Of the many heartbreaking stories I’ve read or heard during this ghastly pandemic, one stands out as especially distressing, almost criminal. The headline, on page one of The New York Times on April 12, read: “Empty Shelves, but Farms Put Food to Waste — Milk, Eggs and Produce Buried and Dumped.”

That day I was researching food insecurity and soaring rates of metabolic disease as an often overlooked reason for the high risk of Covid-related illness and death among African Americans, Hispanics and people in poor communities.

The article told of staggering food waste — tens of millions of pounds of fresh food, including 3.7 million gallons of milk a day, that farmers cannot sell because restaurants, hotels and schools were closed in a belated effort to squelch the pandemic. Some of the surplus food was donated to food banks and feeding programmes that have been overwhelmed by demands to nourish the needy but have limited ability to store and distribute perishable food.

Despite our nation’s ability to produce so much healthful food, fewer than 1 in 5 American adults is metabolically healthy, Dr Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts University, US, told me the week before.

Mozaffarian explained that poor metabolic health was the immunity-impairing factor underlying cardiovascular disease, type 2 diabetes and obesity-related cancers that left so many nutritionally compromised Americans especially vulnerable to the coronavirus now all but paralysing the country.

“Only 12 per cent Americans are without high blood pressure, high cholesterol, diabetes or prediabetes,” he said. “The statistics are horrifying, but they happened gradually enough that people just shrugged their shoulders. However, beyond age, these are the biggest risk factors for illness and death from Covid-19.”

The characteristics of what doctors call the metabolic syndrome — excess fat around the middle, hypertension, high blood sugar, high triglycerides and a poor cholesterol profile — suppress the immune system and increase the risk of infections, pneumonia and cancers. They’re all associated with low-grade, body-wide inflammation, Mozaffarian explained, “and Covid kills by causing an overwhelming inflammatory response.”

Alas, the metabolic well-being of many is now further endangered by currently advised limits on shopping trips, an increased reliance on canned and packaged foods high in fat, sugar and salt and emotional distress that prompts some people to turn to nutritionally questionable “comfort foods”.

The pandemic has cast a glaring light on long-standing costly and life-threatening inequities in American society. Those living in economically challenged communities, and especially people of colour, are bearing the heaviest burden of infections. But while diet-related disorders increase vulnerability to the virus, limited national attention has been paid to lack of access to nutritionally wholesome foods that can sustain metabolic health and support a vigorous immune system.

Clearly, when this pandemic subsides, a lot more attention to the American diet will be needed to ward off future medical, economic and social calamities from whatever pathogen next comes down the pike.

There have been several successful pilot programmes demonstrating the cost savings and health benefits of actually providing healthy foods to people with diet-related disease.

The Pennsylvania-based Geisinger Health System began a programme in 2016 called Fresh Food Farmacy to give free nutritious food to food-insecure people with type 2 diabetes and their families. The organisation created a food pantry in its Pennsylvania, clinical centre that provides enough fresh fruits and vegetables, whole grains and lean proteins to feed each family two healthy meals a day five days a week, along with weekly menus and recipes. Among the first 95 members enrolled, there was a 40 per cent decrease in the risk of death or serious complications and an 80 per cent drop in medical costs per year, Dr Andrea T. Feinberg reported.

In 2018, John Hancock replaced its usual life insurance policies with John Hancock Vitality providing financial incentives to foster healthier lifestyles, including up to $600 per year to purchase healthier foods.

In October, Kaiser Permanente started Food for Life to enhance access to affordable, healthy food, which the organisation estimates could reduce medical care costs by about 45 per cent . As a first step, residents eligible for California’s food stamp benefits will be offered medically tailored meal delivery options for patients and their families.

Last spring, Mozaffarian and colleagues published a brief report headlined “Food Is Medicine — The Promise and Challenges of Integrating Food and Nutrition Into Health Care” in JAMA Internal Medicine.

Promoting the benefits of providing free medically tailored meals to food-insecure patients and their families, they noted that diet-related diseases lead to “suboptimal school and work performance, increased health costs and lower productivity and wages.”

In other words, consuming a more wholesome diet is a win-win investment.

NYTNS