The National Institutes of Health must address our abysmal diet and nutrition

American’s life expectancy is decreasing due to diet-caused diseases, our children are sick with fatty liver disease and Type-2 diabetes, and our food companies are substituting harmful ultra-processed foods as healthy school meals. Yet our National Institutes of Health continue to focus on discovering expensive treatments for diet-caused diseases such as obesity rather than successful strategies that result in fewer sick people. 

Congress has a chance this year to change that. With President Biden’s nomination of Dr. Monica Bertagnolli as the new director of the NIH, Congress has a unique opportunity to direct its focus toward urgently needed nutrition science research and policy solutions. The congressional leaders responsible for overseeing the nomination process should ensure that Bertagnolli plans to prioritize nutrition science when she becomes the next leader of the agency. The Senate HELP Committee advanced Bertagnolli’s nomination on Wednesday. 

Over the past two decades, America has witnessed an alarming rise in cases of obesity and other diet-related diseases. The most recent data reveal that a staggering 42 percent, roughly 100 million, U.S. adults have obesity — a rate that has surged by over 10 percent since 2000. 

The implications of this crisis are dire, with diet-related diseases like cardiovascular disease, cancer and diabetes accounting for half of all deaths in the U.S. annually. Notably, these diseases contributed to one-quarter of the colossal $1.5 trillion spent on healthcare in 2018, as reported by the Government Accountability Office. All told, the economic cost of nutrition-related chronic diseases has been estimated at $16 trillion from 2011 to 2020. Overweight and obesity is also a leading barrier to military readiness. 

Despite the mounting health concerns and exorbitant costs associated with obesity and diet-related diseases, nutrition research has been consistently sidelined at the NIH. In fiscal year 2019, the NIH’s nutrition research investments were estimated at just $1.9 billion annually, a meager 5 percent of total NIH funding. More alarmingly, only 1.3 percent of the NIH’s total funding was dedicated to studying the role of diet in preventing or treating diseases in humans. This disparity illustrates a fundamental failure to address the pressing need for comprehensive nutrition research. 

The neglect of nutrition research within the NIH is further exemplified by reporting showing that in 2019 the NIH “proposed closing the only facility on its campus for highly controlled nutrition studies,” a disconcerting proposal that fortunately met resistance from external groups. Even more concerning, the words “nutrition” or “diet” did not appear at all in the NIH’s 150 page fiscal year 2020 budget congressional justification, and the word “food” made just a single appearance in reference to the Food and Drug Administration. 

Under Bertagnolli’s leadership, the NIH has an unparalleled opportunity to tackle urgent nutrition-related research questions. A prime example is the need to understand why highly processed foods, which comprise over 50 percent of the American diet, contribute to weight gain. While an NIH trial established a link between processed food consumption and weight gain, the precise mechanisms remain unknown, necessitating further research. 

Given Bertagnolli’s expertise as a cancer doctor and current director of the National Cancer Institute, prioritizing nutrition research aligns with her interests. It is estimated that approximately 32 percent of cancer cases could be prevented through dietary changes, emphasizing the urgent need for robust nutrition science to combat this devastating disease. 

Although Dr. Francis Collins, the longest-serving director of the NIH, made significant progress in biomedical research, nutrition was not prioritized during his tenure. As Congress evaluates President Biden’s nominee, it is imperative that they secure Bertagnolli’s unwavering commitment to investing in obesity and nutrition research during her tenure at the NIH. She was given that opportunity by Sen. Bill Cassidy (R-La.) at an Oct. 18 Senate hearing on her nomination, but she failed to do so and missed an opportunity to make preventing obesity a priority. Senators should receive that commitment before confirming her. 

Only by redirecting the agency’s focus and adequately funding nutrition science can we hope to address America’s diet-related disease crisis and alleviate the burden it imposes on our society. The time to act is now, and it starts with ensuring that nutrition science becomes a paramount priority at the NIH.

Jerold Mande is co-founder and CEO of Nourish Science, adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health and former senior adviser to the FDA commissioner and deputy undersecretary at the U.S. Department of Agriculture.