With its ambitious plans to improve the nation’s health and food security, the White House will host a conference on hunger, nutrition and health this month, the first of its kind in more than 50 years.
While this is long overdue, medical professionals like me are heartened that the Biden administration has put this issue on its plate. They set themselves the lofty goal of ending hunger and increasing healthy eating and physical activity in the United States by 2030 so that fewer Americans suffer from diet-related diseases, such as diabetes, obesity and hypertension. It’s not just a national problem, but one that affects close to the nation’s capital: more than half of all adults in Washington, DC are affected by obesity.
While some are skeptical of achieving such ambitious goals in less than eight years, it can be done with the right Congressional commitment to our communities. There are concrete steps that, like diet and physical activity, will put us on the right path to better nutrition and better health. Major systemic changes can be made if our legislators are ready to seize the moment.
It starts with passing new legislation requiring providers to integrate nutrition education into health care.
Nutrition is the basis of health. According to the United States Government Accountability Office, the leading causes of death nationwide are directly linked to poor diet and nutrition. Although health care providers – not to mention the public – recognize that diet is the primary treatment for many chronic diseases, most of us do not have easy access to nutrition advice, primarily because our health care providers lack training in nutrition. This lack of training makes it virtually impossible to start the conversation and limits referrals to specialized services such as registered dietitian nutritionists and certified nutrition specialists. Another barrier to the involvement of nutrition specialists is low insurance coverage, which can be overcome by a referral clinician with sufficient nutrition training.
Fortunately, the U.S. House of Representatives passed a bipartisan bill (H.Res.784) in May to facilitate federal oversight and require “sufficient background training in nutrition and diet for physicians and healthcare professionals are meaningfully integrating nutritional interventions and dietary recommendations into medical practice. .” If this becomes law, it will help integrate nutrition training into the nationally required medical curriculum, ensuring that future physicians are equipped with the nutrition knowledge to better serve their patients.
Yet even if the bill is passed by the Senate and signed into law by the President, implementing nutrition education will take significant time, investment, and nationwide coordination.
To this end, we must also work from the bottom up.
It is essential that healthcare professionals discuss nutrition with their patients; however, all the training in the world won’t matter if people don’t have access to healthy food. One of the best ways to provide our communities with healthy food is to give the many existing community organizations working to improve food security and nutrition the resources they need to scale up their efforts.
According to the most recent data from the US Department of Agriculture, more than 38 million people – more than 10% of the nation – live in food-insecure households. In the nation’s capital, 1 in 10 residents, a third of whom are children, suffer from food insecurity.
How is this possible in an obesity epidemic? Obesity is a lack of nutritional security, which manifests itself in inexpensive, high-calorie foods that are largely devoid of vitamins and minerals. To be nutritionally safe, foods that promote well-being and prevent and treat disease must be readily available.
Fortunately, many community-based organizations embedded in urban and rural communities work diligently to fight hunger and provide culturally appropriate nutritional advice that is effective and well received by their communities. Rather than reinventing the wheel with new organizations or programs, government at all levels should support the growth of already successful organizations.
Another action we can take is to encourage businesses and consumers to make healthy choices. Too often, we focus only on discouraging unhealthy food choices, for example through sin taxes on junk food and soda, instead of incentivizing healthy food choices. Why not subsidize healthy foods instead of, say, corn, which is made into high-fructose corn syrup and added to ultra-processed foods that lead to weight gain and contribute to chronic disease and the cost of health ?
If people can get good food for less, they will buy it. While disincentives can be effective and appropriate in some cases, subsidizing healthy foods — at local grocery and convenience stores, as well as farm and mobile markets — can remove financial barriers for people looking for options. healthier while simultaneously addressing nutritional insecurity and diet-related chronic diseases.
While systemic change often takes time, there are system-level changes we can make now. Ultimately, millions of lives are at stake. Whether individually or collectively, life-changing health goals require a great deal of effort, investment, perseverance and patience. They can be accomplished, and we will all be healthier because of it.
Leigh A. Frame, Ph.D., MHS, CERT’20, is the executive director of the Office of Integrative Medicine and Health, co-founder and associate director of the GW Resiliency & Well-being Center, and professor of medicine at George Washington University.
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