,i #aacth ,,congress #b;d ,session ,h4 ,r4 #dcgh ,,in ,,the ,,house ,,of ,,representatives ,april #b1 #bjad ,mr4 ,grijalva 7for himself and ,mr4 ,ryan of ,ohio7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to require the ,secretary of ,health and ,human ,services to issue to ,federal agencies guidelines for developing procedures and requirements relating to certain primary care ,federal health professionals completing continuing medical education on nutrition and to require ,federal agencies to submit annual reports relating to such guidelines1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,education and ,training for ,health ,act of #bjad or the ,,eat for ,health ,act of #bjad4 #b4 ,findings ,congress finds the following3 7#a7 ,in #bjab1 ,united ,states health care spending was approximately #h1bcc per resident and accounted for #ag4f percent of the ,nation's gross domestic product4 ,this is among the highest of all industrialized countries4 7#b7 ,expenditures in the ,united ,states on health care surpassed #b4f trillion in #bjaa1 more than three times the #gad billion spent in #aiij1 and over eight times the #bec billion spent in #aihj4 7#c7 ,estimates of health care costs attribute over #ge percent of national health expenditures to treatment for chronic diseases4 7#d7 ,a ,march #bjjc report from the ,world ,health ,organization concluded diet was a major cause of chronic diseases4 7#e7 ,seven out of #aj deaths among people in the ,united ,states each year are from chronic diseases such as cardiovascular disease1 obesity1 diabetes1 and cancer4 7#f7 ,approximately #ha4a million ,american adults in the ,united ,states have at least one form of cardiovascular disease4 ,approximately #b1cjj ,american adults in the ,united ,states die every day from cardiovascular disease4 ,in #bjaj1 cardiovascular disease cost ,american taxpayers #ahi4d billion4 ,the ,american ,heart ,association estimates that1 by #bjcj1 direct costs related to cardiovascular disease will triple to around #hah billion4 7#g7 ,research has shown that following a healthful diet can not only reduce symptoms related to cardiovascular disease but also actually reverse damage done to the arteries4 7#h7 ,two-thirds of adults in the ,united ,states are currently overweight1 and half of those overweight individuals are obese4 ,one in three children are now overweight1 and one-fifth of children are obese4 ,in #bjjh1 direct medical costs associated with obesity totaled #adg billion4 7#i7 ,an estimated #be4h million people in the ,united ,states have diabetes4 ,another #gi million ,american adults in the ,united ,states have prediabetes4 ,the ,centers for ,disease ,control and ,prevention predict that one in three children born in #bjjj will develop diabetes at some point in their lives4 ,total estimated costs of diagnosed diabetes have increased #da percent1 to #bde billion in #bjab from #agd billion in #bjjg4 ,research shows that reducing fat in the diet can reverse the symptoms of type #b diabetes1 not just manage the symptoms4 7#aj7 ,cancer kills approximately #egj1jjj ,americans each year1 accounting for one in four deaths4 ,more than #a4e million new cancer cases are diagnosed annually4 ,in #bjaj1 the direct costs of cancer were #ajb4h billion4 ,estimates expect that number to rise to #agb billion by #bjbj4 7#aa7 ,according to the ,journal of the ,american ,college of ,nutrition1 physicians feel inadequately trained to provide proper nutrition advice4 ,ninety-four percent feel nutrition counseling should be included during primary care visits1 but only #ad percent felt adequately trained to provide such counseling4 7#ab7 ,a #aihe ,national ,academy of ,sciences report recommended that all medical schools require at least #be contact hours of nutrition education4 ,in #bjjd1 only #ch percent of medical schools met these minimum standards by requiring #be hours of nutrition education as part of their general curricula4 ,by #bjaj1 that number had shrunk to #bg percent4 7#ac7 ,in #bjjd1 #cj percent of ,united ,states medical schools required a dedicated nutrition course4 ,in #bjaj1 only #be percent of such schools required such a course4 7#ad7 ,according to a #bjji national survey of medical colleges published in ,academic ,medicine1 more than half of graduating medical students feel their nutrition education is insufficient4 #c4 ,department of ,health and ,human ,services guidelines1 and ,federal agencies annual reports1 relating to certain primary care ,federal health professionals completing continuing medical education on nutrition 7a7 ,guidelines ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall issue guidelines to ,federal agencies for developing procedures and requirements to ensure that every primary care health professional employed full-time for such agencies have at least #f credits of continuing medical education courses relating to nutrition 7as described in subsection 7c774 7b7 ,annual reports ,for #bjaf and each subsequent year1 the head of each ,federal agency that employs full-time primary care health professionals shall submit to ,congress a report attesting1 in a form and manner specified by the ,secretary of ,health and ,human ,services1 to the extent to which the agency has adopted and enforced the guidelines issued under subsection 7a7 with respect to such professionals employed by such agency during any portion of the previous year4 ,if the agency1 with respect to such previous year1 did not fully adopt and enforce such guidelines with respect to such professionals1 the head of the agency shall include in the report for the year the percentage of such professionals employed by such agency to furnish primary care services who during such previous year completed #f credits of continuing medical education courses relating to nutrition 7as described in subsection 7c774 7c7 ,continuing medical education relating to nutrition ,for purposes of subsections 7a7 and 7b71 continuing medical education courses relating to nutrition shall include at least courses on the role of nutrition in the prevention1 management1 and1 as possible1 reversal of obesity1 cardiovascular disease1 diabetes1 and cancer4 7d7 ,definitions ,for purposes of this ,act3 7#a7 ,primary care health professional ,the term primary care health professional means a physician or nurse practitioner who furnishes primary care services4 7#b7 ,nurse practitioner ,the term nurse practitioner has the meaning given such term in section #ahfa7;aa77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#e774 7#c7 ,physician ,the term physician has the meaning given such term in section #ahfa7r77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7r77#a774 7#d7 ,primary care services ,the term primary care services has the meaning given such term in section #ahdb7;i77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieu7i77#d771 but shall include such services furnished by a nurse practitioner as would otherwise be included if furnished by a physician4