Potential Policy Approaches to Address Diet-Related Diseases

The Centers for Disease Control and Prevention (CDC) recently published 2 reports that should inspire vigorous action to improve the diets of individuals in the United States. One report found that in 2015-2016 the prevalence of obesity (BMI ≥30) in adults (39.6%) increased to new highs, and obesity levels remained disturbingly high among youth (18.5%). By comparison, in 1976-1980, only 15.0% of adults and 5.5% of youth were obese. Each uptick in the prevalence of obesity increases the risks of hypertension, stroke, myocardial infarction, certain cancers, and, especially, type 2 diabetes. High BMI is responsible for an estimated 386 000 excess deaths per year.

A second report, based on 24-hour urinary excretion samples from 827 individuals, found that mean sodium consumption was approximately 4000 mg/d, or more than 1.5 times the recommended daily limit of 2300 mg. High sodium intake increases the risk of hypertension and, thus, myocardial infarction and stroke. Excess sodium intake may cause as many as 92 000 deaths annually.

According to a report from the US Burden of Disease Collaborators, dietary factors were associated with 529 299 deaths in 2016 in the United States, making them the leading risk factor for mortality. Social inequities in dietary patterns are increasing. It may be expected that such findings would prompt concern among policy makers, but neither Congress nor the executive branch has proposed a comprehensive plan to improve the US diet.

It is time to reinvigorate the discussion about preventing diet-related diseases. While more research on effective interventions is needed, this Viewpoint presents a 7-pronged policy-oriented proposal intended to promote a healthier food supply and improve diet quality to prevent disease.

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