Diet quality, measured objectively, is the single leading predictor variable for all-cause mortality and total chronic disease risk in the modern world. As goes diet quality, so goes the probability of more or less years in life, more or less life in years. So go the prevalence and predation of obesity*, diabetes, heart disease, COVID, many cancers, stroke, dementia, disabling arthritis, and more. Diet quality is by no means the only thing that matters, of course, but it is the single thing at the population level that matters most.
A rather deplorable, generally unmeasured diet quality hides, and festers, in plain sight. That sad fact is revisited each time the “typical American Diet” is referenced with derision, lamentation, or exasperation. Famously, we don’t tend to manage what we fail to measure. Our failure to quantify the liabilities of diet in each of us is not the only reason we allow the problem and its dire consequences to persist, but it is salient among them.
We have heard from on high and from within the House of Medicine that diet quality should be measured routinely, i.e., treated as a vital sign. Historical methods of assessment don’t allow for this, costing too much in time, effort, attrition, accuracy, and yes, money. But innovation in this area has come at last, and now- we might append “could” to “should.”
