By Dariush Mozaffarian, MD, DrPH
Dariush Mozaffarian is Dean of the Tufts Friedman School of Nutrition Science & Policy, and the Jean Mayer Chair and Professor of Nutrition. The only graduate school of nutrition in North America, the Friedman School produces trusted science and real-world impact in nutrition. Dean Mozaffarian joined us at Spotlight Health to talk about nutrition, health, and the tantalizing possibility that once-taboo foods are now good for you. In this piece, adopted from an essay published in the Huffington Post, he looks at why, during this election season, we’re ignoring the most pressing issue of our time: food.
Amid the hoopla and distractions of the 2016 elections, real issues have been raised and discussed. Questions have been posed, and answers proffered, on wide-ranging topics including jobs, Syria, tax policy, immigration, healthcare, education, the courts, banking, our relations with China, Russia, and Europe, and many more. While the replies may not always have been satisfying, at least these many subjects, from large to small, global to local, have been raised and considered.
Yet, astonishingly, the 2016 elections have so far ignored the one topic that is among the biggest challenges and opportunities of our time: our food. Whether for health, the environment, or the economy, nutrition is the dominant issue facing the world today.
Our food system is also the leading cause of environmental impact on the planet.
Poor nutrition is the leading cause of poor health in the United States and globally, causing more deaths and disability than any other factor. For anyone who has seen their doctor recently, or who cares for patients themselves, just pause to consider the irony: nutrition, the number one cause of illness, is largely ignored by the health system, whether in medical education, the electronic health record, reimbursement priorities, quality standards, or many other facets.
Our food system is also the leading cause of environmental impact on the planet. How we grow our food accounts for 70% of water use, 90% of tropical deforestation, immense challenges to the oceans and fish stock, and as much greenhouse gas emissions as all of the world’s transportation — cars, trucks, buses, planes, trains, and ships — combined. Whether for water, land, oceans, or climate, our food system is the crucial foundation for either harm or positive change. We need a secure, sustainable food system for our children and theirs.
Combining these health and environmental impacts, how we eat is easily the major economic issue of our time. We spend 3 trillion dollars each year on health care — 5 times more than all our military spending, and nearly 1 in 5 dollars in the entire US economy. From small businesses to major self-insured companies, the crushing cost of healthcare represents one of the greatest obstacles to growth, new jobs, and success. We’re fooling ourselves by arguing about cost-control through changes in insurance access, tort reform, copayments, drug development and pricing, or personalized medicine. Such advances may lead to greater efficiency and cost-effectiveness — i.e., a better health return on every dollar spent — but very rarely to actual cost-savings: actually spending less dollars. The only way to substantially reduce the hundreds of billions of dollars we spend each year on preventable and curable diseases is through better lifestyle in the population, and especially better dietary habits.
Remember Congress’ great budget sequestration battle in 2013? The entire disputed amount, across all the programs cut, was about $85 billion per year. Just the cost of diabetes and pre-diabetes — most of which is preventable and curable through better lifestyle — is $322 billion per year. If we add the costs of other diet-related diseases, such as heart disease, obesity and its many other downstream effects, cognitive decline, and several cancers, we easily reach $1 trillion annually. Imagine how much less wrangling and partisanship there would be, and how much more achievement and accomplishment, by returning all these dollars back into our coffers. Improving our food system, and how we eat, should be a bipartisan priority.
Importantly, our food system also contributes to harsh inequities. People with lower incomes and less influence often have the worst diets, leading to a vicious cycle of poor health, lower productivity, increased health costs, and poverty. And this starts early, with kids suffering less optimal development, decreased ability to concentrate and succeed in school, lower wages, and a greater chance of poor health. Food not only influences disease, the environment, and the economy, but has profound implications for equity and social justice.
How can this be? As we’ve watched the 2016 elections unfold, where are all the corresponding questions on food, nutrition, and health? On food and the environment? On the impacts on healthcare spending and the economy? On nutrition and social justice? This gap, between the size and scope of the problem and the attention it receives, is larger for food and nutrition than for any other issue.
As we enter the final phase of the election campaign, our food system should be front-and-center, receiving abundant attention from candidates, the media, debate moderators, and the public. Whether for president, congress, governorships, or local elections, the candidates must be familiar with nutrition’s central role in the current and future success of our nation, and the voters must demand to know where the candidates stand on the issues. This will lead to a new series of elected nutrition champions in federal, state, and local offices who make these health, equity, environmental, and economic issues a central platform of their efforts.
This is nutrition’s time.
Whether in the current administration or the next one, we also need another White House Conference on Nutrition. The last and only such conference was held in 1969–47 years ago. It was directed and organized by Dr. Jean Mayer, Special Consultant to the President, who went on to lead Tufts University and found the only graduate school of nutrition in North America, our Tufts Friedman School of Nutrition Science & Policy. That Conference achieved many successes, including improved programs for school lunch, child nutrition, and nutrition education; greater access to food assistance including a new program for Women, Infants, and Children (WIC); and consumer protection and information activities for the public and industry. Since that time, many other White House Conferences have been held on topics such as bullying (2011), conservation (2012), mental health (2013), working families (2014), and aging (2015, the sixth such White House conference since 1961). In 50 years, our food system has changed radically. A new, executive-level emphasis on food and nutrition is essential, including for health, hunger, medical care, jobs and the economy, and sustainability.
This is nutrition’s time. More than ever, the public is deeply interested in healthy and sustainable eating, while many across industry recognize that their success depends on being part of the solution. And, tremendous advances in nutrition science and policy science have us poised to deliver major breakthroughs toward a healthier and more prosperous America. With strong elected leaders, we can bring together modern science and robust stakeholder networks to achieve real change. And we could do this quickly, learning from past successes to accomplish in 10 years what required 50 years for tobacco reduction, 70 years for car safety, and 100+ years for water and sanitation.
But first, we have to have the conversation. If no one is talking about these issues, they will remain buried, overshadowed by tangential topics. As we enter the last lap of the 2016 elections, it’s time for food to be a major issue on the table.