September marked a milestone for policymakers, stakeholders, and nutrition experts as many convened for the White House Conference on Hunger, Nutrition, and Health. It’s been more than 50 years since the last conference in 1969. At that time, the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and federally-supported school lunches were established to address the crisis of hunger and malnutrition.
The issues a half-decade ago have been replaced with rising obesity rates, diabetes, heart disease, cancer, and other chronic diseases in children, teens, and adults. While these problems continue to plague our nation, previously established nutrition policies have done little to change the unhealthy landscape.
The White House Conference on Hunger, Nutrition, and Health recommendations presented a repeat of previous policies that will not move the needle forward when addressing widespread chronic disease caused by poor eating and lifestyle.
However, we did see cracks in the walls of many institutions that guide nutrition policy, which could facilitate improvement. However, it will take out-of-the-box thinking and taking advantage of resources that may never have been considered, such as naturopathic medicine and private-public partnerships.
The following are INM’s recommendations to the naturopathic medical community and our health partners.
1. Nutrition Education in Medical Schools. Director of the Center for Food Safety and Applied Nutrition (CFSAN) at the Food and Drug Administration (FDA), Susan Mayne, PhD, is leading reforms to mandate more nutrition education in medical schools. “The national strategy recognizes that we need to do better,” she said. Her organization is calling for nutrition to be a part of the medical exam boards. She believes this will incentivize medical school graduates to learn more about healthy eating and food as medicine. “Physicians need to really understand nutrition because they are a key gateway to communicating to consumers,” Mayne said.
INM’s Comments: While our organization applauds the suggestion to educate more physicians about nutrition, changing eating habits takes more than a few nutrition classes. In their four years of medical school, licensed naturopathic physicians receive nutrition classes and hundreds of hours of behavioral training. Poor eating habits can be a combination of access, awareness, and social, cultural, and psychological behaviors. Nutrition is only one aspect of making healthier food choices.
Many of the White House recommendations at the conference rely heavily on taxpayer dollars for services that pay for Medicare and Medicaid. Since conventional medical student residencies are paid for as a part of Medicare funding, it is INM’s opinion that the concept of Food as Medicine, as well as nutrition and behavioral education, should play a significant role in medical school and residency programs (more below).
Given that educating others—including patients and the medical community—is part of a naturopathic physician’s education, the profession is ready to play the role of “doctor as teacher.” The word doctor is derived from the Latin doctore, meaning to teach.
Naturopathic medicine has a history of working with conventional medical providers in various clinical and educational settings. Naturopathic doctors are ideally suited to train medical students in Food as Medicine, as well as nutrition and behavior training to empower patients and promote healthy choices.
2. Food as Medicine. Currently, the Food as Medicine: Food Insecurity program is limited to an HIV-related Comorbidities, Coinfections, and Complications plan. This program falls within the oversight of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institute of Nursing Research (NINR).
INM’s comments: Food as Medicine is a vital part of wellness for all communities. Imagine if a Food as Medicine program was applied to at-risk communities across the country for the most common chronic conditions, including obesity, heart disease, diabetes, and multi-complex metabolic disorders. Studies show it has remarkable potential.
Adherence to the current dietary guidelines from the public is as low as 50%. When food as medicine principles are applied to applied to individuals with chronic diseases of heart disease, diabetes, and kidney disease, compliance rises to 90%, according to this 2022 food as medicine study.
Outcomes included: 20-30% cardiovascular (CV) event risk reduction;
5–10% LDL cholesterol reduction;
4-11 mmHg systolic blood pressure reduction;
30% reduction in metabolic syndrome prevalence;
3–5% weight reduction;
56% lower chronic kidney disease mortality rates, increased dialysis-free time of 2—5 years;
and heart failure patients— 16% fewer hospital readmissions.
Heart disease and diabetes cost employers and the healthcare system more than $550 billion annually, according to the Centers for Disease Control. As much as 61% of costs are due to high hospitalization and readmission rates.
When the cost savings for a Food as Medicine program are applied, here is how it shakes out:
- Decreased CV event saves $5–11 billion annually and $1 to $8 billion in hospitalization costs; Dialysis rate reduction saves $14 to $29 billion annually;
- For heart failure patients, a savings of $234,096 per 100 patients and a 38-day shorter length of stay (saving $79,425 per hospitalization).
3. The White House recommendations list a number of government programs for childhood nutrition education, including the Healthy Kids, Healthy Future Technical Assistance Program (TAPS), which funds 10 states to improve and expand nutrition and physical activity through existing state programs. In 2020, the program’s total reach was 2,246 childcare programs and 70,000 young children.
INM’s Comments: While it’s well understood that school-embedded programs increase fruit and vegetable consumption and decrease sugar intake, our organization would like to see more private, public partnerships for youth culinary nutrition. There are more children who need culinary nutrition education than the government can support. The solution is private-public partnerships with well-funded corporate entities, community engagement leaders from food banks, YMCAs, Boys and Girls Clubs, and other like-minded non-profits.
Hands-on programs like the Food as Medicine Everyday (FAME) series promotes the learning of healthy eating and culinary skills to give adults and children the information they need to make healthier choices. Children who participate with adults identify new foods, gain confidence to try different foods, and show enthusiasm for assisting with food preparation at home. INM has partnered with FAME in our Naturally Well kid’s culinary nutrition program, which launched in the fall of 2022 in southern Arizona.
Ours is a hybrid learning model, using videos, hands-on classes, a pre-written curriculum, in-class rewards, and smartphone apps to reinforce learning. INM would like to see more programs like this; however, that can only come true if corporations provide financial support. Click here for more information on Naturally Well.