This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:

• Timothy Coetzee, Fast Forward, LLC, National Multiple Sclerosis Society
• Marlene E. Haffner, Haffner Associates, LLC
• Steven E. Kahn, Division of Metabolism, Endocrinology, and Nutrition, Seattle VA Puget Sound Health Care System
• Michael S. Lauer, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by Alastair J.J. Wood, Symphony Capital, LLC. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.