Interview conducted by Laura DeStefano
Chronic disease is among the greatest health challenges of our time, affecting more than half of Americans and accounting for approximately 90 percent of U.S. health care spending. Now, a wave of scientific advances is changing what we know about why chronic diseases develop and how they can be better managed — or prevented altogether.
On October 19, 2026, the National Academy of Medicine’s Annual Meeting Scientific Symposium, Harnessing Science, Prevention, and Innovation in Chronic Disease, will bring together experts across science, medicine, public health, policy, and other fields to explore these exciting developments.
We spoke with NAM member Brendan Lee, MD, PhD, chair of the symposium planning committee, about why the time is right for a new approach to chronic disease.
This interview has been edited for length and clarity.
NAM: Why did the NAM choose chronic disease as the focus of this year’s Scientific Symposium?
Lee: Chronic disease is probably the major societal health challenge of the 21st century—not just in the United States, but globally. An estimated 6 in 10 Americans have at least one chronic disease, and 4 in 10 have two. When you look at the aggregate impact on individuals, the economy, and the social fabric of our country, it is absolutely enormous.
At the same time, there are a lot of innovations and potentially transformative developments that may change how we approach chronic disease. The challenge is making sure those advances can broadly benefit people everywhere. That combination of tremendous need and tremendous opportunity makes this a particularly timely topic.
What do we gain by thinking about “chronic disease” as a whole, as opposed to looking at specific conditions like heart disease and diabetes?
One of the interesting things about chronic disease is that it isn’t defined by a single biological mechanism or organ system. These diseases develop over long periods of time—sometimes beginning long before symptoms appear—and are influenced by many different factors, including our genetics, the environment, and social conditions. They also tend to interact with one another. Diabetes affects heart disease risk, for example, and obesity is a driver of many different chronic diseases.
When we planned this symposium, we deliberately decided not to focus on one particular disease. We wanted to look across diseases and ask: What are the common factors that cause chronic diseases to develop? What can we do to prevent or delay them? And once we establish that a patient has a chronic disease, what new approaches can we use to manage it?
How early in life does the risk of developing a chronic disease begin?
There is strong evidence that the risk of developing chronic disease starts in the prenatal period, before someone is even born. There is even research exploring possible intergenerational effects—whether exposures experienced by our parents could influence our own risk.
Nutrition is one important example. We know that nutrition during pregnancy and childhood, as well as what we eat as adults, affects chronic disease risk, but there is a tremendous amount of information about nutrition that isn’t necessarily backed by equally strong evidence. One of the challenges for science is separating plausible hypotheses and popular claims from interventions that we can demonstrate actually improve health.
This seems especially relevant at a time when there’s so much direct-to-consumer marketing about supplements, diets, and other health “hacks.” Will the symposium delve into the influence of these factors?
It’s a real challenge. With nutrition and supplements, many interventions are readily accessible. You don’t need a prescription, so an idea can quickly take on a life of its own outside the kinds of randomized controlled trials we traditionally rely on.
Take something like magnesium and sleep. There are studies suggesting magnesium can help with sleep, and we know sleep is important for health. You can construct a very plausible hypothesis connecting those ideas.
But a plausible hypothesis is a long way from definitive evidence that an intervention has a particular effect on chronic disease. That’s one of the challenges we face with nutritional interventions and is something we’ll explore at the symposium.
What scientific developments make you most optimistic that we can change the trajectory of chronic disease?
GLP-1 drugs are one of the major transformative interventions we’ll discuss. We know the enormous impact they can have on obesity and diabetes, and we’re now seeing signals of their potential effects on other conditions. We have to be careful about drawing conclusions beyond what clinical trials were designed to test, but the potential downstream impacts are very exciting.
Another area I’m excited about is the possibility of treating inflammation. We’re increasingly understanding chronic inflammation as a driver across very different conditions, from metabolic diseases to neurological diseases. The challenge is that inflammation isn’t all bad—our bodies need it to fight infection, regenerate tissue, and heal wounds. So the question is how to target only harmful inflammation.
We’re already seeing examples of what becomes possible when we understand these mechanisms better. In multiple sclerosis, improved understanding of inflammatory pathways has led to the development of therapies that target them. Another emerging area is repurposing cell therapies such as CAR T-cell therapy to target dysfunctional immune cells involved in inflammatory disease.
Are we moving toward a future in which chronic diseases could actually be cured rather than managed over a lifetime?
I would be careful with the word cure, because cure suggests “one and done.” I don’t think that’s easy to achieve. Even with something as impactful as a GLP-1 drug, for example, we know that when treatment stops, its effects on metabolism and obesity can reverse.
I think the opportunity is to prevent or delay the onset of disease and dramatically minimize its symptoms and impacts. This probably won’t come from any single intervention. It will likely be achieved with a combination of approaches—from nutrition and changes in our social environments to medicines and other treatments.
There’s another important piece of this puzzle. Imagine that we do develop a magic pill that could cure chronic disease. If we can’t get that pill to everyone who needs it, have we really solved the problem? Scientific discovery is only part of the equation. Economics, policy, and access ultimately determine how much impact a given innovation has. And policy has to include community engagement and advocacy. Without partnership with advocacy groups and the community, we won’t get anywhere.
When it comes to preventing chronic disease, what is ongoing research adding to the advice we’ve heard for decades—eat well, exercise, don’t smoke, etc.?
We’re beginning to understand much more about the connection between our social and environmental experiences and our underlying biology.
Stress is a fascinating example. There is increasing evidence that psychological stress can translate into changes in biological signals that affect fundamental processes such as mitochondrial energy production. We’ve talked about the “mind-body connection” for a long time, but research is beginning to connect some of these concepts with underlying biology.
That’s why the symposium isn’t simply about telling individuals to change their behavior. We’ll also be talking about the environments and communities people live in, disparities and inequities that affect chronic disease risk, and the policy changes that can help make prevention possible.
With a problem as enormous and complex as chronic disease, what do you hope people take away from the symposium?
It’s essential to understand that no single approach or intervention is going to be able to make an impact alone against chronic disease. Biology matters. Genetics matter. Nutrition and our environment matter. Social conditions matter. Economics and policy matter. To make a real impact, we have to integrate all those perspectives.
Scientists, clinicians, economists, policy experts, and social scientists understandably become very focused on the problems within their own fields. Meetings like this give us an opportunity to look beyond those boundaries. I’ve often told trainees that innovation comes from bringing multiple disciplines together in a new way to solve a problem. That’s one of the real strengths of the National Academy of Medicine.
Chronic disease is multifactorial and complex, and there are enormous challenges ahead. But in spite of that complexity, we can make progress. That’s the take-home message I hope people leave with.
Explore the Annual Meeting agenda and register here.
Laura DeStefano is the Director of Strategic Communications & Engagement at the National Academy of Medicine and a science communicator.
Disclaimer: The information provided in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.
