Hi and welcome back. We're now going to start the unit on nutrition and chronic disease and with me in the studio today are Ashton and Emily students in YSPH? So to start out our first part, I want to get into a little bit about the importance of diet and dietary choices, specifically with respect to chronic disease. So to remind you from our introductory segment, we talked a bit about cardiovascular disease and heart disease. And we showed this wheel of causation or the of the very many factors that contribute to heart disease. And many of these we talked about are preventable, and many of these are even traceable back to diet. A lot of the global burden with respect to chronic disease and obesity can be traceable to this high energy diet. That's not particularly nutritive, and then in trying to determine how to go about changing this or helping this, the panel concluded that really this requires social environmental changes. And these social environmental changes are those that will help individuals make better dietary choices. Again, some of the primary points are specific interventions or specific areas of improvement on various levels of the diet. And all the way it comes down to okay, we need to help individuals make better choices, but we needed to get at the policy level, that's really has to happen socially and environmentally. So now to kind of think about how we do things at the public health level, a lot of times we do it with respect to education, right? So we have for example the USDA Food Pyramid. Have you guys seen this before? >> Yes. >> Yes, do you remember the first time you saw it? >> Elementary school. >> Something like that. >> We really are. >> Right, yeah, I kind of feel like this was taught in kindergarten, right? >> Yeah. >> So we all know the food guide pyramid and how we're supposed to not have a whole lot of fats, but we are supposed to have lots of fruits and vegetables. And these are the kinds of things that the WHO report and other CDC sources and so on considered to be a high fat or a high quality diet or our dietary index is based on how well our daily dietary choices approximate or fit into the food guide pyramid, right? So this is like the healthy diet score and so on is based on this. So I want to remind you again of these slides that we also showed in the introductory lecture. So we pretty much we all know this, right? We're taught that some elementary school, we've learned in kindergarten. We all know, we don't have this at the top of the pyramid have lots of the healthy grains and fruits and vegetables and so on and 0.3% of it. Was that 0.0? I can't even tell. >> Is it 0? >> Is it 0.04 of adults are actually achieving- >> [LAUGH] >> A healthy diet score, right? So there's a gap between what we know and what we are able to do. So yes, there's this individual level achievement if you will but no one is able to do it, right? So why perhaps because we've got a environmental or social situation going on. And this is just to show you that children, the problem is also there, that very few kids are achieving the the ideal. >> Striving for the 0.0. >> For 0, right? >> So much for kindergarten. [LAUGH] >> Right, yeah, okay, and well and I'll talk a little bit about school programs to will provide some information about what might be happening around the school lunch program and so on. But okay, So now I want to know what's happening, all right? We know what we've got the information. In many cases we have access to the healthier options, of course, not everyone has access, so that's a big social problem we need to think about. But even for people who are in a privileged situation where they have access to healthy foods still getting 0.0.