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Introduction

The increasing rate of chronic disease in the United States has become a persistent, complex problem in the past few decades, one not easily solved. As researchers, health care providers, policy makers, community organizations, and various stakeholders seek to improve the health of individuals and communities, the role of diet in chronic disease has become an important area for exploration. Accordingly, on August 15–16, 2023, the Food Forum of the National Academies of Sciences, Engineering and Medicine held a workshop titled Dietary Patterns to Prevent and Manage Diet-Related Disease across the Lifespan.^1,2 In her introductory remarks, workshop planning committee chair Robin A. McKinnon, U.S. Food and Drug Administration, observed that research shows that current dietary patterns in the United States are not aligned with recommendations (see Figure 1-1). “As a population,” she noted, “we underconsume vegetables, fruit, and whole grains but exceed recommended intakes for things such as added sugars and saturated fats, which collectively has implications for health and health care costs.” She also highlighted the impact of this underlying

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¹ The workshop agenda, presentations, and other materials are available at https://www.nationalacademies.org/event/40430_08-2023_dietary-patterns-to-prevent-and-manage-dietrelated-disease-across-the-lifespan-a-workshop (accessed September 21, 2023).

² The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.

morbidity, which became apparent during the COVID-19 pandemic, when individuals with preexisting symptoms had a greater risk of severe disease and death. She also emphasized the complexity of understanding the many factors contributing to access to healthy food and informed food choices.

For the purposes of this workshop and in accordance with the Dietary Guidelines Advisory Committee (2020), McKinnon defined “dietary patterns” as the combination of an individual’s complete dietary intake over time, as a description of a customary way of eating, or as a combination of foods recommended for consumption. She explained further that there are many diet-related diseases, but for this workshop speakers would focus on diseases linked to the highest rates of morbidity and mortality in the United States, including cardiovascular disease, diabetes, obesity, and certain cancers. Additionally, while physical activity is an important modifiable risk factor that influences diet-related disease outcomes, the workshop would be focused on dietary patterns and would not address physical activity. McKinnon also explained that while “food as medicine” initiatives would be included in the discussion, the workshop would not cover medically tailored meals, nor would it cover any topics under consideration by the 2025 Dietary Guidelines Advisory Committee. Finally, McKinnon highlighted the cross-cutting themes that would be highlighted throughout the workshop: equity, data quality and the current evidence base, policy challenges and opportunities, technology, and communications.

Discussions on day 1 of the workshop included dietary assessment; novel biomarkers for assessing dietary quality; and how diet influences the developmental origins of chronic disease, as well as the multitude of modifiable influences on dietary patterns and how they affect chronic disease risk and susceptibility (Chapter 2). Speakers also discussed the existing inequities in nutrition and food choice (Chapter 3) and the potential to influence these inequities through changes from industry and behavioral economics (Chapter 4). Day 2 of the workshop focused on perspectives on translating science into practice to improve adherence to dietary guidance, highlighting examples of organizations working to advance the health of communities through legal and policy opportunities for intervention (Chapter 5). The statement of task for the workshop is presented in Box 1-1. The workshop agenda, acronyms and abbreviations used in this publication, and biographical sketches of the workshop speakers and planning committee members can be found in Appendixes A, B, and C, respectively.

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