Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority

Abstract

Background The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain. Objectives Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations. Methods We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations. Results Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA. Conclusions The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.

Teaching Kitchens in the Learning and Work Environments: The Future Is Now

“…Why then, do these same valued centers of disease prevention, treatment, and management serve some of the most unappealing, unappetizing, and toxic foods in human history? Let us not forget 3 facts: 1) At the top of the list of leading risk factors for deaths in the United States is the category of “dietary risk” 1 ; 2) Both patients and their health-care providers eat every day. Usually 3 or more times per day; and 3) There is ample evidence that a medical provider's personal behaviors (e.g., not smoking or quitting smoking, exercising regularly, wearing sunscreen, etc.)…”

Sustainable Agri-Food Systems: Environment, Economy, Society, and Policy

“…This is done, among other ways, by operationalizing the holistic and systemic concept of "One Health" [24,316,317], which relates the health of humans with that of animals and ecosystems/environment. Such a call, particularly timely and relevant in the current context of the COVID-19 pandemic, which affected different components of the agri-food system, such as agricultural production, food distribution, and food consumption and dietary patterns [20,24,98,[318][319][320][321], carries implications in terms of food and nutrition security [24,320]. In this regard, referring to nutrition research in the US, Fleischhacker et al [320] argued that "The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system" (p 721).…”

“…Such a call, particularly timely and relevant in the current context of the COVID-19 pandemic, which affected different components of the agri-food system, such as agricultural production, food distribution, and food consumption and dietary patterns [20,24,98,[318][319][320][321], carries implications in terms of food and nutrition security [24,320]. In this regard, referring to nutrition research in the US, Fleischhacker et al [320] argued that "The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system" (p 721). The focus on health is also related to food safety, which is fairly addressed in the analyzed literature [322][323][324][325][326][327][328][329][330], especially concerning foodborne diseases [329].…”

“…; Augstburger and Rist[426]; Augustin et al[427]; Baiguzhinova et al[428]; Bajželj et al[429]; Baldos et al[164];Bartelmeß and Godemann [430]; Bas-[198]; Bloom et al[439]; Blumberg et al[153]; Bocken et al[440]; Borelli et al[189]; Downs et al[464]; Drewnowski et al[253]; Duro et al[119]; Duru and Le Bras[317]; Ebel[465]; Echeverría et al[207]; El Bilali[43]; Eriksson et al[466]; Esposito et al[99]; Evans and Johnson[294]; Fardet and Rock[467]; Fardet and Rock[468]; Farmery et al[469]; Feijoo and Moreira[470]; Fernandez-Mena et al[230]; Fesenfeld et al[471]; Fischer and Miglietta[472]; Fleischhacker et al[320]; Fogarassy et al[473]; Forber et al[86]; Formoso et al[474]; Fortes et al[475]; Freed et al[476]; Frison and Clément[477]; Gaitán-Cremaschi et al[478];Galli et al [58]; García-Oliveira et al[479]; Gausa et al[480]; Gerritsen et al[481]; Gerten et al[61]; Gésan-Guiziou et al [482]; Ginani et al [483]; Girard [484]; Mulesa and Westengen [181]; Mullender et al [520]; Muscio and Sisto [100]; Naja et al [521]; Negra et al [215]; Nicol and Taherzadeh [263]; Niederle and Schubert [522]; Nosratabadi et al [523]; Nowack and Hoffmann [524]; OʹKane and Pamphilon [525]; Omotayo [184]; Omotayo and Aremu [334]; Oo et al [526]; Palmioli et al [527]; Park et al [528]; Pereira et al [529]; Pham and Turner [322]; Pilipuk [530]; Przelomska et al [531]; Queenan et al [67]; Raheem [532]; Ray et al [332]; Read et al [101]; Reay et al [533]; Reinhardt et al [534]; Resnick [535]; Ricci and Banterle [163]; Ridoutt and Navarro Garcia [177]; Ringling and Marquart [203]; Rippin et al [321]; Rockstr...…”

Lifestyle Medicine for Women: The Time Is Now!

“…Prevention is only 3% of the nearly 4 trillion-dollar annual spending on US health care, 49 despite the fact that improving lifestyle could prevent 80% of disease. 50 Research on nutrition had fallen as a percentage of federal research funding in recent years, 51 and the National Institutes of Health (NIH) recently proposed closing its last remaining in-house facilities for nutrition research. 52 Until 1993, women of reproductive age were routinely excluded from NIHfunded clinical trials.…”