Our premise is that the US government has an established role in both tracking diet related diseases and in prevention of these diseases. As such, we note that the four major causes of morbidity and mortality associated with diet are heart disease, cancer, cerebrovascular disease and diabetes, The trends for these are generally toward decreasing incidence with the exception of diabetes, undoubtedly due in some part to US policies on nutrition. However, the trend for overweight, which is closely related with those illnesses: and for diabetes is increasing. We also note that there are socioeconomic concerns with overweight and the other illnesses that are negatively correlated with income and positively correlated with minority status. Also, children are increasingly becoming a concern due to the increasing incidence of overweight among children. The US government's role has been primarily in regulations addressing labeling and food fortification and developing dietary guidance. In terms of getting people to eat a healthier diet there are three avenues: (1) relying on individual choice between groups of foods; (2) relying on individual choice within groups of foods, or (3) presenting consumers with better food choices by encouraging manufacturers to reformulate foods. We argue that the latter has been neglected as a policy tool in the US arena and that we should be both tracking these foods and formulating policy to encourage positive development of these foods. We raise some possibilities for further study as to how and whether US policy can or should encourage such markets. (C) 1999 Published by Elsevier Science Ltd, All rights reserved.
