A National Focus on Food as Medicine

On Wednesday, September 28^th, 2022, at the White House Conference on Hunger, Nutrition and Health, President Biden introduced a national strategy that recognizes the critical role that nutrition plays in health.  Efforts were spurred by the fact that 80% of our health expenditures go to treat preventable illnesses, and that one in ten households still do not have access to enough food.   He gathered elected officials, as well as philanthropic chef José Andrés, and private citizens, including young activists, to speak regarding the need for action and to highlight the creative community efforts already undertaken.    

We have known for decades that what we eat affects our health, but traditionally, that has not been the focus of healthcare.  Preventable diseases like high blood pressure, high cholesterol, type 2 diabetes and coronary artery disease are often the result of doing too little activity and of eating too many high calorie processed foods that have too few nutrients.  Additionally, we have 10% of our population suffering from hunger with insufficient calories and nutrients. 

Mayor Eric Adams of NYC told his own story of having lost his sight with a new diagnosis of diabetes.  He said, “It wasn’t my DNA, it was my dinner,” that caused his diabetes.  He changed to a plant-based diet and was able to reverse his diabetes.  His mother was previously dependent on insulin, and was able to stop using it after changing to a plant based diet also.  

In New York, led by Bellevue, there are now 11 hospitals that serve plant-based meals to their in-patients as the default choice.  When I was in training, all patients, including those admitted for heart attacks or strokes, were served meat or eggs and bacon, or other equally unhealthy choices, at a time when they would be eager to learn about how to better serve their bodies. What we were told at the time was that they should be given whatever protein they’re willing to eat so the damage would heal.  We all get more than enough protein.  Well-prepared lentils or veggie burgers could make their debut here. 

The Secretary of Health and Human Services, Xavier Beccera said it well: “It is better to build strong children than to repair broken men.” (and women!).

Proposed policy changes include educating young students about nutrition and its importance in their long-term health, and offering fresh, tasty, plant-based foods at school.  This might include having local food management specialists assist with recipes, and purchasing more products from local farmers.  This would result in healthier meals and stronger rural economies.  All neighborhoods need to have access to healthy foods. Overall planning would also include increased access to parks, more hours of physical education in school and in after school programs.  

The students in some schools already have Meatless Mondays or Plant Powered Fridays, and can bring these ideas home.  SNAP dollars (formerly known as food stamps) in some communities can be leveraged to “double up bucks” at farmers markets to purchase produce.   Some schools have gardens. Some pediatrics clinics write prescriptions or give vouchers for produce.  

For those covered by Medicaid and Medicare, there will be improved access and coverage for nutrition and obesity counseling.  Education is planned for the general population, but also for physicians and other healthcare professionals, since historically we have had very few hours of formal teaching in this realm.  

José Andrés, a Spanish American chef and founder of the World Central Kitchen, has supplied millions of meals domestically and in disaster areas.  He spoke eloquently and from the heart.  He noted that most of us can’t appreciate the feeling of extreme hunger, of barely being able to concentrate at school or work, and then suffering the indignity of waiting in line to be given food.  He feels strongly that the local population must take action, and in disaster areas they do.  They have the most empathy for their neighbors who have sustained losses. Waiting for the government is not a good solution, he said.  He proposed having a Food Corps to make a concerted effort to involve local businesses, faith groups and government to improve access in many ways to healthier food options.

Several inspiring talks were given by young activists of high school and college age, who started work in distribution of quality food when they were 8 years old and younger.  Other private innovators involved in food insecurity asked “What do you want your legacy to be?” How can you make a difference?  Another recognized that policy makers and community groups need physicians’ input about what their patients need in order to be healthy.  

Diet-related diseases take a huge toll on a majority of the population.  Research has shown over and over again that what we eat and how active we are determine our risk for high blood pressure, high cholesterol, diabetes, heart attacks, strokes and many types of cancer.  We in Lifestyle Medicine are dedicated to educating and trying to affect change to improve the ‘healthspan’ of the population – longevity with good health.   Hopefully national recognition of this issue is the first step in the right direction.