While much of the rationale has focused on our government's flat-footed response and poor public health infrastructure, this ignores a significant and underrecognized risk factor -- the exceedingly poor baseline health of our country's population.
Among the most significant risk factors for hospitalization and death in Covid-19 are the presence of diet-related chronic diseases such as hypertension, heart disease and obesity. America's starting point? Nearly three out of four American adults are overweight or obese.
And half of US adults have diabetes or pre-diabetes. A 2018 study found that only 12% of Americans are metabolically healthy, which is defined as having optimal levels of blood markers and pressures as well as waist circumference. Diet-related diseases are no longer the things you have to worry about down the road. In a pandemic environment, they could hasten death next week.
Poor metabolic health stems, in part, from poor-quality diets and poor nutrition. Just as baseline chronic disease portends a worse outcome for individuals with Covid-19, our food system is our country's pre-existing condition that leaves us all at greater risk. As doctors and chefs, we feel that now, more than ever, it is critical to address nutrition insecurity in America head on.
While food insecurity is about providing more food, nutrition insecurity is about providing the right food, so we and our children can build the metabolic heath we need to better survive this and future pandemics.
Most of our legacy food policies were born of national security concerns in the 1940s. They were conceptualized during a time of absolute caloric deprivation, when as many as 40% of military recruits were ineligible for service because of malnutrition and being underweight. Soon initiatives such as the National School Lunch Program, the modern food stamp program and other nutrition assistance programs followed.
In the private sector, subsidies enabled mass production and stockpiling of food in preparation for food scarcity during the next global conflict. The postwar industrialization of food led to a domestic food market rife with highly processed, carbohydrate-laden, shelf-stable and convenient foods.
Consumption of these cheap products increased, while consumption of fresh fruits and vegetables decreased. The American diet flipped from largely whole foods to highly processed foods requiring little time and cooking. The diet-related disease debacle we face today is one unintended outcome.
Programs born of good intent for reasons of national security and convenience no longer fit the bill. Instead of keeping our children and most vulnerable healthy and productive, we are now sicker than we were post-Depression. A 2018 report filed by Mission: Readiness, a council of retired admirals and generals who advocate for policies that help kids stay healthy, in school and out of trouble, stated that, "In the United States, 71 percent of young people between the ages of 17 and 24 do not qualify for mil