The federal government’s approach to nutrition research is, at best, scattershot.
Right now, more than 10 departments and agencies invest in critical nutrition research, including the NIH, USDA, CDC, FDA and others. In total, less than $3 billion in funding is earmarked for this work, even though diet-related conditions and their societal burdens have climbed.
We know more about the food-related causes of conditions such as diabetes, heart disease and more, yet we as a country aren’t spending on the right solutions for them.
In June, at the #NutritionLiveOnline2020 event hosted by the American Society for Nutrition, the Federal Nutrition Research Advisory Group and others discussed ways to strengthen federal nutrition research, including new cross-governmental coordination and ways to boost spending overall. The result of all this was a white paper that was just released.
From the executive summary:
“Diet-related illnesses are the leading source of poor health in the US. Nearly 3 in 4 American adults are overweight or obese, and 1 in 2 have diabetes or prediabetes—and these rates continue to rise. Poor nutrition further contributes to cardiovascular diseases, several cancers, poor gut health, and many other disorders. Beyond effects on health, these diet-related diseases create enormous strains on productivity, health care spending, health disparities, and military readiness. Our food system also strains our natural resources, a crucial new area of intersecting science and policy.
“Profound disparities in both diet-related chronic diseases and food insecurity, for example, are experienced by low-income, rural, minority, and other underserved populations. Nearly 3 in 4 young Americans do not qualify for military service, with obesity being the leading medical disqualifier. Obesity and other diet-related chronic diseases are endemic among veterans, while obesity and food insecurity coexist in many active-duty military families. Over just 50 y, federal health care spending has risen from 5% to 28% of the federal budget, while US business (inflation-adjusted) spending on health care has increased from $79 billion to $1180 billion. Approximately 85% of current health care spending is related to management of diet-related chronic diseases. Estimated US government expenditures on direct medical care for diabetes alone (∼$160 billion/y) exceeds the annual budgets of many individual federal departments and agencies, including, among others, the Departments of Education (DoE), Homeland Security (DHS), and Justice (DoJ) and the NIH, CDC, Environmental Protection Agency (EPA), and FDA.
“These strains have been further exposed and exacerbated by coronavirus disease 2019 (COVID-19). This includes, for example, challenges related to hunger and food insecurity, major diet-related comorbidities for poor outcomes from COVID-19, insufficient evidence on optimal population resilience through better nutrition, and inadequate surveillance and coordination of our food system.
“Addressing each of these issues requires a better understanding of their multilevel, interrelated biological, individual, social, and environmental determinants, and the corresponding translational solutions. However, the current scope and pace of nutritional knowledge and discovery are insufficient to address the fundamental nutrition-related challenges facing the nation.”
I’m not one for more government, but sometimes the solution is obvious. This is one of those times.
$3B is a lot of money for the government to spend on anything, but it’s barely scratching the surface of this massive problem.
We spend about $1.7 trillion a year in the United States on food, and we spend another $1.2 trillion annually on health care related to diabetes, cardiovascular disease, and other chronic conditions that can be traced back to nutrition. In fact, the U.S.’s top five diet-related chronic diseases cost the U.S. economy $1 trillion each year, in terms of the estimated cost of direct medical costs and the indirect impact of productivity losses due to illness and premature death.
It’s not enough, and even the funds we are dedicating to this aren’t being managed properly in order to have the best impact. The white paper’s recommendation make sense: create a new Office of the National Director of Food and Nutrition and a new US Global Nutrition Research Program to oversee this. Create a new National Institute of Nutrition and National Center for Nutrition Research within the NIH to manage their funding. And expand USDA spending on nutrition research, education, etc.
Will it work? I don’t know. But right now we’re spending trillions on solvable health problems — it’s worth a shot.