Congress: Close the gap between funding for nutrition research and the toll diet-related disease takes on Americans (Stat)

STAT | You are what you eat. Every year, new scientific discoveries make clear that food is critical to health. In recent years, nutrition research trials have shown that a Mediterranean diet reduces cardiovascular disease; ultra-processed foods increase weight gain; omega-3 fatty acids improve IQ in preterm babies; cocoa prevents heart attacks; and vitamin D supplements do — well, almost nothing.

But many questions remain: What’s the best diet for weight loss? Do supplements really work? Can certain foods or better nutrition help cancer treatment, maintain brain health, treat autism, or improve immunity? What’s the best way to nurture the gut microbiome?

It will take years before answers to these and many other questions emerge — time the U.S. does not have as obesity and diet-related diseases rise at alarming rates. What’s needed right now is a national nutrition science moonshot.

Diet-related conditions are the leading cause of death and disability in the U.S. Not only is poor nutrition deadly, it’s expensive: The combined health care spending and lost productivity from suboptimal eating costs the economy $1.1 trillion each year. Obesity alone has far-reaching consequences for the education system, American workplace, and national defense, with 1 in 3 young adults disqualified to serve in the military because of excess weight. Americans who live in rural areas, have lower incomes, or are part of certain racial or ethnic groups often face higher rates of diet-related diseases like diabetes, obesity, stroke, and heart disease. The combined toll of poor nutrition is astronomical.

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It’s Time To Prioritize Nutrition: Better Diet Quality Leads To Better Health And Wellbeing For Americans (Forbes)

FORBES | 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.

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The White House Conference on Hunger, Nutrition and Health is an opportunity for transformational change (Nature Food)

NATURE FOOD | More than 50 years ago, President Richard Nixon convened the 1969 White House Conference on Food, Nutrition and Health, bringing together all the agencies of the US government, Congress and other stakeholders to address widespread hunger in the United States. That conference — chaired and organized by Dr Jean Mayer, the founder of the Tufts Friedman School of Nutrition Science and Policy — was historic in its vision, bipartisanship and impact. The insights and recommendations of the 1969 conference established nearly all of the major US food and nutrition programmes that are in place today. This included major expansion and harmonization of the National School Lunch Program; major expansion and harmonization of the Food Stamp programme (now the Supplemental Nutrition Assistance Program (SNAP)); creation of the School Breakfast Program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); and development of a new focus on food-based dietary guidelines and new consumer protections such as nutrition facts labelling2. Together, these policies achieved success in their major goal: to reduce caloric hunger nationally.

However, much has changed since 1969, and the United States and global community face stark new food and nutrition challenges. Chief among these are the intertwined pandemics of obesity and type 2 diabetes, as well as globally rising cardiovascular diseases, cancers and other diet-related diseases. In the United States, half of all adults have diabetes or prediabetes, while 3 in 4 are overweight or have obesity. In addition, undernutrition has still not been eradicated globally — a dire double burden of malnutrition. In 2020, about 3.9% of US households experienced very low food security, and an additional 6.6% experienced low food security.

In our nation and around the world, nutrition insecurity and diet-related chronic diseases also disproportionately afflict racial and ethnic minorities and lower income, rural and other underserved populations. At the same time, the industrialization of food, from the Green Revolution to food science, successfully mitigated the leading nutritional concerns of the twentieth century: mass starvation due to a soaring world population, endemic vitamin deficiency diseases, and common foodborne pathogens; however, it is not well designed for the needs of the twenty-first century: a fully healthy, just and sustainable food system. Together, these burdens on human health and natural resources are also producing tremendous economic losses in the United States and worldwide. The COVID-19 pandemic and the Russia–Ukraine war have further underscored fundamental weaknesses across our food systems, including fragile supply chains, persistent food and nutrition insecurity, and increasing inequities. COVID-19 also intersects directly with obesity, diabetes and hypertension, which are the top risk factors, beyond age, for poor outcomes from infection.

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Commissioner Califf needs to put the F back in FDA (Stat)

STAT | Robert Califf is taking the reins as commissioner of the Food and Drug Administration with the nation in a nutrition crisis. Americans are living shorter, less-healthy lives due to the foods they are being sold. The new commissioner can meet this challenge by harnessing the FDA’s effective but underused food-related regulatory powers, which were created with FDA itself for a similar food crisis more than 100 years ago.

At the turn of the 20th century, food was making Americans sick. Illnesses due to chemical and microbiological contaminants were among the top 10 causes of death. Food producers, eager to meet consumer demand for cheap, quick, appealing, and tasty food, were adding harmful ingredients without concern for people’s safety and were intentionally mislabeling food. Milk contained chalk and formaldehyde; canned foods had salicylic acid, borax, and copper sulfate; corn syrup was sold as honey; and colored animal fat from pig stomachs sold as butter. Food manufacturers were unchecked by government regulation, basic food safety, or labelling requirements.

Under the leadership of President Theodore Roosevelt and Harvey Wiley, a chemist working for the U.S. Department of Agriculture, the federal government was able to make the country’s food supply safer through research and policy. Wiley conducted groundbreaking research on food additives by testing them on a group of men that came to be known as “the poison guard.” This research culminated in sweeping food safety laws — and the founding of the FDA — through the 1906 Pure Food and Drug Act.

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Rethinking How And What We Eat With Dr. Mark Hyman (Forbes)

FORBES | If Dean Ornish is the father of lifestyle medicine, Dr. Mark Hyman is the food as medicine master. With his New York TimesNYT+1% best-selling books, a top-rated podcast, “The Doctor’s Farmacy,” and visionary leadership of the Center for Functional Medicine at Cleveland Clinic, Hyman is changing the conversation about the nation’s relationship with food to improve health—not just for brains and bodies, but for the planet.

I sat down with Hyman recently for my podcast, A Second Opinion, to talk about his latest book, “The Pegan Diet, 21 Practical Principles for Reclaiming your Health in a Nutritionally Confusing World.” As a heart surgeon who in the operating room daily witnessed the devastating consequences of diet-related disease, I truly appreciate Hyman’s no-nonsense and easily digestible guide to using food as a therapeutic tool for better health. And as a former policy maker in the Senate, I love his ability to connect the misaligned incentives of our government to the health of each of us—and what we can do about it.

Hyman’s innovative approach reminds me of the groundbreaking work of Ornish, who argued in our talk in 2020 that lifestyle change—including plant-based diets low in fat and sugar, regular moderate exercise, strength training, stress management and social support—can treat and often reverse life threatening conditions like heart disease and diabetes.

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How to wean America from its dangerous food addiction

(The Week, posted on May 22, 2012 )

By Bill Frist, M.D.

The nation’s obesity epidemic is as much about brain chemistry as it is poor diet and laziness — a fact we must realize if we’re going to treat obesity effectively

In ancient history, eating was for survival. Food was tough to come by and we consumed what we needed. Food was a necessity. In today’s America, it is an addiction.

Much of the conventional wisdom about obesity, including what your doctor has probably told you, is wrong. My fellow doctors, for the past four decades, have preached a “calories in — calories out” approach, suggesting that weight loss must be achieved by restricting calories or expending more energy. That approach is failing… miserably.

Contemporary medical research, most of which has not yet made it to mainstream understanding, suggests we should focus on two other more promising areas: Food addiction and diet. Consider it an “it’s what you eat” approach that takes into account human biology and the response to certain food types.

According to the research of Nicole Avena of Princeton University, eating sugar triggers a dopamine-mediated response in the same part of the brain that is similarly targeted by cocaine, nicotine, and other highly addictive substances. Originally, this “reward center” evolved to reinforce behaviors, such as food and sex, that maximize species survival.

To combat this epidemic, we may have to start with the brain, not the stomach.

Sugar, however, seems to hijack the same neural and biochemical connections in the brain. The intense cravings for sugar may be explained by the intensity of dopamine secretion in the brain when we consume sugar and high-fructose corn syrup, both of which are staples of the common American diet. Consistent eating of sugary and processed food literally rewires our brain. In 2011, 28 studies, from animal investigations to clinical studies of compulsive eaters, all point toward unhealthy foods as being addictive.

So why do we get fat? It’s not a simple matter of calories consumed and calories expended. It’s probably wiser to think of obesity as a result of a hormonal imbalance, with the dominant obesity hormone being insulin.

Insulin secretion is stimulated by eating easily digestible, carbohydrate-rich foods: Refined carbohydrates (including flour and cereal grains, starchy vegetables such as potatoes, and sugars) and high-fructose corn syrup. Eating more of these makes us fat, hungrier, and even more sedentary.

Why does all this matter? First, your kids are going to live a life with more disease and will die younger than they should. This does not have to be the case, but we can only reverse course if we act. With a third of adolescents in the U.S. overweight, and adolescent diabetes and prediabetes skyrocketing from 9 percent in 2000 to 23 percent in 2008, we are on the path to an explosion in heart disease, high blood pressure, and cancer.

Second, healthcare spending is driving you and the country bankrupt. Obesity, a problem which didn’t really exist even 40 years ago, today accounts for almost a fifth of our nation’s health spending, which amounts to more than $150 billion every year. That is an annual tax of $1,400 on every household, and it continues to escalate.

The good news is that the obesity problem is solvable. It is reversible, if we act smartly, both individually by our own life choices and collectively through wiser, more active public policy.

What can we do?

1. Focus on the root causes of why people crave food, often hungering for the unhealthiest options, and not just deal with the aftereffects. Studies show that exercise alone does not lead to weight loss (but it is very healthy for you!), replacing lost calories with increased appetite. It’s what you eat that you should concentrate on. Weight loss regimens succeed long-term when they get rid of the fattening carbohydrates in your diet.

2. Think out of the box. If the increasingly strong hypothesis that sugar is addictive is correct, we need to treat it as such. An addiction demands attention to replacement foods, development of new classes of anti-craving and relapsing medicines, and possibly even more intense use of 12-step programs for therapy.

3. Public policy tools and tactics that affect advertising, availability, and cost (including taxation) have been effective in fighting alcohol and tobacco addiction. Our society instinctively rejects policy that suggests “food police.” In the future, however, expect these tools to be considered much more aggressively since obesity stands as an even greater public health threat than tobacco.

We cannot afford to ignore obesity. But let’s be open to changing our approach. To combat this epidemic, we may have to start with the brain, not the stomach.


This article was originally featured in The Week