Nutrition policy must be at the center of the conversation

In the coming months, much conversation will be centered around how to mitigate and prepare for pandemics like COVID-19. As we look at the death toll from this disease, reports show that many of the people who died had obesity and other related ailments including Type 2 diabetes. There’s a clear correlation between death rate and obesity and diabetes — the more severe, the higher the death rate.

One way to mitigate these problems is to put nutrition at the forefront of the conversation. With a healthy population, America is better prepared to fight viruses or other unforeseen health concerns.

The cost of avoiding pandemics will link to the overall cost of health care, but the bigger cost we should be looking at is the cost of poor nutrition, and how the current U.S. Dietary Guidelines are hurting our nation rather than helping it. We also should look at why an approach based on the most rigorous science available — one that includes controlling carbohydrates – continues to get omitted from the conversation.

Right now, the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) are in the process of updating the U.S. Dietary Guidelines — the government’s nutrition policy. But once again, they will be leaving most Americans behind by focusing their recommendations exclusively on the healthy population, a shockingly low percentage of us.

They are leaving out nearly 3 out of 4 Americans who are overweight or obese as well as the 50 percent who are diabetic or prediabetic. This ignored group of more than 100 million people need nutrition advice even more than the rest to help them achieve better health and in the process, save health care dollars.  

Since the U.S. Dietary Guidelines were introduced, adult obesity rates have doubled, while childhood obesity has tripled. Annual medical spending attributed to obesity nationally is nearly $150 billion, about half of which is paid to Medicare and Medicaid. And rates continue to climb. Researchers have estimated that by 2030 if obesity trends continue unchecked, obesity-related medical costs alone could rise by $48 to $66 billion a year in the United States. 

The American Diabetes Association estimated that the total cost of diagnosed diabetes rose to $327 billion in 2017 from $245 billion in 2012, a 26 percent increase over a five-year period and diabetes rates continue to rise. There is no question that nutrition therapy can prevent and reverse the effects of obesity, prediabetes and diabetes, and there is a good chance other chronic diseases like heart disease, cancer and neurological conditions would be positively affected as well.

The ADA has acknowledged the important role nutrition plays in managing diabetes and even noted that low carb diets may serve as an appropriate nutrition therapy. As so many Americans struggle to pay their increasing health care costs and the federal government grapples with how to help better manage these costs, changing the Dietary Guidelines is a necessary, effective and affordable solution.  

The evidence is clear. If we don’t change course, many Americans will continue to follow guidelines that not only won’t improve their health but could make them sicker. We can alter this path by acknowledging that low-carbohydrate nutrition requires a more personalized approach. Our nation has embraced personalized medicine and it is transforming health care.

The federal government has the opportunity now to create 2020 Dietary Guidelines that are based on the strongest, most current science that provides nutrition recommendations that all Americans can follow to improve their health and reduce our nation’s health care costs. As health care costs continue to soar and chronic disease rates continue to rise, we cannot afford to wait another five years to get this right.  

The science is overwhelming supporting restricting carbohydrates as a therapeutic approach to manage obesity, prediabetes and diabetes. The case is urgent, and the solution is apparent. What remains is for the U.S. government to step up and safeguard public health immediately.

Jeff S. Volek, Ph.D., R.D., is a full professor in the Department of Human Sciences at The Ohio State University, he has published 320 peer-reviewed articles examining health and performance effects of low-carbohydrate diets and other dietary and exercise patterns.