T he health of Americans is less than optimal, with alarming rates of chronic diseases such as Type 2 diabetes, obesity, and heart disease. The Supplemental Nutrition Assistance Program has the potential to improve the health of its 45 million recipients, yet the program has no nutritional guidelines. In fact, research suggests the program negatively affects the health of many of its users. The Special Supplemental Nutrition Program for Women, Infants, and Children, on the other hand, has a history of beneficial outcomes for its users, in large part because of its nutritional guidelines and program limitations. The Supplemental Nutrition Assistance Program program may benefit from following the model of a large-scale federal food program that improves the health of its beneficiaries. THE HEALTH OF A NATION Many Americans are in less than optimal health. Approximately two thirds of adults are overweight, half of whom are obese. 1 Diabetes prevalence continues to climb, with 29.1 million Americans suffering from the disease and approximately 86 million more with prediabetes. 2 Economically disadvantaged people are at heightened risk, with approximately 70% higher prevalence of diabetes 3 and 19% higher prevalence of hypertension, 4 compared with the highest-income population. Such chronic diseases are directly related to lifestyle, especially poor dietary choices. NUTRITION FOR BETTER HEALTH To promote better health, the U.S. government issues nutritional guidelines and related educational materials. The Dietary Guidelines for Americans, currently the 2015À2020 Dietary Guidelines for Americans, 5 serve as the blueprint for federal food programs and nutrition policies that, in turn, affect large programs, such as the National School Lunch and Breakfast Programs, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program. These recommendations generally emphasize plant-based foods; more than three quarters of MyPlate, the government's representation of the dietary guidelines, is dedicated to vegetables, fruits, and grains. Although its remaining section on protein sources includes meat, MyPlate recommendations also encourage Americans to think beyond meat and poultry and incorporate more legumes, including soy products, nuts, and seeds, into their diets to meet protein needs. Additionally, the Dietary Guidelines for Americans cite vegetarian and Mediterranean diets, both of which are rich in plant-based foods, as examples of healthful dietary patterns Americans could follow for optimal health. 5 Diets focused on foods from plant sources are associated with lower rates of obesity, diabetes, cardiovascular disease, hypertension, and certain forms of cancer, among other health problems, 6,7 all of which currently exact a large personal toll, as well as an enormous financial burden on individuals, governments, and businesses.
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