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Approximately 30 percent of the edible food produced in the United
States is wasted and a significant portion of this waste occurs at
the consumer level. Despite food's essential role as a source of
nutrients and energy and its emotional and cultural importance,
U.S. consumers waste an estimated average of 1 pound of food per
person per day at home and in places where they buy and consume
food away from home. Many factors contribute to this
waste?consumers behaviors are shaped not only by individual and
interpersonal factors but also by influences within the food
system, such as policies, food marketing and the media. Some food
waste is unavoidable, and there is substantial variation in how
food waste and its impacts are defined and measured. But there is
no doubt that the consequences of food waste are severe: the
wasting of food is costly to consumers, depletes natural resources,
and degrades the environment. In addition, at a time when the
COVID-19 pandemic has severely strained the U.S. economy and
sharply increased food insecurity, it is predicted that food waste
will worsen in the short term because of both supply chain
disruptions and the closures of food businesses that affect the way
people eat and the types of food they can afford. A National
Strategy to Reduce Food Waste at the Consumer Level identifies
strategies for changing consumer behavior, considering interactions
and feedbacks within the food system. It explores the reasons food
is wasted in the United States, including the characteristics of
the complex systems through which food is produced, marketed, and
sold, as well as the many other interconnected influences on
consumers' conscious and unconscious choices about purchasing,
preparing, consuming, storing, and discarding food. This report
presents a strategy for addressing the challenge of reducing food
waste at the consumer level from a holistic, systems perspective.
Table of Contents Front Matter Summary 1 Introduction 2
Understanding Food Waste, Consumers, and the U.S. Food Environment
3 Drivers of Food Waste at the Consumer Level and Implications for
Intervention Design 4 Interventions to Reduce Food Waste at the
Consumer Level 5 Strategy for Reducing Food Waste at the Consumer
Level 6 A Research Agenda for Improving Interventions to Reduce
Food Waste and Their Implementation Appendix A: Public Session
Agendas Appendix B: Literature Search Approach Appendix C:
Additional Information on Food Waste Appendix D: Interventions to
Reduce Food Waste at the Consumer Level: Examples from the
Literature Appendix E: Research on Behavioral Change from Other
Domains Appendix F: Committee Member Biographical Sketches Appendix
G: Glossary
Older adults are a growing demographic group in the United States,
and a range of physical, social, financial, and cultural factors
affect their nutritional status. Metabolic and physiologic changes
that accompany normal aging modify the nutritional requirements of
older adults. An examination of evidence is needed to better
understand how nutritional status is associated with aging and risk
of mortality or chronic disease among older adults. Underpinning
many, if not most, nutritional problems in older adults is
socioeconomic status. Therefore, understanding access challenges to
healthy food, including geographic, financial, and transportation
barriers, also is needed to better understand how to meet the
nutritional needs of older adults. On October 28-29, 2015, the Food
and Nutrition Board convened a workshop, Meeting the Dietary Needs
of Older Adults, in Washington, DC. Participants examined factors
in the physical, social, and cultural environment that affect the
ability of older adults to meet their daily dietary needs. This
report summarizes the presentations and discussions from the
workshop. Table of Contents Front Matter 1 Introduction and
Background 2 Emerging Insights (Physiological) 3 Emerging Insights
(Ecological) 4 National Programs Addressing Dietary Needs of the
Older Population 5 Role of Community and the Food Sector 6
Potential Research Priorities and Gaps Appendix A: Workshop Agenda
Appendix B: Acronyms Appendix C: Speaker Biosketches Appendix D:
Planning Committee Biosketches
The U.S. food system provides many benefits, not the least of which
is a safe, nutritious and consistent food supply. However, the same
system also creates significant environmental, public health, and
other costs that generally are not recognized and not accounted for
in the retail price of food. These include greenhouse gas (GHG)
emissions, soil erosion, air pollution, and their environmental
consequences, the transfer of antibiotic resistance from food
animals to human, and other human health outcomes, including
foodborne illnesses and chronic disease. Some external costs which
are also known as externalities are accounted for in ways that do
not involve increasing the price of food. But many are not. They
are borne involuntarily by society at large. A better understanding
of external costs would help decision makers at all stages of the
life cycle to expand the benefits of the U.S. food system even
further. The Institute of Medicine (IOM) and the National Research
Council (NRC) with support from the U.S. Centers for Disease
Control and Prevention (CDC) convened a public workshop on April
23-23, 2012, to explore the external costs of food, methodologies
for quantifying those costs, and the limitations of the
methodologies. The workshop was intended to be an
information-gathering activity only. Given the complexity of the
issues and the broad areas of expertise involved, workshop
presentations and discussions represent only a small portion of the
current knowledge and are by no means comprehensive. The focus was
on the environmental and health impacts of food, using
externalities as a basis for discussion and animal products as a
case study. The intention was not to quantify costs or benefits,
but rather to lay the groundwork for doing so. A major goal of the
workshop was to identify information sources and methodologies
required to recognize and estimate the costs and benefits of
environmental and public health consequences associated with the
U.S. food system. It was anticipated that the workshop would
provide the basis for a follow-up consensus study of the subject
and that a central task of the consensus study will be to develop a
framework for a full-scale accounting of the environmental and
public health effects for all food products of the U.S. food
system. Exploring Health and Environmental Costs of Food: Workshop
Summary provides the basis for a follow-up planning discussion
involving members of the IOM Food and Nutrition Board and the NRC
Board on Agriculture and Natural Resources and others to develop
the scope and areas of expertise needed for a larger-scale,
consensus study of the subject. Table of Contents Front Matter 1
Introduction 2 The Economics of Food Prices 3 Understanding
Measures and Strategies 4 Examining Social and Ecological Costs and
Benefits 5 Attaching Value to Costs and Benefits 6 Exploring Costs
and Benefits 7 Reflecting on the Path Forward Appendix A: Workshop
Agenda Appendix B: Speaker Biographical Sketches Appendix C:
Workshop Attendees Appendix D: Abbreviations and Acronyms
Despite efforts over the past several decades to reduce sodium
intake in the United States, adults still consume an average of
3,400 mg of sodium every day. A number of scientific bodies and
professional health organizations, including the American Heart
Association, the American Medical Association, and the American
Public Health Association, support reducing dietary sodium intake.
These organizations support a common goal to reduce daily sodium
intake to less than 2,300 milligrams and further reduce intake to
1,500 mg among persons who are 51 years of age and older and those
of any age who are African-American or have hypertension, diabetes,
or chronic kidney disease. A substantial body of evidence supports
these efforts to reduce sodium intake. This evidence links
excessive dietary sodium to high blood pressure, a surrogate marker
for cardiovascular disease (CVD), stroke, and cardiac-related
mortality. However, concerns have been raised that a low sodium
intake may adversely affect certain risk factors, including blood
lipids and insulin resistance, and thus potentially increase risk
of heart disease and stroke. In fact, several recent reports have
challenged sodium reduction in the population as a strategy to
reduce this risk. Sodium Intake in Populations recognizes the
limitations of the available evidence, and explains that there is
no consistent evidence to support an association between sodium
intake and either a beneficial or adverse effect on most direct
health outcomes other than some CVD outcomes (including stroke and
CVD mortality) and all-cause mortality. Some evidence suggested
that decreasing sodium intake could possibly reduce the risk of
gastric cancer. However, the evidence was too limited to conclude
the converse-that higher sodium intake could possibly increase the
risk of gastric cancer. Interpreting these findings was
particularly challenging because most studies were conducted
outside the United States in populations consuming much higher
levels of sodium than those consumed in this country. Sodium Intake
in Populations is a summary of the findings and conclusions on
evidence for associations between sodium intake and risk of
CVD-related events and mortality. Table of Contents Front Matter
Summary 1 Introduction 2 Approach to Evidence Review 3 Sodium
Intake and Intermediate Markers for Health Outcomes 4 Sodium Intake
and Health Outcomes 5 Findings and Conclusions Appendix A: Acronyms
and Abbreviations Appendix B: Committee Member Biographical
Sketches Appendix C: Open Session Agendas Appendix D: Biomarkers
Figure Appendix E: Literature Search Strategy Appendix F:
Presentation of Results - Evidence Tables
Traumatic brain injury (TBI) accounts for up to one-third of
combat-related injuries in Iraq and Afghanistan, according to some
estimates. TBI is also a major problem among civilians, especially
those who engage in certain sports. At the request of the
Department of Defense, the IOM examined the potential role of
nutrition in the treatment of and resilience against TBI. Table of
Contents Front Matter Summary Part I: Background 1 Introduction 2
Nutrition in Clinical Practice Guidelines for Traumatic Brain
Injury 3 Understanding Pathophysiological Changes Part II:
Nutrition and TBI 4 Approach for Selecting Nutritional
Interventions: Mechanistic Targets 5 Acquiring Resilience to TBI
Prior to Injury 6 Energy and Protein Needs During Early Feeding
Following Traumatic Brain Injury 7 Antioxidants 8 Branched-Chain
Amino Acids 9 Choline 10 Creatine 11 Ketogenic Diet 12 Magnesium 13
Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) 14
Polyphenols 15 Vitamin D 16 Zinc Part III: Recommendations 17
Summary of Recommendations Appendixes Appendix A: Agenda Appendix
B: Evidence-Based Guidelines for Traumatic Brain Injury Appendix C:
Workshop Speakers' Papers Appendix D: Glossary Appendix E: Acronyms
Appendix F: Committee Member Biographical Sketches
Recent outbreaks of illnesses traced to contaminated sprouts and
lettuce illustrate the holes that exist in the system for
monitoring problems and preventing foodborne diseases. Although it
is not solely responsible for ensuring the safety of the nation's
food supply, the U.S. Food and Drug Administration (FDA) oversees
monitoring and intervention for 80 percent of the food supply. The
U.S. Food and Drug Administration's abilities to discover potential
threats to food safety and prevent outbreaks of foodborne illness
are hampered by impediments to efficient use of its limited
resources and a piecemeal approach to gathering and using
information on risks. Enhancing Food Safety: The Role of the Food
and Drug Administration, a new book from the Institute of Medicine
and the National Research Council, responds to a congressional
request for recommendations on how to close gaps in FDA's food
safety systems. Enhancing Food Safety begins with a brief review of
the Food Protection Plan (FPP), FDA's food safety philosophy
developed in 2007. The lack of sufficient detail and specific
strategies in the FPP renders it ineffectual. The book stresses the
need for FPP to evolve and be supported by the type of strategic
planning described in these pages. It also explores the development
and implementation of a stronger, more effective food safety system
built on a risk-based approach to food safety management.
Conclusions and recommendations include adopting a risk-based
decision-making approach to food safety; creating a data
surveillance and research infrastructure; integrating federal,
state, and local government food safety programs; enhancing
efficiency of inspections; and more. Although food safety is the
responsibility of everyone, from producers to consumers, the FDA
and other regulatory agencies have an essential role. In many
instances, the FDA must carry out this responsibility against a
backdrop of multiple stakeholder interests, inadequate resources,
and competing priorities. Of interest to the food production
industry, consumer advocacy groups, health care professionals, and
others, Enhancing Food Safety provides the FDA and Congress with a
course of action that will enable the agency to become more
efficient and effective in carrying out its food safety mission in
a rapidly changing world. Table of Contents Front Matter Summary
Part I: Setting the Stage for Understanding and Improving the U.S.
Food and Drug Administration's Role in the Food Safety System 1
Introduction 2 The Food Safety System: Context and Current Status
Part II: Toward a Stronger and More Effective Food Safety System 3
Adopting a Risk-Based Decision-Making Approach to Food Safety 4
Sharing the Responsibility for a Risk-Based System: Models of
Governance and Oversight Part III: Implementation of the New Food
Safety System 5 Creating an Integrated Information Infrastructure
for a Risk-Based Food Safety System 6 Creating a Research
Infrastructure for a Risk-Based Food Safety System 7 Integrating
Federal, State, and Local Government Food Safety Programs 8
Enhancing the Efficiency of Inspections 9 Improving Food Safety and
Risk Communication 10 Modernizing Legislation to Enhance the U.S.
Food Safety System 11 Achieving the Vision of an Efficient
Risk-Based Food Safety System Appendix A: Workshop Agendas Appendix
B: Past Recommendations About the U.S. Food and Drug
Administration's Food Safety Program Appendix C: Food Safety
Systems in the United States and Other Countries Appendix D: The
U.S. Food and Drug Administration's Food Defense Program Appendix
E: The U.S. Food and Drug Administration and Imported Food Safety
Appendix F: Food Safety Research at Intramural and Extramural U.S.
Food and Drug Administration Research Centers, by Topic Appendix G:
U.S. Food and Drug Administration Food Protection Plan Appendix H:
Glossary Appendix I: Acronyms and Abbreviations Appendix J:
Committee Member Biographical Sketches
Physical fitness affects our ability to function and be active. At
poor levels, it is associated with such health outcomes as diabetes
and cardiovascular disease. Physical fitness testing in American
youth was established on a large scale in the 1950s with an early
focus on performance-related fitness that gradually gave way to an
emphasis on health-related fitness. Using appropriately selected
measures to collected fitness data in youth will advance our
understanding of how fitness among youth translates into better
health. In Fitness Measures and Health Outcomes in Youth, the IOM
assesses the relationship between youth fitness test items and
health outcomes, recommends the best fitness test items, provides
guidance for interpreting fitness scores, and provides an agenda
for needed research. The report concludes that selected
cardiorespiratory endurance, musculoskeletal fitness, and body
composition measures should be in fitness surveys and in schools.
Collecting fitness data nationally and in schools helps with
setting and achieving fitness goals and priorities for public
health at an individual and national level.
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