The food system is systemically failing US consumers and causing widespread sickness that can only be fixed through systemic change, according to industry experts at the 2026 Food As Medicine summit in Chicago.
Roughly 10,000 people die per week (about 600,000 a year) due to preventable diet-related disease in the US, according to a panel led by Rick Leach, executive director of the Food as Medicine Initiative at Arizona State University.
Leach offered a litany of sobering statistics to kick off the two-day conference:
- 20% of US children are obese
- 32% of adolescents are pre-diabetic
- 60% of adults suffer from at least one diet-related disease
“It’s not just destructive on families and communities, but the hit to the US economy is about $1.1 trillion annually due to increased health care costs and lost productivity,” Leach said.
Health care professionals, insurance representatives, food manufacturers and others at the sixth annual summit discussed efforts to right the ship using healthier eating as a catalyst for change.
Systemic failures in health and food
The country’s obesity epidemic is due to a range of missteps across the food ecosystem, according to Leach.
“The situation we’ve gotten ourselves into is not because of one reason,” he said. “It’s a systemic failure.”
Among the top causes is the failure to integrate nutrition into health care, Leach said, noting that med students receive about 20 hours of nutrition education, typically in the first two years of education.
Nearly nine in 10 doctors (87%) feel they are not adequately trained to guide patients on the topic of nutrition, Leach explained.
Most nutrition interventions are not covered by health insurance, he added. “One of the keys is addressing that diet-related diseases are not really integrated into the health care system,” he said.
The health care system’s shortcomings in relation to diet-related disease is only part of the problem, he said, adding that the food system is also broken.
“Ultra-processed food makes up about 60% of the diet of the average American,” he explained. “There’s a lot of data out there saying that’s not healthy, folks.”
Nutrition in medicine growing
Lack of education on nutrition in the medical profession is only part of the problem, according to Geeta Maker-Clark, a medical doctor at Endeavor Health and director of Integrative Nutrition and Advocacy at University of Chicago Pritzker School of Medicine.
Americans often are dealing with three or four chronic diseases at once, which has a compounding effect that no single physician “can take care of in a visit or in multiple visits, because we don’t have the systemic support,” she said.
Maker-Clark has helped develop a culinary medicine program at the University of Chicago and Endeavor Health system in the Chicago area. The program teaches nutritional science and the art of cooking with the intent of treating and preventing chronic disease, she explained.
“It’s to make delicious meals that prevent and treat chronic disease, that are culturally appropriate and that are accessible and equitable to our communities – it’s a big task,” she said.
Over the last 11 years, the program has graduated more than 800 doctors, and the practice of culinary medicine has expanded to roughly 80 medical centers nationwide, Maker-Clark explained.
The growing field represents a promising step forward in a system desperately in need of transformation, she said.
She hopes stakeholders across the health care and food landscapes can come together to cover the services of dietitians and nutritionists, so medical professionals can work in clinical settings with their support.
“We have the ability to do this. This requires systemic transformation on an insurance level,” she said, noting that while well-trained in her profession, she still is unable to prescribe food to her patients.
Legislation needed for systemic change
The concept of food as medicine also is gaining traction at for-profit health care companies like Centene Corporation, which is the largest Medicaid managed care organization in the US, serving roughly 12.4 million Medicaid members in 30 states.
Centene sees food as medicine as an opportunity to reduce avoidable health care costsHaleta Belai, vice president of the Drivers of Health program at Centene, said .
“Despite a tremendous amount of disruption in health care over the last year or two in particular, we have seen continued momentum around food is medicine in health care, and specifically, we’ve seen bipartisan interest at every level of government, where folks are seeking solutions to address chronic conditions earlier and at lower costs, and that is something to be optimistic about,” she said.
Fifteen states proposed legislation in 2026 that would advance food as medicine initiatives, and 10 states are using services in managed care to integrate food as medicine as a benefit, Belai noted.
Centene also sees an opportunity for the Department of Health and Human Services to define food as medicine as a primarily health-related activity, she said. That would help health plans to offer a food as medicine benefit to patients with chronic conditions.
Preventing negative health outcomes earlier would improve a benefits system that is currently “highly reactive,” according to Belai.
“We have to wait until individuals are far advanced in their chronic condition. We have to wait until they have a high risk of hospitalization,” she said. “This shift to defining food as primarily health related would enable us to engage more proactively, and would do so in a way that doesn’t require any additional legislation or funding.”
