Where Does Nutrition Fit in Healthcare?

The VA Center for Innovation (VACI) is seeking ways to prevent the onset of diabetes, to reverse its progress, and to one day offer Veterans hope of eliminating the disease permanently.  Reducing the burden of obesity and diabetes will lead to significant reductions in healthcare costs and improved quality of life for Veterans.

Many changes at the VA in the past few years have focused on improving the quality of care for Veterans and better management of limited resources, such as money, facility space, and health care provider time. VACI is currently sponsoring the VA Nutritional Study Design (VANS-D) Project, an undertaking anticipated to serve both goals.

Overweight, obesity, and diabetes are among the most critical health issues confronting Veterans today. Nearly 75 percent of Veterans are overweight and close to 40 percent are obese; 20 percent of Veterans seen as patients in the VA Medical Centers have diabetes. It’s well known that interventions for treating obesity and other cardiovascular risk factors have many features in common with those used to prevent and treat diabetes.

Complications of diabetes can be devastating and expensive. Poorly-managed diabetes results in increased risk of heart attack and stroke and is the leading cause of blindness, end-stage renal disease, and amputations. Better blood sugar control through lifestyle modification translates into fewer medications, physician visits, and hospitalizations, all of which means increased healthcare savings.  More importantly, fewer complications mean an improved quality of life for Veterans with diabetes.

As the VANS-D Project team, we believe that nutritional intervention holds the promise of providing a simple, inexpensive, effective, and evidence-based approach that can not only save resources, but eyes, limbs, and lives.

A variety of dietary approaches have been shown to lead to better health, but reduced-carbohydrate and Mediterranean diets seem to have unique features that are particularly beneficial to individuals affected by obesity or at risk for diabetes.

Over the past decade, clinical trials have demonstrated repeatedly that dietary modification to either a Mediterranean-type diet relatively rich in monounsaturated fats or a carbohydrate-restricted diet that also improves the quality of carbohydrates consumed are both promising approaches for addressing obesity as well as diabetes. Researchers and clinicians within the VA are already exploring the use of these diets to improve health outcomes and treatment options for Veterans. The VANS-D Project builds on the programs currently in place to include longer-term and larger-scale investigations.  Rigorously testing the long-term benefits of these dietary approaches will help to inform preventative medicine approaches within the VA for decades to come.

Gary Taubes, MS – VANS-D Co-Technical Director, “Author of Good Calories, Bad Calories”

Jeff S. Volek PhD, RD – VANS-D Co-Technical Director, Associate Professor, Department of Kinesiology, University of Connecticut

Adele Hite, MPH, RD, MAT – Research Assistant, Principal Author, University of North Carolina at Chapel Hill

Brittanie Volk, MA, RD – Research Assistant, University of Connecticut

Catherine Chenard, MS, RD, LD – Research Assistant, University of Iowa

Laura Kunces, MS, MS, RD – Research Assistant, University of Connecticut

Marin Thompson, MS – Research Assistant

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