September should be a big month for nutrition. For too long, we have struggled and failed to curb food and nutrition insecurity, to mitigate rising rates of obesity, and to reduce the prevalence of diet-related chronic illnesses such as diabetes, hypertension, and coronary artery disease.
This issue is very real to many of us, but it is especially real to me.
For nearly 12 years as a cardiac surgeon, I operated five days a week on people’s hearts, palpating and coming face to face with fatty, calcified, and hardened coronary artery disease caused in large part by bad nutrition. I saw firsthand how, despite growing up hearing that “you are what you eat,” many of us fail to consume nutritious foods fundamental to promoting health and wellness. We know better.
Our nutrition – or lack thereof—has thwarted our nation’s health and wellbeing. And it’s costing many Americans their lives and their savings. It is time we act on what science, clinical medicine, and public health experts have long understood: our country must prioritize better nutrition policy.
Creating A National Strategy
During my 12 years serving in the US Senate, I saw the importance of smart, informed policy in effecting nationwide change, especially in the food and nutrition space. I am hopeful that we can begin to develop similarly impactful nutrition policy next week at the White House Conference on Hunger, Nutrition, and Health—the first such conference in over 50 years. This is a tremendous opportunity for leaders, policy makers, and stakeholders to radically enhance our nation’s health and wellbeing.
Historically, efforts to combat our nation’s food challenges have been focused on making sure that every American has enough to eat. And we should be extremely proud of the remarkable success our country has made since the last White House conference on hunger in 1969. But now , we face an entirely different set of crises that extend beyond just reducing hunger.
The greatest food challenges currently are bad diet, bad nutrition, and bad food choices. Our struggles in each of these areas are tearing down the health of most Americans, causing many of our health outcomes to move in the wrong direction, and are placing unbearable strain on our healthcare system.
The numbers don’t lie. Poor diets are making us sick and leading to rising healthcare costs. Each year over 300,000 deaths and more than 80,000 new cases of cancer are attributed to poor nutrition. Moreover, the healthcare costs for diet-related chronic diseases are estimated to be upwards of $604 billion per year with the broader health impacts of our food system costing Americans over $1 trillion. For a country that spends 19.7% of its GDP – nearly 1 in 5 dollars – on healthcare, this is inefficient, wasteful , and unacceptable.
In many cases these downward trends are only getting worse. The good news, though, is this is fixable. But it will take new bold policy, new investments in science, and new concerted alignment of political will and private sector action.
Informing The White House Conference
Throughout the summer I served as a co-chair for a Task Force that, in preparation for the upcoming conference, authored a nonpartisan Report with 30 specific recommendations. Our multi-sector, bipartisan, 26-member group was convened by the Chicago Council on Global Affairs, Food Systems for the Future, the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, and World Central Kitchen.
The 30 actionable recommendations were formulated from substantive suggestions and insight from across domains such as federal nutrition programs, public health and nutrition education, healthcare, science and research, business and innovation, and federal coordination. We focused on social benefit and cost savings, with the inclusion of both private sector perspective as well as those with lived experiences. But nutrition and science led the way.
Though each of the recommendations is significant, below are two that I believe are especially noteworthy: emphasizing “food is medicine” and cultivating a national nutrition strategy.
Accelerate access to “food is medicine” services to prevent and treat diet-related disorders: Health and wellbeing are intricately linked to the foods we eat. And, as a nation, we eat poorly. Just as food contributes to illness and disease, it also has the power to heal. Hospital systems, health plans, and practitioners should all be directly involved in food interventions. And rational, science-based policy should follow.
For instance, Medicare and Medicaid should expand reimbursement for medically tailored meals which have been shown to improve diet-related outcomes and advance health. And private sector entities have a major role to play as well. One example is Mom’s Meals which is already delivering annually more than 65 million medically tailored meals nationwide – most to vulnerable populations. With the right public policy working hand-in-hand with the private sector, we can accelerate much needed change at scale, advancing health and reducing costs in the process.
Create a new, national nutrition science strategy to improve coordination and investment in federal nutrition research focused on prevention and treatment of diet-related programs: We need better nutrition research and data. Robust data and evidence-based science are fundamental to developing the right policies and programs. Our Report found that nutrition-centric research is currently funded by more than 10 different government departments without coordination or eye to synergy.
Developing proper coordination for improved research and impact will require an increase in investment upfront. At Nourish Science, an organization cofounded by Dr. Jerome Adams, Thomas Grumbly, Jerold Mande and me, we specifically recommend increasing federal support for nutrition research by two billion dollars annually across multiple agencies, including the National Institutes of Health, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services. This increase will allow better oversight, coordination among agencies, and higher quality research and data on nutrition.
Accelerating “food is medicine” and creating a nationwide nutrition strategy will set the stage for strong policies and programs. These two recommendations are critical in linking nutrition with health and healthcare services and cultivating a culture of wellbeing.
Recommendations From Nourish Science
We established Nourish Science to help solve our nation’s food and nutrition crises, to cultivate a healthier population, and to eliminate health disparities in the process. The organization is orchestrated around the vision to ensure that every child reaches the age of 18 at a healthy weight . Here are three additional ways we suggest the White House take action:
- Support both the Food and Drug Administration and the US Department of Agriculture’s Food Safety and Inspection Service (FSIS) food regulation capabilities to reduce the chronic disease risk of processed foods by regulating food ingredients and additives, such as sweeteners, sodium, and refined carbohydrates.
- Make nutrition and diet-quality core objectives of the Supplemental Nutrition Assistance Program (SNAP) by using incentive programs, healthier retail environments, and more effective education programs.
- Appoint a Deputy Assistant to the President for food, nutrition, and health at the White House Domestic Policy Council who can oversee nutrition policy and research.
These three recommendations, if taken seriously by the Biden-Harris Administration, can lead to long-lasting, transformative change in the nutrition space.
Integrating Better Nutrition Into Federal Nutrition Programs
For the conference next week to be a success, I believe it must also underscore the principle that every American deserves fair access to the right, nutritious foods. But will the Biden-Harris Administration step up and prioritize nutrition—especially within federal nutrition programs— to combat the burgeoning obesity epidemic, and reduce disparities and diet-related disease?
Conversations have already tended toward expanding and increasing investment in our federal food support programs like SNAP. And, though this will increase food security for many, it alone does nothing to promote improved nutrition.
SNAP benefits are associated with a high sugar, ultra-processed diet. Data show that SNAP participants have worse nutrition than Americans not using the program, suggesting that the federal program may be aggravating many of the diet-related health problems we now face. A 2016 USDA report on SNAP purchases found that sweetened beverages (the number one contributor to weight gain over a lifetime) were the second most purchased product for SNAP households. In comparison, it was the fifth most purchased product for similar, non-SNAP households.
Four years ago, I co-chaired the Bipartisan Policy Center’s SNAP Task Force. Together we authored a report that recommended limiting the purchase of sugar-sweetened beverages with SNAP benefits. We urged that SNAP’s core objectives should be supplemented with a federal focus on nutrition and diet quality. Now is the time to make nutrition a key component of this program.
Any increasing investment in federal food support programs should be accompanied by simultaneously addressing our nation’s obesity and nutrition crises. If we truly want to combat hunger, improve nutrition, and reduce diet-related disease, we can start by doubling down on diet quality and nutrition specific research and education.
To tackle our nation’s most pressing food challenges, we must prioritize nutrition. Bad foods, bad diet, and overall bad nutrition are making Americans sick. Next week’s White House conference presents a wonderful opportunity to inform policy level change that will directly benefit the health and wellbeing of every American. But this will only be achieved if we prioritize nutrition in clinical settings, as a part of our federal nutrition programs, and if we double down on improving nutrition research and data.
The time to act is now. We can – and must – step up to ensure that every American has access to the right fuel for a happy, healthy life.