Q&A with Nancy Roman: What providers can do to help stop obesity

The Partnership for a Healthier America is hosting a summit next week in Chicago that brings together food companies, providers, policymakers and thought leaders in the healthcare space to address one of the most pressing social determinants of health: obesity. Modern Healthcare's Population Health Reporter Steven Ross Johnson recently talked with Nancy Roman, President and CEO of the not-for-profit about the organization's efforts. Roman works closely with Former First Lady Michelle Obama who launched the Let's Move campaign during her time in the White House and is the Honorary Chair of the Partnership for a Healthier America. The following is an edited transcript.

MH: What are you seeing as far as solutions to the obesity problem?

Roman: A lot of big consumer packaged good companies have really taken a lot of the salt, and fat, and sugar out of their foods. And part of what we're seeing now is people are looking at portion control, and mindful eating. When you remove sugar from yogurt, it begins to affect palate for people who consume that product regularly. When you bring portion size down to a reasonable amount for a treat, it begins to shape what the American consumer expects in terms of size and amount of treat.

But we're also seeing artificial intelligence moving in on marketing. We see a big shift where the advertising industry is really moving to the individual consumer over social media. You can't capture 40% of the nation on Sunday night TV with a food ad. It's going to the individual. So that gives retail more power. I think we really have to be mindful of it, from a social justice perspective, because if you're optimizing every single consumer based on their personal preferences, you can envision a world where the already healthy and many times wealthy, get healthier, and those who aren't so healthy get optimized for inexpensive, refined carbohydrates that are really causing some of the problems. So that's an area we have our eye on as well.

MH: How does your prior work on hunger issues with the United Nations affect your current role?

Roman: The shape of malnutrition looks very different at home than it does in many of the developing world countries, but it's no less dangerous. In fact, I think because it's misunderstood, it can be more insidious. When you look at a thin malnourished child, suffering in a place that's been in war or in climate change you know that there's a deficit and a problem. But when you see somebody in the U.S. who may be overweight, but malnourished and pre-diabetic, heart disease, even with increased proclivity for cancer, that's less visible here. And we have a stigma issue associated with it here. We're trying to correct a broken system.

I'm not really particularly interested in blaming anyone. If I were forced to assign blame, I'd have to assign it on we the people and our taste buds, right? We demanded salty, fatty, sugary, convenient foods and the food industry gave them to us. I also don't hold the automobile industry guilty for climate change, you know? We wanted cars that drove fast and everything. I look at it through a lens, not so much though of blame, but as who has the power to affect change? And that's where the companies really do have the power, and responsibility to bring about change.

MH: What can healthcare providers do to address childhood obesity?

Roman: I believe there's a lot of work hospitals can yet do in cleaning up their own act, in terms of the food that they serve people in their cafeterias. And even their patients in some instances. I believe the medical community really has a long way to go in recognizing the power of food, to prevent a lot of these diet related diseases. We still have a health care system that spends most of its time addressing the problem once it's already well established. The medical industry itself is not going to be able to use food to prevent everything, but I sure do think the medical community can be part of a driver of the conversation to correct the food system. I definitely believe in medical schools, they should be taking more classes on nutrition, and really understanding the power of food to really prevent some of these insidious diseases.

But they alone won't be able to prevent it, because their patients live in a built food environment. Access, affordability, all of that has to change in order for them to fully succeed. But I think the conversation needs to change completely.