Alarming trends call for action to define the future role of food in nation's health

The polling results are included in an expert analysis of U.S. health and the future of food that outlines steep challenges to improving nutrition security, caused by systemic factors that can make it more difficult for people to access healthy food. The report, released today by Deloitte, the American Heart Association and Research!America, details the urgent challenges to creating a food system that effectively integrates nutritious food into health care for the prevention, treatment and care of cardiovascular disease and other chronic conditions.

These findings were announced at The Drake Hotel in Chicago, the birthplace exactly 100 years ago of the American Heart Association, the world's leading public health organization focused on heart and brain health for all.

"Efforts led by the American Heart Association have cut death rates from heart disease by half in the past 100 years, but as we look to our second century of existence, the trends are ominous," said Nancy Brown, chief executive officer of the American Heart Association. "We are committed to averting a crisis of unparalleled health and economic burdens due to cardiovascular disease and obesity in the coming decades."

According to stark projections published June 4 in the Association's flagship peer-reviewed journal Circulation, obesity, if left unaddressed, will be a significant driver of sharp increases in cardiovascular disease that are anticipated by 2050:

• More than 6 in 10 (61%) U.S. adults are projected to have some form of cardiovascular disease by 2050 -- up from about half of all adults currently.
• Obesity rates will increase nearly 40% in adults. from 43.6% to 60.6%, and by more than 60% in children, from 20.6% to 33% by 2050.
• The highest growth of obesity prevalence is expected to be among adults 20-44 and 45-64 years old. In children, a steep growth of obesity is projected in all age groups.
• More than 150 million people (close to half of the nation's population) will have a poor diet -- the most prevalent factor affecting health conditions such as hypertension, obesity and diabetes.

Obesity is also a major factor in the public's perceptions of health in the U.S., according to the public opinion survey. A resounding 94% of respondents believe that obesity is either a somewhat (41%) or very (53%) serious concern.

More than 3 in 4 respondents (77%) said they would like to eat a healthier diet. However, respondents reported significant barriers to achieving that, including:

• The cost of healthy food (60%): Many find it challenging to afford nutritious options.
• Stress eating (42%): Emotional factors play a role in dietary choices.
• Lack of preparation time (33%): Busy schedules hinder meal preparation.
• Lack of knowledge (32%): Understanding what foods are healthy and how to prepare them remains a challenge.

"The results show significant differences in how historically underrepresented groups rank the barriers to healthy eating," said Mary Woolley, president and CEO of Research!America, a nonprofit medical and research advocacy alliance. "Nearly 7 in 10 Asian American (66%) and Hispanic (68%) respondents said the cost of healthy food was their biggest barrier to healthy eating. Black respondents were more likely to cite gaps in knowledge about healthy food (38%) and difficulty accessing stores that carry a selection of nutrient-dense foods (25%) as barriers to healthy eating."

The U.S. Health and the Future of Food report implicates food and nutrition insecurity (the inability to attain adequate calories and nutrition to support health), ultra-processed foods and the lack of resilient and adaptive food and agricultural systems as major contributors to poor diets. As cited in the report, approximately 1 in 7 people in the U.S. faced food insecurity in 2022 -- a total of 44 million people, including 13 million children, marking the highest rates since 2014.

"The impact of food insecurity is felt disproportionately in rural (90%) and southern (80%) U.S. counties, but food and nutrition insecurity exist across the U.S.," said James Cascone, partner, Deloitte Sustainability, Climate & Equity strategic growth offering and the Future of Food leader for the Americas. "Factors including consumer preferences, cultural norms and unhealthy food marketing, compounded by social inequities and food and nutrition insecurity, impede access to healthy foods. The resulting decline in diet quality significantly raises the risk of chronic conditions including cardiovascular disease."

Nearly 60% of the U.S. diet is comprised of ultra-processed foods that are high in refined grains, calories, sodium, sugar and saturated fat, and are more often selected by consumers over nutritionally healthier alternatives, according to statistics cited in the report. The report calls for stakeholders including health care professionals, food industries, policymakers and others to drive innovations that enable food systems to bolster health outcomes.

"Healthy, nutritious food not only leads to better overall health -- it can be a critical tool to treat, manage and prevent chronic disease," said Kevin Volpp, M.D., Ph.D., American Heart Association volunteer, scientific lead for the Association's food is medicine initiative Health Care by Food™ and founding director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania's Perelman School of Medicine and the Wharton School. "Cross-sector collaboration and research-backed innovation in public and private sector programs are needed to stem the combined tidal wave of obesity and nutrition insecurity, threatening the health of millions of people in the U.S. now and for decades to come."

The Association's Health Care by Food™ initiative is investing in research, advocacy and education to integrate cost-effective food is medicine approaches into the health care system. Initial pilot studies funded by the Association are underway to help strengthen the evidence base by demonstrating the effectiveness of healthy food interventions applied within the health care system.

The Association also is driving greater understanding of the components of specific foods and their role in human health in collaboration with the Periodic Table of Food Initiative (PTFI). PTFI was established by multiple academic disciplines along with the technology, philanthropy and nonprofit sectors five years ago to better understand food biodiversity by building a unique database of the global food supply to inform dietary recommendations and agricultural practices to enhance both human and planetary health.

Brown noted that additional health and nutrition solutions are needed to prevent projected increases in cardiovascular disease incidence and cost.

"We must make bold moves to change the troubling trajectory of cardiovascular disease. That is why the American Heart Association will soon launch a novel, longitudinal direct-to-patient registry of individuals living with overweight and obesity and those prescribed treatment for weight management," Brown said. "Building on our decades of experience in patient registries and inspired by the Framingham Heart Study, this groundbreaking registry will provide seminal research to improve understanding of the causes and treatments for obesity, and how obesity is managed by health care professionals."

The new initiative will help set the stage for fundamentally shaping public health guidelines related to nutrition and obesity. Brown called on others to embrace these types of innovative and comprehensive approaches to improving the nation's health.

"Collaborative efforts from public and private entities are imperative to advance health and nutrition approaches that could shape the course of public health in the next century," Brown said. "We invite stakeholders from across the health and nutrition sectors to join us in this fight to ensure that every person has access to nutritious food that leads to better health."