Reemphasizing Nutrition and Diet in Managing Chronic Endocrine Disease, With Jeffrey Mechanick, MD

Despite taking a relative backseat in practice, diet and nutrition are still critically important in preventing and forestalling chronic endocrine diseases like diabetes and obesity.1

Healthy diet patterns and the omission of detrimental eating behaviors play a major part in curbing a variety of endocrine diseases. While not single-handedly influencing the progress of obesity and diabetes, this lifestyle change is still foundational in preventing or reversing prediabetes, as well as avoiding adrenal fatigue, hyperuricemia, thyroid diseases, osteoporosis, and a laundry list of other conditions.2

In a presentation at the American Association of Clinical Endocrinology (AACE) Annual Meeting 2026 in Las Vegas, Nevada, Jeffrey Mechanick, MD, medical director of the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Fuster Heart Hospital and a professor of medicine at the Icahn School of Medicine at Mount Sinai, broke down the importance of having endocrinologists return to prescribing dietary interventions for patients with or at risk of chronic metabolic diseases.1

“In the old models, we really viewed nutrition as diet and dietary counseling, and the role of physicians was somewhat nebulous – they played a role, but we had dieticians who would handle the dietary counseling,” Mechanick told HCPLive in an exclusive interview. “If you had an individual endocrine disorder, there might be a set of dietary recommendations for that particular disorder. But in the new model, nutrition is more than just diet. Nutrition is the interaction of diet, which is the environment, and metabolism, which is really your body.”

Mechanick emphasized the need for further education on nutrition, particularly the interplay between the metabolic system and the exposome. Nutrition is far from limited to diet and exercise – environmental conditions and exposures can have a substantial impact on the development of chronic diseases.1

“The problem that’s plaguing not just endocrinologists, but really the whole healthcare arena right now, is that we need more education on nutrition,” Mechanick said. “Not just dietary counseling or dietetics, but the interaction of these dietetics with metabolism, and that requires some formal education and experiential learning. It requires going to meetings and having good research.”

Additionally, a growing focus on “precision nutrition”, focusing on variability between metabolic systems rather than generalizing treatment across all patients or disease states. Many chronic diseases in endocrinology are also driven by genetic and environmental factors, making lifestyle interventions difficult to generalize. To that end, Mechanick encourages clinicians to tailor their diet and nutrition suggestions to each patient.1,3

“In order to do precision nutrition or precision medicine, you must incorporate hidden variables,” Mechanick said. “Those hidden variables are not only some residual risk in terms of biological variables, but also social determinants of health – discrimination, crime, poverty, housing, education - and structural determinants of health – the policies and politics that create these social determinants. They need to be incorporated into any precision medicine plan to prevent chronic disease and mitigate its progression.”

Editors’ Note: Mechanick reports disclosures with Abbott Nutrition, Twin Health, and Merck.

References

1. Mechanick J. Keynote: Nutrition and Chronic Disease: A Hero’s Journey in AACE. Presented at the American Association of Clinical Endocrinology Annual Meeting 2026, Las Vegas, NV. April 22-24, 2026.

2. Soetedjo NN. The role of nutrition in various endocrine and metabolic diseases. Clinical Nutrition Open Science. 2025;62:164-188. doi:10.1016/j.nutos.2025.05.015

3. Voruganti VS. Precision Nutrition: Recent Advances in Obesity. Physiology (Bethesda). 2023;38(1):0. doi:10.1152/physiol.00014.2022