Why America needs new urgency around diet-related diseases

Americans were more vulnerable to serious illness and death from COVID in part because of our poor health status heading into the pandemic.

• Now, preparations for future public health emergencies have to include chronic diet-related illnesses, including those stemming from the obesity crisis, health experts say.

Why it matters: Obesity and related diseases like diabetes were closely linked with a far higher risk of serious illness and death from COVID.

• That was particularly true among older adults, communities of color, and disadvantaged communities, Anand Parekh, chief medical adviser at the Bipartisan Policy Center, told Axios.

"Preventing chronic diseases has to come back as the top public health priority for the nation," said Parekh, while discussing a report from the center on the topic.

• "The better our health status, the more resilient we can be if there is an emergency like COVID to reduce morbidity and mortality."

State of play: Obesity — which is linked to disorders like Type 2 diabetes, high cholesterol, high blood pressure, coronary heart disease, stroke and sleep apnea — was experienced by about 42% of U.S. adults in 2017–2018, or about or about 107 million adults, per data cited in the BPC report from the National Health and Nutrition Examination Survey. That's up from 30% in 1999-2000.

• Multiple studies have tied chronic conditions to poorer COVID outcomes. For instance, about 30% of COVID-19 hospitalizations were found to be attributable to obesity, with about 20% of hospitalizations linked to diabetes and about 26% linked to hypertension, according to a study published in the Journal of the American Heart Association.
• The risks of ICU admission, mechanical ventilation and death were higher with increasing body mass index, according to the CDC, citing reviews of COVID-19 cases.
• Diabetes, hypertension, obesity and smoking contributed to nearly 30% of COVID-19 deaths, another study published in BMJ Open found.

Between the lines: This is also a major equity issue, as well as an economic one, as people with lower incomes, people of color and people from disadvantaged communities are more likely to suffer from chronic health conditions.

What they're saying: "We know that diet-related diseases make people vulnerable to a lot of the ravages of this pandemic. In so many ways, it revealed the brokenness of our food system," Sen. Cory Booker, D-N.J., told Axios in an interview in December.

• "Every time [public health officials] talked about social distancing, mask-wearing, getting a vaccine, why weren't they talking about this?" said Booker, who co-sponsored legislation last fall calling for a national White House conference on food, nutrition, hunger, and health to address nutrition insecurity and diet-related chronic diseases.

What to watch: Experts in the diabetes field are hoping the disproportionate impact of hospitalizations and deaths among diabetics may inspire more awareness and preventive care, the New York Times reported recently.

• There's also renewed interest from the private investment sector to back new obesity drugs, CNBC reported.
• The Bipartisan Policy Center report calls for Congress and the Centers for Medicare and Medicaid Services to reexamine laws blocking Medicare from covering FDA-approved drugs that treat obesity.
• "You don't often hear from [CMS] about obesity but you'd think, 'Boy, given these numbers, this should be a high priority,'" Parekh said.