve
2015 Dietary Guidelines Advisory Committee

Subcommittee 2: Dietary Patterns, Foods and Nutrients, and Health Outcomes
Tuesday, October 28 from 11:00am to 12:00 pm ET (8:00 to 9:00 am PT)
Call-in number: (b) (6)
Access code: (b) (6)
Web conference: (b) (6)

404
PSC-HHS-000404

From:
Sent:
To:
Cc:
Subject:
Attachments:

Wednesday, October 29, 2014 9:23 AM
Millen, Barbara E; jtb4@cornell.edu; Casavale, Kellie (OS/OASH); Obbagy, Julie - CNPP;
Anna Maria Siega-Riz
Evidence Summary CVD and Sat Fat 10 28 Frankhu AHL.docx
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127
Maria Siega-Riz
attached file.
Dear all,
comments.
Regards
Frank
Eve,
405
PSC-HHS-000405
Frank
Hi Frank,
Eve

Maria Siega-Riz
Frank
406
PSC-HHS-000406
TuftsUniversity
711WashingtonStreet
Boston,MA02111
phone:6175563127

407
PSC-HHS-000407

Barbara
Dr.BarbaraE.Millen
bmillen@bu.edu

Dear All,
Frank

2. Evidence table
408
PSC-HHS-000408

Eve

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Part 2 of 2 Response To My 11/18/15 FOIA Request Re: 2015 US DGAC Members Barbara Millen, Alice Lichtenstein, Frank Hu

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Casavale, Kellie (OS/OASH)

Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu>

Anna Maria Siega-Riz, PhD

Anna Maria Siega-Riz, PhD

Miriam E. Nelson, PhD

From: <Millen>, "'Barbara Millen, DrPH, MPH, RD'" <bmillen@bu.edu>

Wednesday, February 25 3:30-6:00 p.m.

and what satellite arrangements might be possible at their institution.

All the best,

Casavale, Kellie (OS/OASH)

Millen, Barbara E <bmillen@bu.edu>

From: Kevin Grinberg [mailto:kevin@activefrequency.com]

Casavale, Kellie (OS/OASH)

Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu>

HealthDay News Servic

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Researchers found that... Read the full article

Health Tip: Avoiding Menopausal Weight Gain

findings to encourage their

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Casavale, Kellie (OS/OASH)

Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu>

Casavale, Kellie (OS/OASH)

Lichtenstein, Alice <Alice.Lichtenstein@tufts.edu>

Kellie, very much appreciated. Very well stated.

From: Lichtenstein, Alice [mailto:Alice.Lichtenstein@tufts.edu]

From: David Spence [mailto:dspence@robarts.ca]

Wednesday, February 11, 2015

Leading the News

to call for limiting cholesterol in diets.

Practice News: VA program needs physicians to provide veterans care

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Government and Medicine

NYTimes examines state efforts to expand Medicaid.

Senators back bill to exempt volunteer firefighters from employer mandate.

Health Coverage and Access

Study supports affordability of health insurance for students.

Quality and Safety

Google search to add illustrations, information on medical conditions.

Napping may help undo negative health effects of a sleepless night.

Surveys: Americans slowly embracing complementary medicine.

Researchers studying genomes of exceptional responders.

Health officials, senators agree on importance of

Obama to withdraw most US troops sent to Africa to contain Ebola.

Health and Diet

Pharma & Device Update

Tuesday's Lead Stories