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Nature Food volume 3, pages 561–563 (2022)
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In every country, a clear national strategy, goals and metrics are needed to end hunger, improve nutrition, reduce diet-related diseases and create a just, sustainable and equitable food system. We identify six policy domains where real change can be made to deliver this vision in the United States.
More than 50 years ago, President Richard Nixon convened the 1969 White House Conference on Food, Nutrition and Health, bringing together all the agencies of the US government, Congress and other stakeholders to address widespread hunger in the United States1. That conference — chaired and organized by Dr Jean Mayer, the founder of the Tufts Friedman School of Nutrition Science and Policy — was historic in its vision, bipartisanship and impact. The insights and recommendations of the 1969 conference established nearly all of the major US food and nutrition programmes that are in place today. This included major expansion and harmonization of the National School Lunch Program; major expansion and harmonization of the Food Stamp programme (now the Supplemental Nutrition Assistance Program (SNAP)); creation of the School Breakfast Program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); and development of a new focus on food-based dietary guidelines and new consumer protections such as nutrition facts labelling2. Together, these policies achieved success in their major goal: to reduce caloric hunger nationally.
However, much has changed since 1969, and the United States and global community face stark new food and nutrition challenges3. Chief among these are the intertwined pandemics of obesity and type 2 diabetes, as well as globally rising cardiovascular diseases, cancers and other diet-related diseases. In the United States, half of all adults have diabetes or prediabetes, while 3 in 4 are overweight or have obesity4. In addition, undernutrition has still not been eradicated globally — a dire double burden of malnutrition. In 2020, about 3.9% of US households experienced very low food security, and an additional 6.6% experienced low food security5.
In our nation and around the world, nutrition insecurity and diet-related chronic diseases also disproportionately afflict racial and ethnic minorities and lower income, rural and other underserved populations. At the same time, the industrialization of food, from the Green Revolution to food science, successfully mitigated the leading nutritional concerns of the twentieth century6: mass starvation due to a soaring world population, endemic vitamin deficiency diseases, and common foodborne pathogens; however, it is not well designed for the needs of the twenty-first century: a fully healthy, just and sustainable food system. Together, these burdens on human health and natural resources are also producing tremendous economic losses in the United States and worldwide7. The COVID-19 pandemic and the Russia–Ukraine war have further underscored fundamental weaknesses across our food systems, including fragile supply chains, persistent food and nutrition insecurity, and increasing inequities. COVID-19 also intersects directly with obesity, diabetes and hypertension, which are the top risk factors, beyond age, for poor outcomes from infection8.
These multi-faceted interrelated challenges can only be solved by comprehensive multi-agency national assessments and planning — a re-imagining of national and global food systems1,9,10. In every country, a clear national strategy, goals and metrics are needed to end hunger, improve nutrition, reduce diet-related diseases and create a just, sustainable and equitable food system.
This is why we are heartened by President Joe Biden’s recent historic announcement of a second White House Conference on Hunger, Nutrition and Health11. This conference, to be held in September 2022, will again bring together all the federal agencies, Congress and other diverse stakeholders to identify ambitious actionable policy solutions to end hunger, improve nutrition and advance health.
Based on their mid-twentieth century founding to address hunger, many national and global food policies prioritize the production of, and access to, calories and isolated vitamins rather than dietary quality and good nutrition. This leaves the most vulnerable populations at greatest risk for diet-related diseases; stunts the physical, cognitive and emotional growth of children; hinders a productive workforce; stagnates federal investments, private sector growth and employee wages due to rising health care premiums; and hampers national military readiness. Many population health outcomes have worsened even though nutrition science has advanced in the last 50 years3, highlighting the ineffectiveness of currently fragmented efforts for translating findings into action.
The food sector is also one of the largest collective employers and wealth generators in the world. In the United States, more than 1 in 10 jobs are related to the food sector12. For centuries, food business innovation and entrepreneurship have offered a major path to personal and community economic empowerment and resilience. Minority communities have long recognized this pathway for prosperity, with the food sector accounting for the highest numbers of new minority-owned small businesses and jobs in the United States13.
Furthermore, many of the strained and closed businesses, lost jobs and lost wages from the COVID-19 pandemic have been in the food sector, with these impacts disproportionately affecting lower-income communities, who also suffer most from fragmented supply chains and nutrition insecurity13. At the same time, billions of dollars in global investments are pouring into food sector innovation to create more nourishing and sustainable companies and products. Yet, no nation has taken the lead to incentivize such capital nor harnessed it to equitably improve nutrition, economic empowerment, asset ownership, and community health and wealth.
The goal of the 2022 White House Conference on Hunger, Nutrition and Health is to provide a national strategy to end hunger, improve nutrition and reduce diet-related disease11. To achieve success, the conference will need to cast an ambitious vision while focusing on achievable goals. While this has implicitly constrained detailed consideration of other aims, such as those for global nutrition and sustainability, addressing national hunger, nutrition and health provides a critical foundation for examination and action in these important related areas.
Although the White House will be announcing its metrics and priority policies at the conference, we hope that these will include ambitious new aims and actions to greatly reduce food insecurity, improve population nutrition towards national dietary guidelines, and meaningfully reduce major diet-related conditions such as hypertension, diabetes and obesity. Importantly, the White House has emphasized the importance of centring all goals and actions around health equity and social justice, incorporating the perspectives of traditionally marginalized people with diverse lived experiences in hunger, poor nutrition and diet-related illness. Such emphasis is critical to ensure that resulting actions do not ignore or worsen disparities, but increase nutrition security and health equity across subgroups by age, sex, race, ethnicity, income, geography and urban or rural residence.
Although we do not know what policies the White House will propose in September, our knowledge and experience suggest feasible goals and strategies that can help orient and ground the national discussion, in the United States and elsewhere, around ambitious and achievable actions. We recognize that success will require multi-pronged efforts from multiple sectors. Therefore, leading up to the conference, we and others are organizing national and community policy convenings and listening sessions to bring together civil society, academia, the private sector and people with lived experiences to develop evidence-based consensus, produce strategic assessments and propose pragmatic new solutions14. Given the ambitious three focal areas — hunger, nutrition and health — it is essential to prioritize double and triple duty actions that will address two or all of these targets. We see potential for complementary actions across six domains.
Poor nutrition is the top cause of disease in the world, yet it is ignored by most health systems. Innovative new strategies must integrate food and nutrition into healthcare for disease treatment and prevention. Examples include sharing technology, goals and actions across healthcare and federal nutrition programmes; incorporation and scaling of produce prescription programmes and medically tailored meals into health systems; and new accreditation and physician licensing requirements that ensure meaningful nutrition education15,16.
As in many countries, US federal nutrition programmes, such as school meals, summer meals, SNAP, WIC and senior nutrition programmes, provide a critical safety net to those in need17. Advances in technology, behavioural economics and cross-agency coordination (for example, with healthcare) can strengthen, modernize and leverage these investments to address hunger, nutrition and health. Stronger nutrition standards and greater investment in school meals are clear priorities. Federal nutrition programmes should also develop new strategies to increase accessibility, affordability and intake of protective foods like fruits, vegetables, legumes, whole grains, nuts, seafood and yogurt; and create procurement reform to shift from lowest-price decision-making to incorporating externalities like resilience of local and regional food systems, food justice for workers, and community empowerment.
Innovative public health, regulatory and educational approaches can increase public knowledge and reduce consumer confusion, leverage shared community knowledge and learnings and advance nutrition education for priority populations. Examples of relevant actions include dedicated funding for updating, disseminating and evaluating national dietary guidelines and dietary references intakes; effective product labelling to empower consumers, including front-of-pack and warning labels; streamlining processes and timelines for securing health claims on more nutritious products; sustained investment in national food and nutrition surveillance; and implementing voluntary or mandatory standards for additives such as sodium and sugar and on food marketing to children.
We stand at the cusp of exciting discoveries around food and human health that will dramatically improve the way we view, prevent and treat diet-related diseases. National governments must lead in supporting independent research to rapidly advance emerging science around food and the gut microbiome, plant bioactives, food processing, personalization, timing of meals, brain health, immunity, healthy aging, infertility, mental health, allergies and more; must accelerate critical science around food and obesity, diabetes, cardiovascular diseases and cancers; and must invest in translational science around community interventions, behavioural change, health equity, consumer communication, healthcare systems and federal feeding programmes. In the United States, a new national nutrition ‘moonshot’ can grasp these opportunities, including a new National Institute of Nutrition at the National Institutes of Health (NIH); emphasis at the US Department of Agriculture (USDA) on the nexus of production, human health and sustainability; and improved coordination and investment in nutrition research across the NIH, USDA, US Department of Defense, US Agency for International Development, Veterans Affairs, Centers for Disease Control and Prevention, US Food and Drug Administration and Federal Trade Commission18. These efforts can be complemented with training and support of a modern and diverse nutrition science workforce including basic and translational perspectives.
Tremendous new interest and investment is being directed towards private sector innovation — including in farms, food manufacturing, retail, restaurants, and supplement and wellness companies19. A coordinated new national strategy can help to guide such efforts to be science-based and to advance food security, nutrition, equity, health and sustainability. Government actions can include tax policy and other incentives across sectors for R&D, production, manufacture and marketing of healthier foods; investment in a national ecosystem of food entrepreneurs; federal grants and loans that support minority business owners to advance nutrition and economic empowerment; and new public–private partnerships to accelerate nutrition science and translation. The investor community is also a ripe constituency for progress, including national development and implementation of ‘ESG + nutrition’ investment metrics19, and incentives for benefits corporations that value and integrate social and environmental goals. In addition, the conference can convene and encourage the private sector to make their own commitments toward achieving the hunger, nutrition and health goals of the conference.
In 2021, the US Government Accountability Office (GAO) — the government’s internal auditing agency — identified federal investments in 200 different policies to improve nutrition, but these were fragmented across different 21 agencies and without sufficient coordination to achieve intended goals20. The GAO recommended that Congress identifies a new federal entity with sustained authority to coordinate national food and nutrition policy. This goal could begin to be addressed by a well-resourced interagency taskforce, for example, it could be co-chaired by the secretaries of the USDA and US Department of Health and Human Services. However, an interagency taskforce might not sustain success as such groups can be defunded or disbanded with changes in administrations. Long-term success could be better served with the creation of a new White House Office of Food and Nutrition, analogous to actions taken by Congress around national intelligence after the 11 September terrorist attacks in the United States; and a new overall national strategy around food and nutrition, analogous to the whole-of-government environmental strategy created by the 1969 National Environmental Policy Act18.
Meaningful policy actions across these six domains will together help to achieve the goals of the White House Conference to address hunger, nutrition and health. The actions described herein are neither intended to be comprehensive nor final, but a starting point for further discussion and consideration by the government, civil society, academia, the private sector and other stakeholders. For example, hunger can also be targeted through anti-poverty actions such as raising the minimum wage, investing in public schools, ending red-lining, building affordable housing and creating new jobs in low-income communities. Nonetheless, many of the ideas discussed above are highly promising double- and triple-duty actions to achieve national goals.
The announcement of the 2022 White House Conference on Hunger, Nutrition and Health represents a historic moment in US food and nutrition policy and, by extension, given US influence, in global food and nutrition policy. More than 50 years have passed since the nation came together to address food, and it is now facing very different issues and goals. The 2022 conference provides an opportunity for a new national roadmap with clear, actionable recommendations to radically transform hunger, nutrition and health and that will be implemented by the administration, Congress, civil society, the private sector, and other stakeholders. We hope that the 2022 conference will build the foundation for a twenty-first century food system that is nourishing, equitable and sustainable. A resilient, equitable and nutrition-focused food system will end hunger and advance well-being, reduce healthcare spending, support racial and economic equity, catalyse new jobs and small businesses, advance minority-owned businesses and rural development, enhance military readiness, reduce climate change, preserve the globe’s natural resources, and provide for greater security and prosperity for all nations.
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Tufts Friedman School of Nutrition Science and Policy, Boston, MA, USA
Dariush Mozaffarian & Daniel R. Glickman
World Central Kitchen, Washington, DC, USA
José R. Andrés
Food Systems for the Future, Chicago, IL, USA
Ertharin Cousin
Bipartisan Policy Center, Washington, DC, USA
William H. Frist & Daniel R. Glickman
Chicago Council for Global Affairs, Chicago, IL, USA
Daniel R. Glickman
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Correspondence to Dariush Mozaffarian.
The authors are the co-chairs of an independent taskforce, not endorsed by or affiliated with the US government, that is working to inform the 2022 White House Conference and generate actionable recommendations to end hunger, improve nutrition and improve health (see https://informingwhc.org/). D.M. reports research funding from the National Institutes of Health, the Gates Foundation, The Rockefeller Foundation, Vail Innovative Global Research and Kaiser Permanente; reports personal fees from Acasti Pharma, Barilla, Danone and Motif FoodWorks; is on the scientific advisory boards of Beren Therapeutics, Brightseed, Calibrate, Discern Dx, Elysium Health, Filtricine, HumanCo, January Inc., Perfect Day, Tiny Organics and (ended) Day Two and Season Health; has stock ownership in Calibrate and HumanCo; and has chapter royalties from UpToDate (all outside of the submitted work). J.R.A. is the founder of World Central Kitchen and the CEO of ThinkFoodGroup. E.C. is the CEO of Food Systems for the Future, which has received support from the Kroger Foundation, Pepsi Foundation, Tysons Foundation and Walmart Foundation; serves on the board of directors for Bayer and Mondelez; and serves as a sustainability advisory board member for DSM. D.R.G. is a member of the advisory board of Just Meat, a cell-based meat company; is on the board of directors of the Chicago Mercantile Exchange; and is a senior advisor to The Russell Group, a Washington-based advocacy group. W.H.F. declares no competing interests.
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Mozaffarian, D., Andrés, J.R., Cousin, E. et al. The White House Conference on Hunger, Nutrition and Health is an opportunity for transformational change. Nat Food 3, 561–563 (2022). https://doi.org/10.1038/s43016-022-00568-x
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Published: 08 August 2022
Issue Date: August 2022
DOI: https://doi.org/10.1038/s43016-022-00568-x
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