We Need Better Answers on Nutrition

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The U.S. is overdue to establish an institute devoted to research on the top cause of poor health.

By Joon YunDavid A. Kessler and Dan Glickman

Poor nutrition is a leading cause of poor health and spiraling health care spending. Research from the Tufts Friedman School suggests that poor eating causes nearly 1,000 deaths each day in the United States from heart disease, stroke or diabetes. In 2016, the direct and indirect costs of chronic diseases as a result of obesity were $1.72 trillion — almost 10 percent of the nation’s gross domestic product.

Poor eating also contributes to disparities in well-being, especially among children: a vicious cycle of bad health, lost productivity, increased health costs and poverty. Poor nutrition and obesity are also a major threat to military readiness. A recent report from Mission: Readiness, a group of more than 700 retired admirals and generals, noted that obesity is the leading medical disqualifier that prevents otherwise qualified Americans from joining the military.

Yet many of the most fundamental questions about foods and health — especially their impact on the economy and the military — remain unanswered. There is also tremendous confusion about what constitutes a healthy diet. Despite the urgency of these questions, the sum of research funding for nutritional research across all federal agencies — like the agriculture department, Health and Human Services and Department Defense — is only about $1.5 billion annually. To put this into perspective, national spending on candy purchases is about $40 billion per year.

That is why our country needs an institute devoted to research on the top cause of poor health. We would call it the National Institute of Nutrition, and it would be part of the National Institutes of Health.

The institute will facilitate and help coordinate incisive research into nutrients, foods and their relationships to better health. Some examples of its focus would include:

  • How to leverage food and nutrition policy and public-private partnerships in a “food is medicine” effort to reduce health care costs.

  • Optimal nutrition for military readiness.

  • Optimal nutrition for treatment of battlefield consequences, including bodily injuries, brain injuries and post-traumatic stress.

  • Relationships between the gut microbiome and health.

  • Personalized nutrition based on life stage, metabolism, health state, health goals and genetics.

  • Health and metabolic effects of major food groups for which effects remain unclear or controversial, such as cheese, yogurt, whole-fat milk, unprocessed red meat, coconut oil, fermented foods, organic foods and more.

  • Optimal diets for weight loss and weight maintenance.

  • Optimal diets to prevent and treat Type 2 diabetes and pre-diabetes.

  • Optimal diets for cancer, both to reduce side effects of chemotherapy and radiation and also to directly target the cancer.

  • Health effect of trace bioactives and phenolics, like those in extra-virgin olive oil, cocoa, green tea, coffee, red wine, blueberries and more.

  • Effective behavior change and systems approaches for healthier eating.

  • Effective approaches to reduce dietary and health disparities.

  • Effects of foods on brain and mental health, from the developing brain in infants and children to protecting against memory loss, dementia and depression later in life.

  • Effects of foods on allergies and autoimmune and inflammatory diseases.

  • Coordinated new science for translation into national dietary guidelines and policies, such as the Dietary Guidelines for Americans.

Discoveries in these areas will help bring down health care costs and recover productivity loss as a result of diet-related diseases like obesity, diabetes, heart disease, many cancers and more.

They will also benefit our military readiness, including treatment of injuries. A new nutrition institute will not include regulatory or enforcement functions. Those will remain at the Food and Drug Administration and Department of Agriculture. As the convening body for research in the country, the National Institute of Nutrition would encourage the participation of a large group of stakeholders providing important input into the science of nutrition.

There are numerous precedents for creating a nutrition research institute at the N.I.H., which was created by an act of Congress in 1930. Several new institutes have been added there in the years since: For example, in 1937, Congress passed legislation to add a new National Cancer Institute. Ideally, Congress would draft and pass a bill to create and fund a nutrition institute.

Although their existence and benefits today are obvious in retrospect, we did not always have— and thus needed to create — institutions such as the Institutes of Health and F.D.A. But their contributions have far surpassed our imagination. The N.I.H.’s original founding vision was to detect cholera and yellow fever. Yet, it began to help train young physicians and now supports cutting-edge research that helps treat and cure many types of diseases. Similarly, the F.D.A.’s founding vision was to regulate contaminated foods; now it helps bring safe and effective drugs to market. None of these mandates or benefits were foreseeable at their founding, and the same is true for founding a nutrition institute today.

Establishing a place to research nutrition is also crucial to retain American competitiveness. The governments of China, India and Japan fund similar institutions.

Improving the nation’s health through better nutrition will pay large and direct economic dividends. An independent analysis concluded that every $1 spent on research by the N.I.H. has led to $3.20 in economic gains, a return-on-investment of more than 300 percent.

Given the role of diet in health and well-being, the current challenges to our military readiness and the spending of one in four federal dollars and one in five dollars in our economy on health care, the right question to ask ourselves is, can we afford not having a National Institute of Nutrition.

Dr. Joon Yun is a radiologist and an American hedge fund manager. Dr. David Kessler served as the commissioner of the Food and Drug Administration for President George H.W. Bush and President Bill Clinton. Dan Glickman was the secretary of agriculture from 1995 to 2001.

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