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FDA has announced a joint research initiative with NIH

Under the new Nutrition Regulatory Science Program, the FDA and NIH will implement and accelerate a comprehensive nutrition research agenda that will provide critical information to inform effective food and nutrition policy actions to help make Americans’ food and diets healthier. The initiative will aim to answer questions such as:

• How and why can ultra-processed foods harm people’s health?
• How might certain food additives affect metabolic health and possibly contribute to chronic disease?
• What is the role of maternal and infant dietary exposures on health outcomes across the lifespan, including autoimmune diseases?

This sounds terrific —and I’m all for all of this.

An article about it in JAMA, of all places, raises some concerns.  It quotes Jerry Mande,

The bad news, he noted, is that the announcement may follow a recent pattern within the federal government of unveiling an initiative but providing few details on how it will be executed. The April press conference held by the HHS and the FDA on eliminating synthetic food dyes is one such example, in his view.

It also quotes me as noting that the announcement is short on detail and even shorter on timeline.

The food industry is in a difficult position…Ultraprocessed foods are among their most profitable, and food companies consider the ability to market to children to be essential to their business models. They could voluntarily start making and marketing healthier products and reducing unhealthy ingredients, but experience tells us that they won’t do this unless forced.

MAHA has now issued requests for proposals on two initiatives.

I.  A Research Study of Contaminants in School Meals

This pilot study supports a comprehensive, FDA-led initiative aimed at evaluating the toxicological safety and nutritional quality of meals served in all schools that actively participate in the National School Lunch Program (NSLP), including both public and nonprofit private schools…Schools must be equipped to engage in structure intervention activities and collaborate with a partner to support the transition to minimize the use of foods commonly considered ultra-processed.

The goals of this funding opportunity

1. Identify contaminants (e.g., heavy metals) present in school meals.
2. Promote whole food offerings and minimize the use of foods commonly considered ultra-processed,
3. Measure potential changes in contaminant levels and nutritional content pre- and post-intervention.

Yes, let’s give kids real foods in school, preferably and whenever possible cooked from scratch.  But,

• Are heavy metals a problem in school meals?  What other contaminants are of concern?  Why?
• How are schools to increase whole food offerings when the administration has cancelled the farm-to-school program?
• Will schools be given the additional funds needed to pay for whole foods and the staff to cook them?

The offer is for grants of about $2 million each.  The timeline for submission is short (check the links for how to submit and by when).

The FDA sent further information to applicants.

It also sent an FAQ.

Comment: I have a nagging suspicion that what this is really about is a push to substitute “cleaner” products for current products used in schools.  This is a concern because so many of the people now associated with HHS sell “clean” products and, no doubt, would love to sell them in schools.  Substituting one product for another will not solve the single major problem faced by school meal programs: lack of adequate funding for personnel, equipment, and fresh food.

II.  Take Back Your Health Campaign

Purpose:  The purpose of this requirement is to alert Americans to the role of processed foods in fueling the diabetes epidemic and other chronic diseases, inspire people to take personal responsibility for their diets, and drive measurable improvements in diabetes prevention and national health outcomes.

Scope: The U.S. Department of Health and Human Services (HHS) will launch a series of bold, edgy national campaigns with innovative messaging to inspire and empower Americans to reclaim control over their health. This initiative will challenge individuals to adopt disciplined, lifelong habits—centered on eating real food, physical fitness, and spiritual growth—to build a healthier, stronger nation.

As Stat News puts it, HHS plans ‘bold, edgy’ campaign on ultra-processed foods and diabetes. 

The campaign, estimated to cost between $10-20 million, will urge Americans to shift their behaviors and see health wearables as ‘cool’.  The call for pitches was posted on the evening of June 12, with a swift deadline of June 26. It asks not only for “daring, viral messaging to motivate behavior change” but for campaigns that specifically “popularize technology like wearables as cool, modern tools for measuring diet impact and taking control of your health.” Surgeon general nominee Casey Means’ health tech company, Levels, uses continuous glucose monitors and lab testing to help people track their health.

Comment: Oh dear.  Personal responsibility.  Never mind that the MAHA Commission report clearly identified environmental factors as responsible for epidemic chronic disease.  Neither of these initiatives gets at changing the “toxic” food environment.  To really do that, MAHA would need to stop food industry marketing of ultra-processed foods, especially to children.  And to get at other environmental causes of poor health, especially for children, it would need to take on the cigarette industry, the gun lobby (guns are a leading cause of kids’ deaths), and the industries that dump chemicals into the water and food supplies.

I’m totally for educating people about healthy diets, eating real food, and physical fitness.  But education is not enough to change behavior.  Education has to be backed up by policy.

Where’s the policy?  For that, we must wait for the next MAHA Commission report, due out in August.  Stay tuned.

 

 

The Chef Ann [Cooper] Foundation has issued This report.

The report, while recognizing obstacles, explains why scratch cooking matters so much.

To protect and improve children’s health — and to access cascading academic, environmental, and economic benefits — schools must serve students more minimally processed meals cooked from scratch. While most schools want to serve their students more scratch-made meals, their ability to do so is significantly limited by systemic labor, financial, and infrastructure barriers, as well as public perceptions that devalue the critical role school food professionals play in suppporting the well-being of our nation’s children.

Its food policy priorities are well worth attention, especially now when the Make America Healthy Again (MAHA) movement is focusing on schools.

Let’s hope the MAHA leadership takes a good look at this report.  Thanks Chef Ann!

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Published this week!  Information is here.  Get 15% off with this code: FSGPIC15

[Sorry for my error: This post did not get sent out yesterday to subscribers so I am re-posting it.  Apologies if you are getting it twice.]

Let me start by confessing that I did not review the references in the MAHA Comission report I wrote about last week—except for mine.

The reference to my book, Food Politics, is a bit garbled (In Food Politics?  No.  This is Food Politics), but these are basically OK.  It’s easy to make mistakes like that one and I rely on the help of many proofreaders and factcheckers to try to avoid such errors in my published books and articles.  I checked a couple of the other references related to food topics and they seemed basically OK too.

So I was surprised by the report from NOTUS that The MAHA Report Cites Studies That Don’t Exist,

This finding was immediately attributed by the New York Times and other sources to the report’s having been referenced by Artificial Intelligence (AI), a tool well known to be scientifically inaccurate and to make things up.

To immediately plagiarize (well, quote) Ted Kyle at ConscienHealth: The MAHA Report: Make America Hallucinate Again.

I was also surprised—no, dismayed—by the administration’s response to these discoveries.

According to FoodFix,

White House Press Secretary, Karoline Leavitt told reporters…“I understand there were some formatting issues with the MAHA report that are being addressed,” Leavitt said. “But it does not negate the substance of the report, which, as you know, is one of the most transformative health reports that’s ever been released by the federal government, and is backed on good science that has never been recognized by the federal government.”

FoodFix also quotes the HHS Press Secretary:

Minor citation and formatting errors have been corrected, but the substance of the MAHA report remains the same — a historic and transformative assessment by the federal government to understand the chronic disease epidemic afflicting our nation’s children…“It’s time for the media to also focus on what matters.”

Formatting issues?  Oh come on.

Calley Means, the top advisor to RFK Jr, posted “The least surprising thing about the MAHA Report is that the media and failed medical leaders are talking about footnotes instead of its actual content.”

Sorry.  Footnotes matter.  Everything in a report making policy recommendations depends on where its information comes from.  Hallucinating references implies hallucinating data.

The MAHA Report is now being continually updated to fix the citation problem.

Some of the updates are introducing other errors. 

Yikes.

The Washington Post has published details: The MAHA Report’s AI fingerprints, annotated.

I was interviewed by Reuters about all this:

Nobody has ever accused RFK Jr. of academic rigor…The speed (of the MAHA report) suggests that it could not have been vetted carefully and must have been whisked through standard clearance procedures. The citation problem suggests a reliance on AI.”

Science magazine headlined the downplaying of the fake citations and pointed out the irony:

Problems with the MAHA report’s integrity came to light even as Kennedy has threatened to prevent government scientists from publishing in leading medical journals like The Lancet, The New England Journal of Medicine, and JAMA, which he claims are “corrupt” and controlled by pharmaceutical companies. Kennedy has instead proposed a state-run alternative.

Discovery of the fake citations also came just days after President Donald Trump unveiled an executive order that called for “Restoring Gold Science Standards” to government activities…One goal, Trump wrote, is to ensure that “Federal decisions are informed by the most credible, reliable, and impartial scientific evidence available.”

Yeah, right.  The MAHA report cites articles—26—from those “corrupt” journals as sources for its statements.

All of this has led cartoonists like Clay Bennett to ridicule the report.

Here’s another good one from Carlos Muñoz.

Ridicule—or lack of credibility if you prefer—is one reason why this matters.

What I had drilled into me as a graduate student in molecular biology was the importance of reading references, and never under any circumstances citing a reference I hadn’t read.

Why?  Because the credibility of my work depends on where I got my information—how I know what I claim to know.

When I managed the editorial process for the 1988 Surgeon General’s Report on Nutrition and Health, checking references was crucial to supporting the report’s recommendations.  It took years to get the report out, not least because of the enormous amount of vetting involved—from scientists, but also government agencies.

This report, unfortunately, was a rush job.  It astonished me that it got done in only three months (I really want to know who wrote it).

It’s one thing to make editorial errors in citing references (try as hard as I can to get them right, errors invariably get overlooked).

But this report had references that were made up.  Hallucinated.  This means nobody looked at them.

If its references are not reliable, nothing else in the report can be trusted either.

And that’s a shame.  It said a lot of things that badly needed to be said.

Too many corners were cut in throwing this together at the last minute.  I know this was a rush job because I have four versions of the report.

• Version 1: May 22 early morning.  It has no references at all.  My first reaction: What?  No references?
• Version 2: Also May 22, but later in the morning. It has references but not much in the way of formatting.
• Version 3: May 22. This is the one released to the public.
• Version 4: This is the one online on May 31.  Other versions, perhaps multiple, came in between and may come after.

None of this bodes well for the future of MAHA initiatiatives.  Sad.

 

Let me start by confessing that I did not review the references in the MAHA Comission report I wrote about last week—except for mine.

The reference to my book, Food Politics, is a bit garbled (In Food Politics?  No.  This is Food Politics), but these are basically OK.  It’s easy to make mistakes like that one and I rely on the help of many proofreaders and factcheckers to try to avoid such errors in my published work.  I checked a couple of the other references related to food topics and they seemed basically OK too.

So I was surprised by the report from NOTUS that The MAHA Report Cites Studies That Don’t Exist,

This finding was immediately attributed by the New York Times and other sources to the report’s having been referenced by Artificial Intelligence (AI), a tool well known to be scientifically inaccurate and to make things up.

To immediately plagiarize (well, quote) Ted Kyle at ConscienHealth: The MAHA Report: Make America Hallucinate Again.

I was also surprised—no, dismayed—by the administration’s response to these discoveries.

According to FoodFix,

White House Press Secretary, Karoline Leavitt told reporters…“I understand there were some formatting issues with the MAHA report that are being addressed,” Leavitt said. “But it does not negate the substance of the report, which, as you know, is one of the most transformative health reports that’s ever been released by the federal government, and is backed on good science that has never been recognized by the federal government.”

FoodFix also quotes the HHS Press Secretary:

Minor citation and formatting errors have been corrected, but the substance of the MAHA report remains the same — a historic and transformative assessment by the federal government to understand the chronic disease epidemic afflicting our nation’s children…“It’s time for the media to also focus on what matters.”

Formatting issues?  Oh come on.

Calley Means, the top advisor to RFK Jr, posted “The least surprising thing about the MAHA Report is that the media and failed medical leaders are talking about footnotes instead of its actual content.”

Sorry.  Footnotes matter.  Everything in a report making policy recommendations depends on where its information comes from.  Hallucinating references implies hallucinating data.

The MAHA Report is now being continually updated to fix the citation problem.

Some of the updates are introducing other errors. 

Yikes.

The Washington Post has published details: The MAHA Report’s AI fingerprints, annotated.

I was interviewed by Reuters about all this:

Nobody has ever accused RFK Jr. of academic rigor…The speed (of the MAHA report) suggests that it could not have been vetted carefully and must have been whisked through standard clearance procedures. The citation problem suggests a reliance on AI.”

Science magazine headlined the downplaying of the fake citations and pointed out the irony:

Problems with the MAHA report’s integrity came to light even as Kennedy has threatened to prevent government scientists from publishing in leading medical journals like The Lancet, The New England Journal of Medicine, and JAMA, which he claims are “corrupt” and controlled by pharmaceutical companies. Kennedy has instead proposed a state-run alternative.

Discovery of the fake citations also came just days after President Donald Trump unveiled an executive order that called for “Restoring Gold Science Standards” to government activities…One goal, Trump wrote, is to ensure that “Federal decisions are informed by the most credible, reliable, and impartial scientific evidence available.”

Yeah, right.

All of this has led cartoonists like Clay Bennett to ridicule the report.

Here’s another good one from Carlos Muñoz.

Ridicule—or lack of credibility if you prefer—is one reason why this matters.

What I had drilled into me as a graduate student in molecular biology was the importance of reading references, and never under any circumstances citing a reference I hadn’t read.

Why?  Because the credibility of my work depends on where I got my information—how I know what I claim to know.

When I managed the editorial process for the 1988 Surgeon General’s Report on Nutrition and Health, checking references was crucial to supporting the report’s recommendations.  It took years to get the report out, not least because of the enormous amount of vetting involved—from scientists, but also government agencies.

This report, unfortunately, was a rush job.  It astonished me that it got done in only three months (I really want to know who wrote it).

It’s one thing to make editorial errors in citing references (try as hard as I can to get them right, errors invariably get overlooked).

But this report had references that were made up.  Hallucinated.  This means nobody looked at them.

If its references are not reliable, nothing else in the report can be trusted either.

And that’s a shame.  It said a lot of things that badly needed to be said.

Too many corners were cut in throwing this together at the last minute.  I know this was a rush job because I have four versions of the report.

• Version 1: May 22 early morning.  It has no references at all.  My first reaction: What?  No references?
• Version 2: Also May 22, but later in the morning. It has references but not much in the way of formatting.
• Version 3: May 22. This is the one released to the public.
• Version 4: This is the one online on May 31.  Other versions, perhaps multiple, came in between and may come after.

None of this bodes well for the future of MAHA initiatiatives.  Sad.

 

The MAHA Commission released its report last week: The MAHA Report: Make Our Children Healthy Again.  Assessment.

This is one impressive report, forcefully written and tightly documented (it cites my work, among that of many others).

Overall, it paints a devastating portrait of how our society has failed our children.

It begins by stating that “The health of American children is in crisis” due to:

• Poor diet
• Aggregation of environmental chemicals
• Lack of physical activity and chronic stress
• Overmedicalization

The result: high rates of obesity, type 2 diabetes, neurodevelopmental disorders, cancer, allergies  and mental health problems among kids.

Here are some selected items I particularly appreciated in the report.  The bullet points are direct quotes.

On poor diet

• Most American children’s diets are dominated by ultra – processed foods (UPFs ) high in added sugars , chemical additives , and saturated fats, while lacking sufficient intakes of fruits and vegetables.
• Pesticides , microplastics , and dioxins are commonly found in the blood and urine of American children and pregnant women— some at alarming levels.
• Children are exposed to numerous chemicals , such as heavy metals , PFAS , pesticides , and phthalates, via their diet, textiles, indoor air pollutants, and consumer products.
• To get into schools , many food companies have reformulated their products with minor ingredient adjustments to qualify for the federal Smart Snack program by meeting the school nutrition standards, which children can purchase separate from school meals.

The driving factors for poor diets

• Consolidation of the food system
• Distorted nutrition research and marketing
• Compromised dietary guidelines

On the dietary guidelines  

They maintain problematic reductionist recommendations, such as:

• Advising people to “reduce saturated fat” or “limit sodium” instead of focusing on minimizing ultra-processed foods.
• Treating all calories similarly, rather than distinguishing between nutrient-dense foods and ultra-processed products.
• Remain largely agnostic to how foods are produced or processed: There is little distinction between industrially processed foods and home-cooked or whole foods if their nutrient profiles look similar.
• Added sugars, saturated fats and sodium are treated as proxies for ultra-processed foods. For instance, a cup of whole-grain ready to eat fortified breakfast cereal and a cup of oatmeal with fruit might both count as “whole grain servings,” and the guidelines do not weigh in on differences in processing.

They also,

• Do not explicitly address UPFs.
• Have a history of being unduly influenced by corporate interests .

On food systems

• The greatest step the United States can take to reverse childhood chronic disease is to put whole foods produced by American farmers and ranchers at the center of healthcare.
• Traditional Field Crops vs. Specialty Crops : Historically, federal crop insurance programs have primarily covered traditional field crops like wheat , corn , and soybeans, while providing much less support for specialty crops such as fruits, vegetables, tree nuts, and nursery plants.

On Corporate Capture 

• Although the U.S. health system has produced remarkable breakthroughs, we must face the troubling reality that the threats to American childhood have been exacerbated by perverse incentives that have captured the regulatory bodies and federal agencies tasked with overseeing them .
• Limited comparisons between industry-funded research versus non- industry studies have raised concerns over potential biases in industry-funded research…Additionally, some industry leaders have engaged in promoting ghostwriting and sponsored reviews to influence the scientific literature.
• Notably, this ghostwriting strategy mirrors tactics used by the tobacco industry to distort scientific consensus is largely propelled by “corporate capture,” in which industry interests dominate and distort scientific literature, legislative actions, academic institutions, regulatory agencies, medical journals, physician organizations, clinical guidelines, and the news media.
• The pharmaceutical industry, with its vast resources and influence, is a primary driver of this capture, though similar dynamics pervade the food and chemical industries.

Research recommendations

• GRAS Oversight Reform: Fund independent studies evaluating the health impact of self-affirmed GRAS food ingredients, prioritizing risks to children and informing transparent FDA rulemaking.
• Nutrition Trials: NIH should fund long-term trials comparing whole-food, reduced-carb, and low-UPF diets in children to assess effects on obesity and insulin resistance.
• Large-scale Lifestyle Interventions: Launch a coordinated national lifestyle-medicine initiative that embeds real-world randomized trials-covering integrated interventions in movement, diet, light exposure, and sleep timing-within existing cohorts and EHR networks.

Comment

The report has been criticized for not getting some of the science right.  The agriculture industry is particularly concerned about the attack on the chemicals it uses.  It is said to be outraged by the report.  The report did throw Big Ag this bone: “Today, American farmers feed the world, American companies lead the world, and American energy powers the world.”

But the report raises one Big Question:  What policies will this administration come up with to deal with these problems?  These, presumably, will be in the next report, due in about 80 days.

This is an extraordinary report, a breath of fresh air in many ways, and I would love to know who wrote it.

But to fix the problems it raises will require taking on not only Big Ag, but also Big Food, Big Pharma, Big Chemical, and other industries affected by these and its other recommendations (the report also says a lot about drugs and mental health).  Big Ag has already weighed in.  Others are sure to follow.

Oh.  And it’s hard to know how policies can be implemented, given the destructive cuts to FDA, CDC, and NIH personnel and budget.

I will be watching this one.  Stay tuned.

Resources

• The press release: MAHA Commission Unveils Landmark Report Exposing Root Causes of Childhood Chronic Disease Crisis
• The Executive Order establishing the MAHA Commission
• The Commission report: Make Our Children Healthy Again Assessment

Additional resource

• Errol Schweizer sent me his analysis on Medium, well worth reading.

 

5 food experts making sense of MAHA’s vision for a new way of eating

Marion Nestle

Marion Nestle, a nutritionist at New York University, molecular biologist, and the author of more than dozen books, has been a prominent voice on nutrition and advocate for food policy reform for years. But as a New York Times headline recently declared, “At age 88, she’s meeting her moment” in the MAHA-verse.

Nestle isn’t on board with all of Kennedy’s food concerns — she’s pretty neutral on seed oils, for example. But they share many criticisms of the food industry, arguing that the rise of addictively delicious, nutritionally deficient ultra-processed foods is linked to higher obesity levels in the U.S. and favoring measures like banning soda from the Supplemental Nutritional Assistance Program. (Nestle wrote the book on the soda industry’s threat to public health, 2015’s “Soda Politics.”) As such, Nestle’s commentary is a valuable guide to understanding the logic behind Kennedy’s proposals, whether or not you agree with them.

It’s actually six others: Dariush Mozaffarian (Tufts), Susan Mayne (former FDA official), Eri Schulze (UPSIDE Foods), Jerold Mande (Nourish), and Helena Bottemiller Evich (Food Fix).

I’m happy to be in their company.

The President’s proposed budget cuts are worth a close look.

In addition to what I’ve posted this week, I have a few comments about it.

Most of the government’s budget cannot be cut; it is mandatory.

Mandatory expenditures include defense, interest payments, social security, Medicare and Medicaid, and, yes, SNAP.   These can only be cut by an act of Congress.

The cuttable discretionary programs are the ones aimed at helping everyone, but especially the poor and vulnerable (they grey parts in this chart). 

The rhetoric—anti-woke, anti-Biden, anti-science—reminds me of the McCarthy era anti-Communist rhetoric.

Anything that Biden did is bad.  Anything aimed to help minorities or women is bad.  Anything that promotes research or tries to mitigate climate change is bad.

Is the Trump Administration engaging in “soft” eugenics, as The Guardian puts it?

By avoiding discussion of education, employment, social support networks, economic status and geographic location – the social determinants that public health experts agree influence health outcomes – Kennedy, in lockstep with top wellness influencers, is practicing soft eugenics…At the heart of all these policies is soft eugenics thinking – the idea that if you take away life-saving healthcare and services from the vulnerable, then you can let nature take its course and only the strong will survive….Maha perfectly mimics Maga’s deregulatory ethos: cut social services for vulnerable populations while parroting populist language that further helps consolidate power for the most well-off.

Food for thought, as we say.

Resource

Civil Eats on the effects of Trump’s first 100 days on the food system

I’m struck by the harshness of the USDA’s recent press announcement:  In First 100 Days, Secretary Rollins Puts Farmers First, Reverses Woke Priorities of Biden Administration

“It is absurd that while the Biden Administration was driving up inflation, American taxpayers were forced to fund billions in woke DEI initiatives. American farmers and ranchers don’t need DEI, they need reduced regulations and an Administration that is actively putting them first. In the first 100 days of the Trump Administration, USDA has done exactly that, by cancelling over 3,600 contracts and grants saving more than $5.5 billion. I look forward to finishing our work of cleaning out Biden’s bureaucratic basement and moving forward with this Administration’s priorities that put American farmers first,” said Secretary Rollins.

The statement boasts that Secretary Rollins

• Issued a memorandum to rescind all DEI programs and celebrations.
• Directed USDA to review Inflation Reduction Act funding to ensure that programs are focused on supporting farmers and ranchers,
• Terminated 597 grants, which totaled more than $3.45 billion and over 3,000 contracts totaling $1.8 billion…in unnecessary and wasteful spending.
• Canceled nearly 1,000 employee trainings, more than 750 of which focused on DEI alone.
• To ensure that taxpayer dollars are directly supporting farmers and not serving as a Green New Scam slush fund for non-governmental organizations, Secretary Rollins announced the cancellation of the Partnerships for Climate-Smart Commodities (PCSC).

I am having a hard time understanding how these actions will help farmers and ranchers, especially because one of the cut programs was the Patrick Leahy Farm to School Grant, which paid farmers to provide fresh food to schools—a totally win/win program costing a tiny fraction of USDA’s budget but of inestimable worth to participating local farmers.

The anti-woke rhetoric reminds me of the McCarthy anti-Communist era.  If Biden did it, it’s bad.  If it helps vulnerable Americans, well, it’s “leftist ideology.”

I do not see how any of this will Make America Healthy Again.

If you think it will, please explain.