Dariush Mozaffarian, Marion Nestle, and A-dae Romero-Briones on next steps for greater access to healthier food for all.
Dariush Mozaffarian, Marion Nestle, and A-dae Romero-Briones on next steps for greater access to healthier food for all.
December 24, 2021
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As 2021 comes to an end, we take stock of another momentous year that marked massive upheavals in the food system and across society. To lead us into 2022, we asked some of the leading thinkers and doers working on the frontlines of food, justice, and climate to share their thoughts with us about the most pressing issues, what they’ll be working toward in the new year, and what propels them to keep going.
Today, we hear from Dariush Mozaffarian, Marion Nestle, and A-dae Romero-Briones about nutrition research and policy and efforts to improve food and nutrition access.
Dariush Mozaffarian, Dean of the Friedman School of Nutrition Science & Policy at Tufts University
In your testimony to the Senate Agriculture Committee, you described a “true national nutrition crisis.” What do you see as the biggest factors contributing to that crisis?
Our food system has dramatically changed over 40 years, and it’s changed in broad ways, from how we grow our food, to how we process it, to how we sell and market and eat it. And those changes together are contributing to a tidal wave of obesity and diet-related illnesses. So, it’s critical that we act upon the drivers of that crisis that we already know and then expand our science to figure out the ones that we don’t understand yet.
What are the big gaps you see from a research perspective?
I would say maybe we know 40 percent of what we need to know about the heart and 25 percent of what we know about diabetes. Every nation in the world has growing [rates of] obesity, and we don’t really understand the drivers of it. [We don’t understand] why we are actually getting more obese. There is also huge disagreement about the best diet for turning this around—a low-fat diet, a low-carb diet, the Paleo diet. Some people say we have to eat natural food. Some people believe it’s all pesticides and additives and we have to eat “clean” food. There’s no consensus.
Finally, we don’t understand the thousands of things that are in our food. There’s evidence that cocoa and green tea might be good for us, but why? How do nutrition and the microbiome impact autism? What about fertility, or brain health? We don’t even understand those conditions. It doesn’t mean we’re paralyzed and we shouldn’t take any actions; but there’s a lot we don’t understand.
What do you think of the efforts taken by the current administration and Congress on food and nutrition policy so far? What is working, and what needs work?
The administration and Congress should be congratulated for addressing acute food insecurity. There have been huge, successful efforts to combat food insecurity through expanding SNAP, emergency waivers for schools, Pandemic EBT, and many other programs. On the flipside, there has been very little done to address nutrition insecurity. If we’re going to get calories to people without working on the nutritional quality of the food, we’ve only solved half the problem.
You’ve called for a national nutrition strategy and a White House conference on nutrition, both as part of a bigger federal government effort. Why do you think these efforts will be effective?
The Government Accountability Office report that came out in September highlighted the challenge and the solution. It identified 200 different federal efforts fragmented across 21 agencies that are aiming to address nutrition. They’re not harmonized, and there is not a strategy to bring them together, so they haven’t been effective. They said very clearly that diet-related diseases are deadly, costly, and preventable and that we need an actual federal plan. If we don’t have a plan, we’re not going to fix the problem.
The last time the federal government sat down and looked at our food and nutrition landscape was in 1969 at the White House Conference [on Food, Nutrition, and Health]. That led to some major changes in our food policy and programming. So, 53 years later, we need to do that again.
Are there any policy initiatives going into 2022 that you think could make a real difference?
There is interest in a White House conference on hunger and health; both the House and the Senate have had bipartisan bills that have proposed it. Secretary Vilsack has said he supports it. If that happens, it has to be accompanied by a commitment from the White House and Congress to actually implement the recommended policy. And I think that could be really positive.
I think that there are at least some members in Congress who understand the principle of “food as medicine,” the fact that the biggest single missing thing in our healthcare system is addressing food, and that there are effective ways to do that, whether it’s produce prescription programs or medically tailored meals.
Nutrition science also has to be advanced. We’re on the cusp of incredible new discoveries and starting to understand nutrition, and if we can accelerate that with stronger science it would be very important. USDA has a pretty big science budget, and if they’re able to shift and ensure that their science focuses on not just agricultural production but on the nexus between production, human health, and sustainability, that would be a big advance. NIH has started to respond to calls for more nutrition science research. They’ve launched a precision nutrition initiative. They’ve created a new office of nutrition research in the office of the director. Those are small changes, but they are changes, so I’m hopeful. And on a more practical political level, there’s the Child Nutrition Reauthorization and the farm bill that have to happen, and so there are opportunities there.
As we prepare to enter a new year, are there any policy measures that you believe need more attention?
My first priority is to start regulating food industry efforts to get people to eat junk food or what we are now calling ultra-processed foods. These are the heavily processed products—what Michael Pollan called “food-like objects”—that don’t look anything like real foods.
To do this, we have to keep food companies out of public policy and public health decision-making. The prevalence of obesity increased rapidly starting in the early 1980s. Since then, any time the government has attempted to regulate the food industry or make unambiguous recommendations about what people should and should not eat, the food industry would block those attempts, weigh in, and the advice came out in euphemisms.
Dietary guidelines use euphemisms; they talk about nutrients (salt, sugar, saturated fat) instead of the junk foods that contain them. I want guidelines to say what they mean: Avoid or minimize intake of ultra-processed foods.
We now have hundreds of studies showing a link between frequent consumption of ultra-processed foods and being overweight, type 2 diabetes, heart disease, even overall mortality. A well-controlled clinical trial done by a first-rate investigator at National Institutes of Health (NIH) shows that feeding people a diet based mainly on ultra-processed foods makes them eat more calories—500 more a day—without realizing it. Let’s do a big public health campaign against ultra-processed foods that teaches people what they are, how to recognize them, and why they should be eaten in smaller amounts. I think that would make a big difference.
As Michael Moss’s work shows, these foods are addictive or semi-addictive. People really love them and “can’t eat just one.” Dietary guidelines should make that clear. And no question, we need to stop companies from marketing these products to kids. For this, food and beverage companies have no business being at the table when public health recommendations are addressed.
What are you feeling optimistic about?
Students! I get to teach young people who get these issues, care about food, and want to use food to change the world. They want food systems that are healthier for people and the planet. They understand food inequities and want to redress them. They totally get what’s not working about our current economic systems and want to use food to fix those problems. The future is theirs and I want to do all I can to cheer them on.
A-dae Romero-Briones (Cochiti/Kiowa), Native Agriculture & Food Systems Director of Programs, First Nations Development Institute
For 2022, what are some of the most significant things you’re working toward?
I think one of the most exciting things for us at First Nations is our breastfeeding and first foods work. We are going to be working with Indigenous communities on encouraging breastfeeding, but also the barriers to breastfeeding. That’s the missing piece in our food sovereignty work. And so we’re using that program to empower communities to look at how women and children get their initial understandings of health, nutrition, and food. By focusing on breastfeeding and first foods, we get to focus on women and children, who are really the pillars of nationhood, the pillars of nutrition. There’s always this third-party arbitrator who tells us whether or not we’re eating the right things, or how we should be growing our food. But, ultimately, when we’re born into this world, we have mothers, grandmothers, and aunties who are our nonverbal teachers of what it means to be healthy and connected to our community and our food.
At the onset of the pandemic, Indian Country was in the crosshairs. How has your work changed since then?
I’ve learned a lot. One, I’ve learned that I have to trust Indigenous people—our knowledge and our own internal reactions to what’s happening in the world. Because, ultimately, we were able to respond to COVID. At first, I saw food supply chains fail and food not getting to Indigenous communities. But, maybe a month or two later, what I saw was incredible—communities coming together, people checking on elders, hunters sharing their meat—it was an incredible time of togetherness, even though it was in reaction to a very tragic failure of our supply chains. Indigenous communities came together nonetheless, and with a strength that I haven’t seen, ever.
And in 2022, we have several opportunities to strengthen food supply chains; we’re looking at how to restructure food pantries and food banks in Indian Country so that they’re supportive of food sovereignty, as opposed to being a kind of mainstream food surplus dump. And that is exciting, because Indian people are taking control of their own food distribution points, their own supply chains, their own food banks and food pantries. We also have a program focused on food storage. One of the things we saw in COVID was a need to more massive amounts of food. But many Indigenous communities didn’t want refrigerated semi-trucks or refrigerated buildings, because they believe it’s energy intensive, and against some Indigenous values to hoard food like that. We’re looking at how food storage plays into the different models of food supply and food systems.
What else is making you feel hopeful right now?
I’ve been working with a small elementary school called Keres Children’s Learning Center, made up of Keres-speaking children in an immersive language program, and we talk weekly about food. I am 100 percent sure that our future is going to be great, because these children understand food systems in such a pure way; that food is a way to show community and show love. There’s so much care in these children and they teach me so much every day.
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