,i #aag? ,,congress #b;d ,session ,h4 ,r4 #hifd ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,septemb] #bb1 #bjbb,mr4 ,grijalva 7= himself & ,mr4 ,mc,govern7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to require ! ,secret>y ( ,heal? & ,human ,s]vices to issue to ,f$]al ag5cies guidel9es = develop+ proc$ures & requirem5ts relat+ to c]ta9 prim>y c>e ,f$]al heal? pr(essionals complet+ cont9u+ m$ical education on nutrition & to require ,f$]al ag5cies to submit annual reports relat+ to su* guidel9es1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,education ,& ,tra9+ = ,heal? ,act ( #bjbb or ! ,,eat = ,heal? ,act ( #bjbb4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,accord+ to #bjai ,national ,heal? ,exp5diture ,acc\nt data1 ! gr[? 9 total national heal?c>e exp5ditures 9 #bjai rea*$ #c4h trillion1 or #aa1ehb p] p]son4 7#b7 ,accord+ to ! ,c5t] = ,disease ,control & ,prev5tion 7,,cdc7 ar\nd #ij p]c5t ( annual heal? exp5ditures are = p ) *ronic & m5tal heal? conditions4 7#c7 ,accord+ to ! ,,cdc mo/ p 9 ! ,unit$ ,/ates don't eat a heal?y diet & consume too mu* sodium1 saturat$ fat1 & sug>1 increas+ _! risk ( *ronic diseases4 ,few] ?an #a 9 #aj adolesc5ts & adults eat en\gh fruits or vegetables4 7#d7 ,accord+ to ,national ,c5t] = ,*ronic ,disease ,prev5tion & ,heal? ,promotion 7,,nccdphp7 six 9 t5 ,am]icans live ) at lea/ "o *ronic disease1 l he>t disease & /roke1 canc]1 or diabetes4 7#e7 ,sev5 out ( #aj dea?s among p 9 ! ,unit$ ,/ates ea* ye> are f *ronic diseases su* z c>diovascul> disease1 obesity1 diabetes1 & canc]4 7#f7 ,accord+ to ,,nccdphp eat+ heal?y helps prev5t1 delay1 & manage he>t disease1 type #b diabetes1 & o!r *ronic diseases4 7#e7 ,accord+ to ! ,,cdc1 he>t disease is ! lead+ cause ( dea? = ,am]ican adults4 ,approximately #fei1jjj ,am]ican adults die ea* ye> f c>diovascul> disease4 ,coron>y he>t disease alone co/s ,am]ican taxpay]s #cfc billion ea* ye>4 7#g7 ,rese>* has %[n t foll[+ a heal?ful diet1 includ+ a plant-bas$ diet1 c n only r$uce symptoms relat$ to c>diovascul> disease b c also actually rev]se damage done to ! art]ies4 7#h7 ,accord+ to ! ,j\rnal ( ! ,am]ican ,m$ical ,association1 two-?irds ( adults 9 ! ,unit$ ,/ates are curr5tly ov]weight1 & half ( ^? ov]weight individuals are obese4 ,"o 9 ?ree *ildr5 are ov]weight1 & "o-fif? ( *ildr5 are obese4 ,! ,unit$ ,/ates sp5ds ab\t #adg to #baj billion a ye> on obesity relat$ diseases1 includ+ type #b diabetes1 hyp]t5sion1 he>t disease1 & ar?ritis4 7#i7 ,an e/imat$ #cd4b million p 9 ! ,unit$ ,/ates h diabetes4 ,ano!r #hh million ,am]ican adults h pr$iabetes4 ,! ,c5t]s = ,disease ,control & ,prev5tion pr$icts t "o 9 ?ree *ildr5 born 9 #bjjj w develop diabetes at "s po9t 9 _! lives4 ,total direct e/imat$ co/s ( diagnos$ diabetes increas$ f #ahh billion 9 #bjab to #bcg billion 9 #bjag4 7#aj7 ,a cons5sus /atem5t endors$ by ,am]ican ,association ( ,cl9ical ,endocr9ology1 support$ by ! ,academy ( ,nutrition & ,dietetics1 & co-sponsor$ by ! ,endocr9e ,society reports t plant-bas$ diets & o!r nutrition int]v5tions aid type #b diabetes remission4 7#aa7 ,accord+ to ! ,am]ican ,canc] ,society1 !re w be an e/imat$ #a1iah1jcj new canc] cases diagnos$ & #fji1cfj canc] dea?s 9 ! ,unit$ ,/ates 9 #bjbb4 ,t is equival5t to ab\t #a1fgj dea?s p] day & acc\nts = ne>ly #a ( e #d dea?s4 ,! ,national ,canc] ,in/itute e/imates t canc]-relat$ direct m$ical co/s 9 ! ,u4,s4 7 #ahc billion 9 #bjae & are project$ to increase to #bdf billion by #bjcj1 a #cd increase bas$ only on population gr[? & ag+4 7#ab7 ,accord+ to a #bjjh survey publi%$ 9 ,j\rnal ( ! ,am]ican ,college ( ,nutrition1 physicians felt inadequately tra9$ to provide prop] nutrition advice4 ,n9ety-f\r p]c5t felt nutrition c\nsel+ %\ld be includ$ dur+ prim>y c>e visits1 b only #ad p]c5t felt adequately tra9$ to provide su* c\nsel+4 7#ac7 ,a #aihe ,national ,academy ( ,sci5ces report recomm5d$ t all m$ical s*ools require at lea/ #be contact h\rs ( nutrition education4 ,accord+ to a #bjji national survey ( m$ical colleges publi%$ 9 ,academic ,m$ic9e1 only #ch p]c5t ( m$ical s*ools met ^! m9imum /&>ds by requir+ #be h\rs ( nutrition education z "p ( _! g5]al curricula 9 #bjjd4 ,by #bjaj1 t numb] _h %runk to #bg p]c5t4 7#ad7 ,accord+ to ! ,j\rnal ( ,nutrition 9 ,cl9ical ,practice 9 #bjaj1 m ?an half ( graduat+ m$ical /ud5ts felt _! nutrition education 0 insuffici5t4 7#ae7 ,recogniz+ ! importance ( nutrition1 ,heal?y ,p #bjcj--! ,f$]al ,gov]nm5t's framework = a heal?i] ,nation--includes a goal 7,,nws-#je7 to increase ! proportion ( heal? c>e visits by adults ) obesity t include c\nsel+ or education relat$ to nutrition1 weight loss1 or physical activity4 ,accord+ to ,heal?y ,p #bjcj1 only #bd4h p]c5t ( physician (fice visits includ$ c\nsel+ ab\t nutrition or diet 9 #bjaf4 7#af7 ,accord+ to ,mission3 ,read9ess1 obesity disqualifies #ca p]c5t ( y\? f s]v+ if !y s *oose4 7#ag7 ,accord+ to ! ,j\rnal ( ,am]ican ,heal? ,promotion1 ! milit>y sp5ds well ov] #a billion a ye> to treat weight-relat$ heal? problems su* z he>t disease & diabetes ?r\gh its ,,tric>e heal? insurance = active duty p]sonnel1 res]vi/s1 retirees & _! families4 7#ah7 ,accord+ to ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 racial & e?nic m9ority gr\ps exp]i5ce high] rates ( *ronic heal? conditions1 includ+ diabetes1 hyp]t5sion1 obesity1 he>t disease1 & canc] :5 comp>$ to _! ,:ite c\nt]p>ts due to ,social ,det]m9ants ( ,heal?1 includ+ lack ( access to nutriti\s food4 #c4 ,dep>tm5t ( ,heal? & ,human ,s]vices guidel9es1 & ,f$]al ag5cies annual reports1 relat+ to c]ta9 prim>y c>e ,f$]al heal? pr(essionals complet+ cont9u+ m$ical education on nutrition 7a7 ,guidel9es ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all issue guidel9es to ,f$]al ag5cies = develop+ proc$ures & requirem5ts to ensure t e prim>y c>e heal? pr(essional employ$ full-"t = su* ag5cies h cont9u+ education c\rses relat+ to nutrition 7z describ$ 9 subsection 7c774 7b7 ,biannual reports ,n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act & ea* subsequ5t ye>1 ! head ( ea* ,f$]al ag5cy t employs full-"t prim>y c>e heal? pr(essionals %all submit to ,congress a report atte/+1 9 a =m & mann] specifi$ by ! ,secret>y ( ,heal? & ,human ,s]vices1 to ! ext5t to :i* ! ag5cy has adopt$ & enc\rag$ ! guidel9es issu$ "u subsection 7a7 ) respect to su* pr(essionals employ$ by su* ag5cy dur+ any portion ( ! previ\s ye>4 ,if ! ag5cy1 ) respect to su* previ\s ye>1 did n fully adopt & enc\rage su* guidel9es ) respect to su* pr(essionals1 ! head ( ! ag5cy %all include 9 ! report = ! ye> ! p]c5tage ( su* pr(essionals employ$ by su* ag5cy to furni% prim>y c>e s]vices :o complet$ cont9u+ education c\rses relat+ to nutrition 7z describ$ 9 subsection 7c774 7c7 ,cont9u+ education relat+ to nutrition ,= purposes ( subsections 7a7 & 7b71 cont9u+ education c\rses relat+ to nutrition %all include at lea/ cont5t on ! role ( nutrition1 9 ! prev5tion1 managem5t1 &1 z possible1 rev]sal ( obesity1 c>diovascul> disease1 diabetes1 or canc]4 7d7 ,def9itions ,= purposes ( ?is ,act3 7#a7 ,cont9u+ education ,! t]m cont9u+ education is def9$ z c\rses t meet requirem5ts = ,cont9u+ ,m$ical ,education 7,,cme7 or ,cont9u+ ,education 7,,ce7 by m$ical or nurse practition] pr(essional organizations or c]tifi$ accr$it+ bodies4 7#b7 ,nurse practition] ,! t]m nurse practition] has ! mean+ giv5 su* t]m 9 section #ahfa7;aa77#e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#e774 7#c7 ,physician ,! t]m physician has ! mean+ giv5 su* t]m 9 section #ahfa7r77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7r77#a774 7#d7 ,prim>y c>e heal? pr(essional ,! t]m prim>y c>e heal? pr(essional means a physician or nurse practition] :o furni%es prim>y c>e s]vices4 7#e7 ,prim>y c>e s]vices ,! t]m prim>y c>e s]vices has ! mean+ giv5 su* t]m 9 section #ahdb7;i77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieu7i77#d771 b %all include su* s]vices furni%$ by a nurse practition] z w\ld o!rwise be includ$ if furni%$ by a physician4