DES MOINES, Iowa – Democratic candidates running for president in 2020 have multiple ideas about how to fix the nation's health-care system, but one cardiologist says they should also be addressing what's making people sick.

Cardiologist and Dean of the Friedman School of Nutrition Science and Policy at Tufts University Dariush Mozzaffarian says 50 years ago, when the population was exploding, the goal was to reduce hunger, so food was designed to contain as many calories as possible.

For most people today, hunger is no longer an issue, but he says many continue to eat in quantities that lead to diabetes, heart disease and obesity.

"I would like to see the Democratic candidates have a platform around food,” says Mozzaffarian. “It's the number one cause of poor health, it's the number one issue for sustainability. You know we have childhood obesity, it's a huge issue for the economy, and nobody's talking about it."

Reports show Iowa is among the top 10 states with the nation's highest adult obesity rates, and nationwide, three in four adults are overweight or obese. Mozaffarian says if the nation wants to reduce disease and its costs, meaningful health-care reform is critical and should be a nonpartisan priority.

Mozaffarian has joined a Silicon Valley investor and a former U.S. Food and Drug Administration leader to build momentum on Capitol Hill to put more federal money into nutrition. He believes it would benefit the economy, creating new jobs around healthy food that could be exported to the rest of the world.

He says right now, nutrition research is fragmented and too many people don't know what to eat.

"We recently published a paper and 42% of calories in the U.S. food supply are poor quality carbohydrates,” says Mozzaffarian. “So, think about that – almost half of the calories in the U.S. food supply come from refined starch and sugar."

The U.S. spends more money on health care than any other country in the world. Mozaffarian notes that people with lower incomes often have the worst diets – which creates a cycle of poor health, lost productivity, increased health costs and poverty.




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Alabama is one of 14 states opting out of the 2024 summer electronic benefit program.

As summer rolls around, there will be no programs in place to help low-income families with grocery costs.

LaTrell Clifford Wood, hunger policy advocate for the group Alabama Arise, said as a result, more than 500,000 children who usually receive free or reduced lunch could go without meals. She noted while summer feeding programs will be available, they will not reach everyone in need.

"Ninety-four percent of Alabama children who rely on free and reduced-price meals won't have access to them over the summer," Clifford Wood reported. "That means that only 6% of the children who rely on those meals during the school year are going to be fed through summer feeding programs."

Clifford Wood warned limited hours, transportation and strict program rules will hinder many families from benefiting from such vital programs. The Alabama Legislature did not allocate the necessary $15 million for the program by the end of the last session. However, Clifford Wood noted there is a chance the program will be funded in the summer of 2025.

As legislators focus on next year's budgets, Clifford Wood stressed the need for funding next summer's EBT program. She pointed out Alabama Arise is calling for lawmakers to allocate funds from the Education Trust Fund to combat child hunger, affecting one in four children in the state.

"This is a program that's been tested for 13 years," Clifford Wood emphasized. "It's had three rigorous evaluation periods, and it was shown to improve the diet of children and decrease children's food hardship by a third."

Clifford Wood believes prioritizing children's needs and addressing food insecurity is a form of preventive care and serves as an early investment in the state's overall wellness.

The Food Research and Action Center said funding the e-benefits program would also benefit the economy - adding anywhere from $98 million to $117 million. The Alabama Senate Finance and Taxation Education Committee is expected to vote on the budget next week.

California's program helping low-income families buy fresh fruit and vegetables is on the chopping block and health care advocates are asking legislators to save the Market Match program.

Gov. Gavin Newsom has proposed cutting most of the program's $35 million budget to help close the state's budget shortfall.

Sophia Vaccaro, a participant in Market Match from Echo Park, said she depends on Market Match in more ways than one.

"It helps people being able to stretch their budget further," Vaccaro explained. "Then, I think it helps the community, in that it creates a sense of camaraderie at the farmers' market and makes people more invested in the community itself."

The program matches every dollar CalFresh customers spend on fresh fruits and vegetables at a farmer's market up to between $10 and $20 per day. It is active at 294 sites across the state and is partially paid for through federal matching funds.

Dr. John Maa, surgeon at Marin Health Medical Center and board member of the San Francisco Bay Area chapter of the American Heart Association, said Market Match promotes healthy eating and boosts the local farm economy.

"An improved diet really will have long-term meaningful impacts on health, and also reduce health care costs," Maa explained. "It really helps to sustain the growers and the merchants. I guess it's a win-win-win."

Siu Han Cheung, outreach coordinator for the Tenderloin Neighborhood Development Corporation and board member of the Heart of the City Farmers' Market, argued the program is vital to residents across the state.

"If the Market Match will be cut, that is terrible," Cheung stressed. "That means they have less money to buy their food. So, Market Match is very important for the low-income families and the seniors."

Legislators and the governor are working toward the May budget revisions, and must pass a balanced budget by June 15.

South Dakotans face high prices at the grocery store and some are working to ease the burden.

A new report from the Federal Trade Commission finds some grocery retailers used the supply-chain disruptions of the pandemic to raise prices and collect bigger profits, even after supply chains regulated.

One South Dakota group is trying to reduce sticker shock by targeting the state sales tax on groceries. Dakotans for Health is sponsoring a citizens ballot initiative to repeal the 4.2 % tax.

Rick Weiland, co-founder of the group, said lower food bills would make a meaningful difference for some.

"People of modest means, or low income hardworking families, disproportionately spend upwards of 30% on food," Weiland pointed out. "This is going to be helpful."

South Dakota is one of only two states in the country to apply its full state sales tax rate to groceries with no exemptions, Mississippi being the other. More than 9% of South Dakotans are considered food insecure, meaning they do not always have access to enough healthy food.

The grocery tax has been a popular topic among state legislators in recent years. Republican Gov. Kristi Noem even campaigned on the promise to repeal it. Critics have said proposing a tax cut without a way to finance it is irresponsible.

Weiland pointed out Gov. Noem had a formula spelled out when she brought forward her bill in 2023, which was voted down.

"She had no problem defending her position in front of the Legislature, in terms of how much revenue the state was going to lose and where they could make it up," Weiland recounted.

The initiative needs about 17,500 signatures by next month to appear on the November ballot.