Tobacco Documents Online

CENTER FOR SCIENCE CSPI IN THE PUBLIC IrUEREST Publisher nt Nut7ZtIOn Action Healthletter March 10, 1993 President Bill Clinton 1600 Pennsylvania Avenue, NW Washington, DC 20500 Dear President Clinton: We urge you to include strong incentives for dietary treatment and prevention programs in health-care legislation. Such measures will save thousands of lives and billions of dollars. In the past two decades medical research has established that the typical American diet promotes disease. A diet high in fat, cholesterol, and sodium and low in plant-based foods (beans, vegetables, fruits, whole grains) contributes to heart disease, stroke, obesity, diabetes, and colon and possibly other cancers. Those diseases cause a tremendous amount of sickness, death, and personal suffering, and impose steep costs on our health-care system. Most importantly, clinical research has proven that several chronic diseases can be treated simply with a healthful diet -- one low in fat, saturated fat, cholesterol, and sodium, and a high proportion of plant-based foods. Remarkably, people with heart disease can obtain not just relief from symptoms, but reversal of the underlying cause of their disease primarily by changing their diets (exercise, smoking cessation, etc. also play important roles). In the case of heart disease, diet can often mitigate the need for coronary-bypass surgery or angioplasty. Both are extremely expensive, with bypasses costing about $40,000 each, for a total annual cost of $15 billion, and angioplasties costing well over $10,000, for a total annual cost of $4 billion. Dietary therapy is often highly effective and far cheaper. Moreover, when surgeries are deemed necessary, subsequent dietary therapy and other lifestyle changes can greatly improve their long-term success rate. Despite those benefits. dietary counseling and treatment are often not included among reimbursable health-care services. Likewise, for people with diabetes, high blood pressure, and high blood cholesterol, diet can reduce or eliminate entirely the need for expensive drugs or other medical interventions. In addition, those drugs may cause adverse and unpleasant side effects. ~ 1875 Connaddaa .tvnue. NW, Suite 300, WQsbrrigton, D.0 20P09-5728 •(202) 332-9110 • FAX (202) 265-4954 Executive Ditector: Mzbriel ~laQabson, P14. D. .40 ,.,_0.e ,... .~ •a ro....

We urge you to include a strong "health through diet" component in health-care legislation. To foster the use of diet to treat illness, we urge that: * dietary and other lifestyle therapies (assisted by appropriate classes, books, counseling, videos, etc.) for diabetes, high blood pressure, high cholesterol, and heart disease should be included in the basic benefit Dackacef * reviews of dietary treatment be conducted to enhance their effectiveness and compare their utility to other approaches. Health-care reform should also include a strong prevention- oriented nutrition component for the general public. We suggest: * requiring every hospital, HMO, or similar facility to mount health-promotion campaigns that would include "health through diet" cooking and shopping courses for patients or interested members of the community as part of a basic benefit package; * providing state and local health departments with funds and guidance for the development of comprehensive community-wide health-promotion campaigns aimed at promoting major dietary changes (as well as other lifestyle changes important to health promotion and disease prevention, such as exercise, smoking cessation, and alcohol education and treatment) in homes, workplaces, and elsewhere. The Department of Health and Human Services should develop a manual on community involvement, videotapes for professionals and the public, PSAs, etc. Modest funding (e.g., 20 cents per person) should be provided to each state wanting to undertake such programs; and * providing medical schools with financial incentives to ensure that all students receive nutrition (and other prevention-oriented) education. The program we have outlined would require minimal expenditures, but offer major cost savings and dramatic improvements in health and happiness. We would be pleased to assist you in every way possible. Michael F. Jaco s n, Ph.D. Executive D ctor Center for Science in the Public Interest on behalf of:

Oliver Alabaster, M.D. Institute for Disease Prevention School of Medicine George Washington University R. James Barnard, Ph.D. Professor Department of Physiological Science University of California, Los Angeles Gerald S. Berenson, M.D. Director Tulane National Center for Cardiovascular Health Professor Tulane University Medical Center School of Public Health and Tropical Medicine David H. Blankenhorn, M.D. Professor of Medicine/Director, Atherosclerosis Research University of Southern California, School of Medicine W. Virgil Brown, M.D. Professor of Medicine Emory University T. Colin Campbell, Ph.D. Professor of Nutritional Biochemistry Cornell University William P. Castelli, M.D. Director Framingham Heart Study National Heart, Lung, and Blood Institute Boston University School of Medicine William E. Connor, M.D. Professor Department of Medicine Section of Clinical Nutrition and Lipid Metabolism Oregon Health Sciences Center William H. Dietz, M.D. Director Clinical Nutrition New England Medical Center Johanna Dwyer, D.Sc., R.D. Director, Frances Stern Nutrition Center Professor, Medical School and School of Nutrition Tufts University June A. Flora, Ph.D. Assistant Professor Department of Communication Stanford University Barbara V. Howard, Ph.D. President Medlantic Research Institute Donald B. Hunninghake, M.D. Professor of Medicine and Pharmacology University of Minnesota Norman M. Kaplan, M.D. Professor of Medicine Southwestern Medical School University of Texas Peter Kwiterovich, Jr., M.D. Director, Lipid Research Atherosclerosis Unit School of Medicine Johns Hopkins University Barbara Levine, Ph.D. Assistant Professor of Nutrition in Medicine Medical College Cornell University Marion Nestle, Ph.D. Professor and Chair Department of Nutrition, Food, and Hotel Management New York University Robert Pritikin Director Pritikin Longevity Center

Eric Ravussin, Ph.D. Clinical Diabetes and Nutrition Section, NIDDK National Institutes of Health Roger Sherwin, M.D. Professor Department of Epidemiology and Preventative Medicine University of Maryland School of Medicine Jeremiah Stamler, M.D. Professor Emeritus Department of Preventive Medicine Northwestern University Medical School Peter D. Wood, D.Sc. Associate Director/ Professor Stanford Center for Research in Disease Prevention Stanford University School of Medicine %j