To Solve the Nutrition Crisis, Biden Must First Look Inward
Link to story as originally printed in the New York Daily News
By Nina Teicholz and Jennifer Friedlin
Last week, President Biden announced that he would convene a White House Conference on Hunger, Health and Nutrition, the first in more than 50 years, to address the epidemics of hunger and diet-related diseases that plague America.
One place to start is by considering the government’s own broken food policy.
The last conference during the Nixon administration paved the way for the establishment of the Dietary Guidelines for Americans. These guidelines shifted the American diet to one weighted towards carbohydrates.
In the late 1960s, carbohydrate intake amounted to 39% of the American diet. The guidelines, which are considered the gold standard of nutrition, recommend a diet of 45% to 65% carbohydrates and up to 10% of calories as sugar. This guidance is reflected in everything from the advice doctors give to patients to the food prescribed through federal nutrition programs, for meals in pre-kindergarten-12 schools, nursing homes, military mess halls, and more.
Since the guidelines came into being, diet-related diseases have surged. For example, this year, an additional 1.4 million Americans are projected to join the 37.3 million, or 11% of us, already coping with diabetes, a physically and financially devastating illness that is increasingly manifesting in young people. In 2021, the diabetes rates in the Bronx, Queens and Staten Island were higher than the national average at 15.7%, 13.2% and 13%, respectively.
With an annual price tag of $327 billion in direct costs and lost productivity, diabetes is also the nation’s most expensive chronic illness. Individuals with diabetes incur medical costs about 2.3 times higher than those without.
While much attention has been given to the harm caused by refined sugar, the problem with an overload of carbohydrates is that, whether whole or refined, they turn to sugar upon digestion. This means that even whole grains will reliably spike glucose in the blood. Over time, eating a diet high in carbohydrates, “healthy” or not, exhausts the body’s ability to process sugars, leading to a condition called insulin resistance, a precursor to pre-diabetes, weight gain and most other diet-related diseases.
In announcing the conference, Biden noted that diet-related diseases increased the risk of severe COVID-19, but he did not note that high blood sugar, which causes diabetes, was one of the factors most tightly linked to increased risk for hospitalization and death.
A large body of scientific literature now exists to show that a diet low in carbohydrates can reduce blood sugar levels and even reverse a diagnosis of type 2 diabetes — within weeks. For example, a 2021 issue of Nutrients cites dozens of clinical trials demonstrating how carbohydrate restriction helps people to combat diabetes, obesity, high blood pressure and inflammation, among other cardiovascular risk factors.
The evidence has become so compelling that leading health groups have endorsed this nutritional therapy. In recent years, the American Diabetes Association (ADA) and American Heart Association (AHA) have both recognized that lower-carbohydrate diets are unparalleled for controlling blood sugar, and the ADA dubbed it a standard of care.
If the White House wants to reduce the prevalence of diet-related diseases, it should follow the lead of the AHA and ADA and reevaluate the Dietary Guidelines for Americans to offer an alternative for the 50% of Americans with diabetes or prediabetes, not to mention other diet-related diseases.
This sensible approach appears unlikely. Last month, the United States Departments of Agriculture and Health and Human Services (USDA-HHS) began the process of reviewing the guidelines for 2025 by publishing a list of scientific questions that an as-yet-unnamed committee will review. Astonishingly, there was not a single question about low-carbohydrate diets on the list. During the last review, for the 2020 guidelines, USDA experts also overlooked the evidence, saying they could find only a single clinical trial on low-carbohydrate diets — despite the existence of at least 75 such trials at the time.
President Biden’s concern about the nutritional health of Americans offers a fresh opportunity for the White House to start reversing trends of worsening health that began decades ago and shows no signs of abating. Failure to do so will be costly to all Americans and unfair to the millions of vulnerable individuals who trust in and live by the government’s nutrition policy.
Teicholz is the author of “The Big Fat Surprise” and founder and board chair of The Nutrition Coalition, a non-profit that supports evidence-based dietary policy. Friedlin is president of The Nutrition Coalition.