In remarks delivered at the National Food Policy Conference last week in Washington, DC, Gottlieb said ways must be found to lessen the burden of chronic diseases, most notably cardiovascular disease and cancer.
New medical treatment approaches have made great strides in treating these diseases, he said. But helping people to make better choices must play a key role in prevention, Gottlieb said.
One of the cornerstones of this strategy is the ongoing effort to restrict tobacco use, Gottlieb said. But the other foundational piece is to improve Americans’ food choices.
Importance of nutrition
“Improving the nutrition and diet of Americans would be another transformative effort toward reducing the burden of many chronic diseases, ranging from diabetes to cancer to heart disease,” Gottlieb told the audience.
“The public health gains of such efforts would almost certainly dwarf any single medical innovation or intervention we could discover,” he said.
More than 20% of deaths from cardiovascular disease can be attributed to dietary factors, Gottlieb said. And obesity continues to rise. In 2007-2008, 33.7% of adults in the US were obese; that rose to 39.6% in 2015-2016. And children are getting fatter too. In the same time period the obesity rate among children rose form 16.8% to 18.5%.
“Even a small advance in the nutrition of a single individual, which might have only a limited—although discernible—impact on a person’s individual risk for chronic disease, would have a massive impact once we aggregate all those small health gains across tens of millions of lives,” Gottlieb said.
A big way in which FDA can help consumers make better choices is to revamp claims. Gottlieb said the notion of what’s ‘healthy’ needs to be updated to align better with what consumers understand by the term. This is especially true on how much fat intake can be considered healthy and what kinds of fats contribute to overall health.
While Gottlieb didn’t mention dietary supplements per se, he did stress the critical importance of nutrients within food. People eat food, not nutrients, but they need to know how nutrient dense their diet really is, he said.
“As we broaden our message, we can’t undermine the importance of nutrients in our health message. Availability of information about nutrients — both those that we need to limit, such as added sugars and sodium, and those that consumers aren’t getting enough of, like potassium, remains a core aspect of our role and nutrition strategy,” he said.
This issue came to the fore in a public way several years ago when the manufacturers of the KIND whole food nutrition bars ran into problems with FDA over their ‘healthy’ claims because the overall fat content was too high, even though that fat was coming from nuts, not processed fats.
KiIND won on a petition to FDA, but Gottlieb said it’s time to align the ‘healthy’ claim with the latest science on the subject.
Another claim that looms over the marketplace is ‘natural.’ Gottlieb said the agency has received thousands of comments on the subject, and will have more to say about the definition of this term “soon.”
Another important element in helping people to make those better choices is to revamp the way food manufacturers communicate with their consumers. Gottlieb acknowledged that consumers are asking for cleaner, easier to understand labels. Among the changes that could be made would be to standardize how nutrients are called out. Would ‘Vitamin B12’ be a more understandable way to announce the presence of this substance rather than calling it ‘cyanocobalamin’ for example?
Gottlieb noted that the formal effort to revamp food labels is more complicated than changes it has made in other industry sectors it regulates. There are more moving pieces to consider, for example. To that end, Gottlieb said the agency has proposed pushing compliance on the labeling changes out to 2020 for the biggest manufacturers.
Standards of identity need to be updated, to take advantage of new possibilities in cheese and yogurts, Gottlieb said. He also reiterated the agency’s goal to foster sodium reductions in American diets.
“Our work in food is a unique challenge for the agency because we’re creating a set of rules that has a broader range of stakeholders than the other areas we regulate,” he said.