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Remarks of Secretary Tom Vilsack at the Maine Medical Center

Location: Portland, ME

SECRETARY TOM VILSACK: Thank you. I want to thank everyone for being here today. Kevin and I had lunch yesterday and he was extraordinarily proud of Maine and Portland and what's being done here and I know he is disappointed that he's not part of this event today, but I will do my best to make sure that I say enough about him for you to know how much I appreciate his friendship. He served with me when I was governor of Iowa. He served as the director of our Department of Human Services. He did an extraordinary job there, so when I had this extraordinary opportunity, I called him again to service and he has -- he has really stepped up. I really want to thank the Maine Medical Center for giving us this opportunity to have this conversation today. And, Dr. Rogers, I'm very impressed with the -- with the decorations here. You can come to the USDA and help us convey -

DR. ROGERS: I would be happy to.

SECRETARY TOM VILSACK: I'm sure you would. And certainly the work that you are doing with Let's Go is really what it's all about. It's a combination of physical activity and education about what -- what's right in terms of nutrition. I want to thank Rich Petersen. What a great job you've done here. I'm really impressed with this auditorium. You don't normally see an opportunity like this in a medical center, so it's great to be here. And, Mayor, thank you for your leadership. I'm impressed with the work that you are doing to try to expand healthy food choices in your state or in your city and I'm sure that you're having an impact not just here in Portland, but across the state. James, thanks for pitching in for Kevin.

We have got several other folks here from USDA I want to recognize. Virginia Manuel is our RD director. Nice to see you. Don Todd is our FSA state director and Juan Hernandez, NRCS. Those folks are in the front row here today. And I know we have got representatives from the senator's office and from the congressional staff office as well. Let me start this morning by telling you a personal story. I started out life in a Catholic orphanage. I held out hope until about midday yesterday that I wouldn't be here, that I would have another opportunity, but a fellow from Argentina got it, so here I am.

Anyway, I started out life in a Catholic orphanage. And I don't know obviously much about my early life, but what I do know is when I was adopted into my family, they have this picture of me, it's the first picture that was taken of me, and I obviously -- I was obviously a fellow who was well fed in the orphanage. My parents used to say that when they went to the orphanage, they looked for a child that they believed was healthy, and I was the plumpest kid in the orphanage, and they thought if he's plump, he must be healthy. Food has always been a challenge for me. It has been a struggle. In my early life, when I was the age of some of these young people behind me, I was overweight. And going to school when you're overweight can sometimes be difficult. You can be confronted with folks making fun of you. Your self-image gets impacted. And obviously you really can't concentrate and you cannot be the student you were intended to be if you are worried about what people think of you, so weight has always been an issue for me and it's one that plagues me even today. It even got me to the point where -- I'm in the presence of a great athlete and Olympic star. I have actually run five marathons. Now I'm sure that my total time is probably the total amount of time that you've run in your entire life, but I finished that doggone distance five times and I still look the way I look, so you know that I've got eating issues.

But we in this country have a challenge with our children and I wish it was just a single challenge. I wish it was hunger or obesity, but the reality is they are twin evils. They are present in every city, in every town, and every school. There are youngsters who are dealing with weight issues and self-image issues and there are youngsters who are literally not well fed, and in some cases, not fed at all coming to school. And the impact of this is obvious. It obviously impacts the educational achievement of those youngsters. And these young people today are in a very extraordinary competition. They are not competing just with the youngsters in Maine or in Connecticut or in my home State of Iowa, they are competing against youngsters all over the world. These youngsters are in a world global competition and the competitors are training and educating and stretching and doing all the things that they can do to have what we have in this country, so they are hungry for success.

So these youngsters will face a competitive world unlike anything we have seen as adults and so they have got to be at the top of their game, so they can't be dealing with an image of, you know, am I overweight, do I not fit the right profile, am I hungry, can I not concentrate because I'm thinking about the fact I didn't have breakfast, so it's an educational achievement issue, and as a result, it's an economic security issue. It's also, as it's been alluded, a healthcare issue.

Youngsters who are hungry or those who are chronically overweight will have those chronic diseases that they take into adulthood and that will obviously increase the cost of healthcare and decrease the quality of their lives, so it's a healthcare issue, but this may surprise you. In addition to being an education issue and a healthcare issue and an economic issue, it is also a national security issue.

Interestingly enough, in 1946, when the school lunch program was established by President Truman, it was because he was concerned that we didn't have enough people consuming enough calories so that we would have enough young people to defend the country where we were put under attack.

Today, we have got retired admirals and generals in the mission readiness effort alerting the country to the fact that we have a shrinking number of young people physically fit and ready for military service. With an all volunteer military, if that pool of resources begins to shrink, you may not have sufficient numbers to meet the security needs that our country has. So this issue isn't just a feel good issue, this issue is really about the future of this country. And we have a challenge.

A third of our youngsters, obese or at risk of being obese. 10 percent of the households in this country have children who are living in a food insecure environment. 3.9 million households across the country have youngsters who at some point in time during the month may likely not get enough nutrition as they are expected to get.

So when I took this job and when I was given this opportunity from President Obama, I wasn't surprised that the very first thing he said to me, the very first instruction that he gave to me was he wanted our children to be well fed. That was the first thing he said. Because he understood the consequences of us not attending to this. He knew that if youngsters were going to have a shot at the American dream, if they were going to help rebuild the middle class in this country and strengthen this country, they had to be at the top of their game and nutrition was certainly an important part of it.

So I offer a few solutions today and offer good news in terms of the steps that are being taken at USDA to partner with state and local officials and with folks who are interested as Dr. Rogers is and you all are in creating new opportunities and new partnerships to make sure that our youngsters understand that healthy choices are the right choices.

We started obviously by affiliating ourselves with the First Lady's Let's Move initiative which is obviously an extension of the Let's Go initiative. It is really about calories in and calories out. You want those nutritionally dense calories coming in and you want to utilize that hour of time working, being outdoors, moving around, so that you -- you can have the proper balance. But we also looked at our own programs at USDA and the first thing we did was to look at women and infants and children and realized that we had a WIC program and we realized that we could reformulate the package of nutritional assistance that's being provided to young parents, to expectant moms, to infants and to young children. We reformulated that package to provide for more nutritious choices and we also gave them an opportunity to extend that choice to farmers markets.

We have been very much involved in expanding farmers markets and I will talk about that in just a few minutes, but now WIC recipients will be able to get a portion of their package satisfied at a farmers market, that link that the Mayor was talking about, keeping the economic activity here in a local way. We also focused on summer feeding. We recognized despite the good work of our school programs, that as soon as the school bell rang and school was over, millions of youngsters were put in a situation where they would be significantly food insecure during the summer months. And much of the good work that's done during the school year can take a back seat in the summer, so we have worked with mayors, we have worked with hospitals, we have worked with faith based organizations. We now have 38,000 sites that we're cooperating with across the United States to provide summer feeding opportunities and we are looking for creative ways to make sure that we get the foods to where the youngsters are. We are going to the ballparks and the swimming pools with mobile carts. We are encouraging the bible schools and the classes that take place during the summer to create nutritious snacks and meals.

We are working with these 38,000 sites to feed 143 million meals during the summer to nearly 3 million children. Now when you think about that number, just remember that 32 million children participate in the school feeding programs, 32 million in the school lunch program, and of that number, about 20 million are free or reduced lunch kids, so there's a difference between 3 million and 20 million which is why it's important for us to continue focusing, as the Mayor has, on expanding summer feeding programs and looking for additional partners. It doesn't take a lot of money and we can partner and we can provide resources under our nutrition programs to partner with you to create a good summer feeding program.

We also felt that it was necessary to address the issues in the school, but we didn't just want to do this without having some understanding of what needed to be done, so we asked the Institute of Medicine to go in and take a look at our school lunch and school breakfast programs and to give us a critical analysis of what we were feeding our youngsters. And they came back and they were quite clear about the nature of those meals. They said there's too much sodium, there's too much sugar, and there's way too much fat. You have got to reformulate and redesign those meals. You have got to have youngsters have opportunities for more fruits and vegetables, more whole grains and more low fat dairy. So we began a collaborative process with the School Nutrition Association and schools across the United States to formulate sort of a new focus, a focus that established that calories do matter and that the makeup of the meal matters, so we launched this new effort.

And candidly, we are learning about the process. There are some schools that are having a difficult time embracing this new change. There are others, especially the elementary schools, that are embracing it because these youngsters actually do want the healthy choices that we are providing, so there's a generational shift that's required and I think there's a generational shift that's taking place particularly among our young children. They get it. They want fruit. They aren't interested in sugary drinks. They are interested in more nutritious water or low calorie drinks. They want fruit. They want vegetables. They want milk products.

So we want to encourage that next generation as they continue through middle school and into high school to continue making those healthy choices, so that's one of the reasons why we not only reformulated the meal program, but we also said it is a matter of the a la carte line and the vending machines in schools, that we can't send an inconsistent message by suggesting more fruits and vegetables, whole grains and low fat dairy and focus on calorie counting and then have the vending machines filled with exactly the opposite. So we put out our competitive foods rule this year, it is now available for comment, and the gist of it is to substitute those unhealthy choices with healthy choices.

So you are going to see more water, you are going to see more low cal drinks, you are going to see fruits and vegetables in those vending machines that will reinforce the message that we are trying to convey.

Recognizing that maybe it's kind of hard to get some folks convinced that they should eat fruits and vegetables, we invited chefs from all over the United States to come into schools. We challenged them. We said here is a couple of bucks, what would you do with a couple of bucks, how could you make this meal something that a young person would want to eat. And it's amazing what the chefs have done. They have come up with extraordinary menus. In fact, we challenged the chefs and youngsters across the country in a contest. We said give us your best recipes. And so now on our website,, we've got a cookbook that contains some of the best recipes that you can do within the guidelines and financial resources of the Healthy Hunger-Free Kids Act that you can produce that are tasty.

I went to a school with Rachael Ray one day. It was turkey tacos. I was candidly a little suspicious. I'm serious, it was one of the best things I have ever eaten and it was within the guidelines -- financial guidelines set for school meals. So we have got Chefs Move to Schools, we have the cookbook, and we've also encouraged school gardens.

One of the first things I did as Secretary was to go out in front of the USDA building in Washington, DC. I took a jackhammer and I jackhammered out asphalt parking lot. I had done that as a construction worker as a kid, so it felt pretty good to get back into it. I didn't do it for very long, but I started it. And we got rid of that asphalt parking lot and we put in place an organic garden. We did this to celebrate President Lincoln's 200th birthday and we declared it as a people's garden. It's an educational tool as people walk around the building and they learn about the various things that we're growing and things of that nature.

Well, we said, you know, shoot, why stop with one garden? Why not encourage every location that USDA has to consider having a small garden? We have got FSA offices that actually are located where there is no green grass, no soil whatsoever, who have taken -- it's a sock-like material, filled it with compost, and they are actually planting things on a -- on an asphalt parking lot and that's their people's garden. We've harvested over 3 million pounds of fruits and vegetables and herbs and we gave them to food banks and community kitchens over the last year because now we have 1,865 of these people's gardens.

They are in schools, they are in communities, they are at FSA and RD and NRCS locations around the state and country. And we have partnered with Keep America Beautiful and they have helped to spawn an expanded garden opportunity. And school gardens are a great educational tool. They link youngsters to their food. They understand the risks of growing, they get a better appreciation for what farmers and ranchers do in this country, and they enjoy eating what they grow.

So we have done that and we have increased the reimbursement to schools so that they are in a little better situation financially to be able to pay for improved meals. We focused also on encouraging more breakfast consumption. We have 32 million children engaged in the school lunch program, but we have far fewer than that engaged in the school breakfast program. And one of the reasons is that 13 percent of our schools in America don't offer breakfast.

So we have partnered with Share Our Strength and their No Kid Hungry Campaign. They recently did a study of the impact of school breakfast and they found that youngsters who have school breakfast -- youngsters who have breakfast do better in school and they increase their opportunities to graduate by 20 percent from high school. So it's a real learning opportunity, so we are going to continue to encourage schools to look at school breakfast programs.

And it was mentioned that we have the Healthier U.S. School Challenge. We have seen a dramatic increase in the number of schools embracing that challenge. When we came into office, I think there were like 600 or 700 schools that qualified. Today, we have over 3800 and we just continue to add schools in large part because of the First Lady's efforts. And we partner. You all partner here. I've heard some of your partnerships. But we have an interesting partnership with the Dairy Council and our dairy producers. They have affiliated themselves with the National Football League. The National Football League has the Play 60 Initiative, but we just added a Fuel Up to Play 60 where we have low fat milk treats with NFL players coming in and explaining to youngsters at a young age the importance of nutrition and physical activity. And it's been a great partnership, you know. It's something that really gets people's - young people's attention when you bring an NFL or former NFL player into the school and they talk about the importance of nutrition to their success. It really gets kids thinking.

So we have been very, very active. We have been active in linking schools to the producers in their community. We have an aggressive Farm to School Program. In fact, Portland was a recipient of a grant from our Farm to School Program that basically allows you to have a better connection with your farmers. It just makes economic sense to try to maintain the dollars and the economic activity and so we want to see an expanded opportunity in schools linking up with local producers trying to figure out what is grown and raised in an area, and instead of having it trucked a thousand miles and all the gas emission issues that that entails, basically buying local and investing local.

So part of the solution is this generational shift. Part of it is in schools. Part of it is in the partnerships that we have and summer feeding programs. Another part of this is, as mentioned, access to food outside of school. And unfortunately, too many people in America today live in areas in cities and in rural areas which are called food deserts, areas where they frankly don't have access to even a small scale grocery store, much less a full scale grocery store. They may have access to a convenience store that has a very, very limited offering.

So we have just published and improved on our ERS site a food access research atlas which basically locates all of the food deserts in America, so you can go onto our website, you can put the clicker on Maine, and you can find where all of the food deserts exist in the State of Maine. And we have been working with our healthy food financing initiative with the Department of the Treasury, Department of Health and Human Services and USDA to help find the resources to encourage full scale grocery stores to be located in these food desert areas.

The Treasury Department has the tax credit program that they use, HHS has a grant program it uses, and we have technical assistance that can be provided to communities to help them locate a grocery store. Interesting example of this, Whole Foods is opening a store next month, I believe, or the month after in Inner City Detroit. I spoke to the CEO of Whole Foods, Walter Robb, he's a good friend. I said, Walter, it's great that you've got these great grocery stores, it's great, I can buy virtually anything I want. Frankly, when I go in that store, half the stuff, I don't even know what it is. It's great. Wonderful. But you know what, I can afford to go to your store. Not every American can do that. What are you doing for those folks who have -- don't have the paycheck I have? He said, what do you mean? I said, well, I just had a series of ministers come into my office from the City of Detroit -- inner city of Detroit and they are worried about their congregation. They see a lot of challenges from the food perspective. So he sent his team to Detroit, they came back and they said, you know, our business plan doesn't work in the inner city of Detroit.

To Walter's credit, he said, you know what, go back and make a different business plan. Tailor it to the inner city. So they did a survey of what people would want in a grocery store, they substantially reduced the size of the grocery store, and I believe that they are essentially operating it at no profit, bringing the cost down, provide the food that people want, develop relationships with the churches to provide incentives for people to come, and now that inner city of Detroit area is going to have a grocery store instead of a convenience store that sells only a very limited and expensive number of snacks. So we have to address the food desert issue in a creative way.

We are also significantly expanding farmers markets. There's been a 68 percent increase in farmers markets since I became Secretary in large part because myself and the Deputy, Deputy Merrigan, have worked on a program called Know Your Farmer, Know Your Food. It is designed to create and help promote local and regional food systems. This is an important component of rebuilding a rural economy. Not everybody can sell their wares on the commodity market and make it. Some of these smaller producers have to have the ability to sell directly to a consumer that they can see. Farmers markets provide that opportunity.

So we have seen this increase in part because of the promotion moneys that we are providing to farmers markets. And we are also encouraging our SNAP families, the families who are receiving food assistance, not just simply to use their card at the traditional grocery store, but we are expanding opportunities to use those cards at farmers markets, so we have seen a dramatic increase in the number of farmers markets, in fact, 100 percent increase where SNAP beneficiaries can go to a farmers market and use their card. We provide the resource to have the farmers market have the technology that will allow that card to be used.

Now some people will say, well, that's great, Mr. Secretary, it's great you are talking about more fruits and vegetables, but surely you know that it is a lot more expensive to eat fruits and vegetables than it is to eat some of the processed food that folks often buy. Well, we actually did a study recently that basically turned that notion on its head. The reason why we think fruits and vegetables are a bit more expensive is because the way in which we calculate it. We calculate it based on a 100-calorie portion, so you would ask yourself how much does 100 calories of potato chips cost versus 100 calories of broccoli. Folks, do you know how much broccoli you need to get to 100 calories? You need a lot of broccoli. And so it becomes easily more expensive, but if you did the calculation based on portion size, then it becomes a lot less expensive.

And so what we are trying to do through our SNAP education program and through a number of studies that we have done is to try to convince people that it's not as expensive as you might think. And we have a thrifty menu plan available on our website through our SNAP program that gives people recipes to extend and stretch that food dollar in a nutritious and appropriate way, so it doesn't always have to be expensive. And we are also trying to address this whole issue of, you know, how do I -- you know, the 5-2-1-0 program is great, easy to remember, but I don't know about you, but the food pyramid that we had, I'm Secretary, I said, well, I've got to know this. I really worked hard trying to memorize that thing. I just never got it. That little guy climbing up the -- I just never got it, so we developed the My Plate icon. I get this. Half your plate, fruits and vegetables. The other half, you know, your carbohydrates and protein. Really simple.

And so using that and the new dietary guidelines, we are promoting portion size and we are promoting what a healthy plate looks like. And we are seeing great acceptance of this icon and a great understanding of it. And we are providing tips for parents to promote this notion with their youngsters. We have got, another website. I really encourage you to look at this website because it has got planning techniques for communities that are interested in healthy choices. It has got tips for moms and dads who are hurrying and trying to get through a busy life, how they can put a meal together and still have it be nutritious with less focus on processed food that might have a high sodium or high sugar content.

We even got the kids involved. We had a kids contest to have a healthy food app for their iPhones so that they could have a better understanding of what they were consuming and the snacks that they were eating. And we finally have a thing called Super Tracker. To a certain extent, it's an interesting process. I signed up for it. It says, you know, what's your height, what's your weight, what's your goal, and if you say you want to lose 5 pounds, it will tell you that based on your height and weight and age, you should consume so many calories a day and then it gives you sample menus for that calorie count or that calorie amount. And then every couple of weeks, it sort of pings you on your e-mail, how are you doing, you know, it's like I haven't forgotten about you, are you still weighing yourself, are you still doing what you need to do, here's a tip, you can substitute this for that and reduce your calories, so it's a great tool.

So the generational shift, creating greater access to information and to healthy food. There is also an issue I think we have to address in the context of the fact that this is a complex set of issues and there are folks out there that sometimes focus on a very narrow piece of this and they get wound up about it. We have got - a lot of people talking about how many calories are in the school meals and whether that 230-pound linebacker is getting enough. There are snacks and there are ways in which that 230-pound linebacker -- I had a 230-pound quarterback in my family. I don't care what you do at school lunch, he's going to be hungry at 3:00 o'clock. No matter what you feed him, he's going to be hungry, and so we want to make sure that we have snacks available. But focusing on these smaller issues sometimes I think prevents us from looking at the broader challenge we face and we don't want to lose focus on the importance of this issue by getting down in the weeds on a particular aspect of it.

You know, there is obviously a discussion about Mayor Bloomberg's sugary drink ban and, you know, he's doing his best to try to control this, but we don't want that court battle to take us in a different direction and lose sight of what he's trying to do. And what he's trying to do and what we're trying to do is make sure that healthy choices are available, that portion sizes are appropriate, and it is sort of moderation in all things. So we are a little bit concerned about that and we are hopeful that people will redirect the conversation away from those small matters -- important, but small in the scheme of things -- and bring it back to healthy choices. Calories in, calories out, being conscious of the kind of calories you are consuming, making sure that you are creating the kinds of communities that encourage physical activity. And we want to be a partner at USDA in providing additional research as well.

We know that we don't have all the answers. We are doing continued research on how we make those meals attractive enough and what the strategies are for encouraging young people when they go into that lunch line to make the healthy choices. One interesting tip is -- there is a research project on it -- you have to think about this. If you go back in time to fifth grade or eighth grade, if you take some school districts that have decided to put their young people in some of the serving lines, not all of them, just some of them, so they put them in the salad bar. So there's, you know, captain of the football team at the salad bar. There is, you know, the leader of the school play at the salad bar. There's the valedictorian at the salad bar. What kind of message does that send do you think? Well, it sends that's the cool thing to do. And we have done research on this and it works. Kids gravitate to the salad bar and they take the salad, eat it, and go on their way. So, you know, there are lots of research things that need to be done so that we can create an atmosphere where people are making healthy choices.

Let me finish with this. So you can see that it is going to require time. It is going to require an understanding of the importance of this. It is going to require focus on access to information and quality food and a commitment to keep it going. This can't be just a fad. This really has to be something that gets ingrained in the way in which we do business in this country. So the nation's governors met in Washington, D.C. not so long ago and they invite celebrities to speak to them in their governors-only sessions. And this is the 50 state governors and four territorial governors, they get in a room, no staff, they bring a special guest in and they have a conversation. Well, I'm told that their guest was Dr. Oz.

Now Dr. Oz has entered my life because I have an iPad and apparently people know somewhere that I have struggled with my weight, because every time I open my iPad and every time I go to a website, there is always an ad for some miracle vegetable oil or something - some supplement that I can take that Dr. Oz has promoted and it is always there. And you are like really, is it really that easy to lose 10 pounds if I just take a little pill? Well, Dr. Oz was talking to the governors and one governor said, Doctor, what's the one thing that we can do as governors, if we couldn't do anything else, what could we do? And his point was you should focus on weight control, just, you know, proper weight, so if you did that, you would solve a significant number of your healthcare issues. Your budgets would be much stronger and your people would be much happier. That's why I'm here today. Because we think this is an issue that deserves the nation's attention.

We believe it requires us to work collaboratively and in partnership. And we may have differences of opinion about certain aspects of this, but we all ought to be sold on the notion that in order for these youngsters who are behind us and the youngsters that we care about to have the greatest opportunity for success, we as a country, we as adults, we as parents and grandparents have got to make sure that we help them make the best and healthiest choices they can make because it is central to their success and their success is central to our country's success. Thank you very much.

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