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Episode 113
The Doctor's Farmacy

How COVID-19 Shines A Light On Our Broken Food System

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Only 12% of us in the US are metabolically healthy—it’s pretty alarming when the healthy population is the minority. 

And in the age of COVID-19, it’s important to recognize that those with a chronic disease are at an exponentially higher risk of hospitalization than someone who is metabolically healthy. If we as a population were healthier (think less obesity, type 2 diabetes, cardiovascular disease, cancer, etc.), the evidence supports that we’d be faring much better throughout this pandemic.

Of course, a major driver of chronic diseases and the risks they create is our food system. We can’t expect to be a resilient population if we aren’t feeding our bodies real food with real nutrients we can use to function optimally. 

To dig into this topic further, I was excited to sit down with Dr. Dariush Mozaffarian on this episode of The Doctor’s Farmacy

Throughout our talk it’s clear that nutrient status has massive implications for our immune health. More and more information is emerging on the relationship between certain nutrients and the severity of COVID-19 and Dr. Mozaffarian shares which he feels are the most promising to research in regards to this specific virus. 

We can’t talk about a lack of proper nutrition amongst the general public without recognizing the role the food system plays. Dr. Mozaffarian and I talk about strategies for including the “Food as Medicine Model” as part of our standard healthcare system, including using SNAP (our food stamps program) to better support the people who rely on it most—children, the elderly, and our veterans. 

Food and disease are not independent topics. While we continue to think about immune health more than ever before, we need to recognize the essential role of food and work to change our broken food system from the ground up. 

I hope you’ll tune in to learn more.

Find the “Report of the 50th Anniversary of the White House Conference on Food, Nutrition, and Health: Honoring the Past, Taking Actions for our Future” at https://sites.tufts.edu/foodnutritionandhealth2019/

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

In this episode, you will learn (video / audio):

  1. Three ways COVID-19 influences food and nutrition, and visa versa
    (3:25 / 3:28)
  2. How our national health and economic outcomes from COVID-19 might be different were we a metabolically healthy society
    (7:34 / 7:37)
  3. We can improve our metabolic health in real time
    (9:50 / 9:53)
  4. Micronutrients and their potential for preventing and reducing COVID-19 severity
    (11:29 / 11:32)
  5. Strategies to address our chronic disease pandemic and problems with our food system
    (28:38 / 28:41)
  6. How obesity is affecting our military and national security
    (33:20 / 33:23)
  7. Why we need a coordinated national organizing office around food and nutrition policy
    (48:15 / 48:18)
  8. Functional Medicine for our food system
    (54:52 / 54:55)
  9. Obstacles to changing and improving our food system
    (56:09 / 56:12)
  10. Educating policymakers through strategic collaboration among stakeholders
    (1:00:27 / 1:00:30)

Guest

 
Mark Hyman, MD

Mark Hyman, MD is the Founder and Director of The UltraWellness Center, the Head of Strategy and Innovation of Cleveland Clinic's Center for Functional Medicine, and a 13-time New York Times Bestselling author.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

 
Dr. Dariush Mozaffarian

Dr. Mozaffarian is a cardiologist, Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and Professor of Medicine at Tufts Medical School. As one of the top nutrition institutions in the world, the Friedman School’s mission is to produce trusted science, future leaders, and real-world impact. Dr. Mozaffarian has authored more than 400 scientific publications on dietary priorities for obesity, diabetes, and cardiovascular diseases, and on evidence-based policy approaches to reduce these burdens in the US and globally. He has served in numerous advisory roles including for the US and Canadian governments and, in 2016, Thomson Reuters named him as one of the World’s Most Influential Scientific Minds.

Transcript

Dr. Dariush Mozaffarian:
Our policies are not in line to help or support people to eat healthy food. We have almost three in four American adults are overweight or obese, and about half of American adults have diabetes or prediabetes.

Dr. Mark Hyman:
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman, and this is a special episode focused on COVID-19. I’m so lucky to have my friend and colleague, Dr. Dariush Mozaffarian, and known to his friends as Dari, who’s an extraordinary doctor. He’s one of the few guys out there in academic medicine who really understands that food is medicine and talks about it non-stop other than me, which is pretty awesome. He’s a cardiologist. He’s the Dean and John Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy. He’s Professor of Medicine at Tufts Medical School. He’s one of the top nutrition researchers in the world.

Dr. Mark Hyman:
Their goal at the Tufts Friedman School is to produce trusted science, future leaders, and real-world impact. It’s not just an academic center, it’s about focusing on policy and changing the world. There’s no one in medicine in academia I know who’s done more to advance nutrition in the policy frontier to speak out about the things that matter than Dari. He has authored more than 400 scientific publications, which is unbelievable. I’ve read most of them. I’ve quoted most of them. Well, not really, I probably haven’t read most of them, but I read a lot of them. If you read my book, he’s like a key feature in the book on how we focus on issues of obesity, diabetes, heart disease, and evidence-based policy approaches to really reduce this burden of chronic disease in the United States and globally. He’s all over the place.

Dr. Mark Hyman:
He’s on advisory roles in the US and Canadian governments, the American Heart Association, the World Health Organization, the United Nations. He’s been featured in The New York Times, Wall Street Journal, NPR, and Time Magazine. He was named as one of the world’s most influential scientific minds. I think of all the people out there talking about food and health, and chronic disease, and food policy changes, there’s no one with more depth, with more humanity, and more brilliance addressing this than Dr. Mozaffarian. So, welcome to The Doctor’s Farmacy.

Dr. Dariush Mozaffarian:
Wow, Mark, thank you so much. With that introduction, we’ve set up the listeners for disappointment.

Dr. Mark Hyman:
You’re my hero, you’re my hero. You’re an intellectual hero, and I learned so much from you. We want to talk today about what seems to be unrelated to COVID-19, which is an infectious disease, but it’s diet and chronic disease. You wrote an article with the Former Secretary of Agriculture Dan Glickman that was posted on CNN entitled, ‘Can diet flatten the curve for COVID-19?’ It’s sort of like, “Huh, how does that even make sense?”

Dr. Mark Hyman:
So, we’ve heard all about these ideas of flattening the curve with social distancing and hand washing and contact tracing and isolation and testing, but your article presented a very different view about how we can use food and nutrition and specific nutrients to actually help us address this pandemic. So, can you tell us why you wrote this article and why this is more important now than ever to address these issues?

Dr. Dariush Mozaffarian:
Yeah, I think, Mark, it’s really clear to those of us who are following this crisis that COVID-19 has really laid bare these incredible challenges, these incredible disparities, these incredible unreasonable aspects of our food system. There’s so many ways that COVID-19 influences food and nutrition, and food and nutrition influence COVID-19 back. I’ll just go through them quickly and we can go about each of them.

Dr. Mark Hyman:
Yeah, go.

Dr. Dariush Mozaffarian:
So, one is immunity, the actual immune response to COVID, and then actually the blunting of the excessive inflammatory response to COVID. We can talk about nutrition and actually the immune response. Two is hunger and food insecurity, which of course cause incredible human suffering with this economic shutdown and lost wages and schools being closed. But also, malnourishment, we know from long clinical experience, malnourishment further predisposes people to infection. So, that’s the second [crosstalk 00:04:38].

Dr. Mark Hyman:
So that doesn’t mean you’re skinny and wasted away. It could be that you’re nutrient deficient, which is really common in America.

Dr. Dariush Mozaffarian:
Absolutely. Absolutely. There’s what we call hidden hunger. People look like they’re getting enough food, but there’s hidden hunger, because they’re not getting the right nutrients.

Dr. Mark Hyman:
What’s paradoxical is the most obese are often the most nutrient deficient when you look at their numbers, right? This is kind of interesting.

Dr. Dariush Mozaffarian:
Yeah. I think then these other aspects of COVID that are crucial to kind of just quickly mention are third, the incredible intersections of supply chains, and food waste, and getting food to people. We don’t really have a national food system or even a global food system. We have this fractured supply chain that’s now become very, very dire. And then I think one of the most important things for really thinking about COVID long term, because this is going to be with us for some time, many years, is the incredible relationship between poor metabolic health, diabetes, hypertension, heart disease, obesity, and poor outcomes with COVID.

Dr. Dariush Mozaffarian:
The latest analysis from New York, which has had the most cases in the United States, showed that with each of those conditions, diabetes, hypertension, obesity, there was about two to three times higher risk of hospitalization. If you put those three things together, lots of people have diabetes, hypertension and obesity, there would be 16-fold higher risk of hospitalization. We’re modeling this now. It’s very plausible that if we had a metabolically healthy population, COVID would be much, much less severe.

Dr. Dariush Mozaffarian:
So, thinking about nutrition, and the immune response, malnourishment and hunger, and food insecurity, disparities, the very high rates in African Americans, very likely related to nutrition in a major way, the challenges to food systems and supply chains and food waste, and then metabolic health. These are all things that you and I and others who study food have known about that food and nutrition are a dire challenge and an incredible opportunity to improve the health of the population, but COVID-19 has really like taken a knife and slice down this curtain that was kind of hiding it and made it very obvious.

Dr. Dariush Mozaffarian:
So, if five years from now, we’re back to just where we were a couple of years ago, there’s no improvement in our food system and the quality of the food and the way we get it to people and the science that we have to address these questions, I would be just devastated. I would be so disappointed that we haven’t realized the opportunity here to fix the food system.

Dr. Mark Hyman:
So, let me get this straight. What you’re saying is that if you have chronic diseases and multiple chronic diseases, that your risk of being hospitalized is 16 times higher. That if you’re metabolically unhealthy, you’re more likely to get sick because your immune system isn’t working, and then only 12% of us are actually metabolically healthy. So, that means if we actually had a healthy population that was eating a diet that created metabolic health instead of the opposite, which we’re doing now, that this may just be like a bad flu. We wouldn’t have full hospitals, and a society that’s shut down, and trillions of dollars in economic losses.

Dr. Dariush Mozaffarian:
All the evidence supports that. Of course, we can’t do a randomized trial and wave a wand and make everybody know about the healthy to test that, but all the evidence suggests that. As you said, based on national data, only 12% of adults in this country are metabolically healthy. That’s just taking things like waist circumference, blood glucose, blood pressure, cholesterol. If you just measure those things, only 12% of adults are metabolically healthy. Most of those are people in their 20s, who haven’t yet really had a lifetime of poor diet and poor lifestyle. So, the vast, vast majority of American adults over 40 are metabolically unhealthy.

Dr. Dariush Mozaffarian:
Given these associations, as I mentioned, even just with one of these risk factors doubling or tripling the risk of hospitalization and you start piling them up together. In terms of risk of death, there’s been so few deaths, especially under age 70, at least one of these other conditions. So, it’s very plausible that if we had a very metabolically healthy population, instead of 12% metabolically healthy, we had 12%, metabolically unhealthy. What if 9 out of 10 of us are metabolically healthy, then COVID-19 would be a far, far less severe disease, many, many fewer hospitalizations, many fewer deaths. We wouldn’t be shutting down the economy. We wouldn’t have these hospitals overloaded. Our health care providers putting themselves in danger and fatigue and working triple shifts.

Dr. Dariush Mozaffarian:
What’s really important here is that we can actually fix this now in real time. So, it doesn’t take years and years and years to reverse diabetes, or to reverse hypertension, or to reverse poor metabolic health. It does take years and years to change weight for many people, but metabolic health, whatever your weight, we can pretty rapidly improve metabolic health over months, sometimes even shorter, but certainly over months. The country, in addition to the things that we’re doing, social distancing and testing, we should be launching a national campaign to improve the way we move and eat to improve our metabolic health.

Dr. Mark Hyman:
To both protect ourselves, and to protect our nation, and globally to protect ourselves. I mean, what you’re saying is pretty radical. Yes, we may take a long time to lose all the weight we need to lose, but in a very short order by changing the food that goes in, putting in good stuff and taking out the bad stuff, which you’ve written so much about in thousands of articles, that we could quickly revert to a more normal metabolic health, reduce our inflammation, improve our immunity. We see this, I’ve seen this. Even a great example for people to understand is when someone who’s very, very overweight gets a gastric bypass. Within weeks, their diabetes goes away. They’re still very overweight, but their metabolic health changes because they’re eating a very different diet.

Dr. Mark Hyman:
That’s the key to remember, that your metabolic health can be really quickly reverted. So, on a macro level, we sort of painted a picture of the poor-quality diet we have that’s leading to obesity and poor metabolic health, which would make a massive difference if we changed. But you also were talking about what happens on the micro level on the micronutrient level. That’s really fascinating to me. I just shared an article that I read this morning that was done in China, where in China, it has some of the widest disparities in Selenium levels in the soil. So, in some provinces, there’s almost no Selenium. In other provinces, there’s abundant Selenium in the soil. So, the populations, some are very deficient, and some were adequately nourished with Selenium.

Dr. Mark Hyman:
In this one study, this was just one micronutrient, right? In the populations that had the highest levels, they had three times better cure rates for COVID-19 than the lowest levels. The populations with the lowest level of Selenium died five times as much as the ones with the highest levels. That’s just one nutrient. So, you were talking the other day about what you’re trying to do, which is develop a study to look at a collection of nutrients that together could bolster the immunity of our population. You’re trying to get this study going. So, tell us about what are these nutrients? How does it work? What are you trying to find out through looking at this study?

Dr. Dariush Mozaffarian:
All great questions. Yeah, first and foremost-

Dr. Mark Hyman:
[crosstalk 00:12:46] ocean, right?

Dr. Dariush Mozaffarian:
That’s right. Yeah, I think first and foremost, I’ve always been a guy who believes in foods, foods, diet patterns. From all the cardiovascular literature, there’s been failed nutrient supplement after failed nutrient supplements. A single supplement doesn’t really make a big difference. It’s really about your overall food. There are some exceptions. I think Omega 3’s, Omega-3 fatty acids in particular. There’s definitely been only some studies for benefits, mixed findings. But on average for complex chronic diseases like cardiovascular disease and cancers and some other conditions, supplements don’t seem to replace foods.

Dr. Dariush Mozaffarian:
So, I raised that because I come at this as a skeptic. I come at this as an automatic skeptic that individual nutrients could make a difference. Yet as soon as COVID hit, I started reading and consulting with colleagues, experts in nutrition immunology, nutrition infectious diseases. We have some of the world’s leading experts-

Dr. Mark Hyman:
That’s a thing, nutrition immunology. That’s a thing, right?

Dr. Dariush Mozaffarian:
Absolutely. We have an incredible expert Dr. Simin Meydani at Tufts, who’s the Former President of the American Society for Nutrition, the former head of all of research at Tufts, very, very much just had a career studying nutrition immunology. So, together and recruiting other experts, we started looking at the evidence. There’s actually very compelling evidence from cell models, animal experiments, and even human studies about single nutrient supplements and infections.

Dr. Dariush Mozaffarian:
Specifically for COVID, there’s lots of research that suggested that some of the very same proteins that the COVID virus uses for its own entry and replication, that have been in other viruses like SARS, these nutrients have specific benefit for activity against those proteins. So, I think there’s maybe 8 or 10 nutrients that are potentially promising that could have an effect. I would put those effects in sort of three camps. One camp is direct potential effects against COVID specific proteins. So, there’s proteins that are needed for the virus to enter the cell. There’s proteins needed for replication and reproduction.

Dr. Mark Hyman:
Like Zinc, right?

Dr. Dariush Mozaffarian:
For example, Zinc inhibits… I’m looking at my notes here to get the terminology exactly correct. Inhibits the RNA dependent, RNA polymerase, which is needed for viral replication. That’s been seen with SARS, the SARS RNA polymerase and that’s very similar polymerase to COVID-19.

Dr. Mark Hyman:
What that means is that the virus basically hijacks your genetic material and uses that little assembly line to produce and replicate itself. That interrupts that assembly line production is what you’re saying.

Dr. Dariush Mozaffarian:
Exactly. Another nutrient is Quercetin. Quercetin a flavanol binds to the H2 receptor which SARS uses to get into the cell. High level computer modeling has just very recently identified Quercetin as one of the top candidates for blocking COVID entry into the cells. I can go through those nutrients. One camp has actually direct effects against specific effects against COVID. A second camp of effects is just generally improving pathogen killing. So, we know again from animal experiments and in the humans, if you’re deficient in these nutrients, actually clinically deficient in these nutrients, Zinc, Selenium, some of the B vitamins, some other vitamins, the immune system doesn’t function as well.

Dr. Dariush Mozaffarian:
In animal experiments and even some human trials, if you give these vitamins, you improve T-cell function. The T-cells are crucial to fighting viruses. You improve T-cell function and you boost immune response, just general immune boosting response. And then the third category of effect of these about 8 or 10 nutrients, which to me, I think is actually the most interesting for COVID, is some of these nutrients help fight the pathogens that are invading the lungs, but also, importantly, dramatically ramped down, prevent, soften the excessive inflammatory response that really leads to death with COVID. COVID kills us mostly not because of the virus itself, but because there’s this overwhelming, excessive inflammatory response in the lungs called cytokine storm, where you get way too high levels of inflammation.

Dr. Dariush Mozaffarian:
The body’s trying too hard to fight COVID, which may explain why people with inflammatory conditions like diabetes and hypertension and obesity are at higher risk for hospitalization and death, because they’re more and more likely to get this cytokine storm. Many of these nutrients have really clear experimental benefits against reducing cytokine storm, Zinc in particular, Quercetin, EGCG, which is from green tea. EGCG, for example, multiple diverse models of lung injury, if you injure the lungs in many different ways, including viral infection. In animal models, it blunts that excessive response and animals heal better and live longer.

Dr. Dariush Mozaffarian:
So, if you put all these nutrients together, I can’t tell you for sure that they would have efficacy against COVID, we don’t know. But compared to some other things that have been tested, there’s at least as much evidence to test these, compared to let’s say, chloroquine or hydroxychloroquine.

Dr. Mark Hyman:
Yeah, and a lot less side effects.

Dr. Dariush Mozaffarian:
A lot less side effects. These are very, very safe. So, we’re really interested in doing a rigorous randomized trial to test these. What really keeps me up at night right now is research takes time. It takes time to put together the protocol, get the human subjects’ approval, and get funding. So, we’re going to go to major federal and foundation funders and try to get this trial started as soon as possible. But we could complete this trial in a few months if we have the sufficient funding. I can tell you more, we can talk more about some specific nutrients.

Dr. Mark Hyman:
Yeah. Well, it’s fascinating. It’s so fascinating because what you’re saying is so based on science. It’s so out of the purview of what we normally think about. People will go “Where’s the evidence?” It’s there, it’s not something you normally pay attention to. It’s sort of in the side mirror. If you think about just this one Selenium study, if there was a drug that could reduce mortality fivefold, it would be headline news, right? This is just one [inaudible 00:19:52]. When you use them synergistically, they work synergistically with multiple different mechanisms.

Dr. Mark Hyman:
So, I guess, I know what I’m having for dinner. I’m having a couple of Brazil nuts, don’t have more than two or three, because they get too much Selenium. I’m going to have chicken liver for the vitamin A, I’m going to have oysters and pumpkin seeds for the Zinc. I’m going to have quercetin-containing onions and [inaudible 00:20:14] spinach. I’m going to have porcini mushrooms and herring for the vitamin D. I’m going to top it off with some green tea at the end. I think it’s going to help me with my immune system.

Dr. Dariush Mozaffarian:
Well, that’s pretty tough for most people to get the ingredients.

Dr. Mark Hyman:
I know it all tastes together.

Dr. Dariush Mozaffarian:
So, I think in terms of specific nutrients, we looked at several-

Dr. Mark Hyman:
Yeah, I forgot I’m going to make a curry because of the turmeric that you mentioned.

Dr. Dariush Mozaffarian:
Yes. So, some of the promising nutrients that we think are less specific to COVID but interesting, but not at the top of our list are vitamin C, vitamin D, turmeric, Selenium, and the B vitamins, are all nutrients which could have some efficacy and benefits for the immune system. They don’t have this specific evidence for pathway specific to COVID-19. The Selenium study you just mentioned is kind of one of the first. So, they’re interesting, vitamin A also. They’re all interesting. I think the ones that we have put together that we think are the top candidates are Zinc, Quercetin, vitamin E, and EGCG. We actually think it’s the combination, putting the four together that would have benefit, really testing the combination, because they all have subtle, mild small effects. These aren’t drugs. This is pharma-

Dr. Mark Hyman:
I’m sure you’re getting a lot of big pharma wanting to fund these studies, right?

Dr. Dariush Mozaffarian:
Exactly. There’s no profit in testing these, right? But if we test the combination, we think that together, they’ll work synergistically and in a complimentary way. Again, they’re so safe to test.

Dr. Mark Hyman:
So, you’re saying this is not something you use in an ICU, but this is in the general population could help us be more resilient in the face of COVID-19?

Dr. Dariush Mozaffarian:
Well, we think the best population would be people who are just diagnosed, right? This could work for prevention. This could work in the sickest patients in the ICU, but that seems less likely. So, I think based on mechanisms, when you’re first diagnosed, these nutrients could help reduce the progression, reduce the severity, reduce the days of illness, prevent you from getting to the hospital. If you’re in the hospital already, prevent you from needing a mechanical ventilator. So, that’s the population we’re going to target. I want to emphasize that I’m not recommending people go out and start taking these things, because we don’t know yet if they have activity against COVID.

Dr. Mark Hyman:
But you’re getting my immune boosting dinner of chicken livers and herring, right?

Dr. Dariush Mozaffarian:
Yes, eat healthy food.

Dr. Mark Hyman:
No problem with that.

Dr. Dariush Mozaffarian:
Eat healthy food.

Dr. Mark Hyman:
There’s a lot of these nutrients that are in food. If you eat them regularly, you’re going to up your levels of these nutrients. It’s not that hard. I mean, vitamin D is a little hard. You have to eat a lot of herring and a lot of porcini mushrooms, or you have to go in the sun half-naked for 20 minutes between 10:00 and 2:00 south of Atlanta, or take a supplement. But for most of these, you actually can get them from your food. I think food first is always the strategy. That’s really why now, for two reasons, it seems like what you’re saying. One, you want to improve your diet, because you want to improve your metabolic health in terms of insulin resistance and the inflammation that goes along with being overweight and chronic diseases.

Dr. Mark Hyman:
But you also want to up level your nutrient density, the micronutrients in your food by choosing smartly the foods that contain these nutrients. So, you kind of have a double strategy for addressing your metabolic and your nutritional health to make yourself more strong in terms of preventing and maybe in recovering from COVID-19. You’re also going to be helping society at large by taking care of yourself, by reducing the burden on our hospitals and healthcare systems and helping us be able to open up the economy. That’s maybe why some of these European populations are not struggling.

Dr. Mark Hyman:
I mean, look at Sweden, I mean, they’re generally much healthier population. They’re one of the healthiest populations in the world. They have an open society, but they’re not seeing the same rates as we are. I’m wondering if maybe that’s partly because of their general health. What do you think?

Dr. Dariush Mozaffarian:
Well, we know for sure, again, from clear evidence in the United States that if you don’t have these conditions, you have far, far lower risk of hospitalization and death. So, I actually think that probably the regions of the world where per infected person we’re going to see the fewest deaths are going to be the rural, low income regions of the world. So, there’s our doorbell live podcasting.

Dr. Mark Hyman:
The beauties of working at home. I had my cat walk through the scene.

Dr. Dariush Mozaffarian:
I’m sure my children will run by. But I think that it’s very plausible that in rural, Sub-Saharan Africa, rural Asia, rural regions where there’s a lot of poverty, there’s going to be huge rates of infection, I mean, very rapid rates of infection. But the percentage of people who are going to be hospitalized and dead among the infected I think is going to be quite low. This is why, getting to your point about why food is so important, for this double benefit. This is why we need a policy fix. This is why as you cover in your book, our policies are not in line to help or support people to eat healthy food. We have almost three in four American adults are overweight or obese, and about half of American adults have diabetes or prediabetes.

Dr. Dariush Mozaffarian:
When you start saying that the healthy population is the small minority of the population. That’s not okay, right? It should be that people with disease are the minority and we generally have a healthy population. We’ve completely flipped that on its head. We have a tiny, tiny proportion of the population that’s actually healthy and everybody else has disease. Most of that disease, not all of it, most of that diseases is strongly diet-related.

Dr. Mark Hyman:
You wrote in your CNN article that before COVID-19, poor diet kills 530,000 Americans every year, about 1,500 deaths every day. That was before COVID-19.

Dr. Dariush Mozaffarian:
Yeah, COVID-19 is tragic. These 50,000 deaths already in the United States are tragic. We need to be doing everything we can to reduce this. At the same time before COVID-19, around 40,000 Americans were dying every month directly from diet-related diseases that we’ve estimated that would not have happened if they had a healthy diet. We weren’t going up in arms and saying we have to stop this. This is causing catastrophe, but it was. It’s causing billions of dollars, tens of billions of dollars in preventable healthcare costs, which burdens our American businesses, which burdens our federal governments and state government budgets.

Dr. Dariush Mozaffarian:
It’s causing incredible disparities, big differences between the haves and the have nots in our society. It’s causing a lot of suffering, and it’s overwhelming our healthcare system. So, here’s where I think, I’m moving beyond the today to think about the rest of 2020, 2021, the next administration, we really need to take this learning from COVID that we do not have a healthy population. And then when you don’t have a healthy population and a crisis strikes, it shuts down the economy and people suffer, and businesses suffer. We need to take that knowledge and fix the food system. There’s concrete things we can do.

Dr. Mark Hyman:
So, we in medicine have a phrase that’s called acute-on-chronic. Someone’s a smoker, has emphysema, they get pneumonia, they’re not going to do so great. If you’re a healthy young guy and you get a little ammonia, it’s called a walk-in ammonia. It’s like having a bad cold. That’s exactly what’s happening now. COVID is the acute-on-chronic disease, obesity pandemic we have. It may seem like, why are we talking about chronic disease? We have a big infectious pandemic, let’s just focus on that, but now you’re saying it’s a more important time than ever to address this.

Dr. Mark Hyman:
It’s interesting, ironic, you reported a great report on the 50th Anniversary of the White House Conference on Food, Nutrition, and Health that you published with your team from Tufts and colleagues at Harvard, which laid out early in March… Right before this all took off, it was like perfect timing. …a series of strategies to really address this chronic disease pandemic, the underlying failures in our food policies and the food system. It was really brilliantly done and addressed a lot of things we talked about my book, including things like leveraging the power of the USDA programs to improve nutrition, utilizing economic incentives to get people to eat healthier food and disincentivized not so great food, protecting our children from avaricious marketing and advertising.

Dr. Mark Hyman:
I would think if we were foreign nation, we’re doing to our kids what we’re doing to it, we’d go to war to protect them, but we just let it happen. And then you even focused on healthcare and health professionals. How do we get healthcare to focus on food as medicine? How do we train our doctors and healthcare providers to understand nutrition and incentivize better nutrition knowledge and treatment of chronic disease? And then how do we address agriculture and sustainable? I mean, these are all intersecting ideas, not any one of them is going to fix the problem. You sort of identified 11 different key sectors that have to be addressed within these five things.

Dr. Mark Hyman:
Let’s say you were hired by the next president to be the foods czar? What are going to be your key strategies so that we, one, improve the overall health of our population and we make ourselves more prepared for the next pandemic from an infection? How do we address the health disparities, the economic challenges, the climate environmental challenges, all these intersecting issues, which often are siloed? You’re a big systems thinker, and often people are in silos within Congress or within medicine or academia. But somehow, you’ve got to go “Wait a minute, let me go 30,000-feet and see how are all these things connected? How do we solve all of them by working on them in a coherent way?”

Dr. Dariush Mozaffarian:
Well, the inspiration for that report was that in 1960, there was a White House Conference on Food, Nutrition and Health that was focused on the big problem of the day, which was true calorie malnutrition, true hunger. I mean, there were populations in the United States, where you would see kids with the tiny arms and the distended bellies that you now see in sort of famine-stricken nations elsewhere. There’s true lack of food in many places in this country. It was dire.

Dr. Dariush Mozaffarian:
So, Jean Mayer who went on to become President of Tufts and found our school. I hold Jean Mayer professorship, I’m quite humbled to do that. Jean Mayer works with President Nixon, a Republican, to organize this conference. They brought together all the stakeholders and they put together about 1,600 recommendations to fix the food system thinking about pure hunger.

Dr. Mark Hyman:
Only 1,600?

Dr. Dariush Mozaffarian:
Yeah, I say that because there wasn’t one fix, right? But they launched, two years later, 1,400 of them had been implemented. So, that conference dramatically changed in a positive way, the way we approach hunger in this country. So, it led to the standardization of school lunch, expansion and standardization of the food stamps program. It led to WIC. There was no program for mothers with infants, have led to the creation of WIC, which is the program that one and two babies in our country are born on WIC, which is this federal program that gives healthy foods to moms with babies. It led to nutrition facts labeling. It led to other consumer protections at FDA. It was quite instrumental in changing our food policy and essentially eliminating caloric hunger.

Dr. Dariush Mozaffarian:
We have another kind of hunger now, people don’t have healthy food, but it eliminated that sort of severe caloric malnutrition that the country had. So, 50 years later, we said that was the last time there was a high-level federal attention on our food system. We have new problems, right? We have diabetes, obesity, hypertension, incredible disparities, diet-related cancers, all the new things we’re learning about diet and brain health, food allergies, autoimmunity, inflammatory diseases, gut health. We are facing a very, very different food crisis now than 50 years ago.

Dr. Dariush Mozaffarian:
More than half of young Americans can’t enroll in the military because they don’t qualify. The number one medical reason is overweight or obesity. So, a large group of retired admirals and generals of Mission: Readiness, more than 750 retired admirals and generals have said that childhood obesity is a national security crisis [crosstalk 00:33:43] for the military. So, this was an inspiration behind that report.

Dr. Mark Hyman:
Just to piggyback on that and then I’ll let you continue is in that report, the most striking statistic I saw was that the evacuations from Afghanistan and Iraq, there were 72% more evacuations related to obesity-related problems than for war injuries, which was just mind blowing to me. This is not even the people trying to get in, these are people already in the military who are struggling with overweight and obesity and poor health.

Dr. Dariush Mozaffarian:
Well, I’m going to divert away from the report and come back, but a colleague of mine at Harvard who studies occupational health was very interested in first responders, in helping policemen and firemen in improving their health and understanding what was causing their risks, which again in this era is more important than ever. So, we started studying what was killing police and firefighters on the job, on-the-job death. To his great surprise, the number one cause of their on-the-job deaths were heart attacks and other challenges, not getting shot or getting killed in the fire. And then when you started looking at well what’s so different about firemen and policemen, he found that they had higher rates of heart attack for their age than the average American adults.

Dr. Dariush Mozaffarian:
The number one difference, number one risk factor was actually their diet, just horrible diets, because of working shifts, working in their cars, working overnight, sort of the doughnuts, the cop car pulling up the doughnuts, right? So, he sort of shifted his focus to seeing how he can improve the nutrition of police and firefighters. So, it is this quiet and overwhelming disaster that our fighting forces or policemen or firefighters or children are all getting killed, mowed down by metabolic diseases and where we sort of shrugged because it’s happened over decades and humans are evolved. We’re evolved biologically to respond to acute risk. This is going to kill me today. We’re not biologically evolved to understand, in the same way, risks that might kill us over months to years.

Dr. Dariush Mozaffarian:
Because back in the day when we were out on the savanna, we cared about that saber-toothed tiger right in front of us, not something that was going to happen a year later. So, something like COVID, a true crisis, that we think “Oh my god, I could die” changes everything. Yet, diabetes, obesity, hypertension, cancers, autoimmune diseases, allergies, chronic kidney disease, all these things that are diet-related that are still killing our population in incredible numbers we’re sort of assuming as normal. So, to go back to the report, I think there are three big picture principles that I’d like to highlight, that I think our report highlights. One is that there are concrete solutions. There are very real, very concrete solutions that we can fix this. Two, many of these are win-wins.

Dr. Dariush Mozaffarian:
So, this is not like tobacco, where we’re just trying to get rid of an entire industry. We want to help the food industry from farmers, to manufacturers, to restaurants, to producers, to retailers. We want to help them get healthier, more sustainable, more affordable food to people. So, it can be win-win. Three, this can happen quickly. This is not a 50-year plan. We could change things within a few years if we implemented the right policies. As you said, there’s no single magic bullet.

Dr. Mark Hyman:
One of those low hanging fruits. We had a great conversation, where we talked about the Dietary Guidelines for America. The Dietary Guidelines are interesting because they’re designed for a healthy population. You just said that only 12% of us are healthy. So, it doesn’t apply to most of us.

Dr. Dariush Mozaffarian:
Yeah, it is amazing. The Dietary Guidelines are incredibly positive process. I’m not somebody to bash the Dietary Guidelines for America. They’re one of the great things the government does, which is get scientists together, review the guidelines carefully, put out guidelines every five years. There are problems in the process. So, one of the biggest problems is that the scientific report that the scientists write then goes to the federal government. They change it without us exactly knowing how to put out the guidelines. Usually, it’s 90% similar, but some big things are changed probably because of industry influence.

Dr. Dariush Mozaffarian:
So, there are problems, but the other problem that you mentioned that or really the lost opportunity is that the Dietary Guidelines, by definition, by law, I think, are for the generally healthy population. So, they specifically say “These Dietary Guidelines are not to treat any disease or to help give anybody specific dietary guidance. If you have any specific disease, you should see your doctor.” But that means that 90% of Americans, the Dietary Guidelines don’t apply to them because they have diet-related diseases, right? So that’s a challenge, but so the low hanging fruit. Well, I think that there are several, it’s not.

Dr. Dariush Mozaffarian:
One I think one is to engage and leverage the power expertise and finances of the healthcare system for food and nutrition. So, the number one cause of poor health in our country, poor nutrition is ignored by the healthcare system. So, we have to take this massive system that we’ve created, you and I are both doctors, our healthcare system has a lot of wonderful things about it. We have taken this massive system that we’ve created and use its resources and power to help improve food and nutrition, so food as medicine.

Dr. Dariush Mozaffarian:
Things like healthy produce prescription programs, where you go to the doctor if you’re food insecure and have diabetes or hypertension or one of these other conditions and you get a prescription to pay for some or all of healthy food as one example. That’s a clear low hanging fruit to get food as medicine into healthcare. Another one I think is to better use, better leverage the patient of SNAP, the program formerly known as food stamps. About one in seven Americans were on SNAP before COVID hit and it’s going to go up for sure.

Dr. Mark Hyman:
Isn’t it one in four kids?

Dr. Dariush Mozaffarian:
I don’t know the exact statistic, Mark, but there are more kids than adults in SNAP. So, maybe one in four kids. Yeah, there’s a large number of children on SNAP. There’s a large number of elderly on SNAP. There’s a large number of military, active duty military on SNAP. There’s people in the military whose families are on SNAP, because they don’t have enough money for food. So, it’s not just a handout. This is for families, elderly, veterans, active duty military who really need a helping hand to find food. SNAP is a wonderful program, a powerful program to get money to people who need money to buy food. That’s crucial and we need to strengthen. There’s a lot of people who say it costs too much. It’s $70 billion a year. It costs too much, we got to cut its funding.

Dr. Dariush Mozaffarian:
What I say is instead of cutting its funding, let’s use it to lower healthcare costs and then it’ll pay for itself. So, we use it to lower healthcare costs by incentivizing and disincentivizing certain kinds of foods, so that people still have choice. They can still choose what they want to eat, but we’re actually leveraging SNAP to make people healthier.

Dr. Mark Hyman:
Double bucks for the farmers’ market. You get double your money if you use food stamps at your farmers’ market.

Dr. Dariush Mozaffarian:
Yeah, we did a national simulation model in a very rigorous modeling science to say, “What would happen if you did something which we call SNAP Plus?” Your SNAP Plus would be if you bought fruits, vegetables, nuts, whole grains, fish or other seafood, healthy plant oils, beans, a whole range of produce, you’d get 30¢ more on your $1. You’d get $1.30 per $1 of SNAP benefit. At the same time, to help pay for that and also disincentivize unhealthy foods.

Dr. Dariush Mozaffarian:
If you bought soda or other sugar sweetened beverages or junk food or highly processed cured meats, you get 30¢ less than $1. You get 70¢ on the $1 and you know that. You know up front you have a choice of what you want to get, and you can get a little more or a little less on your dollar. That SNAP Plus program would immediately be cost savings. It actually wouldn’t add anything to the SNAP budget-

Dr. Mark Hyman:
It’s like billions of dollars, right?

Dr. Dariush Mozaffarian:
… and it would save tens of billions of dollars in healthcare costs that the government and others are paying. So, it’s just kind of a natural thing to test-

Dr. Mark Hyman:
It’s almost will offset the cost of SNAP, right? That’s what you’re saying, it almost becomes [crosstalk 00:42:49].

Dr. Dariush Mozaffarian:
It wouldn’t fully offset the cost, because still at the end of the day, we’re giving food to everybody including children. So, it would take a long time to see returns on healthcare investment for children. But it would save tens and tens of billions of dollars in healthcare spending without increasing the cost of SNAP at all. So, it would certainly lead to lower government spending. So, I think those are two clear things that could be done. I think two other things I’ll just mention. One is to really help spur and catalyze the ongoing revolution and innovation in entrepreneurship.

Dr. Dariush Mozaffarian:
So, businesses everywhere from farm to retail to personalized medicine to packaged foods are rapidly trying to innovate, because customers are demanding different food. They want food that they think is going to make them healthier, that’s sustainably-sourced, that’s good for the environment, that comes from sustainable labor or fair labor practices. So, companies are scrambling to figure this out. How do we get healthier affordable food to people? Right now, the market is determining what works and what doesn’t.

Dr. Dariush Mozaffarian:
So, that means that companies that are really trying to innovate and do the right thing, if their product costs a little more because they’re making it healthier, if it doesn’t taste quite as good, because they’ve made it healthier, they’re at a disadvantage. That’s insane, right? Well, those companies should be at an advantage. I think we need a national program to spur innovation in business to help reward through tax policy and other policies those companies that are trying to do the right thing. And then I guess I would give two more things.

Dr. Dariush Mozaffarian:
A fourth item, I think, is to really expand federal nutrition research. As the as a percentage of overall research, federal nutrition research has been pretty flat for 40 years while diet-related illness has skyrocketed. So, we should be really prioritizing at the National Institutes of Health, at USDA, at the Department of Defense, at the VA, at the FDA, at NASA, all these places that actually already do nutrition research, we should be really prioritizing and amplifying and coordinating that research.

Dr. Mark Hyman:
The right kind of research.

Dr. Dariush Mozaffarian:
Yeah. Wouldn’t it have been great if over the last 10 years, we had had multiple well-funded studies on nutrients and the immune system? So, when COVID hit, we had already stockpiled that armamentarium of evidence. So, as soon as COVID hit, we could leverage that stockpile, release that stockpile on COVID and not have this crisis, right? So, we really need to much, much better understand food and the microbiome and links to health, personalization, all the phenolics and flavanols that are in foods. Many, many research questions, supply chains, disparities. So, I think that fourth thing is we really need major new investments in federal nutrition.

Dr. Mark Hyman:
Are you talking about the National Institute of Nutrition, right?

Dr. Dariush Mozaffarian:
Yeah, that’s one option. We’ve been reviewing the options funded by the Rockefeller Foundation, and we’ve come up with several options. We’re going to release that report this summer. One of the options could be a new institute at the National Institutes of Health. There’s 27 institutes and centers at the National Institutes of Health.

Dr. Mark Hyman:
Actually, it’s a wrong name. It should be called the National Institutes of Diseases, because there’s no health in there. This would be the first one that focuses on health.

Dr. Dariush Mozaffarian:
Most of them are disease-focused. There’s one heart disease, one on cancer. There are some. I mean, there’s an institute on complementary medicine. It’s fairly small, but there are some that are more [crosstalk 00:46:58]-

Dr. Mark Hyman:
That’s fair, okay.

Dr. Dariush Mozaffarian:
… but there’s National Institute of Nutrition.

Dr. Mark Hyman:
I remember Dan Glickman, your friend and former Agriculture Secretary, said he reviewed the National Institute of Health strategic plan. Food was mentioned in there only once. It was in the context of the Food and Drug Administration. So, that’s like, really.

Dr. Dariush Mozaffarian:
That was last year. In this year’s plan that was released, actually nutrition is mentioned, which is an advanced, mostly around precision nutrition, understanding kind of induced personalized nutrition, which is great. So, that’s an advance.

Dr. Mark Hyman:
Okay, good.

Dr. Dariush Mozaffarian:
We want to go congratulate.

Dr. Mark Hyman:
Good. I didn’t know about that.

Dr. Dariush Mozaffarian:
Yeah, but they need more funding. We don’t want to take away from the existing institutes. We don’t want to say, “Okay, we’re going to create a new National Institute of Nutrition and take away some funding somewhere else.” We want it to be additive, right? Congress has to realize this is a national priority and take this on.

Dr. Mark Hyman:
It just seems so obvious, Dari, because if food is the biggest driver of disease in America, how do we have no institute or organization when the government’s focused on studying? It’s like a what?

Dr. Dariush Mozaffarian:
Well Mark, you hit the nail on the head. Let’s get back, our healthcare system doesn’t address the leading cause of poor health. The National Institutes of Health doesn’t have an institute focused on the leading cause of poor health. The number one cause of death and disability in this country is diet-related diseases, and preventable healthcare spending, and why otherwise qualified military recruits can’t get into forces. I mean, on and on and on, the number one cause of death for first responders is diet-related illness. It all makes sense, right?

Dr. Mark Hyman:
In the front of my book, the opening quote is from Wendell Berry. It says, “We have a food industry that pays no attention to health and a healthcare industry that pays no attention to food.” I think that sort of sums that up.

Dr. Dariush Mozaffarian:
I’m an optimist by nature. After all the doom and gloom, I’m an optimist, Mark. I think your book really lays out some of these options really well that the healthcare industry is now starting to pay attention to food. It’s waking up to this. The food industry is starting to pay attention to nutrition.

Dr. Mark Hyman:
Absolutely.

Dr. Dariush Mozaffarian:
So, these worlds are starting to converge, but it’s happening too slowly. I don’t want to wait 50 years to fix this, right?

Dr. Mark Hyman:
I’ll be 110.

Dr. Dariush Mozaffarian:
Yeah. Healthcare is getting it. Groups like Kaiser Permanente, John Hancock Insurance, others are starting to incentivize and care about healthy eating. Food companies are starting to try to create more nutritious products. So, government has to take on this crazy complicated system, and help spur it, and catalyze that leverage it, and nurture it faster. Which brings me to the fifth kind of low hanging fruit that I think we could do in the next administration would be to create a national organizing office to organize all of these federal food and Nutrition policies and programs.

Dr. Dariush Mozaffarian:
After September 11th, which was a devastating crisis to our country, there was recognition that all of the national intelligence agencies did amazing work separately, but that it wasn’t coordinated. So, the FBI and the CIA and all these other groups weren’t talking to each other. That was limiting our ability to respond quickly and effectively to intelligence and crisis. So, the Office of the Director of National Intelligence has created, the ODNI, which is a cabinet level office, reports to the Office of the President, and coordinates all of our national intelligence, and brings that coordinated single message and information to the President, to Congress, to the heads of agencies, and creates coordinated actions.

Dr. Dariush Mozaffarian:
With the unbelievable fragmentation of our food system and our nutrition response that COVID has really laid bare, it’s time I think, for a similar office around food and nutrition policy. We would call it the Office of the National Director of Food and Nutrition, the ONDFN, very similar to the ODNI, would be a cabinet level position that for the first time ever would say “We’re spending well over $100 billion a year in the federal government on food and nutrition issues, let’s coordinate it. Let’s bring it together.”

Dr. Mark Hyman:
I mean more than that, if you count in the healthcare costs. I mean, 80% of the $1.2 billion Medicare-

Dr. Dariush Mozaffarian:
Way more.

Dr. Mark Hyman:
… we’re talking about trillions of dollars.

Dr. Dariush Mozaffarian:
The federal government with the states because the states pay for Medicaid, but the government alone pays $160 billion a year for direct medical care for type 2 diabetes alone. So, just type 2 diabetes, which is a mostly preventable condition if you can eat well and treatable condition, is $160 billion a year, absolutely. Well over $500 billion a year, if you count the healthcare spending, we should coordinate it.

Dr. Dariush Mozaffarian:
So, that what’s going on in the centers for Medicare and Medicaid services, and what’s going on in school lunch, and what’s going on in SNAP, and what’s going on in WIC, and what’s going on in food labeling, and what’s going on in health claims, and what’s going on in the Department of Defense research around performance and recovery from injury, and what’s going on with VA around our military veterans. All this work, all this programming, which is disjointed and disconnected, all the USDA, incredible USDA agricultural research and policy to help stimulate farmers and rural development.

Dr. Dariush Mozaffarian:
USDA has massive programs to develop rural development. The Farm Bill is the biggest single supporter of conservation. People criticize the Farm Bill, but it’s the single biggest conservation program we have, to help coordinate all of that. So, I think a new national coordinating office is actually not pie in the sky. It’s actually really an idea whose time has come.

Dr. Mark Hyman:
I hope you’re talking that into the ear of the candidates, because this is the moment to make that happen. Drawing the connections, helping people see the intersection of chronic disease, the pandemic we have, our environmental crises, climate change, NASA security, academic performance, on and on, social inequities, health disparities. I mean, these are not separate issues. What’s amazing to me, Dari, these are not hard problems to solve. It’s not rocket science. It’s not like we have to come up for the cure for Alzheimer’s or something really hard. This is something we know about. You’ve been writing about for decades. Your colleagues and everybody at Tufts and Harvard have been shouting from the rooftops.

Dr. Mark Hyman:
The problem is nobody’s really been listening. I think now it’s time for them to really listen. It seems like there’s a real openness to listen. This is that moment in history where there’s a crack in the door. I think we can walk through, and tell a different story, and actually help transform our national food policies and agricultural policies across all the sectors you talked about. I encourage you to check out this report. I mean, it’s fantastic. You can just Google it, the report of the 50th Anniversary of the White House Conference on food, Nutrition and Health that was put out in March as this pandemic started. It really lays out kind of unwittingly the solution for what we have right now. If it literally was implemented tomorrow, I think we’d all be better off.

Dr. Dariush Mozaffarian:
Well I thank you so much for having me and for letting us discuss these issues. This is kind of the principle of functional medicine, right? Functional Medicine isn’t for patients, isn’t some hokey pokey magic. It’s just that when somebody comes in with hypertension and diabetes and joint pain and obesity, you don’t treat each of those as separate problems and give one drive. You say, “Well, what’s the underlying functioning-

Dr. Mark Hyman:
Cause.

Dr. Dariush Mozaffarian:
“… cause of all of this?” Let’s go to the root and try to fix the root of the problem.” Well, this is functional medicine for our country and for our food system. We haven’t even talked about regenerative agriculture. We briefly mentioned kids learning in school, productivity of the workforce, incredible disparities, and injustice across different segments of the population. So, much of this is related to our food and nutrition system.

Dr. Dariush Mozaffarian:
We have to stop trying to put our fingers in the dike one at a time, try to fix these things one at a time, and say “We have a systems problem.” It’s not rocket science. It’s not brain surgery. It’s pretty basic stuff that we can do and it’s win-win. It’s win-win for industry. It’s win-win for farmers. It’s win-win for Pretty much everybody. So, I think the time has come and let’s walk through that door.

Dr. Mark Hyman:
So, I’ve asked you all the easy questions, I want to ask you a hard question. You say it’s win-win. What are the obstacles other than lack of education awareness to actually make this happen? Who are the people or the organizations or companies that are going to be resisting the change? Because I think there will be. How do we work around that? How do we how do we work around that?

Dr. Dariush Mozaffarian:
I think it depends on the approach, right? If the approach is only punitive, which some countries are doing, like Chile, Mexico, some of these new food system programs. They say, “Look, we think there’s too much salt and sugar and saturated fat in the food supply. So, we’re going to penalize companies through warning labels or other things if they have those. We’re going to restrict marketing.” That’s it. If that’s the only approach, food industry is going to be kind of annoyed. They’re going to say, “All you’re doing is hitting us for the negatives in our products. What if we have a fermented product? What if we add fruits in a product? What if we increase whole grains? What if we try to have more healthy oils? You’re not giving us any credit for that.”

Dr. Dariush Mozaffarian:
So, I think that if you take a punitive approach, there’s going to be some big-time opposition from publicly traded companies that have shareholders that they’re beholden to, and financial responsibilities. I think if you take a win-win approach that “Look, we’re going to use sticks and carrots. We’re going to help companies that are doing the right thing. We’re going to help you shift your portfolio. We’re going to reward farms that are doing the right thing.” Of course, there’s some products that are going to be losers, right? So, some single products may not be around that much longer, or they might not be sold that much where they may cost more.

Dr. Dariush Mozaffarian:
Food companies are diverse, and they can sell lots of things. Restaurants are diverse and can sell lots of things. Farmers can over time grow lots of things. So, we don’t have a monolithic system with one product like tobacco that we have to get rid of. So, I think that the real opposition is going to be fear of loss, right? So, nobody wants to lose weight they have now. So, whether it’s fear of loss in research that existing research agencies say, “Well, the new research agency focus on nutrition, I don’t want to lose what I’m doing now.” A food company says, “Look, I don’t want to lose 20% of my portfolio.” A farmer says, “I don’t want to lose…” It’s fear of loss, right?

Dr. Dariush Mozaffarian:
I don’t think there’s anybody entrenched with a line in the sand that “I’m going to grow corn. I want that corn to go to corn syrup in soda. That’s it, no matter what. I don’t care what you say to me. That’s what I want to do.” I don’t think there’s many people that are going to say that. I think that people say, “Look, oh yeah, if I can grow, that corn can go and make whole corn meal that can be healthy and paired with vegetables and be part of a healthy meal. I get actually a little bit more because my crop tastes better and is nutritionally sound, and is grown on regenerative agriculture. I can get a little more profit because customers will pay for that because it lowers healthcare spending.” It can be a win-win.

Dr. Mark Hyman:
I think the report is really brilliant because it threads the needle on that really tough question of “How do you bring everybody along them a team, even the reluctant ones?” I think that’s the brilliance of this report. It’s not blow up the world and start again. It’s like how do we make smart choices in the policies so that we can get alignment on every side of the aisle, on all sides of business, on consumers? Look, I don’t think there’s anybody in any business, in any seat of government, or any one of our citizens who wakes up and says, “You know what? I want to create a system that makes people sick and fat, and kids not be able to learn, and people depressed, and make our national security worse, and causes destruction of our agricultural environment.”

Dr. Mark Hyman:
There’s nobody that says that or wants that as a human being. So, I believe we appeal to human beings who are behind these companies and behind these policies that most of them will be able to be brought along. They’ll be a few, but most of them will be able to bring along. We’ve been in Washington. I think you’ve been a lot in Washington, probably more than I have. What’s really striking is that there’s a really general lack of education awareness about these issues, the level of being informed of policymakers is so low on this. They’re hearing a lot of information from the food industry and from big lobbyists, but there’s not a lot of lobbyists for the good guys, right? We run down to Washington like we pave our own way, but it’s far more in between.

Dr. Dariush Mozaffarian:
Well, these are complicated issues, right? It’s a complicated system. Living in Boston almost 20 years, I’ll say it’s wicked complicated with a really bad Boston accent. It’s wicked complicated. We have a wicked, complicated system. You asked me, what’s the low hanging fruit? I couldn’t give you a 10-second soundbite answer. There are complicated issues here. So, getting that complicated message to the public to policymakers when they’re so busy, they’re so overwhelmed, they have so much they’re doing, they’re thinking about every possible issue under the sun. Getting people to see these interlinkages and these solutions is challenging.

Dr. Dariush Mozaffarian:
So, I think that communication is a huge, huge part of this. It’s not the solution, right? Just talking about it doesn’t fix things, but communication through what we’re doing through other avenues is crucial. There has been historically no funding for that. Nobody’s paying public health experts and physicians and scientists to communicate, where people pay us to teach them to do research. People pay clinicians to see patients, scientists to do research. Nobody pays us to actually go out and spend our time to do this work. I don’t mean we need to get paid extra. I just mean the staff and structures to do that communication, which costs money, don’t exist.

Dr. Dariush Mozaffarian:
So, I actually think that an effort building around the themes in our White House Report, building around the themes in your book, I think an effort to bring some interest in people together, to create a coalition of people and some funding to bring this message out, and to tell people there are actually solutions that will help us right now would be really wonderful.

Dr. Mark Hyman:
We’re on the way. You and I are collaborating on what’s called the Food Fix Campaign, which is nonprofit and an advocacy group, exactly designed to do this. Bringing together a coalition of all the stakeholders across all sectors involved in the food system, in science, and healthcare, and agriculture to really have a coordinated strategy and bring these ideas into the 2,000 key people in Washington, who make the decisions at the White House and Congress and agencies that can make a difference. I think this has really never happened before. I’m super excited about.

Dr. Mark Hyman:
So, anybody listening is excited about this, if anybody wants to get behind it, whether you have money or you have relationships that can make a difference or connections or just ideas, we’d love to hear from you. So, I’m so excited that, even though this is a horrific time, this is going to be a little window of opportunity for us to actually make a big difference. So, I just applaud what you’ve done, what you’re doing. You’re my hero in all this. I vote for you for the head of that office in the cabinet that’s going to be in charge of food, whether you want the job or not.

Dr. Dariush Mozaffarian:
I think I’m quite happy at the Friedman School of Nutrition Science and Policy, but thanks for the vote, Mark.

Dr. Mark Hyman:
Of course. Well thank you so much for being on The Doctor’s Farmacy. I really appreciate your time, I know you’re busy. If you’ve been listening this podcast and you love what you’re heard, please leave a comment. We’d love to hear from you. Share with your friends and family on social media. Subscribe wherever you get your podcasts, and we’ll see you next time on The Doctor’s Farmacy.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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