Joe Biden should declare a food and nutrition war

It’s time for President Biden to create a National Institute for Food, Nutrition and Disease Prevention within the National Institutes of Health (NIH) and make it the central scientific voice on nutrition within the government. That one step could lower American health care costs by hundreds of billions of dollars per year, improve health care, enhance social justice and prepare Americans to survive the next pandemic.

Over the past year, the American health crisis has been put in stark relief. The largely preventable epidemics of obesity, diabetes, heart disease, stroke and cancer are not only growing, they are also creating hundreds of billions of dollars in excess American health care costs. In addition, COVID-19 deaths have been high among those who have poor metabolic health: obesity, diabetes and even high blood sugar in the absence of diagnosed diabetes are key risk factors for death from COVID-19. And these conditions largely emanate from a lifetime of poor food choices, particularly processed foods and those high in refined sugars and grains. This tragedy is disproportionately high among the poor and people of color. 

And yet, in December, the U.S. Department of Agriculture (USDA), supported by the Department of Health and Human Services, endorsed high sugar levels in the “2020-2025 Dietary Guidelines for Americans,” ignoring the 835-page report by their scientific advisory committee that recommended that daily calories from sugar be lowered from 10 percent to 6 percent of the diet. The USDA lawyers stated that there was “insufficient scientific evidence” to reduce guidance on sugar levels — language sadly similar to the cigarette industry several decades ago. It could well have been written by the sugar industry and processed food lobbyists pushing sugar-laced cereals, desserts, drinks and other sweetened foods. The fact is that scientific evidence is overwhelming and their decision has shown that they cannot be trusted as honest brokers in advising Americans on nutrition.

While cynical politics certainly provides one possible explanation, there also may be something far more sinister at play here. 

The politics is straightforward. While the USDA may tip its hat to nutrition, its bread is buttered by the farming and processed food industries. The mission statement for the USDA Food and Nutrition Services clarifies its conflict of interest:

“Working with our public, private and nonprofit partners, our mission is to increase food security and reduce hunger by providing children and low-income people access to food, a healthful diet and nutrition education in a way that supports American agriculture and inspires public confidence.”

The USDA’s sugar recommendation mirrors its 2020 guidance on school lunches, which increased flexibility for serving processed foods and sugar to children, and decreased requirements for whole fruits and vegetables in schools. It also mirrors the interests of the USDA’s 2018 Farm Bill, which allocated $31 billion in support of disease-promoting commodity crops (including soy, wheat, corn and sugar, the vast majority of which are turned into disease-promoting processed foods, oils or animal feed), and just a fraction of that — $772 million, or 2.5 percent of commodity crop spending — toward disease-reversing “specialty crops,” including fruits and vegetables. Shockingly, the USDA also made it significantly easier to import sugar into the U.S. in the middle of the COVID-19 epidemic. In all cases, the result is extra profits for the commodity crop farming community and consumer products companies, and potentially increased disease and death for everyone else.

The sinister side of the coin is that the processed food industry may have intentionally peddled an addictive drug — sugar — that destroys American health for profit. Dr. Robert Lustig’s “The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains,” and Dr. Mark Hyman’s “Food Fix” both make the compelling case that companies are systematically using sugar-laced foods to engender food addictions and aiming them disproportionality at children and the poor.

But the U.S. Department of Health and Human Services (HHS) is no better. In 2016, the USDA and HHS released the National Nutrition Research Roadmap. In 2020, the NIH released the “2020-2030 Strategic Plan for NIH Nutrition Research.” And yet, in spite of  the direct line from high blood glucose to a large proportion of COVID-19 deaths, HHS signed off on higher dietary sugar levels for Americans in the recent dietary guidelines.

Apparently, “roadmaps” and “strategic plans” are worthless when it counts. Spreading nutrition and disease prevention across the USDA and a hodgepodge of groups at HHS and NIH — which are largely focussed on how to treat disease, rather than how to prevent it — is not working. At a minimum, all of this suggests that Americans deserve an independent and well-financed National Institute, focused exclusively on food, nutrition and disease prevention, that can push back against other agencies and special interests. The weak and poorly-financed Office of Nutrition Research within the NIH won’t cut it — a $1.9 billion budget has no real power or leverage — in the face of $3.8 trillion of health care expenditures, 90 percent of which goes towards chronic diseases that are diet-related and preventable. Prevention has high returns to Americans; in contrast, developing and managing disease generates high returns to the commodity crop, processed food, and traditional health care industries. 

Of course, the processed food, farm and traditional medical care lobbies are well-funded and would fight change. But if President Biden is seriously interested in “following the science,” he should support independent science in the area of nutrition and disease prevention, taking a huge step to improve American health.

Casey Means, M.D., is an associate editor of the International Journal of Disease Reversal and Prevention and chief medical officer of metabolic health company Levels. Follow her on Twitter and Instagram @drcaseyskitchen. 

Grady Means is a writer and corporate strategy consultant who served in the White House as assistant to Vice President Rockefeller. He helped draft the HMO Act, provided White House oversight to the National Health Insurance Experiment, and chaired the White House working group on food stamps reform. Follow him on Twitter @gradymeans1.