Improving Nutrition to Turn the Tide on Diet-Related Chronic Disease
By: Susan Mayne, Ph.D., Director, Center for Food Safety and Applied Nutrition
March is National Nutrition Month, and the U.S. Food and Drug Administration is shining a spotlight on the importance of good nutrition and the big impact it has on improving people’s lives and lowering the enormous costs of diet-related chronic diseases. Each year, more than a million Americans die from diet-related diseases like cardiovascular disease, diabetes and certain forms of cancers. In 2020 alone, an estimated 800,000 people died from cardiovascular disease, an even greater number than the horrific toll of COVID-19 during that same year. And obesity, which is both a disease and a condition that increases the risk for other diet-related chronic diseases, has increased to historic levels in children and adults during the COVID-19 pandemic.
The FDA also knows that racial and ethnic minority groups as well as those living at a lower socioeconomic level are disproportionately affected by diet-related chronic diseases. For example, more than 4 in 10 American adults have high blood pressure, but that number increases to about 6 in 10 for non-Hispanic Black adults. Additionally, American Indians and Alaska Natives are diagnosed with diabetes, primarily Type 2, at higher rates than other race-ethnicity groups.
Improving nutrition can turn the tide on the unacceptably high rates of diet-related diseases and deaths in the U.S., saving lives, improving quality of life, and reducing health care costs. We recommend that consumers eat more fruits, vegetables, low-fat dairy products, whole grains, and healthy oils. They also should consume less sodium, saturated fat and added sugars. To help consumers make better food choices, the FDA is ramping up its food labeling and broader nutrition education efforts. We are also redoubling our work on a healthier food supply, working with key partners and stakeholders to improve the food environment so consumers have more healthy food choices.
Sodium Reduction Targets and Food Labeling
The FDA took a very big step in supporting a healthier food supply in October 2021 when we established voluntary short-term sodium reduction targets for commercially processed, packaged, and prepared foods. Consumers typically take in far more sodium than is healthy, and excess sodium consumption is directly linked to hypertension, a leading risk factor for heart attacks and stroke. Most of the sodium comes from processed, packaged, and prepared food, and encouraging sodium reduction across the food supply will make it easier for consumers to access lower-sodium options. The FDA is also looking at our standards of identity – which are like recipes with criteria that certain foods must meet – to see what changes could lead to a healthier food supply.
Food labeling is another tool in the agency’s toolbox that we are employing to create a healthier food supply and empower consumers with information. After the FDA required trans fat to be declared on the Nutrition Facts label, there was an 80% reduction in trans fat in the food supply. Experts have said that this led to prevention of tens of thousands of cases of cardiovascular disease and saved numerous lives. This powerful example underscores the impact of food labeling and how it can lead to enormous public health benefits. The agency has updated the Nutrition Facts label requirements to be more consistent with current nutrition advice. For example, one change that was made requires companies to declare added sugars, which we believe will encourage some companies to reformulate existing food products or create healthier ones. We also now require calories to be listed on certain menus and menu boards to help consumer know what they are consuming away from home.
Our immediate priority in labeling is to make it easier for consumers to identify foods that are part of a healthy eating pattern. The FDA has several initiatives underway to do this. We are updating the nutrient content claim definition for when “healthy” can be used on a food package. Nutrition science has evolved since we first established the claim in the early 1990’s. Along with helping consumers better identify foods that help them build a healthy dietary pattern, the updated definition could also provide an incentive to industry to reformulate so their products can bear the “healthy” claim.
The FDA is also conducting consumer research on a potential “healthy” symbol that would act as a quick signal for busy consumers. In addition, we are working on draft guidance on dietary guidance statements, for example statements about whole grains in a product. The guidance will give best practices for the use of such statements on food labels to describe the role a food or food group plays in a nutritious dietary pattern.
Healthier Diets for Young Children and Addressing Toxic Elements
The FDA is expanding our work to help establish the healthiest diets in young children. Focusing on younger populations is critical because healthy dietary patterns early in life can influence the trajectory of eating habits and health behaviors throughout life. We are taking a holistic approach that encompasses some of our work on reducing toxic elements in infant and toddler food set out in our Closer to Zero Action Plan.
There is great value in addressing toxic elements and nutrition together in young children because many foods that can be higher in toxic elements, such as fruits and vegetables, are also the very foundation of life-long healthy eating patterns. There is much we can do to mitigate exposure to these elements – to as close to zero as possible – for example, by setting action levels. We intend to publish guidance documents this year on action levels in foods commonly consumed by babies and young children.
We also published, in coordination with the U.S. Environmental Protection Agency, updated advice to help those who might become pregnant, are pregnant or breastfeeding, and parents and caregivers who are feeding children, make informed choices about fish that are nutritious and safe to eat. Seafood provides beneficial fatty acids and other nutrients that can help children’s growth and development. The FDA continues to develop a variety of educational materials to enhance the ability of consumers to be aware of the advice and to encourage the consumption of seafood that is lower in mercury.
This is just a snapshot of our nutrition work. The FDA continues to work with our federal partners to create a healthier food supply, empower consumers to choose healthier diets and establish healthy eating habits early. We’re excited about the work we are doing now and the opportunities ahead to help turn the tide on diet-related chronic disease and improve health equity.