It's Time to Make Nutrition Security a Priority For All Americans

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Key Takeaways:

  • Chronic disease can be linked to a poor diet and food insecurity.
  • A new paper says that food security is too narrowly focused on getting enough calories, and should be expanded to “nutrition security,” which includes equal access to nourishing foods that help prevent disease.
  • To ensure access to nutritious food for all Americans, changes need to be made at different levels of government, public health, and among health care professionals.

In the past thirty years, chronic conditions such as type 2 diabetes, cardiovascular disease, obesity, and certain cancers have increased in the US, as has income inequality and food insecurity. Since food and nutrition play a role in preventing or contributing to chronic diseases, it’s important to view equality, food access, nutrition, and health through the same lens.

A recent viewpoint paper published in the Journal of the American Medical Association expressed the need for Americans to have equal access to food – but not just in terms of calories. Food needs to be nutritious to help combat chronic disease.

The viewpoint was written by Dariush Mozaffarian, Dean, Friedman School of Nutrition Science & Policy at Tufts University; Sheila Fleischhacker, public health law researcher, nutrition scientist, and adjunct professor at Georgetown; and chef José R. Andrés, founder of World Central Kitchen, a non-profit organization that provides meals to areas hit with natural disasters.

It’s estimated that food insecurity—being without reliable access to enough affordable, nutritious food—affects about 10 percent of American households. That’s a troubling statistic since food insecurity is linked to poor nutrition and an increased risk of developing a chronic illness.

Even more troubling? 56 percent of US children are estimated to have diets of poor nutritional quality.

Importance of Cost Per Nutrient

In the viewpoint paper, the authors note that food insecurity has historically been addressed by providing people with enough calories, but that’s no longer a sufficient focus. The calories need to come from nourishing foods that are rich in disease-fighting nutrients.

As an example, there are 300 calories in 60 grams of barbeque chips, which provide little protein or fiber, few vitamins, and 300 mg sodium.

For roughly the same cost, there are also 300 calories in a slice of whole-grain bread topped with peanut butter and banana. This option would provide 10 grams of protein, 6 g fiber, and is a source of 14 essential vitamins and minerals.

When looking at food, the cost per nutrient is often ignored but needs to be more prominently addressed.

Verywell reached out to Dr. Mozaffarian, one of the authors of the viewpoint, to learn more about nutrition security, and why it needs to take precedence over food security.

He explained that to effectively address the rising diet-related diseases and inequities in the US, we need to evolve to prioritize nutrition security, which he defines as consistent access, availability, and affordability of foods and beverages that promote well-being and prevent, and if needed, treat disease.  

“With nutrition security, we embrace a solution that nourishes people, instead of filling them with food but leaving them hungry,” says Mozaffarian.

Moving Toward Nutrition Security

Even if food is available, it does not always translate to being accessible, affordable, or enjoyable, and it may not provide all of the nutrients that are required to nourish the body and combat chronic disease.

The term “nutrition security” is broader than “food security," as it ensures foods provide more than calories. The viewpoint paper notes that many government organizations and public health programs focus on food security, but do not focus heavily enough on diet quality or nutrition.

Dariush Mozaffarian, MD, DrPH,

With nutrition security, we embrace a solution that nourishes people, instead of filling them with food but leaving them hungry.

— Dariush Mozaffarian, MD, DrPH,

The authors cite the example of SNAP-Education, which is an educational program within the broader Supplemental Nutrition Assistance Program (SNAP) model. The SNAP-Education arm is meant to educate people about leading healthier lives, but it reaches only 15 percent of SNAP participants – leaving 85 percent without this nutrition guidance.

 “It’s very clear that the quality of our food is one of the most important determinants of our health, especially for nutrition-sensitive conditions like obesity, diabetes, heart disease, stroke, and certain cancers, as well as gut health, immunity, and general well-being,” says Mozaffarian.

What Needs to Change?

There needs to be a greater investment in current public health food security programs, and a shift in clinical care to include nutrition-relevant interventions for lower-income Americans.

“A new national prioritization of nutrition security could foster new goals and investments in our national food system infrastructure - a crucial issue given President Biden’s currently proposed $2.3 trillion infrastructure bill,” says Mozaffarian. “In health care, this means adding produce prescription programs and medically tailored meals, as well as nutrition education for health care professionals.”

Other elements that need to be in place include:

  • Updates to government food policies.
  • Updates to federal nutrition assistance programs.
  • A focus on nutrition security across charitable food networks, such as food banks.
  • Investments in research to create an evidence base to accelerate solutions. 

Mozaffarian explains that major nutrition programs like SNAP and school meals require stronger screening tools, metrics of success, and corresponding policies to prioritize nutrition security.

“And, customers and the government should reward companies that promote nutrition security through their products,” says Mozaffarian.

Nutritious Options

Megan Byrd, a dietitian and the founder of in Keizer, Oregon, applauds the viewpoint paper.

“I love this concept because I feel that food insecurity and nutrition insecurity are different, and the main focus has typically been calories without looking at the quality of calories provided,” says Byrd. 

Megan Byrd, RD

...if you prioritize foods that are high fiber, high protein, and contain healthy fats, you will stay fuller for longer, eat less, and therefore, spend less on groceries each month.

— Megan Byrd, RD

“By shifting our focus toward improving nutrition security, we will be able to address the caloric and nutritional needs of individuals, but also society as a whole,” says Byrd. “I think this is an amazing concept and a step in the right direction.”

Byrd’s practice focuses on maximizing nutrition on a minimal budget, and she knows the power of making every dollar count with it comes to nutrition. 

“The idea that the more food you eat, the fuller you'll be is a little outdated,” says Byrd. “It really is important to focus on quality rather than quantity. In fact, if you prioritize foods that are high fiber, high protein, and contain healthy fats, you will stay fuller for longer, eat less, and therefore, spend less on groceries each month.”

Byrd’s lists top picks for foods that are filling, nutritious, tasty and part of SNAP funding. These can be foundational when nutrition becomes a stronger focus in food security:

  • Oats
  • Frozen vegetables
  • Beans
  • Lentils
  • Brown rice
  • Whole wheat pasta and flour
  • Corn tortillas and cornmeal
  • Carrots
  • Apples
  • Bananas
  • Peanut butter
  • Eggs
  • Potatoes 

What This Means For You:

This viewpoint puts the spotlight on the need to rethink government and public health programs aimed at food security. It's time to ensure that every American has access to affordable and tasty food that promote well-being and help prevent chronic disease.  

4 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mozaffarian D, Fleischhacker S, Andrés JR. Prioritizing nutrition security in the us. JAMA. doi:10.1001/jama.2021.1915

  2. USDA ERS - Food security and nutrition assistance.

  3. Liu J, Rehm CD, Onopa J, Mozaffarian D. Trends in diet quality among youth in the United States, 1999-2016. JAMA. 2020;323(12):1161. doi:10.1001/jama.2020.0878

  4. Simelane KS, Worth S. Food and nutrition security theory. Food Nutr Bull. 2020;41(3):367-379. doi: 10.1177/0379572120925341

By Cara Rosenbloom, RD
 Cara Rosenbloom RD is a dietitian, journalist, book author, and the founder of Words to Eat By, a nutrition communications company in Toronto, ON.