What David Kessler, MD, Likely Means For Biden's COVID-19 Task Force
Preparing to lead the country through the lingering pandemic is no easy feat, by any means, but President-elect Joe Biden is not alone: He has a COVID task force plan, which he announced last week, and it includes some of the leading scientists in the medical field. Together, the 13 individuals aim to advise Biden's COVID-19 response strategy.
The co-chair of this advisory board is David Kessler, M.D., former dean of the Yale School of Medicine and recent guest on the mindbodygreen podcast. From 1990 to 1997, Kessler served as the FDA commissioner, appointed by President George H.W. Bush and reappointed by President Bill Clinton.
Now, he's part of Biden's policy team—and has been throughout Biden's entire campaign—providing the president-elect with daily pandemic briefings. These 80- to 90-page memos were often so robust, Kessler "occasionally fretted to high-level aides that he and [former U.S. surgeon general Vivek Murthy] were taking up too much of [Biden's] time," according to an interview in STAT.
Needless to say, Kessler is into data. From our conversations with him, we know he's all about the nutrition basics, food accessibility, and empathetically approaching metabolic health, which are all core tenets here at mbg. And although we don't have all the details—in 2020, there's little we can say with definitive conviction—here are the big themes we expect to see from Kessler in his newly appointed position:
1. We're going to see an emphasis on metabolic health.
"Once we get through this acute epidemic and get to the other side of it, we can focus on more of the chronic conditions dealing with it," Kessler tells me on the podcast.
Of course, he's talking about metabolic health—it's the underbelly of so many chronic diseases (think diabetes, heart disease, strokes, and so on), and approaching it from a holistic perspective is necessary for combating severe infections down the line. Considering only 12.2% of Americans are metabolically healthy and 20% of people considered "lean" are still metabolically unhealthy, it's crucial for everyone to get their metabolic health in check—even if you're not suffering from any symptoms at the moment.
Although, we realize metabolic health is a huge umbrella term, and there are so many factors at play (FYI, you need only one of these markers to have metabolic dysfunction). Kessler suggests we tackle a few at a time: LDL cholesterol levels, fasting blood glucose, and blood pressure. "If we work on those as a country, we can change health care as we know it," he says.
The question becomes: How do we approach these markers? Well, Kessler explains that lifestyle shifts play a significant role, specifically diet and movement. Although, we can't advise people with a simple, "Lose Weight" campaign. "'Eat less and exercise more' has not been effective," he notes. "Ideal dietary advice for everybody of all physiologies is a mistake." Perhaps we'll see more targeted approaches to how individuals can get their metabolic health back on track—or more education at the very least.
2. Food and nutrition will come front and center.
It took public officials months to start talking about food and nutrition when it comes to preventing severe cases of COVID-19, and the topic still remains buried within the CDC's guidelines. (While they have a useful "Food and Coronavirus" page, it's entirely left out of their "Prevent Getting Sick" section.) But make no mistake: Your meals have much to do with your metabolic health, which—as we explained above—has ripple effects for how your body tackles this virus. According to Kessler, it's time to bring food to the forefront of the conversation.
From what he's told us, there are two important to-do's for optimal health: Eliminate "fast carbs," and introduce foods that lower your LDL levels.
First up, fast carbs: These are your ultra-processed foods, Kessler explains. They're considered "fast," because your body digests them quickly in the upper GI tract. As a result, you become hungry again, sometimes irritable, as you ride along the unforgiving blood sugar roller coaster. As you may know, blood sugar spikes and crashes have their own consequences. Namely, body fat, hypertension, high blood pressure, and diabetes—aka, existing health conditions to watch out for during COVID. He recommends swapping in "slow carbs," which are digested in the lower region of the GI tract (that's where your satiety hormones are released, so you'll stay fuller for longer). "They include vegetables, legumes, and also certain resistant starches or slowly digestible starches," he notes.
As for lowering LDL? According to Kessler, a plant-based diet is "the most dramatic way to get LDL down." That's not to say you've got to cut the animal products cold turkey, but emphasizing nutritious plants is a fast track to healthy LDL levels.
3. We'll start addressing unequal access to healthy food.
Those "fast carbs" Kessler mentioned? Well, oftentimes those are staples in low-income households, as they're easier to mass-produce and sell at a lower price. "We take wheat, corn, and grain kernel and produce thousands of shapes, textures, and products from that," Kessler notes on the mbg podcast. "We took the structure out of food, and we pummeled it in the process." And we're selling it to low-income, minority communities who have limited access to good food and wondering why they're the ones disproportionately affected by this disease.
We can't place the burden on these populations to prioritize healthy food options—it has to happen on a systemic level. "We've got to care more about the health of everybody," Kessler notes. It won't be easy—it'll take more work than a mere promise, that's for sure—but with Kessler on the task force, this issue may get a better seat at the table.
Kessler has been a champion for food equality from the get-go, as he pushed for front-of-pack labeling back in 2014. Having clear, easy-to-identify food labels on processed packaging can help educate those (especially lower-income individuals) about what's genuinely healthy and what's worth leaving on the shelf. "To the harried shopper hoping to make some healthy choices, it would offer a quick way of identifying high-calorie, obesity-inducing food and of finding healthier alternatives," he writes in the New England Journal of Medicine. Of course, there's much more to do on the food equality front, but we're eager to see what else he comes up with in the face of COVID-19.
Kessler sure knows a thing or two about the "food as medicine" space, and he's waxed poetic about the need to ramp up metabolic health in this country. He's certainly not the only expert to emphasize the importance of overall health and well-being, but he is one with the power to influence change at a national level. For now, we wait with bated breath and high hopes.
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