The diseases covered by the audit are both deadly and costly, said Sharon Silas, GAOs health care director and report contributor. But effectively addressing them is a challenge because efforts are fragmented and each agency is doing its own thing, she said. While some agencies may hold programs accountable for the success (or failure) of outcomes, theres no overarching, cohesive strategy or coordination that spans agencies and programs to ensure that these efforts are not working at cross-purposes.
For example, USDA subsidizes corn production, leading to a pervasively low cost for high-fructose corn syrup and a lingering prevalence in American diets. But this runs contrary to HHSs recommendation to reduce consumption of all added sugars, including corn syrup, which thwart peoples efforts to eat healthfully without consuming too many calories. Said Silas, This is my favorite example of how there are these good things these agencies are trying to achieve that are at cross-purposes with the work of other agencies. Another conflict, not mentioned in the report: USDA also oversees the National School Lunch Program, whose nutrition standards do not include limits on added sugars; as a result, the vast majority of U.S. public schools exceed HHSs suggestion that sugar intake be limited to less than 10 percent of total calories, according to research published earlier this year.
Another issue arises around an HHS recommendation for Americans to eat more fruits and vegetables. USDA programs like SNAP and WIC are meant to help provide affordable food to millions of low-income Americans within their own communities. Still, despite a 2011 National Prevention Strategy that helped federal agencies coordinate on devising healthy food guidelines and ways to remind people to fill up half their plates with fresh produce, officials responsible for the strategy said that the subsequent administration did not implement the strategy or report on progress toward meeting 2021 targets because it was not a policy priority for the former Executive Office of the President, according to the report. At DOD, the ShipShape program educates active-duty service members about how to reduce calorie intake. Yet over 30 percent of young Americans aged 17-24 dont even qualify for military service because of their weightmade unhealthy by a range of factors, from diet, to lack of exercise, to tobacco use, long before they seek to join the armed services. A key takeaway from the reports findings, said Silas, is that someone has to make sure various diet-related health and nutrition goals are not in conflict.
