Eating in America Podcast

Please note that a small portion of the text of this podcast is taken from an Eating in America Note, published on EatingInAmerica.co this week.I propose a new, simple definition for highly- and ultra-processed food, the definition of which shouldn’t be, but nonetheless has become, perhaps the most important nutrition issue of 2026. It has been made an issue as a tactic of delay by the Big Food lobby, which will exploit any opening to postpone the possibility of regulation of highly- and ultra-processed food.You haven’t heard from me as much as usual lately because I have been working on this definition intensely over the last few weeks. My hope is to provide a fresh perspective that provides a framework for the clearest, simplest, most durable way forward.Highly-processed food = ultra-processed foodHighly-processed food and ultra-processed food are two terms for the same thing. This is supported by the new Dietary Guidelines, which uses the term highly-processed instead of ultra-processed. I will use the abbreviation HUPF, standing for highly- and ultra-processed food.HUPF and diseaseHUPF has been linked to many chronic diseases, including obesity, heart disease, cancer, diabetes, and dementia.The Tobacco Playbook: the chapter about delay.Big Food knows HUPF as a category is bad for our health and that it will be increasingly regulated at various levels of government. But Big Food has had close ties to the tobacco industry, so, like Big Tobacco, they have learned all the tricks and moves to fight regulation, including those in the chapter about delay in the mythical but often cited Tobacco Playbook. This is the set of schemes and strategies that has been used not only by Big Food, but the alcohol industry and opioid manufacturers, and is being employed now by the gambling industry.To interfere with the growing momentum toward regulation, the question of a viable definition of ultra-processed food has been pushed by the HUPF food lobby, America’s biggest. RFK, Jr.’s Health and Human Services department and the USDA have been struggling to settle on a definition of ultraprocessed food that can be used for writing policy and regulations. Kennedy says the definition is finished and is awaiting the approval of Trump now. This holding pattern means Big Food is not done lobbying on the issue.A simple definition of HUPF is neededI predict the Trump administration will come out with a not-simple, maybe even tricky, definition that is as favorable as possible to Big Food while maintaining the appearance of addressing the concern with HUPF that is a core issue of Trump’s important constituency, the Make America Healthy Again movement.The Big Food lobby and HUPFHowever, what Americans actually need is a clear and simple definition of HUPF that can’t be corrupted by Big Food.I can ‘t know for sure that the federal HUPF definition will be compromised by Big Food’s influence but, given the record of this administration and the record of success and power of the Big Food lobby, it is a safe bet that industry profit will be considered at least equally with public health in the forthcoming Health and Human Services and USDA definition.For examples of the power of Big Food, their lobby got the word “ultra-processed” taken out of this year’s Dietary Guidelines, even though RFK, Jr. is an avowed enemy of HUPF. And the Make America Healthy Again Strategy Report, of September 2025, mentioned ultraprocessed only once, in the context of the need for a definition.Before RFK, Jr. and the USDA issue their Big Food-compromised definition, I have a proposal.First, some background.Carlos Monteiro, the scientist who invented and popularized the term “ultraprocessed food,” did the world a huge service in identifying how the food we are eating is industrial, formulated to be addictive, heavily marketed, all about profitability, and not healthy. Monteiro defined ultraprocessed as generally bad and not ultraprocessed as where the good lies, which is all true. But his definition of ultra-processed was too inclusive and not simple and clean enough to be used for policymaking.Clarity from an unlikely sourceI respectfully offer a simpler way to view what has happened to our food environment and how it happened, a clear dichotomy that was popularized in the late 1960s by none other than the Hippies.Without the benefit of science or research, the love-beaded, bell-bottomed folks of the Counterculture Revolution intuited that the direction the food environment had gone was all wrong. They understood American diets were being co-opted by the marketing and lab-created, unnatural products of Big Food. They said, “What was the matter with the way we were eating before?”The natural food movement blossomsAnd so the natural food movement was born in earnest. In the words of Crosby, Stills, Nash, and Young from 1969’s Woodstock, “…we’ve got to get ourselves back to the garden.”Suddenly un-sugared granola and un-sugared plain yogurt were to be found in small urban food co-ops along with raw milk, whole grains, nuts, honey, molasses, organic vegetables, lentils, brown rice, tofu, and sprouted beans. Highly- and ultra-processed food were rejected. To the youth of the Counterculture, this was an entirely new way of eating, but to the grandparents of those Hippies and their grandparents and their grandparents, this was just the way food was supposed to be. Except for the tofu, of course, which was “far out, man.”The end of World War II and the beginning of the HUPF EraThese twenty-somethings had been born in the years surrounding the dropping of the first nuclear bombs in 1945, ending World War II and beginning the Atomic Age, and the Anthropocene Epoch proclaiming the most pronounced human impact on our planet, and, not coincidentally, the HUPF era.It is no coincidence that the HUPF era directly follows World War II. The needs of the Allied war machine had driven both the development of new HUPF food products for our soldiers and chemical design and manufacturing that fueled the rapid rise of commercial HUPF after the war.HUPF harms? We happily swallowed the problem.Why did it take until the early 21st century, 60 years after the start of the HUPF era, for concern about the radical change in our food environment to come to the forefront in American society? Money, marketing, and our indulgence and belief in the delightful wonders of HUPF, perhaps. You could say we swallowed the problem. Fortunately, the now almost extinct human subspecies called Hippies – I say that with love and peace – seems to have been created on earth to detect the unnatural change in our food that had occurred and to call out the alarm.The Hippies’ natural foods is now a commercial sectorWe are five plus decades beyond the start of the “back to natural foods” movement. That movement is now a fully commercialized sector of our food system with 557 Whole Foods stores globally. And despite the array of HUPF products in Whole Foods stores, the Hippies did start us on a healthy way forward.The stark division identified by the Counterculture between new food and natural food is the true way to think about ultra- and non-ultra-processed food and the best starting point for a definition of HUPF.A new proposed definitionHighly- and ultra-processed food is produced from food or chemicals modified or newly created with methods of the Second or Third Industrial Revolution. That is my definition of HUPF in 23 words.There are several tenets to the definition1. HUPF is unnatural food. Natural food, if processed or modified, is done so with methods that predate the Second Industrial Revolution* (see the footnote for an explanation of the dates and the nature of the first three Industrial Revolutions), and in the case of techniques like fermentation, by thousands of years.EXAMPLEYogurt is a food that can be very healthy in its natural form but is now sold mainly in a modified form with post-industrial ingredients, making it HUPF in those cases. Yogurt is the example almost always cited (to the delight of the HUPF lobby) when the Big Food-inflated problem of defining HUPF is discussed. The question always posed is “What about yogurt with its additives? It’s healthy food!” The answer is “Okay, although healthier in its natural form, but if you want to make a law banning HUPF while making an exception for yogurt: fine, help yourself.”2. Everything that is natural food has been consumed by humans for a long time. Humans have learned what to eat and what not to eat over millennia. We have adapted some food to our biological needs, or, in some cases, our biology has adapted to the available food. What we eat, works for our health.EXAMPLESFirst, we have developed genetic adaptations in some cases. Lactose intolerance develops in children as a way to force their weaning from mother’s milk in order that their new baby siblings can get adequate nutrition. In northern cultures where animal milk is common, lactose intolerance has evolved out of the genetic pools, allowing more resilience to famine. Second, a traditional Inuit diet, which is all protein and fat and lacks vegetables and fruit, adapts the available food by including raw organ meat like seal liver and caribou brain which is rich in vitamins. Furthermore, evolution within the Inuit genes allows the metabolization of fat from their hunted food in a way that reduces bad cholesterol and heart disease.3. Everything that is HUPF is a new or relatively new industrial invention, or it is a food that is a new risk because of mass production allowed by a high level of processing.a. All of the many thousands of food products and additives created after 1945 are HUPF. Keep in mind, please, that 1945 is not a hard and fast date, pending further investigation and discussion of how far back it could be pushed. For now it is a safe and convenient date to mark the watershed after which no new natural food could have been created. We can say no new natural foods have entered human food environments since at least 1945 and any food or additive created after 1945 is HUPF.b. Some HUPF is older.EXAMPLEHydrogenated vegetable oil, or transfat, as in margarine or Crisco shortening, was invented in 1901. It was marketed as a healthy alternative to butter, but in reality, is very toxic to heart health.c. Second Industrial Revolution processes made some moderately processed food into HUPF. These foods had been tolerated without great harm in small amounts in our diets, but they became significant health risks when they became widely and cheaply available by virtue of mass production, made possible by a high degree of processing. The nutritional and structural character of these foods was the same as it was in the pre-industrial age, but industrial processing and mass production lowered cost and allowed over-consumption.EXAMPLESRefined sugar, highly refined flour, salt, and white rice are in this sub-category of HUPF.4. Where natural food is available in sufficient quantity and quality, it is sufficient nutritionally. In such an environment, HUPF brings few nutritional advantages to the table.The health risks are bad but the economics favor HUPF.HUPF is an overwhelmingly negative nutritional contributor to diet but has economic value on the basis of convenience and cost per calorie. Policies addressing the pervasiveness of HUPF in our food environment have to deal with these economic factors, whether it is in the potential increased cost of school lunches -- as in California’s HUPF school food ban -- or when creating sugared beverage taxes, which have the greatest effect on lower-income households.Policy makers are aware that when the choice is between sufficient HUPF calories or insufficient healthier calories, having sufficient calories must win every time. Hungry children, and there are many in America, are not okay. The cost of healthy food is the greatest and broadest nutrition policy challenge in America.We have to acknowledge that HUPF is not by definition harmful.Some HUPF substances are toxic. Some might be fine in low doses found in normal consumption but toxic in high doses. But for most HUPF we don’t have safety data, and it would be very difficult to get. Some HUPF likely have benefits outweighing any risks. For example, seed oils are good replacements for animal fats. Some preservatives like nitrites and nitrates reduce levels of dangerous bacteria but present their own carcinogenic risks. I would suggest the sensible default, where we can afford it, is to pass over HUPF unless there is strong evidence it is safe.HUPF may never be removed from our food supply, but it will hopefully be reduced in many helpful steps and stages.California leads the way, as usualImpatient with delays addressing the health harms of HUPF, some states have proceeded with their own definitions and laws. California leads the way, as usual, using Monteiro’s 2009 definition as a basis.Monteiro’s definition has been widely used in research for approaching 20 years, but it is overly descriptive and inclusive. Nutritionists and policy makers, joined by a happy chorus from the Big Food lobby, have been in consensus that the Monteiro definition is not well-suited for regulatory, law-making, or program-design use.Complexity and exceptions weaken definitions proposed to dateOther nutrition scientists have offered their definitions, hoping to provide a more independent, scientific perspective than any that will come from Health and Human Services and USDA. Typically, these HUPF definitions are not simple and have exceptions built in. Any complexity and any exceptions will be examined by Big Food for an opportunity either to argue that certain HUPF products are not covered or to re-design their products to avoid coverage by regulation. A simple, solid definition presents less openings for argument and so can be more impervious to corruption by Big Food.Also, any definition of HUPF, simple or complex, will require exceptions when implemented in law, policy, regulations, or programs. Exceptions will always be added based on the circumstances of jurisdiction, institutional setting, nutritional needs, economic and financial dictates, or political influences. In order to have a defensible policy, the exceptions should be added to the language of the implementation and not be part of the main definition.EXAMPLEThe usefulness of simplicity is seen in the FDA smoking control regulations where the target was defined simply as nicotine in combustible tobacco products. The streamlined approach to defining the problem helped create an extremely effective regulatory framework for tobacco control.ConclusionHUPF consists of thousands and thousands of substances created mostly in the decades since the end of World War II and the beginning of the Third Industrial Revolution.Most of these modified foods and additives have no substantial certification of their safety on record. They are not sold to us for our health. They are produced to profit the corporate coffers of Big Food. The quick creation of an effective regulatory framework for HUPF, beginning with a strong and durable definition, would reduce health harms and deaths from diseases that are linked to HUPF and point to a possible return to a healthy food environment.Thank you for reading. Your comments, likes, and shares are appreciated as is your support through subscribing!Footnote*The First Industrial Revolution, from the late-18th to mid-19th centuries, was about the transition from the agrarian economy to industrial employment, mainly in textile factories in England. Industrial innovation for the production of HUPF occurred mainly with the Second and Third Industrial Revolutions. The Second Revolution was from the mid-19th to mid-20th centuries and saw massive leaps in technology and communications with the dawn of electricity, steel, telephone, internal combustion engines, and expanded railways. The Third Industrial Revolution was, in essence, the Digital Revolution, which began after World War II. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Trump suppressed a major government-led study on alcohol, health, and risk of death meant to guide the writing of the 2025 Dietary Guidelines for Americans. Although a draft of the report had been released for public comment, this was, nonetheless, a big win for the alcohol industry.This week the scientists who did the research published the results that Trump, Republicans in Congress, and the alcohol industry don’t like. The paper appeared in the peer-reviewed Journal of Studies on Alcohol and Drugs.We’ll walk through what the research says, and, I’m sorry, it may not be good news if you enjoy alcohol, as I and most Americans do.But first, here’s what has happened.The Interagency Coordinating Committee on the Prevention of Underage Drinking, a group with expert scientists endorsed by the USDA, Health and Human Services, and many agencies, was tasked in April 2022 with studying the effect of alcohol on health. Later in 2022 Congress passed a law mandating a similar report from the National Academies of Sciences, Engineering, and Medicine. On paper, the two studies were meant to be complementary and to inform recommendations on alcohol intake in the 2025 Dietary Guidelines. But the National Academies research was tainted from the outset by the strong financial links of some of its scientists to the alcohol industry.Congress attacks the work of the Interagency CommitteeDuring their nearly three years of work, the integrity of the Interagency Committee process was assaulted by Republican Congressmen acting in tandem with the alcohol lobby, who feared the tightening of the 2020 Dietary Guidelines, which recommended limiting alcohol to two drinks per day for men and one drink a day for women. The lobby also feared the Interagency Report would state that alcohol was a cause of cancer, since that evidence had already been solidified in the scientific literature.Representative James Comer, Republican from Kentucky, home of Bourbon whiskey, led an aggressive congressional investigation into the work of the Interagency Committee. In January 2025, at the release of the draft report, Comer issued press releases from the House Oversight Committee on Reform accusing the Committee of work that was unlawful, biased, and wasteful, and executed with a predetermined outcome using cherry-picked data.Meanwhile, the National Academies of Sciences report had been released a month earlier, in December 2024.National Academies report finds drinking causes breast cancerThe National Academies of Sciences found that drinking was a cause of breast cancer. This was bad news for the alcohol industry but represented the minimum about cancer the Academies report could say, given the mounting evidence. The National Academies scientists also reported there was what they called “mid-grade” evidence, not strong but not weak, that moderate drinking, defined as one drink per day or less, resulted in a 16% decrease in risk of death compared to non-drinkers. The alcohol industry liked this.Interagency Committee report finds drinking causes seven types of cancerOn the other hand the Interagency Committee draft report found “… the risk of dying from alcohol use begins at low levels of average use” and from there, the more alcohol the more the risk. In contradiction of the 2020 Dietary Guidelines, the Interagency report said men generally have the same level of risk as women, which is a one in 1,000 risk of dying from alcohol use if consumption is more than 7 drinks per week. The risk increases to one in 100 with more than 9 drinks per week. The Interagency Report also found that seven types of cancer, not just breast cancer, were causes of alcohol-related deaths.These Interagency Committee results were not at all friendly to the alcohol industry, or, frankly, to the many people who drink in what is considered moderation. If the Dietary Guidelines were going to be written in alignment with this study by Health and Human Services and the USDA, the new Guidelines would need to lower the 2020 Guidelines’ recommended limit on alcohol of two drinks per day for men and one for women and add a warning that alcohol is a cause of cancer.The Interagency report is 86’dBut the Trump administration took office two weeks after the Interagency draft was released and the report was never finished and published.The 2025 Dietary Guidelines on alcohol are toasted by the alcohol industryWhen the 2025 Dietary Guidelines were finally finished and released in January 2026, based on a new made-to-order, quasi-scientific report, the alcohol lobby was flush with success. The new Guidelines removed the recommended limit on drinking and instead simply advised, if drinking, to drink in moderation. Going against the science in both the Interagency and the National Academies reports, the Guidelines made no mention of cancer.The Interagency research re-surfaces in a peer-reviewed journalThis week the six original authors of the Interagency report, joined by 19 additional co-authors, published a paper with the results of the Interagency research. Their original findings stand that low levels of drinking don’t have a protective effect – a little alcohol isn’t necessarily bad, but it isn’t good for you. A little more alcohol and then the risk of disease, including cancer, and death becomes apparent. At 8.5 drinks per week the risk of an alcohol-related death becomes one in 100, for both men and women. At the previous recommended limit of 14 drinks per week for men, the risk of an alcohol-related death is one in 25.The publication of this paper is important. It stood up to independent peer review, has four times the number of authors as the original report, and can now be cited by other scientists, policy makers, and program designers going forward.100,000 cancer cases annually due to alcoholStudies have found about 20,000 to 25,000 annual American cancer deaths due to drinking. 83% of these deaths could be prevented by drinking within the 2020 Dietary Guidelines of a maximum of two drinks per day for men, one for women. In thinking about the meaning of this statistic for your own choices, remember that these are just cancer deaths, and that cancer cases due to alcohol total about 100,000 annually. Any case of cancer tends to have a bad impact on life.These two reports raise somewhat different levels of alarm, but both make clear cancer is a risk with drinking.That alcohol causes cancer has so far escaped the knowledge of 60% of Americans. There will be better awareness of alcohol’s relationship to cancer if and when a warning is incorporated in the Dietary Guidelines, as it should have been this year.Informing Americans about the riskThe word is getting out there despite the power of the alcohol lobby. In January 2025, just before Trump took over, the U.S. Surgeon General’s office issued a report saying alcohol is a leading cause of preventable cancer. And, don’t tell Trump this, the CDC still has a web page listing the seven cancers caused by alcohol and advising that reducing drinking lowers cancer risk. By the way, the CDC takes the trouble to point out that red wine (or white, for that matter) carries the same risk as beer and hard liquor.Making personal choicesGiven that the National Academies group had financial links to the alcohol industry and was engaged by Congress to provide a counter to the work of the Interagency group, I lean toward the findings of the more worrisome Interagency Committee study. Of course, neither endorses drinking as a safe habit. As someone who enjoys alcohol, I am still weighing my own, personal level of concern.Eating in America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.I do know I am thankful for the work of all the genuine, independent scientists and public health officials publishing and acting on this issue and that the findings of the Interagency Committee and the National Academies were able to be brought into the open despite the efforts of the Trump administration to repress science it doesn’t like. Let us know what you think in the comments!Thank you for reading.The image in this post was created with AI. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Elon Musk and Joe Rogan, eat your hearts out.In today’s game, three doctors walk into a Fox TV studio for a taping of Survivor, Surgeon General. Two of them work for Fox. Two of them got their medical degrees at schools in the Caribbean. One of them lies about her qualifications. Two of them are selling supplements. One of them isn’t really a doctor and is a recent stockholder in tobacco. Two of them are not completely pro vaccine. Which of these three are qualified to be the U.S. Surgeon General? Who will be voted out? You decide, because you are a whole lot more qualified than the President who nominated them.Candidate #1To recap our game so far, Donald Trump named Dr. Janette Nesheiwat as his nominee for Surgeon General two weeks after being elected to his second term. In his statement, the President-Elect repeated Nesheiwat’s lies about being double-board certified and a graduate of the University of Arkansas School of Medicine. In fact, her medical degree is from a Caribbean university, which as a group are best known for accepting those who fail to get accepted into a U.S. medical school. For many though, the Fox commentator’s real fault was that she was pro vaccine and science. People who wanted someone who could be trusted to speak the truth about everything, not just vaccines and science, objected to the nomination, and everyone else wanted someone who would not speak the truth about science, so they objected, too.“YOU’RE FIRED!”Warming our hearts with his famous Apprentice reality TV show catchphrase, in May 2025 the President told Nesheiwat, “You’re fired!” as the Surgeon General nominee.Candidate #2Next up, vaccine skeptic, supplement seller, tobacco investor, and not-an-actual-doctor Casey Means was the second nominee for the nation’s top doctor. Means is a darling of the MAHA movement, and they love everything about her -- except MAHA folks didn’t mention her holdings in tobacco giants Altria Group and Philip Morris.With everything else to complain about with Means, the tobacco investments did not get much attention, but to me it was a serious red flag. Surgeons General through the years have played a huge role in turning public attitudes about smoking toward the negative, but there is still a long way to go with tobacco. Smoking remains the leading preventable cause of death in America with a half-million deaths annually. We can’t have a Surgeon General nominee who profits from tobacco.“YOU’RE FIRED!”But it was the not-a-real-doctor thing and her vaccine skepticism that tanked Means’ nomination in her confirmation hearing. Trump said, “You’re fired!”Candidate #2Trump’s third nominee hoping to be named “Survivor, Surgeon General,” is Dr. Nicole Saphier. Like Nesheiwat, Saphier both graduated from a Caribbean medical school, yup, and was a commentator on Fox News. Like Means, Saphier sells supplements and has expressed ambiguity about vaccines.Let me be clear, ambiguity about FDA- and, more importantly these days, W.H.O.-approved vaccines is completely inappropriate in a Surgeon General. But since Eating In America is about what we consume in our bodies, I will object to Saphier on the basis that she is yet another snake oil selling nominee, who claims science where there is none, makes health promises where there is no or insufficient evidence or expert scientific consensus, and takes money for products where there is no proven efficacy but there are serious concerns about safety.Outrage #1: Saphier proposed as Snake Oil GeneralSaphier, in addition to her job as a radiologist and work on Fox, is a maker and vendor of a line of wellness supplements. Her company, Drop Rx, sells four elixirs, she calls them tinctures, for about $10 an ounce. They are named “Focus,” “Calm,” “Soothe,” and “FemmeX.” Saphier makes unsupported health claims for these formulations of unquantified herbs and ultraprocessed ingredients and one of them contains an ingredient, kava, that is banned in the U.S. military.I will come back to this outrage, and the even bigger outrage of the way the U.S. handles supplements, in a moment.Don’t mess with the Chinese sea snakeWe all may have become familiar with the term “snake oil salesman” by watching American Westerns where men in bowler hats sold cure-all elixirs out of the back of a covered wagon. There is a surprising origin story to these early wellness hucksters.180,000 Chinese laborers brought the oil of the Chinese sea snake, the extremely venomous black-banded sea krait, when they came to build railroad lines in the American West in the mid-1800s. This traditional medicine is very rich in eicosapentaenoic acid, or EPA, an anti-inflammatory omega-3 oil. The snake oil might have provided some relief for aches from pounding stakes into railroad ties all day and the other difficult and dangerous work these men were doing. There is some evidence that EPA can help with joint pain. But I can’t help speculating if the crates of snake oil didn’t also contain some bottles of snake venom wine, also a traditional Chinese medicine and a more powerful treatment for pain than snake oil.The Rattlesnake KingIn any case, inspired by the widespread Chinese use of sea snake oil, a man named Clark Stanley showed up in Chicago in 1893 dressed as a cowboy and carrying live rattlesnakes and bottles of supposed snake oil that actually contained only mineral oil, beef fat, red pepper, turpentine, and Stanley’s false claims of healing powers. But Stanley was a good hawker, and the snake oil business took off.Snake oil elixir, a new law, and a $20 fineA surge in snake oil and other elixir sales was part of the reason for the passage of the Pure Food and Drug Act of 1906. That law was the basis in 1917 for fining Stanley $20 for his false health claims. The fine didn’t hurt Stanley, but the bad publicity resulted in him having to shut down his factories and, in fact, his whole operation.Defining a supplement: food, drug, or a little of neither?Skipping ahead to 1994, the new Dietary Supplement Health and Education Act categorized supplements as food, not drugs. As a subcategory of food, supplement makers don’t have to prove their products work or are even safe before putting them on the market. Further, while food items aren’t allowed to make unapproved health claims, food supplements are given a lot more leeway. They are not supposed to make health claims, but, well, they do.The American snake oil supplement systemThe system we have is deficient. Americans spend $60 billion a year on supplements that are not reviewed for their health claims or safety.Some of these supplements are meant to be nutritional, like vitamins, minerals, omega-3 fatty acids, or whey powder protein, for example. These should be regulated like food and held to the same strict FDA standard for food health claims.Other supplements are, in essence, over-the-counter drugs. These include products containing psychoactive ingredients. Some supplements in this group are meant to calm us, like bacopa monniera, or make us alert, like ginseng. The other supplements in this group are advertised as being associated with a range of health benefits such as stress relief, inflammation reduction, or soothing digestive issues. Like any drug with a health claim, these should be treated by the FDA as over-the-counter medications and verified for safety and the validity of their claims.Surgeon General hopeful Saphier’s supplementLet’s check one of Surgeon General nominee Saphier’s Drop Rx products, “Calm.” “Physician formulated. A clean product you can trust. Experience the power of nature, backed by science.”So, a doctor designed it, Drop Rx says we can trust its safety, and science says it works. Well yes, there is some science that supports the psychoactive calming effect of ingredients, including kava, in Calm. But there hasn’t been the rigorous testing that should accompany any psychoactive product that is, in essence, a drug.Kava, unfit for serviceBut, worse, the science also points to kava’s risk of liver damage, which is the reason the U.S. military, UK, France and Switzerland have banned kava, and the FDA published advisories about its potential toxicity in 2002 and 2020.There is some confusion about the kava in Calm. In two places the Drop Rx website shows the presence of kava in Calm and in two other places on the website the kava is missing in favor of another psychoactive ingredient. But regardless of the quality, safety, and efficacy of Saphier’s elixirs, the fact that she is selling supplements is the basic issue.What we need in a Surgeon GeneralWe need a Surgeon General who is deeply committed to solidly scientific approaches to saving lives and improving our health, with a desire to communicate about the effectiveness and safety of vaccines, the need to control tobacco and addictive substances including ultraprocessed food, along with addictive media and digital and instantaneous gambling, the need to treat unhealthy weight in Americans, and the urgent need for diligence in the face of new global health threats due to both climate change and the ease of pandemics to spread.As long as Trump puts forward candidates as inappropriate and unqualified as Saphier, we can only hope the game of Survivor, Surgeon General will go on. But, for better or worse, it seems that the lack of an actual Surgeon General is not going to stop the Surgeon General’s office from issuing Surgeon General advisories. This past week RFK, Jr. went ahead and signed and released a Surgeon General’s report warning about excessive screen time for kids.Thank you for reading. Please support Eating in America by subscribing for free or as a paid subscriber to help me keep up the level of research required to make this publication one that can be counted on not just for facts, but for new perspectives and analyses.Game show image created with Gemini AI. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Here’s a story that is so scary and sobering that only a science fiction writer could make it up. Only it is not fiction.And while a mere epidemiologist like me could not have conceived this story – it is too outrageous given what we know today – the story does provide us, and by us, I mean scientists including epidemiologists, media, and the public, at least several sobering lessons.I love food history stories. They can be so informative. Here we go.The butter part of this story started maybe 10,000 years ago, perhaps when some nomads put goat milk into a bladder, and as the nomads walked the bladder bounced around and churned the milk into butter.Butter has been loved ever since.The margarine story started in France in 1869. It was not love at first taste. Napoleon III wanted a cheap, hardy alternative to butter to send to sea with the Navy and to feed the bottom ranks of the working class. The resulting margarine didn’t work out for the Emperor. Neither the Navy nor the poor wanted it. But the idea of a cheap butter substitute was too good to throw away, and in 1901 a chemist invented partially-hydrogenated vegetable oil. Crisco, which was 100% partially-hydrogenated vegetable oil, came on the market ten years later in 1911, and by 1930 margarine was made with partially-hydrogenated vegetable oil.Let’s pause for a reminder. Partially-hydrogenated vegetable oil is a horror story of its own. It is toxic with trans fats, and trans fats can increase the risk of death by a third. 34% to be exact. Trans fats raise the risk of heart attack, stroke, Alzheimer’s, and cancer.Nutritional epidemiologist Walter Willet and others found solid evidence that trans fats were bad for the first time in 1990. However, the FDA, with its cumbersome process combined with pressure from the ultraprocessed food industry, took until 2015 to revoke the GRAS, or Generally Recognized As Safe, status of industrially made trans fats, banning them from food only eight years ago, in 2018. And yes, partially-hydrogenated vegetable oil can be seen as a very early poster child of the ultraprocessed food industry.Back to our story, the butter shortages during World War II conditioned the American public to eating margarine, and the gap between butter and margarine consumption narrowed. In the post-war years, the margarine industry saw a bright future.Convincing the public of margarine’s healthiness with biased-science and mediaIn the most audacious industry funding of research I know of, around 1945 the National Association of Margarine Manufacturers gave funding to three scientists at the University of Chicago and the University of Illinois to compare the health effects of margarine versus butter.That grant in itself was not audacious, but it might have been innovative. We think of industry funded research as part of the playbook written by the tobacco industry, which passed the practice on to the ultraprocessed food, opioid, cannabis, and gambling industries. But, in fact, this was a case of the ultraprocessed food industry funding research eight years before the tobacco industry started its massive effort in 1953 to co-opt the science linking smoking to cancer.Of course, no matter who conceived of the idea of funding science to get advantageous and respectable-seeming results, or, in the case of tobacco, just to cast doubt on the good science coming out, the priorities were always the same, profits before science before health.The audacious piece is what the Chicago scientists were paid to do. Previously all the research on the healthiness of margarine versus butter was done on animals, almost always lab rats. This grant was to do human research.To put this in context, this money was delivered three years before German doctors were put on trial in Nurenberg for their concentration camp medical experiments on prisoners. This money came in the middle of the 40-year course of the Tuskegee Syphilis Study which withheld antibiotics from infected men who were Black. This was nine years before the NIH became the first institution to require a review of human subjects research it conducted. By the way, the NIH review program was only to provide itself legal protection, not primarily as a matter of ethics.Here’s the thing. The doctors in Chicago were paid to conduct their research on orphans in two orphanages. One orphanage ate butter and the other ate margarine. The research went on for two years and was done on 350 children from 2 to 17 years old. They were weighed monthly and their heights were recorded, with blood draws to measure their red blood cell count and hemoglobin. Medical records were checked only to see if one orphanage was seeing a difference in health compared to the other. In their resulting paper the doctors seemed strangely excited the margarine eating children were much healthier than those that ate butter, although they took care to say in the paper that the very good health was certainly not “simply because” of the margarine.It was a poor study with a poor design, written up with bias in favor of its funder, but of course the outrageous, nowadays unthinkable aspect is that forcing this study on these children was seen as acceptable. Children cannot give their consent to being subjects of research. Furthermore, these toddlers and kids and teenagers were wards of the state and in an institution where one might imagine they were experiencing some level of trauma or emotional distress on a daily basis. The margarine research equated them to lab rats with human metabolisms.Having no consciousness about the possible harms of this research to its subjects paid off for everybody but the children. Especially the margarine industry, which saw a favorable paper, “Margarine And The Growth Of Children,” published in the Journal of the American Medical Association, one of the world’s top medical research journals. The very influential TIME Magazine picked up the story, quoting the scientists’ conclusion that “Margarine is a good source of table fat in growing children…”Within a couple of years as much margarine was being eaten as butter. Margarine continued to grow in popularity, becoming consumed twice as much as butter by 1970.Today, Institutional Review Boards, or IRBs, in the U.S., or their equivalent in Europe and elsewhere, but not China or Russia, carefully screen all proposed research plans at universities or any organization doing federally funded research or FDA regulated trials, to ensure strict ethical standards are met. The margarine study would not have passed IRB review.Are our problems with unethical research solved in the U.S.? Apparently not in RFK, Jr.’s department, home to the FDA, NIH, and CDC, three agencies that fund or review a lot of human subjects research.At the end of 2025 it was revealed that the CDC had given a no-bid contract to Danish researchers to test the effect of hepatitis-B vaccines on newborns vs. 6-week old babies in Guinea-Bissau in Africa. The researchers are friendly with anti-vaxxers aligned with RFK, Jr. Kennedy has strongly praised one of the researchers. A leaked protocol for the study points to an intention on the part of the researchers to show that withholding the vaccine for six weeks is safer than giving it at the same time as other newborn vaccines. The World Health Organization is clear that withholding the hepatitis-B vaccine at birth is dangerous, risking the long-term development of serious illness and death due to transmission of hepatitis-B from the mother during birth. 18% of adults in Guinea-Bissau have hepatitis-B.In sum, Kennedy disregarded procedure to give a contract to researchers who designed a study to exploit the high prevalence of a disease in an African nation. The leaked protocol revealed that their intent was to support the CDC’s dismissal under Kennedy of the hepatitis-B vaccine recommendation for newborns. There was no review by an IRB at the CDC of this research. The study has been decried as unethical by the World Health Organization and research ethicists and scientists, and it has been likened to the Tuskegee Syphilis Study. As of March 2026 the study was on permanent hold.Thanks for reading Eating in America. This post is public so feel free to share it.While this began as a horror story about industry-funded, completely unethical research that found that margarine was as healthy as butter, again not true, we ended with another scary story of highly unethical research. Only this latter study was funded by a government politician, RFK, Jr., who happened to be in charge of a group of prestigious scientific agencies and yet had the goal of supporting his own dangerously wrong and unscientific ideas about vaccines. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This month Lela Nargi in an article in The Guardian wrote about one of the studies I led that, together, examined, among other things, the use of cars vs. buses vs. walking to shop for healthy food. I told Ms. Nargi that I thought buses were a terrible way to have to go to get groceries, at least compared to going in a car.As part of the access to healthy food research, we surveyed community leaders in the three communities in Rhode Island where the data collection took place.One woman’s response spoke for many bus users and made a lasting impression on me. She was a shopper who uses a wheelchair, but her comments apply equally to those fully able to walk:If you are allowed to take a small travel cart onto the bus often you have trouble getting it on and off the bus and are in the way of other patrons, so a lot of bus drivers will refuse you service if you try. Many of the bus routes do not go to where there are less expensive markets, and if you want to go to one of them you have to walk quite far. If you find sales in different locations, it’s not worth the effort and extra expense of travel time. Also, the weather is a factor – rain, snow, extreme heat – keeps many people from making the hike to the bus. Sometimes bus routes are a couple of blocks away. If this is the only choice you have, making your way to the market usually means going two-three times a week. There are many people who have to take taxis just to get their groceries home, which is expensive. Most often we are elderly or disabled and must shop on our own, consuming much of our day. When I’m told how lucky I am to be on a bus route, I like to tell people what I must go through to get a few days of groceries, and I prefer to use my electric wheelchair and lug my groceries home on the footrest of my chair.Please support Eating in America and share this post with someone who might be interested.As one community member lamented, the food system was “designed for drivers.”There are a number of studies that measure physical access to food by car, but not many that attempt to measure access by transit bus. It’s difficult, and no one had figured out how to accurately estimate the number of people who could reasonably access a given supermarket or other location (like a health center, for example) by bus. It’s important for policy and planning to see how many people can get to a service location or potential location in a reasonable amount of time. But it’s very tricky to do that.To use a bus, the shopper has to walk to the stop, wait for the bus, ride, and then get off and shop. This assumes there is a bus stop close to the supermarket, which is often the case. Coming back the shopper has a wait for the bus, ride, and walk home from the stop. Walking takes a fairly standard amount of time; bus stop waiting times range from none at all to who knows, depending on the spacing between buses and when exactly the shopper arrives at the stop; and usual bus speeds vary according to the time of day, usually being slowest during rush hours. There aren’t any great software tools to put all these segments together to give the best estimate of how far away a supermarket or pantry could be for a shopper on a time budget, so I had to invent a new method. I won’t bore you with the details, but to see how many people in a community live close enough to reach a supermarket in a reasonable amount of time, you have to figure out what a reasonable amount of time is.For this we depended on a group of community leaders who told us that, if you have a car, a round trip of 18 minutes is reasonable. Let me stop right here for a spoiler alert.Basically, in all three communities, anyone with a car for shopping was within reach of at least one affordably priced supermarket and one healthier food pantry, given a time budget of 18 minutes for the round trip driving. If you had a car, physical access to affordable food for most people was no problem.For those using a bus, the community leaders said a reasonable time budget for the traveling part of the shopping excursion was 36 minutes. This makes sense in these urban or semi-urban communities. It is mostly a given that using a bus is going to take longer than driving a car for food shopping.What doesn’t make sense, when you think about it, is doing the calculation for how accessible food is by bus for a community when you start with the assumption that bus users have twice the time budget to do shopping. I don’t think bus users can be assumed to have more time on their hands than car drivers, but that is the approach taken by other studies like ours, and that is the way we did it. Ours was an inherently inequitable, unequal measure for comparing healthy, affordable food access by car versus by bus. I led the research, and I own that flaw in equity. As you will see, if we had analyzed the data using the same time budget for shopping by bus as for shopping by car, the result would have been dramatic. Perhaps it is dramatic enough to find that given a 36 minute round trip, only half of the people in the three communities had access to an affordable supermarket. Only one out of five could reach a food pantry that offered produce.However, if we had cut the bus round trip budget by half to the 18 minutes allowed for a car round trip, the estimate of the number of people in each community with access to healthy food would have fallen to zero. All of the 18 minutes would have been consumed by walking to and from the bus stop and waiting for the bus on each end, leaving no time to actually ride on the busThere is no perfect method for assessing food access, but the grand lesson is that, apart from all the hassles of using the bus, the time required for shopping by bus is never going to be the same as for driving, no matter how little time you have for shopping because the adults in your household have multiple jobs or you have multiple children to manage.We found out some other interesting stuff. First, supermarkets and some food pantries were the only sources of a reasonable amount of healthy food in our study area. The seventy convenience, corner, and dollar stores in the three communities, and we surveyed them all, did not come close to clearing our low bar for having enough healthy food.Second, the results of our cost analysis of shopping at the accessible supermarkets was a shock. We priced a selection of produce and dry and can goods at each store. The food we checked at the most expensive store cost twice what the same food did in the least expensive store. Shoppers who could access one of the three discount supermarkets could buy twice as much food compared to those who only had access to the most expensive store. The ability to make the food dollar go twice as far makes a world of difference to a family on a limited income, and about 10% of the population of the three communities lives in povertyBuses can be somewhere between tolerable and great for commuting to work. When I was in college, I got up at 4 am every morning for a two-hour ride on two buses to get to my summer job in a cardboard box factory. Even that was tolerable, if just for a summer. But grocery shopping by bus can be hard. What are the grocery shopping solutions for people who don’t have a car, don’t live within a short walk of a supermarket, and can’t afford delivery or a car service for their shopping? Unfortunately, I don’t think there are any easy, global solutions with something so unwieldy as transit systems, but maybe there are some smaller scale solutions, custom fit for the needs of local communities.Maybe it sometimes involves government encouragement of retail food outlets, something that is already in action in several American cities, in addition to myriad government programs that are already in the food business, like assisting or funding food banks, pantries, farmers markets, indoor markets, military commissaries, soup kitchens, taxi voucher programs, and food deliveries for shut-ins.Eating in America is reader-supported. To receive new posts and support my work, consider becoming a free or paid subscriber.Thanks for reading.What are your thoughts about bus access to healthy food? This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Coming up this week, I’ll share what I found doing a study in Rhode Island on the use of buses vs. cars to access healthy food. If you haven’t had to do it, and I’m glad I have never had to, it might be a little hard to imagine how hard it is to shop for groceries relying on the bus.Medicare says yes to Ozempic and ZepboundBut first, there are a couple of big GLP-1 things to talk about. Beginning July 1, people who have Medicare Part D and qualify medically will be able to get GLP-1s to treat unhealthy weight with only a $50 monthly copay, much less than available discounted prices. Currently, Medicare does not cover any weight loss treatment.The benefit is being offered by the Centers for Medicare and Medicaid Services, or CMS, as a pilot program that will end after a year and a half, on December 31, 2027. At that time CMS hopes a permanent program will be in place to continue benefit coverage.A body mass index, or BMI, of 35 provides automatic medical qualification. A BMI of at least 30 in combination with diastolic heart failure, uncontrolled hypertension, or Stage 3a chronic kidney disease also qualifies. Finally, a combination of a BMI of at least 27 and either cardiovascular disease or prediabetes reaches the threshold of medical qualification.To receive the prescribed GLP-1, patients with these conditions must receive prior authorization through Humana, the CMS contractor who will administer the pilot program.Possible and and proven GLP-1 benefits grow and growWhile the inclusion of GLP-1s in Medicare benefits will reduce the risk from unhealthy weight for many, the bigger, long term GLP-1 story is that many of these newly covered Americans will experience other GLP-1 associated health benefits, as might anyone using GLP-1s.At first scientists had it wrong. GLP-1 is a hormone that is produced in the gut in response to eating. The initial belief was that drugs like Ozempic worked for weight loss by supercharging our natural gut GLP-1, and the abundance of GLP-1in the gut made us feel satiated with less food than normal. Turns out that appetite suppression through signaling with GLP-1s seems to happen mainly in the brainstem, which produces GLP-1 in addition to the gut.Also, GLP-1s slow the pace of stomach emptying and that contributes to a reduced desire to keep eating and also helps slow down metabolism. Carbohydrates are digested slower, turning into sugar less rapidly, tamping down glycemic spikes. So, by contributing weight loss and a reduction in blood sugar spiking, GLP-1s are good for control of prediabetes and diabetes.The science and the public embrace of GLP-1s for conditions beyond unhealthy weight and diabetes are unfolding quickly. The benefit of GLP-1s to reduce the risk of cardiovascular events like heart attacks and strokes and for the treatment of sleep apnea is well documented, to the degree these are standard conditions qualifying patients with unhealthy weight but not obesity to receive GLP-1s under many health insurance plans.Losing unhealthy weight is good for your heart health, but, as you may have heard, GLP-1s are good for your cardiovascular system independent of any weight loss.GLP-1s are in love with cytokines. It’s complicated.Cytokines are chemical messengers in our body involved in regulating our immune system. Too much cytokine production is associated with autoimmune disease like rheumatoid arthritis. On the other hand, doctors sometimes inject cytokines to fight cancer or serious infection.The actions of the many cytokines, and their interactions with GLP-1s, are complex, but we know that the way that GLP-1s, working through cytokines, tamp down immune reactions in the body that are causing inflammation is key to benefits GLP-1s provide beyond weight loss.Inflammation can save our life but is also involved in so many of our health problems.To put this in plainer English, GLP-1s can reduce bad levels of inflammation in our organs without turning off immune reactions entirely. Liver and kidney disease and immune system dysfunction can benefit. Arthritis and female and male fertility are being researched in connection with GLP-1s.Nervous system disorders are being investigated, although evidence has been disappointing or mixed in Parkinson’s and Alzheimer’s trials. However, dementia treatment research will continue with GLP-1s and newer, related drugs.Meanwhile promising research has begun on the use of GLP-1s to treat traumatic brain injury. The availability of pill versions of GLP-1s offer additional hope for treatment in this regard. Orforglipron from Eli Lilly, which just came on the market, uses a small molecule structure which can penetrate the blood-brain barrier more easily than injectable versions that use full peptide proteins that are much larger. This not only means better transport of the medicine to the site of trauma but more availability to GLP-1 receptors deep in the brain, so potentially these oral medicines could have more effectiveness for controlling satiety.A very interesting area of research is the often observed effect of GLP-1s on the reduction of addicted or disordered behavior. Many GLP-1 users report a sudden disinterest in drinking alcohol. Disordered gambling, shopping, sex behavior, and eating can be reduced, including simple food addiction and binge and anorexic behaviors. GLP-1s can be associated with reductions in the use of nicotine, opioids, cannabis, and cocaine.Addictions are not a choice we makeI have to pause here because I just listed a number of what we think of as “bad things.” I always like to remind myself that these are just “things.” While all of these things can be bad for us, they are things I and other people are given by genetics, environment, and happenstance, and don’t choose. It’s good to remember that every one of these obsessions comes to us a product for sale, so someone stands to profit from our obsession.We are fortunate to have an increasing arsenal of medical and behavioral treatments, now including GLP-1s, to rid ourselves of these things, and it may be that our society is making some progress in ridding itself of some of the stigma around these things.A tremendous amount of research needs to be done to understand how GLP-1s work and to invent new ones and understand them as well. We are yet to sort out how much of a miracle these drugs are and to discover any risks to using them that may still be hidden.But we may be at the start of a new era with regard to GLP-1s. The health benefits are so evident, and for some people the body image changes are important and apparent. Popular interest in GLP-1s has been extremely high. One in eight American adults is on or has tried a GLP-1. What’s more, dieting and medical treatments are both areas in which Americans as a group have repeatedly shown a willingness to try anything, and that is certainly the case with GLP-1s, be they compounded off-brand GLP-1s made in America or even much, much sketchier next generation GLP-1s like the experimental retatrutide compounded under unknown conditions in China and available on the gray market online.It’s important that RFK, Jr., the FDA, and Trump take an aggressive approach to keep up with the American public, not just with approving new GLP-1s, as they seem intent on doing as fast as possible, but with ensuring GLP-1 safety and clamping down on sources of unregulated substitutes. And with making these medicines affordable to all Americans.What do you think about what might be the awakening of the age of GLP-1s in America? Let us know!Eating in America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Thank you for reading and your support. Please join us in subscribing, if you haven’t, and feel free to share this and any post at EatingInAmerica.co. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Turns out RFK, Jr. could be called today’s James Delaney, the congressman who gave us the Generally Recognized As Safe, or GRAS, system. Kennedy has been voicing many of the exact same nutritional concerns that Delaney expressed – two years before Kennedy was born. And, in the same way that Delaney struggled with the power of what was to become known as the ultraprocessed food industry, Kennedy is struggling today. Because of the influence of Big Food and the lack of will in Congress to properly fund the FDA, the Delaney Act and its GRAS system in 1958 failed to effectively regulate the addition of chemicals to our food. Given the enormous size and power of the ultraprocessed food industry today, Kennedy has a challenge on his hands in reforming it, as he would like to do, for the benefit of the public’s health.So what’s going on with the FRESH Act collision in the House? First, I noticed, as did the nutrition watchdogs Center for Science in the Public Interest and the Environmental Working Group, the appearance of Florida Republican Kat Cammack’s FRESH and Affordable Foods Act. Both CSPI and EWG termed the Act not fresh but rotten.Cammack’s FRESH Act is, in full, the FDA Review and Evaluation for Safe, Healthy and Affordable Foods Act. Cammack and her food industry friends would use it to further eviscerate an already weak food additive safety system. The Environmental Working Group’s Melanie Benesh said, “I did not think it was possible to make our food system even weaker, but this proposal does it.”Cammack’s draft bill was discussed this past week in subcommittee. There is a large amount of doubt about whether it, or any of the several congressional proposals currently in committee that are intended to reform GRAS in a positive, public health direction, will succeed in this session.Cammack’s FRESH act was introduced on April 22nd in draft version. Another Republican, Julia Letlow from Louisiana, an avowed MAHA mom, introduced her own FRESH Act on April 29th. Representative Letlow’s bill, H.R. 8578, the Food Reform for Effective and Sustainable Health Act of 2026 does just two things. This FRESH Act makes the new inverted pyramid Dietary Guidelines into law, and it requires each new Dietary Guidelines to be approved by a new law in Congress. Letlow’s proposal is not as horrible as Cammack’s law, but it isn’t good. It inserts Congress into a supposedly scientific process that is already thoroughly corrupted by politics.Cammack’s aberration is the story, but I mention Letlow’s bad idea because it seemed to me far too unlikely to have two Republican nutrition proposals named the FRESH Act coincidentally introduced in the House seven days apart. Perhaps it is just an attractive name for a bill. There was yet a different nutrition-oriented FRESH Act introduced last year.Maybe I’m just overly suspicious of what goes on in Congress these days, but it seems plausible that the name of Letlow’s bill is meant to be confused and amplified by the anti-MAHA FRESH Act introduced by fellow House Republican Cammack. Letlow is strongly aligned with MAHA and RFK, Jr. and is the deep underdog in a fight for the Senate seat of Louisiana’s incumbent Senator Bill Cassidy. Cassidy, a pro-vaccine physician, is seen as a traitor by Trump and MAHA for torpedoing Trump’s nominee for Surgeon General, MAHA darling Casey Means. With her FRESH Act, Letlow could be undercutting Cammack’s bill and gathering MAHA energy and attention in her Senate fight. Neither FRESH Act is good for public health and science, so another crack in the anti-science, anti-public-health Republican Party is okay from my perspective as a public health scientist.Meanwhile, a year ago RFK, Jr. directed the Health and Human Services Department to begin a rule-making process to close the GRAS loophole through which the ultraprocessed food industry has self-certified as safe thousands of chemicals – without providing the FDA or the public any information. However, experts have doubts that Kennedy’s rule-making will be able to circumvent congressional involvement and, in the end, changing GRAS will require a law.At least RFK, Jr. is acting and some members of Congress have moved to address the GRAS mess. It is an uphill battle against the ultraprocessed food lobby, the biggest in Washington.The ultimate problem with any proposed solution is that the FDA is and always has been underfunded, and the already inadequate staffing has been slashed by Trump. These cuts are badly affecting food safety in all areas, not just additives. One estimate of the cost of establishing the safety of a food additive is 2.5 to 5 million dollars and thousands of substances have already been introduced which have no published safety evidence.An obvious solution is to put the cost of this proof on the manufacturers who would profit. If this means we have a much reduced number of food additives, we should consider the effects of that on an individual basis. We humans coped without these added chemicals in our food for thousands of years. We now have the science to create these complex substances, but we should also use our science to truly understand the health effects of these additives and newly imagined foodstuffs before we sell them.Your support of Eating in America is appreciated. Please share this post, like and comment if you’ve a mind to, and subscribe if you haven’t. Thank you.Image AI-generated. This is a public episode. 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Guess who said:…the survival of the country, as well as its democracy, depends on the health of its citizens. The shocking number of our young men who cannot meet the … physical requirements of our armed services must make each of us ask the reasons for this reservoir of ill health in the midst of such a varied and abundant food supply.It wasn’t Abe Lincoln with regard to the Union forces or Franklin Roosevelt at the outset of World War II, although it very much applied then. Nor was it Robert F. Kennedy, Jr. in his run for the presidency.The quote above is from U.S. Representative James Delaney in 1951, the year following the start of Delaney’s House Select Committee’s years long investigation into the glaring lack of safety in food additives.Delaney is known today for giving us the Generally Recognized As Safe, or GRAS, system of food additive safety assurance or, most would say, lack of assurance. But Delaney’s words sound as though they came from the lips of RFK, Jr. And what Delaney told us was bad in 1951 is still bad, 75 years later.The congressman, increasingly alarmed about what his Committee was finding, wanted to spread the word to the public and build support for a battle with the increasingly powerful food industry. He wrote an article for American Magazine with scary, but not exaggerated, examples of the public at risk from toxic food additives and unregulated pesticides and of the food industry’s eagerness to capitalize on preferences of the human palate while ignoring nutritional needs. The congressman’s condemnation of the food additive practices of the industry, the lack of regulatory oversight, and the sad nature of the food environment as a whole, could have been written today.The date I give for the start of the ultraprocessed food era is 1953. Somewhat arbitrary, but it marks the introduction of Swanson TV dinners, Kraft Cheez Whiz, frozen French fries, Tony the Tiger and Frosted Flakes, and McDonald’s franchises. Delaney’s article provides context for that moment and deepens our understanding of the history of today’s food environment and the rise of ultraprocessed food.First, Delaney told about a peach packer who learned that adding a little of the industrial chemical thiourea would keep his peaches perfect, so he treated a shipment and sent them off. A fellow packer decided to try the same trick except, fortunately, had FDA inspectors test the thiourea first. The rats who were fed it died. When, by lucky chance, the inspectors learned of the first packer’s shipment, a frantic race to find and recall the peaches followed. Fortunately, they were all recovered before any were eaten.Please feel free to share this post.Also in the late 1940s, lithium chloride was put on the market as a salt substitute for people on low-salt diets. Little safety testing had been done, and three people died before the lithium chloride was withdrawn.Delaney goes on to rail against the national distribution of beer sterilized with poisonous hydrofluoric acid by a Massachusetts brewery and an Indiana manufacturer substituting butter with yellow-colored mineral oil labeled “edible fat” in popcorn sold all over the U.S. The mineral oil was found to be eliminating all the fat-soluble vitamins from people, many of them children, and causing vitamin deficiencies.Delaney wrote that chickens (and later it was sheep, pigs, and cattle, too) were being treated with a new hormone called “stilbrestrol” to make them fat and faster growing. Then, despite the FDA’s oversight of pharmaceuticals, stilbrestrol was given to pregnant women, to prevent miscarriage and premature birth, up until 1971, when the practice was stopped because stilbrestrol is a strong carcinogen and causes infertility.Delaney’s list went on. Many chemicals had been newly added to foods in the 1940s. For example, there was a shortage of shortening in 1947, and bread makers began to add emulsifiers and other substances, cutting the amount of shortening by 50% and making the bread softer. 10 million pounds of chemicals like polyoxyethylenes such as Polysorbate-60 were sold to bakers in America in 1949. Delaney was concerned about adding all these untested additives, but he also asked the simple question, ‘Why make the bread white and take out the nutrients?’ That was some far too uncommon common sense for the 1950s.Delaney saw the increased role of soft drinks like Coca-Cola in our diet and worried about the phosphoric acid in it, citing U.S. Navy research that human tooth enamel is dissolved in 24 hours by phosphoric acid. That story seems like it is out of the way-back-machine, but 75 years later Coke still contains phosphoric acid as a main ingredient and great-grandchildren who inherited the practices of the dentists of 1951 are still filling cavities of people who drink Coke.And Delaney worried about the explosion of new pesticides, including the highly toxic chlordane, finally banned in 1988, and DDT. The congressman was concerned DDT was being found in high quantities in meat in supermarkets. Soon, DDT was found stored in the fat of almost all Americans.From a nutritional standpoint, Delaney could be a golden hero of the MAHA movement. In 1951, the Korean War had started, and the congressman decried the state of our food environment as the cause of so many American men being physically unfit for military service, words echoed today by RFK, Jr., who wasn’t born when Delaney said it. The congressman even wondered if the increased number of people with mental illness was related to the new chemicals in the food supply, far before RFK, Jr. gave voice to that concern.In my next post, I’ll discuss how Delaney found it hard to translate into law his clear vision of what needed to be done to fix the American food environment. It wasn’t until 1958 that the Delaney Act, officially the Food Additives Amendment to 1938’s ineffectual Food, Drug, and Cosmetic Act, was passed. The Delaney Act made advances in food safety, but industry lobbying created a giant loophole to allow thousands of chemicals - for which the public has no safety information - into the food supply. Nutrition scientists and food safety advocates have long complained about the Generally Recognized As Safe, or GRAS system, in which the ultraprocessed food industry largely self-certifies the safety of food additives. It is in RFK Jr.’s hands to try to close that loophole. However, a law, the FRESH Act, to reform the GRAS system, has been introduced in Congress by a House Republican — but the FRESH Act grossly reforms GRAS to the favor of the ultraprocessed food industry. We’ll see what happens, but first we’ll discuss it next time.Eating in America is a reader-supported publication. To receive new posts and podcasts and support my work, please join us as a free or paid subscriber.Thanks for reading. I appreciate your support of Eating in America. Please subscribe if you haven’t and share this post with anyone interested in these things. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Yes, I know it is Eating in America, not “Smoking in America”, but today’s news is important, and I had to cover it, given the conclusion this week of EiA’s four-part series on cannabis. Think of this as a little bonus, since I already wrote this post for the Notes social media-ish stream of Substack. (If you are not familiar with Notes, you can find EiA’s Notes collection on the website EatingInAmerica.co. Many of my Notes extend or synopsize EiA posts and podcasts and there are thousands of worthwhile Notes from other authors.)Cannabis has been reclassified today to a Schedule III drug for medical purposes. The Drug Enforcement Administration within the Department of Justice made the change, presumably on the basis of a scientific finding from RFK, Jr.’s Department of Health and Human Services. All of this avoids the further exasperation of Donald Trump, who expressed frustration a few days ago that the rescheduling had not yet occurred after he had ordered it in December.From the public health perspective, the two major benefits of reclassification are the greater ease of doing medical research on a Schedule III substance and the potential for the FDA to regulate cannabis products. The direct health benefits of national regulation could be huge.Thanks for reading. Feel free to share with others.Today’s ultra-high potency products are linked to increased health risks including cannabis use disorder, cannabis hyperemesis syndrome, and psychosis. Any national regulation at this moment would apply only to medical uses, since recreational cannabis will remain fully illegal in federal law. However, according to Reuters, the Department of Justice has scheduled hearings to begin June 29 with the aim of reclassifying cannabis for all purposes.Too bad Trump rescheduled cannabis for medical purposes without first putting together a coordinated program of research and FDA regulation, but as usual he appears to be acting in response to personal appeals and the widespread opinion of potential voters, and not from a public benefit (health and safety, in this case) perspective. If, following the hearing process beginning in June, recreational cannabis is reclassified, that is another moment the administration could embrace setting up national regulation of cannabis and pumping up the research.However, stocks for cannabis-related companies rose sharply yesterday with leaked word of the rescheduling. A windfall of tax savings will occur as medical dispensaries will, for the first time, be able to take tax deductions for their expenses, including rent and payroll. The cannabis business is likely to be suddenly much more profitable.A portion of those profits are certain to appear in increased lobbying power in Washington, D.C., almost certainly fighting against needed national regulations, like potency caps, that could help reduce the risk of harms such as cannabis use disorder. Following the tobacco, opioid, and ultraprocessed food playbooks, Big Cannabis is likely to fight hard and with lots of cash lubrication against regulatory control of qualities of its product, like high potency, which are linked to the tendency of frequent users to use even more frequently than they might want.Rescheduling and any other step to federal legalization offers an opportunity to provide a carefully designed, scientifically-based policy framework for cannabis’s place in our society, including limits on product potency along with testing, labeling, and safety requirements. A smart strategy, one that has been tested country-wide in Uruguay, is to allow a reduced-risk level of cannabis potency that is still satisfying to recreational users, with the goal of displacing cannabis sourced from criminal enterprises in favor of standardized and more trustworthy products from legal dispensaries and pharmacies.From my public health point of view, national cannabis legalization for both recreational and medical use is a step I hope will happen, but only in coordination with ample support of rigorous research and a well-designed and closely monitored program of regulation based on that research.Smoking Eating in America is reader-supported. Please subscribe to help EiA grow!Thanks for reading. I would love to read your thoughts, opinions, and experiences, if you care to share.There’s more on the interesting and unfolding story of cannabis in America with my new four-part series on the subject on Eating In America. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This week Eating in America has ventured out the kitchen door to the living room to explore something that might be on the coffee table of 44 million Americans in the last month. That is to say, cannabis.Cannabis has become widely legal but also highly potent, and regulations are loose and vary by jurisdiction. Enforcement is sometimes loose. There is increasingly good evidence about the risks of cannabis use while at the same time it has become highly accepted as a mostly safe part of our recreational landscape, joining alcohol in that regard. It is also felt by millions of Americans to provide medical benefit that is mostly not available to them from the traditional medical system.What should be medical cannabis look like going forward when each state that has medicalized it has a different system? How big is the money around cannabis today, and how is that influencing policy and public perceptions? And what are some policy changes that would help address safety and public health issues while aligning cannabis use and regulation with both science and public attitudes?And what role does the continuing black market play as regulations are created and refined?POTENCYHigher levels of potency are linked to higher rates of cannabis use disorder, where an individual’s control over use begins to slip while some facet of life – health, relationships, work - is being negatively affected.Growing technique boosted black market cannabis strength from 2% THC content, THC being the high-producing chemical in cannabis, in the 1960s to 17% by 2017. But it was the legalization of recreational cannabis in 24 states and Washington D.C. that spurred the creation of ultraprocessed cannabis now available in legal dispensaries and on the gray market. Extracted cannabis products in dispensaries are on offer at THC levels above 90%.With legality has come not only potency but big money, with an estimated market of $47 billion in sales in 2026. Has the big money in cannabis found Big Tobacco’s playbook? Have they studied the page about encouraging the addictive effects of their products yet not acknowledging them? The gray market producers of high-level THC products made from low-THC hemp, a $24 billion industry, have taken advantage of the lack of age restrictions for hemp products and are blatantly marketing to minors, packaging THC-infused candy and treats in child-friendly packages. Getting them while young was an important chapter in the Big Tobacco playbook.In the 1980s Big Tobacco acquired the ultraprocessed food companies General Mills, Kraft, and Nabisco and brought their playbook with them. The main premise of ultraprocessed food is hyperpalatability, the sense that a food is so good it is hard to stop eating. Addictive qualities and the targeting of children have been key to making ultraprocessed food a $2 trillion dollar industry.The federal government joined with the states in the public health effort to control tobacco and together they have had great success reducing smoking rates. There remains much more to be done, and we can’t tolerate any more U.S. Surgeon General nominees like Casey Means, who owned stock in Big Tobacco.But a framework in which ultraprocessed food could be limited has begun to be constructed, although controlling a $2 trillion dollar industry will demand a prioritization of public health that administrations so far have not been able to make.The federal government’s position with Big Cannabis is actually better than it was with tobacco or ultraprocessed food. Cannabis is still illegal at the federal level. Loosening the cannabis law to a level of tight regulation will be easier than creating restrictions on largely unregulated markets, as was the case with tobacco and will hopefully be the case with ultraprocessed food.Here are seven recommendations for federal cannabis policy.Acknowledging that recreational cannabis use can be safe and is widely popular and that medical cannabis is regarded as uniquely beneficial by patients who use it, a public health first approach would call for, minimally:1. Copious support for research into all aspects of cannabis use, including medical use for physical and mental health conditions.2. Legalization and full regulation at the federal level, including strict product testing for contaminants and chemical components and full labeling of those components. Regulation would cover both recreational and medical products.3. A minimum federal age requirement and safety labeling that would align with the development of scientific evidence about brain development concerns as it becomes available.4. Federal marketing regulation that would require front of package safety labeling, forbid packaging that targets youth, and forbid health claims that are not fully supported by scientific evidence.5. Creation of a window for transition of medical cannabis from state licensed dispensaries to pharmacies, with federal approval of the efficacy of a product allowing insurance coverage and lowered prices for patients.6. Adherence to the November 2026 federal deadline to ban manufacturing and sale of hemp-based products with more than a non-intoxicating level of THC.7. Critically, the setting of maximum strength levels across all types of cannabis products. These potency caps would need to be set at a conservative level until research could prove equivalent safety in higher dose products – or at least provide reliable estimates of increased risk with increased doses upon which to decide ultimate cap levels.On this last point, researchers have proposed the need for potency caps, and others, including recently the New York Times Editorial Board, have proposed cannabis taxation based on product strength. In the same way as whiskey is taxed more than beer, products with higher concentrations of THC would be taxed more than lower THC products.Tiered taxation might be warranted but only if done in combination with caps. It would be irresponsible to allow continued sales of THC concentrations that exceed amounts required for enjoyment by most people. Putting a government stamp of approval on high-doses is not in the public interest. Just as alcohol consumers can drink themselves into inebriation, so can cannabis users continue to consume cannabis until reaching a state of mind (or lack of it) equal to that reached more quickly with high-potency cannabis. They would still have the freedom to take that risk.The result of implementing these measures would be a cannabis landscape somewhat similar to that for alcohol sales. Standards would be set at the federal level and licensing and most enforcement would remain at the local level. Taxation would occur at both the federal and state level, as with alcohol.Thanks for reading Eating in America. This post is public, so please share it!THE BLACK MARKETThe continued activity everywhere of the black or illicit market for cannabis is an important consideration in setting regulatory standards in a legalized environment.Canada had good success in reducing illegal sales, which by 2023 had dropped from 88% to 24% of total sales in the five years following recreational legalization in 2018. (It’s noteworthy that along with recreational legalization, medical sales in Canada decreased from 12% to 4% of total sales.)In 2014 Uruguay became the first country to legalize cannabis, taking an approach that allowed cannabis clubs that could grow their own, home growing, and pharmacy sales of state-controlled and -priced product.Initially the illicit, organized crime-controlled market in Uruguay remained dominant because of overly strict regulations for legal cannabis that included limiting THC levels to just 3%. To increase uptake of the government produced cannabis sold in pharmacies, maximum allowed THC levels were increased to 9%, then 15%, and currently 20%. The organized crime-controlled market is now only 7% of the total, although a gray market of distribution from home growers is estimated at 30% of the market.Uruguay seems to demonstrate a model where potency caps can be put in place while keeping the least safe black market purchases, those from criminal enterprises, small in volume.In the U.S., the volume of black market sales in legalized states varies, influenced by state taxes and regulations and local conditions. California is repeatedly mentioned as a state with significant black market and unlicensed retailer sales.THE CREATION OF BIG CANNABISThe political and countercultural revolution of the 1960s was the turning point for wide acceptance of cannabis in America. The advocacy group NORML was formed in 1970, and the call for legalization began and continued unabated with the work of activists and the funding of various pro-cannabis organizations and efforts by benevolent donors.With the beginning of recreational legalization in 2012, corporate money took over the funding of activists and has also paid for political lobbyists. Large donations to legislators began to correspond closely to “yes” votes for legalization. Congressional efforts to legalize cannabis in 2021 attracted $4 million in lobbying by the cannabis industry and large expenditures by Big Tobacco and beer manufacturers.The cannabis industry might exceed hundreds of billions of dollars in sales in the next decade. Just as with the explosion of ultraprocessed food beginning in the 1970s, the prospect of large cannabis profits has unleashed intense lobbying, in the case of cannabis for legalization and relaxed regulation.The regulatory position of the cannabis industry is strengthened by the happiness of recreational use states which are enjoying the large cannabis tax revenues they are collecting: $4.4 billion in 2024, for example. In 2021, in 11 states with legal cannabis sales, cannabis taxes brought in more revenue than alcohol taxes by 20%.As legalization pushes forward and the need for greatly increased regulation becomes more apparent, the flow of billions of dollars in sales and tax revenues will tend to make further increasing revenue a priority for states and a continued number one priority for the cannabis industry. Public health concerns will need active voices and strong defending.Your subscription supports this work. Paid subscriptions fund each episode’s research and for the remainder of April are 30% off. That’s the conclusion of our series “Ultraprocessed Cannabis: Potency, Policy, and Public Health in America.” You can find the first three articles in the series at EatingInAmerica.co.Help grow Eating in America by liking this post, if you did, commenting if you didn’t, sharing it with others, and subscribing. I love your support. Thanks for reading. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This is a free preview of a paid episode. To hear more, visit www.eatinginamerica.coUsually Eating in America is about what we eat and what people like RFK, Jr. are doing or not doing to make it healthy. But EiA is near the end of four-part series on cannabis, something Kennedy and Trump could help make less of a threat to health, and today we touch on another big failure of Kennedy and the current administration, this time with regard to a smokable substance with strongly negative health effects: tobacco. Look for the final part of my cannabis series in two days, on April 21. We get into black market cannabis, the effect of big money in cannabis, and policy ideas to move forward balancing public health and public opinion.Today’s post is available in its entirety for paid subscribers. Paid subscriptions are 30% for the rest of April!First, the smoking gun.A lot has been going on with Trump, RFK, Jr., and public health in America since the new administration began last year, so it went somewhat unnoticed that in April’s decimation of the CDC, all 120 Office on Smoking and Health staff were fired. The federal government has effectively ended its effort to prevent initiation to tobacco and reduce use.Meanwhile, nearly a half-million Americans continue to die annually from tobacco use.The obliterated Office had been formed in 1978 and has led effective national anti-smoking campaigns, written the Surgeons General’s many reports on tobacco, and run and analyzed the annual National Youth Tobacco Survey, a key tool to monitor smoking among adolescents and older youths. The Surgeons General’s reports had to be restored to public access by court order but are now deep-sixed in an archive, including the last one, 2024’s “Eliminating Tobacco-Related Disease and Death: Addressing Disparities.”Fortunately, the National Youth Tobacco Survey data from 2025 has been released by the FDA, although without comment or analysis that was usually provided by the Office of Smoking and Health.Statnews reported that former Office of Smoking and Health Director Tim McAfee called the closing of the office “the greatest gift to the tobacco industry in the last half century.”FoundayoGood news in the world of GLP-1s, the new daily orforglipron pill from Eli Lilly got very fast fast-track approval on April 1 from the FDA. Eli Lilly, confident that their application would be approved, had started manufacturing the drug months ago, and it is already available for purchase.The pill, brand name Foundayo, can be taken without regard for time of day and with or without food. The other new GLP-1 pill, Novo Nordisk’s Wegovy, must be taken first thing in the morning a half-hour before consuming anything. For those of us who cannot cope with waiting 30 minutes for their first cup of coffee, that might be a deal breaker.The Wegovy pill became available in January. Trials showed average weight loss of 16.6% with Wegovy, about 3% more than the average loss achieved with Foundayo. Side effects are typical of GLP-1s with both pills, but the effect profiles may be better with the Wegovy. Their head-to-head costs are competitive and somewhat less expensive than the injectable version of Wegovy or Eli Lilly’s Zepbound.Both manufacturers are optimistic about uptake on their pills. There is speculation that the pills might work out as a weight maintenance option for many people who create their weight loss with an injectable Wegovy or Zepbound regimen for some months or years but would prefer to take pills for lifelong maintenance of the weight loss.The Gorske dilemmaWhen I was a young man and beginning to collect random ideas about healthy eating, NPR played a story in which a farmer declared he was a vigorous 98 years old and had eaten bacon every day of his life. I was happy to realize eating fried, fatty, salted pork would not automatically result in my death warrant going out to the grim reaper.

Eating in America is typically about what’s on our plate: what we’re eating. However, in this series we’re examining something that is not on everybody’s plate but was consumed by 44 million Americans in the last month. Cannabis is very much “in the air” these days, so to speak, especially if you live in a state where it is decriminalized and the smell of cannabis is easily found on the streets. Cannabis use is not unrelated to our consumption of food and to the food environment. The pleasure people find in cannabis taps into the dopamine pathways in our brain that help us choose what to eat. And the parallels to alcohol use are often pointed out.On Eating in America, we talk a lot about how ultraprocessed food has taken over our food environment. Has ultraprocessed cannabis taken over its world?THC levels in cannabis have exploded in the last 25 years, going from around 5% in illegal cannabis in the 1970s to over 90% for some legal products in today’s recreational dispensaries. Cannabis use disorder is growing along with the potency of products, and research is clarifying that some claims of benefits don’t hold up. Instead, a number of risks are being confirmed.The status of alcohol has often been used as a reference point when discussing cannabis legalization and regulation. While there are natural parallels between alcohol and cannabis distribution and consumption in our culture, there are important differences. On the one hand, alcohol and cannabis are the two recreational substances that are consumed in significant amounts by large percentages of our population. They are both, for the most part, widely available for purchase at prices that most people can afford.However, their effects on the body and mind are very different. Because of its long status as a legal substance, the risks associated with alcohol have been much more researched than the risks associated with cannabis. For example, we now know a heightened risk of cancer begins with the consumption of any alcohol. The World Health Organization and the 2020 U.S. Dietary Guidelines Scientific Advisory Committee are among the groups who have found that the only safe level of alcohol consumption is zero.While far too little research has been done on cannabis with regard to biological safety, research has begun to make clear that there is not much benefit for the mental health conditions for which cannabis is often recommended and good evidence of mental health risks.A new review published in The Lancet analyzed existing randomized controlled trials, the gold standard of cause-and-effect research, and found no difference in outcome with cannabis treatment for anxiety, anorexia, psychotic disorders, PTSD, and opioid use disorder. Cannabinoids in cannabis actually increased cravings in those with cocaine use disorder.The Lancet review did find some evidence that cannabis “can reduce symptoms of … insomnia, tic or Tourette’s, and autism spectrum disorder.” There was insufficient or no data to make conclusions about other mental health conditions like ADHD, bipolar disorder, and depression.While evidence of the mental health benefits of cannabis is limited to a few conditions, the evidence has been mounting about mental health risks. A new Journal of the American Medical Association Internal Medicine review finds cannabis linked to psychosis, cannabis use disorder, and self-harm in adolescents with mood disorders. However, the JAMA review did find some evidence that the main non-psychoactive chemical in cannabis, CBD, by itself, without THC, the part of cannabis that is psychoactive, might help relieve anxiety, although more research is needed.THE ALCOHOL COMPARISONAlcohol is highly regulated at a national level and cannabis is not well-regulated. The amounts of alcohol in a product are clear and well-understood by consumers. While alcohol percentages are not regulated, for fermented products like beer and wine, they are controlled by the biology of yeast, and for distilled products like hard liquor and brandy, they are controlled by manufacturers adhering to convention and optimizing taste.On the fully natural to ultraprocessed spectrum, the process of distilling fermented grains or grapes puts hard liquors and brandy in the processed category of consumables. Beer and wine, the precursors of whiskey and brandy, are lightly processed.There are always trends in alcoholic beverages, but, as a consumable substance, the field as a whole is mature.ULTRA-POTENT AND ULTRAPROCESSEDIn contrast, cannabis products now sold on the black market, in medical dispensaries, and particularly in recreational dispensaries, are very far removed from the relatively low-powered cannabis used by the Chinese in 2,700 BC and in the hippie world of Haight-Ashbury in the 1960s. But in the 70s, a steep upward curve of potency began as a Mexican drug gang in Sinaloa, soon to be a cartel, discovered that isolating the unpollinated female cannabis plant, called sinsemilla, tripled cannabis THC levels, from 2% to 6%.Due to breeding, cloning, and cultivation innovations, THC contents of black market cannabis rose further to 17% on average, by 2017.New products, some found in dispensaries and some, avoiding regulation and law, found on the gray market in gas stations and convenience stores, have further increased potency using THC extraction and concentration methods employing solvents. THC levels for dispensary products can be 90% or more. Some solvents used for extraction are toxic, and incomplete residue removal in substandard manufacturing processes might pose a risk to consumers.With extraction methods creating new ultra-high potency levels, cannabis has entered the era of the ultraprocessed.Ultraprocessed gray market gummies and other products with intoxicating levels of THC are a particular concern. In 2018 Congress deregulated hemp, or cannabis without an intoxicating amount of THC. The intent was to allow hemp-based products containing CBD to be sold without regulation. However, the law did not forbid the conversion of the CBD in hemp into THC through chemical processing.Soon colorful bags of candies and treats with high levels of THC were showing up in gas stations, convenience stores, and smoke shops. Some of these products were packaged to closely mimic popular brands like Frito-Lays and Cheetos or children’s gummies. With no age restrictions, or restrictions of any kind, reports began to come in of children hallucinating at school.Colorful cans of beverages containing THC-derived from hemp have become popular outside of dispensaries, often being used as a substitute for alcoholic drinks. The THC in beverage products has a quick effect compared to edible products like gummies, although not as quick as smoked cannabis.Your subscriptions help Eating in America grow and support the research that goes into each post and podcast. Being a subscriber is free or 30% off in April. Thank you!A handful of states banned all hemp products containing THC and last November Congress inserted a provision into the legislation that reopened the government. The law will limit the THC content in hemp products and ban the conversion of CBD into THC. The law gave the $28 billion hemp products industry a year before the restrictions go active this coming November, but lawmakers are proposing a one year extension. Meanwhile, the regulated cannabis industry has been lobbying for the restrictions to protect their businesses. Meanwhile, THC candies and snacks remain on shelves in many jurisdictions in states like Massachusetts without any restrictions or enforcement against purchase by minors.Both cultivation practices and chemical extraction have greatly increased the potency of cannabis. And there is now good evidence that higher potency cannabis is associated with increased risk of psychosis and cannabis use disorder.Ironically, with the reality of psychosis risk with today’s high potency cannabis, a dose of truth has been bestowed on 1937’s laughable propaganda film “Reefer Madness,” although it seems to me unlikely that there were a large number of cases of psychosis with the low potency cannabis of almost a hundred years ago when “Reefer Madness” was being made.There is cannabis madness today in that there is far too little cannabis science and far too little regulation. As a result, we have a chaotic landscape of cannabis sales, quality, and use. This shouldn’t be the case. Alcohol has been an important point of comparison when the loosening of laws and regulations has been argued for cannabis. However, the marketing, sale, and quality of alcohol is very well-defined, and its use is not confused by dual systems of lightly regulated recreational and medicinal alcohol.On the other hand, the cannabis sanity is in the wide recognition that the fun, stupefying, euphoric, or calming effects of cannabis aren’t a threat to our communities and that, as with the risks associated with alcohol, the risks of cannabis consumption can be reasonably weighed by adults for themselves. But, going forward, the science and regulation deficits have to be fixed.Thank you for reading. In Part Four of “Ultraprocessed Cannabis: Potency, Policy, And Public Health In America,” we check on the continued black market in cannabis, look at how big money in cannabis has become a powerful influence, and propose seven policy and regulation recommendations to bring the public’s comfort with cannabis together with public health moving forward.In Part One of this series, we have a look at the surprising history of cannabis in America. Did you know the Puritans brought it here, and by law they had to raise it because it was so valuable for hemp fiber to make rope and sails? We also discuss medical cannabis, cannabis use disorder, and the increased appearance in emergency rooms of people with uncontrollable vomiting and screaming stomach pain from too much cannabis, in Part Two.You can find all that at EatingInAmerica.co.What are your thoughts and experiences with cannabis, unregulated hemp-based THC products, and the way forward? Please share your comments! Your support for this post and podcast are appreciated. Peace.Eating in America is entirely reader-supported. Please subscribe for free or become a paid subscriber with 30% off in April. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Cannabis was legal in America well into the 20th century and medical cannabis products were manufactured by pharmaceutical companies and widely prescribed and used. Of course, it’s important to keep in mind that this was before modern medicine: before aspirin even.Thirty years after medical cannabis was first re-legalized in California in 1996, what is the role of medical cannabis today?The flip side of cannabis as a medical or mental health treatment is when cannabis use is disruptive, harmful, and risky. What is cannabis use disorder, and is today’s increase in cannabis use disorder related to the potency of cannabis now? Related to this, which is greater: the number of people who drink alcohol almost daily or the number of people who use cannabis almost daily?Cannabis became common in American medicine beginning in 1840 when knowledge of medical uses was brought from India, but medical beliefs and practice around cannabis began to turn in the 20th century. In 1915 California became the first state to make cannabis illegal. Of course, always the eager trendsetter, California was also first to reverse course and re-legalize cannabis for medical purposes in 1996.Medical re-legalization pulled some people away from black market cannabis, allowed professional medical supervision of cannabis treatment, and added to the number of products tailored or specified for treatment of conditions including cancer, chronic pain, multiple sclerosis, nausea, vomiting, epilepsy, PTSD, and arthritis.Now, patients seeking cannabis help in the 40 states with comprehensive medical cannabis programs, along with the District of Columbia and Puerto Rico, can have their need certified by a doctor and then usually pay a fee for a state medical card. Today, around 3 million patients are certified for medical cannabis purchases or home-cultivation.Medical cannabis programs have requirements for lab testing, which increases safety and standardization of doses for patients and lets patients avoid the unknowns of black market cannabis. However, widely varying methodology between labs and cherry-picking of samples submitted to labs have sometimes made test results unreliable and variable according to the lab, putting patients at risk of misdosing. State regulatory oversight has increased over time, but it remains uncertain whether medical cannabis is well-tested for impurities and the cannabinoid content well-quantified at all times in every jurisdiction.Nonetheless, medical dispensaries provide relative safety assurance compared to the black market, where pesticide, heavy metal, and fungal contamination is untested and deliberate adulteration of cannabis with dangerous substances such as fentanyl sometimes occurs.Yet cannabis in a medical dispensary is lightly regulated compared to federally regulated pharmaceuticals. For example, all non-prescription over-the-counter drugs, such as pain relievers and cold medicine, must conform to strict standards published by the FDA. We are far from that with medical cannabis.THE ECONOMICS OF MEDICAL CANNABISMost medical cannabis is not taxed, while recreational cannabis is heavily taxed in some states. However, most patients seeking cannabis face fees for a doctor’s certification and for the state medical card.Medical cannabis patients are more frequently low-income and tend to be older and in worse health compared to recreational users. Perhaps this has to do partly with the more limited access these groups have to traditional medical care.Medical dispensaries risk losing customers to recreational dispensaries in states with both, while paying higher operating costs. While some states with recreational cannabis continue to see increases in the number of medical patients, it may be that more dual-licensing states have a decreasing number of medical patients. However, patients typically don’t find specialized cannabis formulations to treat their chronic conditions in recreational dispensaries, which tend to focus on products with high levels of the psychoactive ingredient, THC, the part that makes users high. Products for medical purposes usually have lower THC doses and, often, high ratios of CBD, a non-psychoactive ingredient, to THC.CANNABIS USE DISORDERThis substance use disorder is defined with 11 criteria that include craving, unsuccessful effort to cut down, and interference with work or relationships. Meeting two or three of these 11 criteria constitutes a mild case of cannabis use disorder and having six or more is a severe case. In 2024, 7% of Americans 12 and up, that is 21 million people, had cannabis use disorder of some severity. Within those numbers, 5% of adolescents and 16% of young adults had cannabis use disorder. That’s 1.2 million kids age 12 to 17 and 5.5 million adults age 18 to 25.Related to cannabis use disorder, the number of people who use cannabis on a daily or near daily basis has been climbing rapidly over the last 20 years, and in 2022 the number of frequent users of cannabis surpassed the number of frequent users of alcohol in America. In the same way that near daily use of alcohol has a statistical association with alcohol use disorder, so does near daily use of cannabis have a statistical association with cannabis use disorder. I find the rapid increase in near daily use of cannabis worrying.Subscribe for free or become a paid subscriber in April with 30% off!The reason that there are now more people who use cannabis near daily compared to those who drink near daily is unknown. I have seen that the 2024 study that reported the increased near daily use did not take into account that medical use of cannabis is frequently on a daily or near daily basis (42% in one study), which would tend to increase the reported overall number of daily or near daily cannabis consumers.Decriminalization of cannabis is, of course, likely the biggest contributor to the increase of near daily use, but it’s concerning that frequent use has been found to be associated with the use of stronger cannabis at the individual level.Both frequent use and stronger cannabis are related to Cannabis Hyperemesis Syndrome, or CHS. Emergency room visits for CHS have risen in the last 10 years. CHS presents in the emergency department as severe nausea, cyclic vomiting, and very bad stomach pain, conditions that can continue up to a week.Some people might have heard a frequently cited estimate of how common CHS is. That estimate is a large number, but, to me, the methodology for making the estimate is very suspect, so I won’t quote it. But, even if on further research the risk turns out to be relatively small, for those who get it, CHS is very, very not fun.Despite cannabis still being listed as a Federal Schedule 1 drug with no accepted medical use, like heroin and LSD, the FDA has approved four THC- or CBD-based drugs. These are for the treatment of nausea from chemotherapy, anorexia, and seizures from two rare forms of epilepsy. The FDA seems to have an encouraging posture towards applications for additional cannabis-based medicines.Alcohol and cannabis are both used by many people to self-medicate. That is unlikely to ever stop. While there is often a difference between what makes people feel better and what science says is the most effective treatment to make them better, there is a validity to both perspectives. After all, even placebos without any biologically active ingredient can be effective. If a benefit is perceived, a benefit is received.Thank you for reading. In Part Three of “Ultraprocessed Cannabis: Potency, Policy, And Public Health In America,” we do a health reality check for and against cannabis; discuss cannabis in relation to America’s other favorite recreational substance, alcohol; and follow the path of ultra-potent to ultra-high to ultraprocessed.If you haven’t already, be sure to check out the first part of our series, where we look at how cannabis got so strong and how the U.S. got a hodge-podge of cannabis regulation. You can find that at EatingInAmerica.co.Your support of Eating in America is so helpful to this Substack’s growth. Please let me know your thoughts about cannabis in the comments. Thank you!Eating in America is reader-supported. Please subscribe for free or become a paid subscriber during the remainder of April with 30% off. This is a public episode. 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Why, what, and how we eat is all about our neurological reward circuits, the dopamine pathways that control so much of what we do. These are the channels tapped, to our detriment, by the designers of ultraprocessed food. They are also the paths that lead to pleasure when we drink, smoke a cigarette, or eat a weed gummy.In this four-part series I’m going to expand the scope of Eating In America a little bit and look at one of the non-food items consumed by 44 million Americans in the last month: cannabis.We begin with a surprising history of ye olde cannabis.It was the Puritans and ye other olde colonists from England that brought cannabis, otherwise known as hemp, to America. It was so valuable for making rope, sails, and clothing, hemp was used as currency. Jamestown was growing it from the start in 1607, and in a while the Virginia, Massachusetts, and Connecticut colonies passed laws that farmers had to grow it. Yes, it was illegal not to grow cannabis, although the cannabis strains in question were industrial hemp, bred for fiber without enough THC content for intoxication.Medicinal use of cannabis began in the 1840s and became very common and widespread. Cannabis was in many medicines, including tonics, tinctures, and extracts. Parke-Davis, one of the world’s largest pharmaceutical companies, was among the drug manufacturers producing cannabis products.The weight of medical opinion began to turn against cannabis in the late 1800s. In 1915, California, always ahead of the times, was the first state to make recreational cannabis illegal. Ironically, later in the century California was the first state to make cannabis legal again.By 1937, 23 states had made possessing cannabis illegal, which is, with almost perfect symmetry, nearly the number of states that have re-legalized recreational cannabis today.In 1937 Congress made cannabis illegal for the first time across America by passing the “Marihuana Tax Act.” Motivated by its own racism, Congress called the drug marijuana, its Mexican name, to promote anxiety and fear about the large number of Mexicans who had come to the U.S.1937’s “Reefer Madness” is an outrageous anti-cannabis propaganda movie intended to stoke the building fear about cannabis. Of course, in the 1970s “Reefer Madness” was resurrected and became a cult classic: a terrible film but amusing for many when sufficiently stoned.I’m using the term “cannabis” throughout this series instead of “marijuana” or a slang term. “Cannabis” is the scientific name for the plant and what the drug was called before the 1930s.In Part 3 we will look at how the hemp form of cannabis has recently been exploited to make high THC content products that have been marketed to youths by unscrupulous producers outside the regulated cannabis industry.So on to our investigation of today’s cannabis environment. Cannabis madness or long-awaited sanity? There are many questions that need addressing.What are the dramatic changes that have occurred in cannabis itself in the last 25 years? What does the evolving legal landscape for cannabis look like in America? How chaotic is the regulatory landscape? What is the role of medical cannabis? How can and, indeed, should medical cannabis dispensaries remain a part of the landscape?Why do more people today use cannabis on a daily or near daily basis than drink alcohol? Yes, since 2022 more people are frequent cannabis users than frequent alcohol consumers!What are the new and increasingly dominant economics of cannabis? And what are some policy changes that would help address safety and public health issues while aligning cannabis use and regulation with both science and public attitudes?Let’s get to sorting out the madness.Tetrahydrocannabinols, or THC, are the psychoactive chemicals in cannabis that are the reason it is so popular as a consumable. THC content in cannabis stayed fairly level at around 5% from the 1970s into the early 2000’s. Since then average levels have climbed steeply to around 20%, a four-fold increase.Cannabis bought on the black market today is often not as strong as that bought in a dispensary, but it can be. And there are concentrated products in dispensaries that can go over 90% THC content.High content extracts are made using solvents. The chemicals used in producing extracts, both regulated and black or gray market, are not well identified, but solvents commonly used in making black or gray market extracts include alcohols, acetone like in nail polish remover, and toxic petroleum-based chemicals.Safely produced or not, these extracted products are ultraprocessed, and so cannabis has joined the food we eat in the era of the ultraprocessed.A visit to a recreational dispensary makes evident that connoisseurs are a part of today’s cannabis culture, not dissimilar to the way connoisseurs are a part of wine culture. There is a lot to know about the psychoactive effects of various cannabis cultivars, blends, and forms of administration. While the Indica plant species label denotes a sedative effect and the Sativa species an energizing or cerebral effect, those are somewhat outdated terms, in that there are many compounds in cannabis called terpenes, each of which has a different psychoactive effect.And then there are the 120 plus cannabinoids, the most well-known two being the psychoactive Delta-9 THC and the not-psychoactive cannabidiol, or CBD. The THC and CBD quantities are stated in products displayed in recreational dispensaries.However, CBD will create differing effects of the THC, depending on the overall blend of compounds, the form of administration, quantities, and the consumer’s biology. For example, sometimes the high is enhanced or muted, or unwanted effects of THC, like anxiety, are reduced. To the uninitiated, trying to figure out the offerings in a dispensary and what a product will be like when consumed can be more guess work than shopping the Burgundy section at a high-end wine shop.So where can cannabis be bought legally today?Cannabis is fully legal in 24 states and Washington D.C. with recreational and medical dispensaries in all of them except for Virginia, where sales will likely be allowed this year. Fifteen more states and Puerto Rico allow only medical cannabis sales, and six more states allow sales of CBD oil with a low level of THC. You will not find any kind of cannabis for legal sale or consumption in Idaho, Wyoming, Nebraska, North or South Carolina.Most states with recreational dispensaries allow a limited amount of home growing, typically 3 to 6 plants per person. Only a few states that allow sales of cannabis solely for medical purposes also permit home cultivation.Cannabis’s illegal status at the federal level has resulted in highly variable regulation and enforcement, ranging from inadequate to, at times, grossly inadequate, as states have legalized cannabis one by one. The patchwork quilt of regulation has two layers since essentially every state that has recreational cannabis started with medical legalization, requiring dual-levels of regulation per state for the co-existing channels of dispensing.Estimates date the growing of Cannabis sativa to 10,000 BC, likely as a grain food and for its useful fiber. The first known medical uses are attributed to the Chinese emperor Shen Nung, around 2,700 BC. Since then, medicinal cannabis has been used and researched around the globe and widely used here in America in the 19th century.However, as we have seen, quoting science writer Stephanie Pain, “In the twentieth century, prescription gave way to proscription.” What was once recommended, became forbidden.Despite cannabis’s illegal status over the last 100 years or so, Americans suffering physical or mental ailments have long sought the return of medicalized cannabis as an adjunct or alternative to federally-approved medicine or treatment.Thank you for reading. In Part Two of “Ultraprocessed Cannabis: Potency, Policy, And Public Health In America,” we take the pulse of medical cannabis and consider the rise of cannabis use disorder.I appreciate your support of Eating in America. I am on a subscriber drive, so please let your friends and family know and feel free to share this post. Every reader and every subscription, free or paid, counts towards helping Eating in America grow, and is appreciated. Like this is, if you do, and let us know your thoughts about the state of cannabis in America! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This is a free preview of a paid episode. To hear more, visit www.eatinginamerica.coYou’ve got a healthy weight, or you are not interested in weight loss, or at least in weight loss using available medical paths like GLP-1s or bariatric surgery – why should you care about GLP-1s?GLP-1s are a factor in the continued fast rise in health care costs in America. If you don’t need them or take them but you have medical insurance or just pay federal taxes, you are likely still affected by the cost and popularity of GLP-1s. (I might point out that most people don’t ever have cancer, but their insurance payments help save the lives of those who do. Maybe it can be seen as a sort of actuarial scientist’s form of karma.) No matter our personal stance, GLP-1s are having an impact on the health and economic well-being of America.I was writing today’s update on GLP-1s when I noticed a Boston Globe Editorial that mused about how the City of Boston wants to control the cost of GLP-1 medications for its employees, how that dilemma was common now across employers and insurers throughout government and industry, and what could be done to control GLP-1 pricing. The end of this podcast is what I posted in the Globe as comment both on its Editorial and the other comments of Globe readers.Also, today, many GLP-1 questions are popping up. GLP-1s and muscle mass – worry or no worry? Stretching out the GLP-1 dose schedule when a patient’s target weight level is reached would be a great way to save money…but does it work without weight re-gain?Also, what is happening with GLP-1 pricing, new products, and Ozempic patent expirations? And could GLP-1s really be made for only $3 a dose? There’s a lot going on.To our questions.If you are using or contemplating using a GLP-1 you have likely been made to worry about the fact that dieting causes loss of the soft tissue we like, such as muscles, along with loss of fatty tissue, which we don’t like. A lot of the anxiety about GLP-1 muscle loss is generated by social influencers and nutrition and conditioning hawkers. Not to worry…but do step up with the strength conditioning.The bigger you are the more muscle you need to support and control your weight. Strength and conditioning is always important, but especially so during weight loss. And, unlike dieting, where will-power is a very poor tool for permanent results, I do recommend putting will-power into play as much as possible if strength exercises are not your thing. Improvements can be seen from workout to workout, whether in the gym or your living room. The important thing is to start and continue on a regular basis, finding as many ways to enjoy yourself and take pride in your gains as possible.A small study has found that once some patients reach their target weight on a GLP-1 they can reduce the frequency of their doses without regaining weight. This finding is hopeful for GLP-1 patients having difficulty with the long-term cost of the medication, but much more research is needed to understand the risks and conditions required for success in any reduced dosing approach. We do know that a complete stopping of GLP-1 treatment is strongly linked to weight regain. Proceed with caution if thinking about a reduced dosage and be sure to consult your health care provider.The Trump administration’s work to reduce GLP-1 costs is welcome but, so far, not a huge game changer. Continued pressure on pricing may come from the introduction of competing medications, but manufacturers other than Novo Nordisk and Eli Lilly have not yet made application to the FDA for any product approvals.But there is room for improvement. A new study released in preprint found that semaglutide, the ingredient in Wegovy and Ozempic, could be sold for $12 a month in generic liquid form for injection and $36 a month in generic pill form, a dramatic savings over the cost of the Novo Nordisk brands.With Novo Nordisk semaglutide patents expiring this year in China, India, Brazil, Canada, Turkey and five other countries, and no patent protection in 150 other countries, theoretically by the end of this year 85% of the world’s population with the disease of obesity could be living in a country with a generic semaglutide medication available.Meanwhile, Novo Nordisk just received fast-track approval for a high-dose form of Wegovy in a pen. The dose in Wegovy HD is three times greater than the highest dose in regular Wegovy and average weight reduction is 21%, compared to 15% with regular Wegovy.Novo Nordisk has also just put its Wegovy pill on the market. Eli Lilly has applied on the fast track for approval for its new GLP-1 pill, Orforglipron. Unlike the Wegovy pill which must be taken on an empty stomach at least 30 minutes before eating anything, Orforglipron can be taken with or without food.That’s a rundown of the some of the biggest news in GLP-1s.The following is based on my response to the Boston Globe Editorial on GLP-1 coverage for City of Boston employees. The Editorial advocated compromises that could result in some people who were already on a GLP-1 being removed from coverage for their medication. The comments featured a lot of folks who were of the mind that will-power and exercise were all that is required for weight loss.Quote: I’m a nutritional epidemiologist and publish EatingInAmerica.co. I have studied the obesity epidemic in America, what has caused it, and the GLP-1 drugs. These highly effective medications are saving lives and reducing chronic disease, including obesity, diabetes, cardiovascular disease, kidney disease, osteoarthritis, and sleep apnea, and generally making life better for millions of Americans.Because of the arbitrarily high prices of GLP-1 medications in America, the point at which health care savings from GLP-1s exceed their costs is somewhere in the future, requiring the decision to cover them at this moment to be based in large part on difficult estimates of the value of these medications to the quality of life of a patient.There is still stigma on these medications because of some remaining popular belief, evidenced in many of the comments to the Boston Globe Editorial, that GLP-1s are the easy way out of unhealthy weight and that all that is required to restore a healthy weight is will-power and exercise. My personal opinion is that because of this remaining attitude it is easier for insurers and employers to restrict coverage to GLP-1s and save money.But why are we thinking about the use of medications to control weight at all? Best would be if we could roll back the clock 50 years to the beginning of the obesity epidemic, or 60 years to when ultraprocessed food was allowed to start taking over our food environment and put strong protections in place against the making and marketing of unhealthy food.

With today’s video podcast, you have your full choice: watch, listen, or, as most do, read Eating in America. Anyway you do it, we are glad to have you here.This post and podcast are about what’s in our food and who’s in charge of making it healthy. While RFK, Jr. and his Department of Health and Human Services are getting a lot of attention when it comes to federal action or inaction on making our food healthy, in many ways it’s the USDA, the Department of Agriculture, that’s more in charge of the healthiness of our food.For example, the USDA is responsible for the safety and inspection of our food. The Department is a full partner with Health and Human Services in writing the Dietary Guidelines that this year famously featured the upside-down food pyramid.But, more importantly, the 2026 USDA budget is $458 billion – nearly half of a trillion dollars. Most of that money flows to agriculture through consumers who receive food assistance like SNAP in order to put food on their tables. Folks being able to afford to eat and not go hungry is certainly a big factor in health. But also, how SNAP and the other programs allow that money to be spent in the store influences the healthiness of the food that is produced. As Jerold Mande in our interview today points out, a lot of states are now beginning to put restrictions on SNAP dollars being used to buy unhealthy products like Coca-Cola.However, a lot of money flows through the USDA to directly support agriculture in this country, and whether that money goes to the production of fruits and vegetables that are in short supply in American diets, which it mostly doesn’t, or whether that money goes to help produce corn for ethanol, feed for cattle and pigs, or ingredients for ultraprocessed food, which are the places most of the money goes, makes a tremendous amount of difference to what our American food environment looks like.Perhaps no one knows more about these issues and how the USDA handles them then our guest on Eating in America today, Jerold Mande.Interview - IntroductionJerold R. Mande is a nationally recognized expert in public health, nutrition, policy. He’s an adjunct professor of nutrition at the Harvard Chan School of Public Health and CEO of Nourish Science, an NGO dedicated to greatly increasing nutrition research, putting bite and muscle (my words) into the FDA’s regulation of food ingredients and additives, including the regulation of ultra-processed food and modernizing SNAP food assistance.This is all towards the overarching Nourish Science mission to change the federal nutrition goal to “ensuring every child reaches age 18 at a healthy weight and in good metabolic health.”Mande has served three presidents in senior policymaking positions at USDA, FDA, and OSHA. He has shaped nutrition, food safety, and tobacco control programs. He led the Nutrition Fact Label Design Team at FDA for George H.W. Bush.And first but not least, Mande started his career with Al Gore in Congress, helping Gore write America’s organ donation laws.Transcript (lightly edited for clarity)RB: “Jerry Mande, it is such a pleasure and honor to have you on Eating in America.”JM: “Ric, thanks for having me.”RB: “So I get sent frequent press releases from the USDA, as I’m sure you do. And I want to save a few minutes in this discussion to get your interpretation about what’s going on with all the program and policy initiatives and media events from the USDA these days.“But first, one of the press releases that I passed over very quickly said the USDA is closing a couple of buildings in Washington DC and Alexandria, Virginia. But that closure had a lot of meaning for you. Will you explain please Jerry, what has happened with those buildings?”JM: “So these closures are core facilities of USDA and represent a demolishing of the culture that makes USDA such a remarkable agency, fulfilling the goal of President Lincoln, who created the agency’s mission to make it “the people’s department.”“First, the Braddock Building in Alexandria is the home of the Food and Nutrition Service. That’s the agency within the USDA that manages 80% of the USDA budget, feeds one in four Americans each year, and houses programs such as SNAP, the Food Stamp Program, the School Meals Program, and the Women Infants and Children, or WIC, program.“The South Building in D.C. proper is attached to the USDA main headquarters building, the Witten Building. It’s the only federal department that is actually on the mall. It’s a short walk from the White House and right next to the Washington Monument. Actually the South Building should be the headquarters building because it’s many times larger. But the headquarters is the Witten Building. It’s a beautiful building.“The South Building when it was built in 1936 was the largest office building in America. It held that distinction until the Pentagon was built. And still today, it’s the second largest.“So the announcement you mentioned, it doesn’t scream out that there’s a problem in getting rid of those buildings. And what they’re doing in getting rid of those buildings is moving those programs somewhere else.”RB: “Well, it occurs to me that USDA Deputy Secretary Vaden, when he announced the closures, said Trump’s idea is to control this sprawling federal bureaucracy. But to control it, they’re actually sending it away to many far, far away places. And that seems the opposite of actually controlling sprawl!”JM: “Just a little bit of background to help explain the impact of these closures. Earlier in my career, I worked at the Department of Health and Human Services, particularly the FDA. These were great agencies, I thought.“And indeed, I thought that the Department of Agriculture was sort of the bad guys because of the industry influence on the issues I worked on, like food labeling, where we had to fight the USDA at every step to get the Nutrition Facts Label that we have in place today. But when I worked at HHS, something just didn’t stand out to me at all.“The HHS, because it was cobbled together over many administrations and literally decades and decades, was scattered all across the country in different buildings and agencies. There is a big building a block off the mall. The secretary works there, but none of our agency heads work there because their agencies are scattered all across the country. I thought it was always a bit dysfunctional, and there were a lot of challenges. But I figured, this is just life in the federal government and that’s as good as it gets, I guess.“But then in the Obama administration, I was invited to join the Department of Agriculture. And it was just this remarkable eye-opening experience that, wow, this agency operates so much better than anything I’ve ever experienced before. And it was because of the culture created by the proximity of all of the staff.”“Secretary Vilsack, the secretary then, and all of his undersecretaries, which are the equivalent of these HHS agency heads, were literally on the same hallway in the Witten building, and all of their staff were right behind them in the big South building. As a result, we met all together, face-to-face, in-person every week. This, what I’ll call the subcabinet, and the physical proximity of all the agencies and the secretary, created just a much more effective culture.“So the [Trump] administration is going to the HHS model: wanting to destroy the culture of the USDA and move its agencies all over.“They began that in their first term. They ran an experiment. They took two of the smaller but important agencies at USDA, the Economic Research Service and the National Institute of Food and Agriculture, both research agencies, and decided they were going to move them to Kansas City. They did and it had the desired effect.“People quit. People didn’t pick up and move to Kansas City. So the elite quality of those agencies was destroyed. The Biden administration tried to build them back, but they still haven’t been as strong and as effective as they had been in the past.Eating in America is a reader-supported. We can only do this with your help. Please become a free or paid subscriber.“The Trump administration took that lesson to heart. If you try to just get rid of an agency altogether, well, that’s up to Congress to do and people go to court and the administration loses. But they said, gee, it’s within our authority to just tell an agency they have to relocate somewhere else. If we can do it within our budget, it seems to be legal, and it’s going to have the net effect of destroying that agency, essentially.”RB: “I think almost two thirds of the Economic Research Service just declined to move to Kansas City, as nice as Kansas City might be.”JM: “No, they have their families, their careers, their lives in Washington. And so four years wiser and learning from their first time, the Trump administration came back and said, just move the agencies someplace different. They’ll explain it that the agencies need to be closer to the people, but you have to say “if it’s not broke, why do you?”“So you have this extraordinary agency with a really remarkable culture that Abraham Lincoln literally put in place and that’s operated at an elite level for 150 plus years. But they came armed with a blueprint of how to demolish that, and that’s what they’ve embarked on. And that’s what these closures represent.”RB: “Thank you for that insight and perspective. The contrast you have drawn between HHS and USDA couldn’t make things clearer.“The other thing I wanted to look at a little bit is what’s going on with the programs. I’m a recent subscriber to the press releases from the USDA. I see a lot of program initiatives. Big ones, like $38 billion in conservation money, $12 billion in Farmer Bridge Assistance, $16 billion in Supplemental Disaster Assistance, and smaller ones, too. And then lots of media events.“What’s going on? Am I incorrect in getting the sense that the USDA is making a push to shore up farm and ranch support in this somewhat chaotic environment for the country and agriculture and ranching?”Thanks for reading Eating in America! This post is public so feel free to share it.JM: “Well, they are trying to support our farmers, our ranchers, and should, right? We rely on only 2 % of the population to feed us all. So it’s a very important thing to do.“But they’re actually good on the food and nutrition issues, particularly the diet quality issues that I’ve devoted my career to.“Food and nutrition, I will divide broadly into three buckets, all equally important. Food justice has to do with making sure Americans who are poor have the support and food that they need, but also that the workers in the system are taken care of.Then there’s diet quality, which is my issue, making sure that the food we eat helps us thrive and certainly doesn’t make us sick or cause a chronic disease. And then, climate and sustainability, agriculture plays a big role in that.My whole career is devoted to the diet quality piece. All three buckets are large areas and equally important. I strongly support work in all of them. I just chose to work in diet and health. It’s the one that most inspires and animates me.“This administration has been remarkable on the diet and health part of food and nutrition. They’re actually doing a great job on MAHA, Make America Healthy Again, particularly SNAP, which is something that I oversaw.“When I was with the USDA for six years, we were trying to make changes, or at least test some changes in pilots about how SNAP could be used as a lever with big food to improve diet quality. We couldn’t get a single state pilot started. They now have 22, which is just remarkable. Twenty-two states no longer sell soda to SNAP recipients [using SNAP dollars], which I think is a great idea.“But on the food justice side and on sustainability and climate, they’re really breaking those things. That’s not their priority, and they’re doing a poor job.“For me, it’s challenging. There are some areas where they’re doing a really great job. The dietary guidelines they put out are a sort of a microcosm of both [the good and the bad]. They’ve said some things that just don’t follow the science. They seem to be heading down the path about eating more red meat. That really is fine. People can eat red meat, but we don’t need to eat more of it. In fact, people should eat less of it. But then at the same time, they’ve said people shouldn’t be eating ultraprocessed foods, which is great - and something a second Biden administration probably would not have said.“So it’s a very unpredictable time and something we’re all trying to still figure out.”Eating in America is a reader-supported publication. To receive new posts and support this work, consider becoming a free or paid subscriber.RB: “Thank you so much Jerry Mande for your perspective on the direction of the USDA these days: both the favorable things that are happening and things that are still, perhaps, lacking in their direction.“I wish we could talk forever because there’s a wealth of knowledge there and some great ideas. What’s the website for folks who want to learn more about your efforts?”JM: “It’s NourishScience.org. And Ric, thank you for having me. I enjoyed this and if you invite me back, I promise to come.”RB: “All right! I will do that! Thanks so much!” This is a public episode. 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RFK, Jr. has gone full publicity blitzkrieg about his success enlisting U.S. medical schools to teach more about nutrition. The Health and Human Services Department is selling it as a great victory for Kennedy’s Make America Healthy Again Movement. However, the omission of a very important item from Kennedy’s proposed nutrition curriculum topics for doctors has hit a very sensitive nerve with me today.First, the background.As Eating in America reported last fall, the Trump administration and the USDA have killed the annual U.S. Food Security Report. After thirty years of continual monitoring of American household food security, the final report was quietly issued, two months late, on December 30.Over the decades, the Food Security Report has been crucial to guide food assistance programs like SNAP and to measure our progress, or lack of it, in reducing hunger in America. Most of us have never had to worry about hunger or food security, but in 2024 one in seven households, 41 million Americans, experienced food insecurity. That was measured at 13.7% of households, a little more than in 2023, but not statistically different.In 2024, 5.4% of households had very low food security compared to 5.1% in 2023, but still not statistically different. Very low food security means sometimes being hungry, skipping a meal, or not eating for a whole day because of lack of money for food.Children experienced food insecurity in 3.3 million households and very low food security in 318,000 households.Why does Trump want to let the fact that hunger is still found in America be hidden? Does he not want to address it? Is he aware that his policies and actions are likely to increase food insecurity and hunger, and he would rather not see statistics proving the rise of food insecurity and hunger in adults and children?Trump’s lack of support for SNAP benefits during last fall’s federal shutdown and his tightening of eligibility requirements make it highly likely that food security, if it were still being measured, would show a downturn and hunger an upturn in the first year of his administration.This masking of hunger in America reminds me how rich coffee plantation owners in Central America, where the use of enslaved people was forbidden, essentially created a system of slavery by maintaining a state of food deprivation on their plantations in order to force the indigenous people to work (Coffeeland, Sedgewick, 2020). Families were tied to the plantation. There were no other source of work and no other source of food. The indigenous laborers were nominally free – there was nothing to rebel against - but because they and their families were hungry, they were subdued, controlled, and subservient.When I see the prevalence of hunger in Americans and the fact that hunger will be officially hidden by our government going forward, I cannot help but see hunger as a device of repression against poor Americans in the hands of Trump and his minions. And in recent months outside of America, Trump has weaponized the hunger of civilians in Gaza and Cuba.So what has this to do with the addition of nutrition to a medical education?I’m getting there.There are two kinds of malnutrition in America, and increasingly around the world: undernutrition and overnutrition.I have only heard RFK, Jr. talk about overnutrition. Overnutrition as expressed in unhealthy weight is all around all of us. Kennedy, Trump, and MAHA advocates and siblings Calley and Casey Means, the latter Trump’s nominee for Surgeon General, all grew up in privilege, moving in elite circles and with exposure mainly to people like themselves, many of whom had issues of overnutrition. Maybe I am wrong, but meaningful exposure to the real lives of Americans with food insecurity and, worse, undernutrition, might never have been part of Kennedy, Trump, and the Means’ real-world education.However, real doctors and health experts, not unqualified people like Casey Means or Kennedy, should be, need to be, attentive to the fact that some of their patients and constituents may be experiencing food insecurity.Doctors in training need to learn that there are quick food security screeners that can be administered in the doctor’s office. The best known is the simple Hunger Vital Sign tool: a two-question validated screener developed by Children’s Health Watch in Boston. It is based on the Trump-killed U.S. Food Security Survey. The doctor or professional simply asks for an “often” or “sometimes true” versus “never true” response to two statements: First, “Within the past 12 months we worried whether our food would run out before we got money to buy more.” Second, “Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.” A response other than “never true” flags the need for a doctor to assist in assuring that the patient’s food security is addressed.So why would teaching the use of a food security screening tool like the Hunger Vital Sign not be at the very top of the list of things about nutrition that a doctor should be taught? It boggles my mind, but food security screening is not explicitly on the list of 71 nutrition competencies Kennedy recommends be addressed in medical education.Kennedy’s list is billed as being based on an expert list of 36 competencies published in the Journal of the American Medical Association in 2024, but it bears little resemblance. The JAMA list puts food security screening as the #2 item, behind #1 “Provides evidence-based, culturally sensitive nutrition and food recommendations to patients for the prevention and treatment of disease.” In general, the JAMA list is written to make doctors-to-be aware and sensitive to nutritional issues and competent to address nutrition in partnership with dedicated nutrition professionals. I like the JAMA list a lot.The Kennedy list is, on the other hand, more like a curriculum for doctors who want to become social media influencers and snake oil peddlers, like our unlicensed-doctor-waiting-to-be-Surgeon-General, Casey Means. For example, recommended core competency #58 is learning how to recommend a wide range of “nutraceuticals” or food and herb-derived supplements like Means sells. And then there are bizarre recommendations for the training of a doctor, like competency #67: “Regenerative agriculture immersion: participate in on-site learning at farms including soil sampling, composting, crop rotation.”Eating in America is a reader-supported publication. To receive new posts and support my work, please join us as a free or paid subscriber.The single competency on Kennedy’s list that pops out as a genuinely valuable addition to JAMA’s list of two years ago is #55: “GLP-1 agonists counseling with diet and lifestyle guidance.” In other words, doctors should be familiar with the growing arsenal of GLP-1 and related medicines, how they work, their powerful intended and side effects, real world food needs stemming from taking GLP-1s, effects - real or feared - on muscle mass, and that there should be no stigma attached to taking GLP-1s. Well, of course, yes.There has long been a push for more nutrition training in medical school. As doctors watched the obesity epidemic explode and attendant chronic diseases increase in America, the nutrition training gap in medical school became undeniable. More awareness and understanding in the medical profession were required, even if effective treatment tools to curb the symptoms of the disease of obesity were not yet widely available.I didn’t understand until I read JAMA’s 2024 recommended nutritional competencies that the need was not for doctors to learn more facts about fats and carbohydrates but to learn how to treat people with respect, understanding, and thoughtful guidance when those people are just coping with the effects of living in a terrible food environment that is allowed to prey on their biology.Fifty-three out of the approximately160 medical schools in the U.S. have capitulated to Kennedy’s somewhat extortionate push to incorporate more nutrition training. The use of any of Kennedy’s 71 competencies is, fortunately, not required by the medical school agreements with Kennedy, and it might be embarrassing to see any medical school work from a list grounded in Kennedy’s personal bias and not in science. However, the list is described by Kennedy as “recommended”, not merely “suggested.”So despite my long-held belief and advocacy for more nutrition training for doctors, I stand with those who are upset by Kennedy forcing the issue on medical schools. Our federal government does not place science and the health of its people above all else. Opening any door to future federal dictates for medical training is scary, given the current administration.This post is public so feel free to share it. Please spread the word.Thank you for reading. Please share this post, give it a like, or let us hear your thoughts in the comments. You are the key to helping Eating in America grow, and I thank you. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Red meat consumption is down, and chicken consumption is up.While the consumption of beef, the most popular red meat, continued to grow in the prosperous years after World War II, it peaked in the 1970s and has rapidly declined since. On the other hand, chicken consumption has been growing steadily since World War II. During the Great Recession of 2007 to 2009, chicken overtook beef as the most consumed animal protein.Shunned by some and loved by others, pork is classified by the USDA as a red meat but was famously and successfully marketed from 1987 to 2011 as “the other white meat.” Observers remarked that the white meat ad campaign contradicting the USDA was paid for by a tax on pig sales organized by the USDA.In fact, pork can be quite lean like poultry, but the fat content of both beef and pork depends on the cut and can vary greatly in both cases. As a nutritionist, I agree with the USDA, and even RFK, Jr., that pork is red meat.Pork’s fortunes have taken small ups and downs, particularly in the Great Depression of the 1930s and during the beef boom of the mid-1970s, when it took a big dip, but consumption has generally grown slowly over time.Altogether, Americans eat a lot of protein, before we even get to plant protein and dairy. According to USDA data there were about 200 pounds of trimmed, boneless meat of various types available for each American in 2021.Those 200 pounds consist of chicken in the number one position at 68 pounds; beef at 56; pork, 48; turkey, 12; and about 20 pounds of fish. That’s over a half-pound of meat, poultry, and fish per American per day.The reason that many Americans have been reducing their red meat consumption is that they’ve received the message about red meat being bad for your health. The true science is very clear on three points: red meat is linked to cancer, red meat in general has a lot of saturated fat which is linked to heart disease, and most Americans get more than the recommended level of protein.Groups concerned with the environment have long publicized the heavy climate burden of cattle. Livestock, mostly cattle, are responsible for 15% of human-created greenhouse gas from their burps and production of manure. Additional sources of emissions are due to the loss of forest for pasture, the production of feed, and manure storage. However, survey data indicate that environmental concerns are not, for most people, a big motivator in their reduction of red meat consumption.Apart from health, the other key factor in reduced red meat consumption, is cost.Since the pandemic beef has led all food products in cost increases: roasts have gone up 74%, steaks 57%, and ground beef 53%. But while alarm bells have been ringing with the price of round roast hitting $9 a pound at the end of 2025, round was at $11 a pound – adjusted for inflation – in 1980, a few years after the peak of beef consumption in the mid-70s.In short, beef got very popular and then very expensive and as the demand fell, prices fell, but now they’re back up despite only a very slow growth in demand over the last decade. It may be a difficult task for RFK, Jr. and the USDA to boost consumption much at this point.And, despite the scientific consensus around the increased health risks associated with red meat, Kennedy wants us to eat more for our health. He believes we need more protein, while most nutritionists agree that generally we eat much more than we need.Kennedy’s beliefs coincide with the mission of the USDA to support the cattle industry. Kennedy embrace of this symbiotic relationship was demonstrated in his February address to the National Cattlemen’s Beef Association, “begging” them to vastly expand the size of their herds to accommodate increased consumer demand and drive prices lower.RFK, Jr.’s comment on herd expansion alarmed environmentalists. According to reporting in The Guardian, The World Resources Institute has calculated that to expand the American herd by 25 million head of beef cattle, 100 million acres of arable land would be required in the U.S. There are currently 86 million head of cattle in beef production, a 75 year low. The conversion of 100 million acres, about the size of California, would come at great cost in methane gas emissions and loss of land that would otherwise be a carbon sink or produce lower-burden plant protein.Will Kennedy succeed?Not only will RFK, Jr. and the USDA be fighting the widening understanding of the health risks linked to red meat and the price of beef at the supermarket, but they will also be fighting demographics. A 2023 study analyzed CDC National Survey data from 2015 to 2018 and found that 12% of American adults eat half of the beef we consumed.That highest consuming population tends to be in the 50- to 65-year-old range. They were kids at the peak of beef consumption in the 1970s.Foods we are exposed to at an early age make a biological imprint on us as part of the creation of our culinary compass. A large component of this early setting of food preferences is our family’s food culture. In short, children and teens fed a lot of meat, as many were in the 1970s, were tending to learn a lifelong meat habit. In coming years, as those heavy meat eaters age out of the population, the beef marketers are going to have to work even harder to bolster sales.Plant protein and grainWhen we hear the advice to eat more plant protein, we may think first about whether we could eat more beans like soy or many others. We may also tend to increase consumption of plant-based meat alternatives, like Impossible Burgers. We may not be conscious that on average 31% of the protein Americans eat already comes from plants, mostly from grains. Our diet is in contrast to the average diet in lower-income countries where 70% of protein comes from plants.What about plant-based meat alternatives?A 2025 study found plant-based, what I call “pretend,” meat had just 1.4% of the retail meat market share in the U.S.It may be difficult to evaluate any health benefits of plant-based meat alternatives compared to actual meat or to plant protein sources in grains or beans, as plant-based meat alternatives are ultraprocessed foods with a wide variety of mixes of ingredients. These highly-promoted, lab-designed and manufactured products are convenient and likely more healthy than red meat products they replace, although pretend chicken or turkey replacements for organic poultry are a hard health sell for me.If you believe in the greater certainty of the health benefits of real food, for additional concentrated plant protein, minimally processed ingredients like beans or moderately processed foods like tofu or tempeh might make sense.Moving forwardSo no, for pressures of cost, health, and the increasing difficulty of political and agricultural policy leaders in denying the climate crisis, I don’t think we are going back to the beef consumption America saw in yester year.The cowboy and beef, and the heightened, comfortable machismo state they have evoked in our culture, are becoming saddle sore, encroached, and endangered in America.In fact, let me be the first, or perhaps among the first, to propose a rational but radical idea. States and localities have authority to regulate and tax unhealthy substances, think tobacco, alcohol, marijuana (for those states where it is legal), and has been attempted in a few places, sugar-sweetened beverages. Tax revenues from these sources can be and sometimes have been used to pay for health expenses incurred by the state because of these substances. What brave state will be the first to tax red meat? Or ultraprocessed food, for that matter?My dream is that nutrition will be an apex science some day: treated as one of the foremost disciplines in maximizing the health of humans. Then, having written the codex spelling out how our bodies metabolize food and how to eat healthy, nutrition can take a seat next to Newtonian physics: always fundamental, exerting its rule every moment of our lives, but just part of life. No need to think about it. In my dream gastronomy will become very simple like basic physics: apples fall from trees, and we eat them… and other real foods.Thank you for reading. Please subscribe if you haven’t, share this post, give it a like, or share in the comments. You are key to keeping Eating in America growing, and I appreciate your help. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This is a free preview of a paid episode. To hear more, visit www.eatinginamerica.coExcess unhealthy weight is a risk factor for serious chronic diseases, including heart disease, stroke, diabetes, osteoarthritis, and cancer. A new study reveals trends in obesity among people who are Black, White, and Hispanic. The projected trend for the next ten years, through 2035, does not look good for any of these groups.In 1990, a little less than 20% of American adults had a BMI of 30 or more, which is the standard, although imperfect, measure of obesity. By 2022, that percentage had risen to 45%. Obesity in the U.S. had more than doubled in 22 years.While all the groups analyzed fared poorly, the levels of obesity among groups ranged from 40% in males who were either White or Black to 60% in females who were Black. Hispanics of both sexes had the biggest jumps in obesity from 1990: 25% increases in both males and females, with 2022 levels of almost 50% in females and 43% in males.Obesity is highest in people who are

GLP-1 coverage shrinks as demand growsAs costs rapidly rose in the last few years due to expanded coverage of GLP-1s like Ozempic, Wegovy, and Zepbound, insurers began to respond with medication management programs and restrictions on coverage. Many GLP-1 patients prescribed for obesity or excess unhealthy weight have struggled to maintain coverage, pay increased costs for coverage, or find the money to buy their medicine without insurance help.GLP-1 medications are highly effective for not only treatment of excess unhealthy weight but for treatment of diabetes. Patients with diabetes have experienced cutbacks in coverage, too, but not to the same extent as those being treated for obesity.Of course, Zepbound and the others are very expensive. A study by authors at Yale, Harvard, King’s College Hospital London, and Doctors Without Borders, estimated that the full price of Ozempic is more than 200 times the cost of manufacturing. But the two major GLP-1 makers, Novo Nordisk and Eli Lilly, operate in an unregulated near-monopoly market in the U.S., where one of eight adults are prescribed a GLP-1.CVS Caremark, an Aetna company, dropped GLP-1 coverage for obesity in July, but is facing a class-action lawsuit to restore it. Many other commercial insurers and large, self-insured employers have dropped GLP-1 coverage for obesity or imposed restrictions or larger shared costs.Three states recently dropped Medicaid coverage for patients to receive a GLP-1 for obesity. Now only thirteen states provide coverage, which is sad given that Medicaid patients are among the most impoverished and a population heavily afflicted by the disease of obesity.It is disturbing to see patients pulled away from access to a highly effective medication which is likely providing substantial health improvement and for which there is no equivalent substitute.Worst are the manipulative processes used by GLP-1 management programs such as EnCircleRx, a cost control program started in 2024 by EverNorth, a prescription insurance company under the Cigna umbrella. In the face of GLP-1 coverage cost increases of as much as 40% a year hitting some plan sponsors in the insurance market, EverNorth offered employers EnCircleRx, with a guaranteed 15% cap on cost increases, year-to-year. EnCircleRx manages costs by creating barriers erected at the prior authorization stage and then finds additional savings with its lifestyle support program.In the first year, eleven million patients were enrolled in EnCircleRx to get their GLP-1. As part of the process most are required to engage at least once a week with a program called Omada Health. Omada provides required nutrition, exercise, and behavioral health education and weigh-ins which are instantly uploaded from a connected digital scale provided by Omada. As beneficial as healthy eating and exercise are, these are likely things these patients have already tried unsuccessfully on their own for losing weight: interventions that science has proven do not work for most people in the long run. However, if a patient stops engagement with Omada, their EnCircleRX GLP-1 coverage can be taken away, and they will have to pay the market cost or drop the medication.The value of a program like Omada for increasing weight loss while on a GLP-1 is questionable. There has come to be considerable medical consensus that these sorts of GLP-1 add-on programs are important for weight loss, and it seems, sort of, like it makes sense, but a good randomized controlled trial proving that assumption is hard to find.Actual nutrition modifications and exercise are not required as part of Omada and similar programs, just receiving the message that they are important. If there was good fact-based evidence that eating changes and physical activity were essential, it seems to be these lifestyle plans would require them.In addition to burdening patients with this sort of “use-or-lose” nutrition and exercise counseling regimen, there are reports of programs like EnCircleRx rejecting patients for coverage out-of-hand, at least until the patient puts in an appeal, even though they meet the requirements for high BMI or elevated BMI in combination with other chronic conditions which can benefit from weight loss like high-blood pressure, high cholesterol, cardiovascular conditions, sleep apnea, or diabetes.Weaker or stronger bones with GLP-1s?Patients who take a GLP-1 to lose unhealthy weight or treat diabetes should be warned that weight loss, especially the sometimes-dramatic losses that can come with GLP-1 use, warrants regular exercise to stem the potential loss of muscle mass. A lot of muscle can be consumed as the body seeks to replace the calories it’s not getting from food by instead burning skeletal muscle along with the targeted fat. Strengthening through resistance work is very important, but vigorous aerobic exercise should be added to the regimen as well.Tangible reductions in strength can be felt with muscle mass loss. What is not tangible, is unseen, and is seldom discussed are changes in bone mass density that may occur with weight loss and GLP-1 use. Weight loss without GLP-1 use is linked to decreasing bone mass density, meaning weaker bones and more susceptibility to fractures. However, studies have reported conflicting results about weight loss caused by GLP-1 use. GLP-1s might provide limited help in increasing bone mass density while losing weight – or they might not. A 2024 randomized controlled study found that the GLP-1, liraglutide, sold as Saxenda for weight loss, reduced bone mass density along with body fat and weight. Exercise combined with liraglutide roughly cut in half the loss of bone mass density.So, for those of us prescribed a GLP-1, in addition to the effect of heavy resistance exercise in stemming the loss of muscle, we have yet another reason to be at the gym.New GLP-1 medications comingThree new GLP-1s may reach the market this year, according to the Journal of the American Medical Association. Eli Lilly, maker of Zepbound and Mounjaro, expects fast track FDA approval of a new semaglutide pill, Orforglipron, targeted at those reluctant to self-inject. Trials of the pill, to be taken daily, delivered an average weight loss of 11% in patients with obesity but not diabetes after about a year and a half.Novo Nordisk has a high-dose version of Wegovy that is also on FDA fast track. The new injectable will have three times more semaglutide in it than Wegovy. Trials in patients with obesity but not diabetes indicate an average 19% weight loss, only about 3% more than Wegovy delivers.Novo Nordisk has also applied for approval of a new injectable, this time combining semaglutide with cagrilintide. The new drug, CagriSema, is on a par for efficacy with the high-dose Wegovy, with trials providing 20% weight loss in patients with obesity but not diabetes. However, CagriSema also registered slightly more side effect reports than Wegovy.Other more powerful GLP-1s and related drugs are in the works. One of the objectives of coming products will be more weight loss but we also might find medications coming which are intended to cause less side effects, which are an important limitation for some folks trying to stay on a GLP-1.Thank you for reading. Please help Eating In America grow by liking, commenting, or passing this along, and please subscribe, if you haven’t, at EatingInAmerica.co. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Everyone on Earth has one food in common, milk. We all drank it as our first meal, even if it was just the milk contained in formula.Breast milk is the most perfect food: the ultimate personalized nutrition. I envy all moms and dads who have experienced breast feeding and its joy and love. Of course, breastfeeding is great if it can happen, but, in the interest of inclusivity, I wasn’t breastfed and I turned out fine.Milk has been in the news a lot lately with full fat milk being promoted in the new Dietary Guidelines and the Whole Milk for Healthy Kids Act signed this month, so I am going to share the answers, many of which I think you will find interesting or useful, to the questions I have had about milk.First, guess the answer, which is better for hydration, water or milk?Full fat milk is 87% water and skim is 90%. A 2016 study found that both full fat and skim milk were better than water for hydration of adults. In fact, milk was more effective than any tested fluid. Oral hydration solution, like Pedialyte or the equivalent homemade solution mixed with the correct balance of sugar and salt, was also effective, as was orange juice. Plain water was on a par with, surprisingly, Coca-Cola, tea, coffee, beer, and Powerade. That’s right, water is just as good as a sports drink for hydration…but not as good as milk.In a small sample of participants, a 2014 study found that milk was better than Powerade for re-hydration after vigorous exercise. The dairy industry has made much out of some small studies that show milk outperforms water for rehydration after heavy sweating. This evidence is weak, but milk does have the electrolytes calcium, potassium, and sodium, which water has little of. More research is needed, but, since milk does deliver protein and good hydration, you might find it a good option after a workout, as I do.Okay, let’s deal with what is in RFK Jr.’s head, and I mean his thoughts about milk, raw and whole.RFK, Jr. says raw milk is good for you. He drinks it.Raw milk can carry Salmonella, E. coli, and Listeria. The USDA, CDC, and FDA all strongly warn against drinking it.Testing has refuted the argument that raw milk is better than pasteurized nutritionally. There is a minor reduction in some vitamins from pasteurization, but not nearly enough to risk a serious illness. The CDC found that from 1998 through 2018, 2,645 people became ill from raw milk, with 228 hospitalizations.However, hard cheese made from raw milk is safer than fluid raw milk. One study found that raw milk hard cheese can meet European Union standards for bacterial safety, but that a rigorous production process is needed, so safety is not guaranteed. Softer cheeses are not as effective in reducing pathogen loads as hard cheese, so beware. Also, FDA research in 2024 and 2025 found that Avian Flu virus, H5N1, can survive the raw milk hard cheese aging process. However, the FDA has found that milk pasteurization does kill the H5N1 virus.Eating in America depends on your support! Please become a free or paid subscriber.Should I buy ultra-pasteurized milk?First Louis Pasteur discovered that the beer fermenting process was caused by yeast, and then he invented pasteurization to kill off the unwanted microbes that could cause beer to go bad. Having revolutioned the beer industry, Pasteur figured out how to pasteurize milk – 161 years ago in 1864.I have a hard time heating milk on the stove for hot chocolate without making a skin on the surface. Have you ever wondered how milk is pasteurized without being ruined? The High Temperature/Short Time method is the common way. Milk is heated to 161°F for just 15 seconds. Milk pasteurized this way is coded for removal from grocery shelves 16 to 21 days after bottling or boxing.Ultra-pasteurized milk, on the other hand, is flash-heated with injected steam to 280°F and then rapidly vacuum chilled. A box of ultra-processed milk can last for months, often without refrigeration. Very convenient, but there is a slightly sweeter, “cooked” taste, and some folks might prefer regular pasteurized milk for some uses. After it is opened the shelf life of ultra-processed milk is similar to that of regular pasteurized milk.The Whole Milk for Healthy Kids Act and the case for whole milkTrump signed the Whole Milk for Healthy Kids Act this month, allowing schools in the National School Lunch Program to serve full and 2% fat milk. This policy is heartily approved by Trump and RFK, Jr.’s MAHA followers.But as Yasmin Tayag points out in the Atlantic, whole milk also connects Trump’s MAGA constituency back to a bucolic, pure, but imaginary American past that appeals to the right and far right. Social media posts by Trump and Kennedy of them with milk mustaches are reminiscent of the dairy industry’s “Got Milk” campaign of the 20th century.And Trump’s post of himself as a milkman further reinforces this connection to a white American past. The milkman image goes way back to Trump’s childhood and reminds us that milkmen delivered milk bottles to doorsteps in the early through the mid-20th century. At one time almost a third of all the milk we drank in America was home delivered. Milkmen were the original Uber Eats, but without the app.Support Eating in America by sharing this post and spreading the word! Framing Trump as a restorer of an old version of America is strong messaging built on a weak basis.The effort to promote whole milk is meant to benefit farmers who hope to sell more, as milk sales continue a 50-year decline. Whole milk is more expensive than reduced fat milks (by which I mean 2%, 1%, and skim milk) because of its fat content, which can be used in other products like butter and cream. So if some people switch from lower fat to full fat milk, that’s good for the dairy industry.What types of milk sell the most?My analysis of USDA 2025 data through November shows that full fat milk is 47% of sales, skim is just 6%. In between are 2% fat, which has 34% of sales, and 1%, which has a modest 13% of sales.In fact, there was a little shift in 2025 with all the buzz about whole milk. Regular full fat milk was up about one percent over 2024, but milk sales as a whole were down about two percent. So despite the promotion of whole milk, for the moment the industry continues to slip in volume.Flavored milk is 11% of all non-organic milk sales. About 2/3 of flavored milk consumed is chocolate, both at school and at home. A survey of 51 flavored milks sold in schools found they all contained added sugar, ranging from 6 to 16 grams worth.Organic milk, by the way, is 7% of all milk sales.Is organic better?How much healthier is organic milk for you than conventional? Pesticides are in conventional cow milk, mainly from cows eating contaminated feed and forage. Most conventionally farmed cows are treated with growth hormones and antibiotics that also show up in their milk.Organic is a little better nutritionally because forage results in somewhat better milk than than the feed mixtures provided to intensively-raised indoor cows. While many conventionally producing cows are allowed to graze, factory farming counts for about 70% of milk production, and the number of small dairy farms dropped by almost half in the last ten years.It would be an easy choice between organic and conventional milk if price weren’t a factor, but this week in the U.S. the average advertised cost of a gallon of organic, $8.16, is exactly three times that of a gallon of conventional milk.Other motivators for organic dairy purchases are the public health benefits of not introducing pesticides and antibiotics into the environment, and the presumption that cows are happier being out grazing in a pasture at least three months a year, as required by the USDA for organic milk cows, as opposed to those many cows that spend their life inside where welfare issues are a concern.Another hopefully interesting statistic: cow milk is almost 100% of American animal milk production, but, worldwide, cow milk is about 80%, followed by buffalos at 15%. Goats, sheep, camels, yaks, horses, reindeers, and donkeys together are responsible for 5% of milk production.Will school kids actually drink more milk if full fat milk is available?Blind taste test studies indicate kids will maybe, maybe not drink more full fat milk than lower fat milk on the basis of taste. One study found consumers can’t tell the difference between milk types by taste alone, while a recent one found a taste preference for full fat milk.Saturated fat?There is new debate among nutrition scientists about whether saturated fat in milk has the same risk-increasing effect on heart health that saturated fat in, say meat, does. More research is needed.It seems very likely to me that if a kid is a milk drinker of whatever fat content, that alone is a win for health, as long as the milk is unflavored and not raw. Milk’s health benefit is further increased if the milk is consumed in place of less healthy juice or sugar-sweetened beverages.Doesn’t removing fat from milk remove vitamins?Calcium absorption in the intestines can’t effectively happen without vitamin D. The vitamins dissolved in the milk fat, A and D, are removed along with the fat in lower fat milk, but they are, by regulation, replaced with 2,000 IU of vitamin A in all lower fat milk.Further, since about 1933, vitamin D has been added to milk. Vitamin D fortification is the primary reason that rickets, the crippling bone disease, is rare in America, 100 years after it was epidemic in northern industrial cities and the poor South. Almost eliminating rickets in America was a big public health and nutrition win.However, rickets has begun to reappear, with a disease rate in the early 2000’s ten times what it was twenty years previously: still very low but unacceptable. Those affected have been primarily poor, dark-skinned children in the South who did not receive vitamin D supplements when breast feeding past six months.Your skin is a vitamin D factory when you get sun exposure. If you are dark-skinned or above the 37th parallel, which runs roughly from San Francisco to Tulsa to southern Virginia, you are likely getting less vitamin D production from the sun than might be optimal.What about the extra calories in full fat milk?A large study, part of the Framingham Heart Study, found no relationship between drinking lower fat versus full fat milk on weight gain. So probably no worries there.Calcium, the wondrous white metal we all need a lot ofCalcium quantities are the same in full and lower fat milk, so this is not part of the whole milk debate. Since calcium is a metal, when you think of it, our bones are made of metal, although a soft one! Calcium is critical to our bone health but also lets our blood clot, muscles contract, and heart beat. We lose calcium all the time through our nails, hair, urine, and feces. If it is not replaced in our food, our body takes calcium from our bones. There are a lot of factors that affect loss of bone mass and microstructure, but studies have shown dairy consumption is a protective factor: it decreases the risk of bone fractures.Milk, yogurt, and cheese are not the only things that can benefit bone health. Physical stress delivered to your bones through exercise helps them strengthen and reduces the risk of osteoporosis. That goes for everyone. There might not be an upper age limit on the benefit of exercise to bone health.For dairy-free consumers, in addition to exercise, to reduce the risk of osteoporosis calcium can be obtained by eating nuts and seeds, kale, broccoli, some lettuces, collard, Brussel sprouts, and cabbage.Many people have good reason to avoid dairy. There is an interesting history to that.It used to be that during childhood everyone in the world gradually lost the ability to digest milk - until about 8,000 years ago when dairy animals were domesticated in Turkey. My theory is that the body’s development of lactose intolerance was nature’s way of forcing the weaning of older children so that young ones could have their turn at the breast.However, along came cow farming, and a genetic mutation that kept lactase production going in the human body through adulthood gradually spread. Then 3,000 years ago dairy herders in Northern Europe experienced selection for the lactase gene during famines – when dairy was the most reliable food source. Those who had the mutation were more likely to live through crop failures.Everyone quotes a 2017 study that found 36% of Americans have lactose intolerance. The rate worldwide according to the study is 68%, but the study’s methods were off, and it was retracted last year. So perhaps we don’t have a reliable figure, but we know a lot of Americans have trouble with milk. Yogurt, by the way, tends to be less troublesome for lactose intolerant folks, since the fermentation process reduces the lactose content in yogurt.The plant milk solutionWhile about 10% of the animal and plant milk market combined is lactase-treated milk for the lactose intolerant, about 15% is comprised of plant-based milks, mainly almond. In 2022 almond milk had about 60% of the market. Oat milk had 20% of sales, with coconut and soy milk each taking about 10%. Almond and oat milk lead sales because of their taste, which is preferred by many.Plant-based milks have good nutrition, and although sugar is added to some, it can be less sugar than the lactose in milk. However, lactose in cow milk is a slow-digesting sugar compared to fast-digesting sucrose in plant-based milk, so expect less glycemic control with plant-based milks.Oxalic acid is in a lot of foods. Be aware that the high oxalic acid content in almond milk significantly reduces the uptake of calcium from the milk. So when an almond milk claims it has more calcium than cow milk, the reason is that it needs to start with more calcium to try to match the ultimate calcium delivery of cow milk.Milk allergyMilk allergy is one of the most common allergies for children. Reactions vary from mild to severe. Happily, most kids outgrow it.Trump’s disgust and dismissal of breastfeedingFirst, in 2011 Trump called a lawyer in a deposition hearing who requested a break to pump milk “disgusting.”Second, for decades the misleading marketing of infant formula in developing countries has caused untold infant deaths due to the use of contaminated water mixed with the powder. Formula use in these places is also associated with nutritional issues and economic stress for impoverished women who are misled into buying formula. America, the World Health Organization, and nutrition and public health experts everywhere had agreed for 40 years that breast feeding was the best source of nutrition to keep infants healthy.However, in 2018, on the order of Trump, who was acting in the interest of formula manufacturers like Nestlé, the U.S. delegation to the World Health Assembly tried to block a resolution to promote breastfeeding and clamp down on inaccurate formula marketing. The U.S. forced Ecuador to withdraw the resolution by using trade threats and threats of withdrawing military assistance for the armed conflict on Ecuador’s border with Columbia. Many other intimidated nations refused to sponsor the resolution until Russia finally did, at which time it overwhelmingly passed.That year, I was in Malawi to gather formula samples to test for contamination. I saw Nestlé formula marketing everywhere. I stood in line at a market behind a clearly low-income woman with a baby. She had one item: formula. She was not buying clean water…I wonder how the U.S.’s own, already subpar, infant mortality rate will fare under Trump?Got Milk?In the face of 50 years of declining sales, the dairy industry has heavily marketed milk as an essential part of the diet to the American public. There are a lot of pluses to milk consumption, full fat or lower fat: great calcium and hydration, a substitute for unhealthy beverages, and it’s got low-cost protein. This may be a too-rare instance of a food industry interest roughly aligning with a public health interest. So, “Got milk?” Heck, yeah!I appreciate your reading. Let me know if you didn’t find 8 interesting facts... Please share, like, or comment at will, and be sure to subscribe at EatingInAmerica.co.You are helping Eating in America grow, and I thank you.Oh, and a…Conflict of interest disclosure. I had an early career in milk nutrition. In 3rd grade I was in charge of bringing the crate of little milk cartons to the classroom where we ate lunch. I was very proud. I think the milk cost 3 cents. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

The long reach of USAID across the globe, saving lives, making friends for America, and elevating this country’s place in the world, ended in 2025. This morning I came across a photo of a food pyramid poster I took at the health headquarters in Nampula Province in Mozambique while I was doing USAID-funded research in 2018 on childhood stunting caused by aflatoxin in mold on staples like maize and cassava.The poster was in Portuguese and focused on a healthy diet for people with diabetes. Nutrition science has corrected its simplistic “fats are bad, carbs are good” stance since the original 1992 American pyramid from which this Mozambican one was derived, but I love the local adaptation with its beautiful cassava, maize, pineapples and papaya.However, I am still not a fan of the pyramid shape to depict a healthy diet. All parts of the diet should be healthy and work together. No food type should be at the pinnacle.It is both surprising and dismaying how the 1992 pyramid has not only re-emerged in America with the new, RFK, Jr. upside-down food pyramid, but that it spread so far around the globe it never really went away.My prediction, and I feel pretty confident here: the new U.S. food pyramid will not achieve the universality of the original. First, I have to think that our global credibility in the realm of health and nutrition has been damaged enough in the last year that many other nations will no longer be ready to accept on face value the science and messaging that has poured out of our country for the last 75 years since the end of World War Two.Second and third, the new pyramid does not make sense graphically or provide the best advice nutritionally.Eating in America depends on you. To receive new posts and support my work, please become a free or paid subscriber.Ok. Enough food pyramid talk for a while, but, in a completely different realm of pyramids, ones you can’t eat, a quick tip that if you happen to be in Austin, Denver, Chicago, DC, Edmonton, Quebec, Montreal, Lisbon, Sydney, or Utrecht, go at once to the Horizons of Khofu. This totally unique, virtual reality experience of the Giza Pyramid in Egypt is at once both realistic and surreal! I went in New York while it was there. Very, very different and very cool.Please share, like, or comment on this post at will. You are helping Eating in America grow, and I thank you. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

The 2025 Dietary Guidelines are finally here. Revealing them took a lot longer than Bobby Kennedy expected. It turns out that, working in secret, Brooke Rollins’ USDA and RFK Jr.’s Department of Health and Human Services went to the trouble of writing a whole new science report to replace the one that didn’t say what they, and their friends in the cattle, pork, and dairy industries, wanted it to say. To create the report, Secretaries Rollins and Kennedy secretly appointed a whole new committee with blatant, strong ties to the industries whose products they were primarily writing about. Creating science takes time, even when it is preordained science, but the secret committee did write a tremendous amount in a very short period. We’ll get back to the report in Part 2 of this podcast.Part 1: Biggest takeaways* One of the most important recommendations in the new Guidelines is to consume no added sugar. This recommendation is for everyone but is also repeated explicitly for children under the age of eleven. The Guideline’s position is clear, direct, and could be – maybe not under Trump but down the road – the basis for policy and program changes that would eventually make a difference in American health and fitness. Excellent progress.* The other big recommendation is to reduce consumption of unhealthy categories of ultraprocessed food, called here “highly processed food.” Highly processed foods are condemned and warned against and that is a pleasant surprise and a political win for Kennedy, who had been shut down on ultraprocessed food in the Make America Healthy Again Strategy Report of September. Regardless of the politics this was excellent progress.* The promoting of red meat is the biggest negative in the new recommendations. The link between red meat and cancer is removed in this version. Big win here for the cattle and pork industries and a step back for healthy food.* The saturated-fat-friendly language relative to meat and dairy is a very bad message for the public, but, for the dieticians and program planners, the retention of the 10% limit on fat calories from previous Guidelines makes adding more red meat and whole fat dairy to the meals they plan a challenge. But, in essence, a big win here for cattle, pork, and dairy.* The alcohol language is watered down. Drink limit recommendations are left out, as is the warning about how any amount of alcohol consumption is linked to cancer. The alcohol lobby is popping their most expensive champaign to toast their win on this.Thanks for reading Eating in America! This post is public so feel free to share it.These Guidelines shift from the previous approach of focusing on a precise standard addressed to dieticians and policy and program designers. The old Guidelines needed subsequent interpretation for the public, while the new Guidelines directly address the public. They are readable, concise, and largely clear. They’ll have to be interpreted back in the other direction – for use by dieticians, policy makers, and program designers. However, the more the public understands what is required, the more they can advocate for the massive change in policies that will allow Americans to achieve healthy diets.The bottom line: the newly issued Dietary Guidelines for Americans, 2025, will do real harm around red meat, alcohol, and saturated fat, but, given that the Guidelines push hard on two important points about sugar and ultraprocessed food that have needed hard pushes, these Guidelines might, on balance, do some real good in the long run. This will depend, however, on if and when valid, true science returns to being an imperative when federal nutrition messaging and health policy are made.Regardless, with the new language in the Guidelines about sugar and highly processed foods, there is no going back. A barrier has been cleared that might allow going forward from a policy standpoint.Eating in America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Part 2: Pseudo-science, propaganda, pyramids, and how it all breaks downPseudo-science and propagandaWe knew the new Guidelines would ultimately be controlled by ideology and big money influence and not by science. Unfortunately, Kennedy and Rollins went to the trouble of having a group of industry-entwined scientists do their bidding and find science to match Kennedy and Rollins’ personal ideas of truth - and provide talking points for their propaganda lies about the old and new Guidelines. If you look in their new Dietary Guidelines upside-down-science report (the conclusions were clearly dictated ahead of time and the science was filled in to support them) you can find a disclosure of Conflicts of Interest that makes Kennedy and Rollins’ complaining about previous industry influence in the Guidelines utter, outrageous hypocrisy. Seven out of nine of the Kennedy/Rollins scientists have strong ties to cattle, pork, dairy, supplement and meal substitute peddlers, Big Food, grain farmers, or GLP-1 business interests.That wacky food pyramid – again?While the official use of the USDA food pyramid is 15 years in the past – it was replaced by the MyPlate graphic in 2011 – its simplicity in depicting the supposedly best way to eat has kept it present in nutrition discussions to the present day. Now RFK, Jr. and USDA Secretary Rollins have officially resurrected it.However, like the prior two food pyramids from 1990 and 2005, this reincarnation is awkward and unrealistic, and, since the pyramid is now standing on its tip, to me it is disconcertingly unbalanced. Grains are now at the bottom (the narrow upside-down tip), essentially making the pyramid represent a low carb diet, which very few Americans are going to agree to adopt any time soon.But wait, the food items are drawn such that the ones lower in the pyramid very slightly hide the items above. Seen this way, the pyramid is like a rack of billiard balls on a pool table, the balls at the tip slightly hiding the balls behind.In this perspective it’s ambiguous as to what is the top and what is the bottom: all of the food items can be seen as on the same nutritional level and contributors to a healthy diet. I like that perspective, intended or not. And it is a clean, attractive graphic, especially compared to the weird 2005 version.The images of frozen peas and canned green beans are quite legible in the new pyramid. I like their inclusion because it acknowledges that frozen and canned vegetables, which are more affordable, can be just as nutritious, and sometimes more so, than fresh ones. And for Americans to incorporate a lot more produce into their diets, it is going to have to be more affordable. And you can see a big slab of healthy salmon up near the top (below a fat-rippled slab of steak, of course!)Oh, and I like the motto that comes with these Guidelines: “Eat Real Food.” This is adapted from Michael Pollan’s mantra: “Eat food. Not too much. Mostly plants.” Kennedy was sure to leave out the “mostly plants” part, but “Eat real food” is still an good motto to promote.The new versus the old recommendations – what went right and what went wrongProteinThe 2025 Guidelines push protein, saying eating twice as much as previously recommended. These Guidelines are friendly to red meat where the 2020 Guidelines encouraged fish and vegetable proteins and discouraged meat that was processed.Americans generally get enough protein. Doubling intake is not necessary under normal conditions.However, increasing protein is, by itself, fine – more protein is, in moderation, nutritionally harmless and, if done as a substitute for refined carbohydrates, provides calories that are metabolized much more slowly, a good thing. The caution would be in adding red meat as part of that increased protein because of red meat’s links to heart disease and cancer.Also, some fish have such high levels of mercury that they should be avoided or eaten sparingly. RFK, Jr. himself had mercury poisoning from frequent eating of tuna. I can’t let it go unsaid that unfortunately, while Kennedy railed against mercury in the environment prior to becoming Secretary of Health, he has had tight lips as Trump has begun rolling back mercury-emission regulations.DairyThe 2025 Guidelines want us to include full fat dairy, but exclude dairy that has added sugar. The 2020 guidelines specified drinking no-fat or reduced-fat milk and omitted any mention of added sugar.The 2020 Guidelines pointed out that 90% of Americans do not consume enough dairy.In that light, the consumption of saturated fat in whole milk and other dairy products could be weighed by the individual against consumption of other sources of saturated fat, like red meat, the goal being to increase milk consumption with its nutrients like calcium and added Vitamin D.Recommending exclusion of added sugar from milk is good. Other ways must be found to increase milk consumption in kids apart from adding sugar in flavored milk.Gut healthGut health appears in the new Guidelines for the first time.They point out that highly processed foods are disruptive for the trillions of bacteria in our colons and that this microbiome of organisms plays a key role in our health. Vegetables, fruits, and fermented and high fiber foods are recommended for gut health.Vegetables and fruitThe essential message in the new Guidelines remains the same: Eat lots of vegetables and fruits, and canned (without sugar) and frozen vegetables and fruits are just fine. The more detailed 2020 Guidelines took care to point out that 90% of Americans don’t eat enough vegetables and 80% not enough fruit.The new Guidelines recommend 3 servings of vegetables and 2 of fruit. This is more or less the same as the 2020 recommendations, but those were expressed in cups. Cups are nice and precise for dieticians planning meals for schools or the military, but don’t communicate well with the public who would rather just know they can grab an apple or put a pile of carrots on their plate to begin to meet their health needs.Any uptick in fruit and vegetable consumption on the part of the public would be a win but still leave consumers far from meeting the fruit and vegetable recommendations. And these Guidelines are all about the public. The dieticians and program planners are going to have to interpret them for their own specific purposes.Healthy fatsThe 2025 Guidelines claim, against the evidence, that saturated fats in meat and dairy are healthy and advocate for their use. However, the 2025 Guidelines still stick to the recommended 10% limit on saturated fat consumption from previous Guidelines and call for more research into healthy fats.Seeds are still identified as good sources of healthy fats in 2025, but, per RFK, Jr.’s personal beliefs, healthy seed oils like canola, soybean, and corn, don’t get a mention.Whole grains and refined carbohydratesThe new Guidelines say to prioritize whole grains and reduce highly refined grains in a way that is stronger than the previous Guidelines.More than two-thirds of our bread, a major source of grain in the American diet, is white, and 23% is a mix of white and whole grain. I like the simple dictum of the 2025 Guidelines: switch from highly refined grains to whole grains. This is a stronger approach for the public than the previous Guidelines’ advice to limit refined grains to 50% of grain consumption, which is an almost impossible calculation to make or goal to achieve for the average American consumer whose highly refined grain consumption is way more than 50%.There are a few additional considerations in the whole grains crusade that always go unmentioned. We often have the wrong idea how much whole grain versus refined flour is in our bread, pasta, frozen waffles, or breakfast cereal labeled as multigrain or as made with whole grains. These products can be mostly refined flour. Where is the acknowledgement of that?And where is the acknowledgement that most of the time to make whole wheat flour, the wheat berry is milled to separate the endosperm (the source of the white flour), from the germ and bran, which are then all separately ground down fine and recombined to qualify for the term “whole wheat” on the label or in the name? This type of whole wheat bread has a palatable, smooth consistency. It just doesn’t have all the nutrients, phytochemicals, and structurally intact fiber that were in the original wheat berries and that are retained in whole wheat flour made by grinding down the wheat berries without separating their three parts. Phytochemicals have very important antioxidant, anti-inflammatory, and antimicrobial effects in our system.Grain products with added fiber similarly are missing vitamins, nutrients, and phytochemicals.Real food in the form of grain is not highly refined. Policy is needed at the federal level to reduce the use of nutrient- and fiber-deficient refined grains in favor of whole grains, and the Guidelines have yet to provide real impetus for that change.Ultraprocessed foodThe new Guidelines call for “a dramatic reduction in highly processed foods laden with refined carbohydrates, added sugars, excess sodium, unhealthy fats, and chemical additives…”No argument from me.SugarOn average according to the USDA, Americans eat and drink 34 teaspoons of sugar a day. That’s 544 calories worth.The 2025 Guidelines say, “While no amount of added sugars or non-nutritive sweeteners is recommended or considered part of a healthy or nutritious diet, one meal should contain no more than 10 grams of added sugars.” I won’t bore you with the math, but this is way less sugar than the old 10% of calories recommendation.The sugar language is perhaps the most important improvement in the Guidelines. Basically, it says don’t eat added sugar, and if you have to, cut down a lot from the average. The sugar recommendation is even stronger for children. Previously the recommendation was that children under 2 should not have added sugar. The new Guidelines say no added sugar before age 11.My hope is that this new sugar language can be a bit of a turning point and momentum can build from here toward political action and regulation aimed to eventually returning control of our sugar-contaminated food environment to the people.SaltThe 2025 Guidelines are basically the same as before but specifically recommend avoiding highly processed foods high in sodium.AlcoholIn a big reversal, the 2025 Guidelines say, weakly, “Consume less alcohol.” The 2020 Guidelines said limit alcohol to two drinks for men, one for women and that alcohol in any amount is associated with cancer.The alcohol industry is the 4th largest lobby in America, after ultraprocessed food, tobacco, and gambling. Alcohol’s big money lobby, and the Trump administration’s level of susceptibility to big money influence, likely explain why alcohol had a huge win in diluting the alcohol recommendations in the new Guidelines.The basis for the watered-down language was provided by a new National Academies of Sciences report on the health effects of alcohol. According to the National Academies’ report, if you are drinking moderately, as within the limits previously stipulated by the Dietary Guidelines, you’re not increasing your risk of death and may be decreasing it. However, there’s no evidence supporting doing away with a moderate drinking limit in the Guidelines and the evidence linking alcohol to the risk of cancer and heart and liver disease continues to strengthen.I guess a reluctant tip of the glass to the alcohol lobby is in order.A proposal for 2030In 2030 when the next Guidelines are due, I would like to propose the name of the document be changed to “Dietary Guidelines for America,” not “Americans.” The guidelines are meant to inform policy formation, but their title implies it is the sole responsibility of Americans as individuals if they want to eat healthy food in line with the Guidelines. However, obesity and malnutrition are diseases, and malnutrition in America is caused not only by inability to get sufficient calories but also by being overfed but still badly nourished. Curing these diseases depends on our government taking responsibility for cleaning up the food environment to make it healthy.Kennedy and Rollins’ introduction to the new Guidelines lays part of the blame for the ongoing devastation of diet-related chronic disease on past federal policies. This is more than true. The worst food environment in American history can only move toward healing and rehabilitation if policy changes are made and new policies formulated.The USDA, Kennedy’s Health and Human Services Department, the larger administration, and Congress should all be working in favor of the people when the people’s interests collide with those of Big Food and Big Agriculture.Thank you for reading. Your support is helping this community grow. Please like, comment, and share Eating in America with your friends.Eating in America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

We toss over 10% of our national food supply out of our homes each year, based on new statistics and methods from the 2025 Food Waste Report by ReFED, a leading non-profit using hard evidence to push for a reduction in food waste. That thrown-away food not only has a significant environmental impact but costs us consumers $262 billion. That is a lot of grocery money: $62 a week on average for a family of four. “Cash in the trash”, the EPA says.The product’s date label is often the only thing we check in deciding whether to chuck food we suspect is too old.In my household we have a range of approaches to dates on a food container. Some of us will not touch a product with a date that has passed, no matter if the label says “Best by,” “Sell by,” or “Use by.” Those products are mostly thrown away around here. Some of us will open a product with a date that has passed, take a look, give it a smell, have a little taste, and, if no alarms are raised, eat it.The confusion and widely differing ideas about date labels stem from the fact that there are fifty states, Puerto Rico, D.C., and other entities and no standard for food date labeling across them. By one estimate there are fifty different terms like “Freshest before,” “Expires on,” and “Sell by” used on products in the U.S.I wondered if Americans all over the country grapple, like me, with the question of what the heck the date on a food product actually means? Are the terms we see on products about safety or quality? And who decides what date to use?Because I have been told the people in Odessa Texas are very nice, and I know the people in food banks and pantries are really nice, I decided to call Libby Stephens, the CEO of the West Texas Food Bank, serving the urban areas of Midland and Odessa Texas plus 19 very rural counties which together are the size of the state of Maine.I asked Stephens if she understood food date labels.“Well, I mean, I think so, just because I’ve been in the food banking world for 15 years. So, there are expiration or “best by” dates, but also from the USDA we do get some different dates that let us know when we can or cannot continue to pass out donated food or salvage and reclamation food that we pick up from grocery stores.”Ok. So the USDA provides some safety guidance – the federal government has no rules or requirements for food dates – and a food bank or pantry can use that guidance in determining when it is still okay to offer food to customers. Stephens again:“We have charts hanging up in all of our processing rooms at the Midland and the Odessa campuses that tell us whether milk is after expiration or not after expiration. Bottled water is up to a year. We really don’t like to take sodas, but those are 9 months. If you get to juices, it’s 6 months past the date. So it just depends on what the commodity is.”Sounds complicated to have to depend on dates, even for the professionals, who in the case of the West Texas Food Bank are taking a date on the product and adding on a recommended margin, which might be quite large but is still regarded as safe. The Food Bank of course wants to be very sure its customers are safe but also wants to make sure they aren’t hungry. Any food bank or pantry is going to want to maximize the amount of safe food it can pass through from donors to those in need.Lots of folks, 43% of us according to a 2025 survey, toss out food close to or past the date on the container.And states are confused as well as consumers. About 20 states ban sales or donations of past-date products. That is good, healthy food that cannot go to a food bank.Economists, nutritionists, environmental scientists, and politicians have been worried for years about the costs to consumers, the environment, and those in need that occur when good food is thrown away because of confusion around food date labels.California again gets honors for stepping up, as California so often does, with an answer. It’s a law that is quite tidy and very easy to understand. As of July 2026 all food products sold in California that have a date must also have the words “Best if used by” or “Use by” in front of the date. Only those terms. No other terms are allowed. If a retailer or distributor wants to have a “sell by” date so they know when to pull a product off the shelves, that date will have to be coded so a consumer can’t read it. And, as in the past, the use of food date labels is not required by the California law.For the consumer this means that if there is a “use by” date, it can be understood to be the last day on which the food packer guarantees the product will not have spoiled. If there is a “Best if used by” date, that marks the end of the estimated period of peak freshness. And remember, freshness is something that deteriorates tiny bit by tiny bit from the minute the product is packed, canned, or bottled to days, weeks, months, and often years past the date on the food container. I trust my senses, including my common sense, along with some basic food safety rules when it comes to things like meat and seafood, to tell me what to do as a product passes its printed date.The USDA backs me up in this:“If the food date label passes during home storage, the food product (except for infant formula) should still be safe and wholesome if handled properly until the time spoilage is evident. Spoiled foods will develop an off-odor, flavor, or texture due to naturally occurring spoilage bacteria. If a food has developed such spoilage characteristics, it should not be eaten.”Neither terminology allowed in the California law, “Best if used by” nor “Use by”, provides a date a product needs to be thrown out. The USDA is clear: “Food date labels are not indicators of food safety.”By the way, it is the manufacturers and packers who decide the dates, often running shelf-life tests to help choose a date for the label. The dates you find on labels might or might not be a sort of science-y choice.Help Eating in America grow by sharing this post!The food dating issue is very big for us a society when you add in the various costs involved in the production and transportation of the food to the consumer: the land, fuel, crop treatments, and a lot of water used for irrigation. And the story doesn’t end with the consumer’s cash in the trash. When the food waste leaves the home, 96% goes to landfills, incinerators, or into the sewer system. The landfill waste decomposes, releasing methane gas, which contributes to the buildup of heat trapped in our atmosphere. All these are reasons why bipartisan legislation, along the lines of what has been enacted in California, has been introduced in Congress to bring federal standards to food date labeling.Meanwhile, when you go to the supermarket, ignore “Sell by”: that is just for the retailer. And remember “Best if used by” is an indicator of freshness and “Use by” is just an indicator of a spoilage timeframe.Thank you for reading. Please support Eating in America and help it grow with your subscription, comments, and likes, and share this with others, please! I’m curious to know what you have been thinking about food label dates. The comments are open to all readers.I wish you lots of love, kindness, good eating, and good health for 2026. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This is a free preview of a paid episode. To hear more, visit www.eatinginamerica.coToday’s post and podcast are especially for Eating in America’s paid subscribers and supporters, who I thank deeply.The fascinating and despicable colonial history of our most beloved drug’s most beloved delivery agent, I’m talking about caffeine and the way we most like to take it, that is in coffee, is told in Coffeeland by Augustine Sedgewick.You could argue that sugar is actually our most beloved drug. David Kessler explains how sugar triggers our reward circuits and is addictive in Diet, Drugs, and Dopamine. I wonder what we can learn about the addictive qualities of ultraprocessed food and why we are not to blame for the eating behaviors brought on by our food environment, and so David Kessler’s book is essential reading. The GLP-1s like Zepbound and Ozempic hold a lot of promise as a fix, although not a cure, for obesity, and they offer benefits for other chronic diseases and disorders. Kessler, a GLP-1 user like me and a doctor, discusses the drugs from a clinical perspective.On the topic of the biological workings of healthy and unhealthy food, Julia Belluz and Kevin Hall provide a valuable and digestible look at the science in the new book Food Intelligence. I like that I’m in harmony with them in singing the hymn that it is not our lack of willpower that is causing endemic unhealthy eating, it is the food system working as Big Food designed it.I am fascinated how three addictive substances on the milder side have so taken over the behaviors of so many people over centuries and have parallel histories involving human slavery or near-slavery: tobacco, sugar, and coffee. We might be a little familiar with tobacco and sugar slavery. They were a part of U.S. history. The Central American coffee plantations of the late 19th century bound indigenous people to the work of the plantation by keeping them in hunger. Only if they worked on the plantation could they get fed. Sundays in that Catholic society were not just a day of rest, they were a day of hunger.I talk in Eating in America about how and why we consume tobacco, sugar, and coffee today, but I feel compelled to understand how the global addiction to them was made possible by the millions of people brutally enslaved or bound to plantations to produce them. Sugar slavery is an immense part of Cuba’s history, so I’m reading Ada Ferrer’s An American History of Cuba.And also my brother teaches in Cuba (and throughout South America) every year. His new book Working with Actors is in my stack because Stephen Bayly is my wonderful brother and the book is great.Chef José Andrés’ Change the Recipe, seems to be about how cooking and serving food are acts of love and generosity but more importantly metaphors for how to live a life of love and generosity and efficacy.John Green’s The Anthropocene Reviewed is interesting…

The new 2025 Dietary Guidelines are due out this month, according to RFK Jr. Significant changes may be coming!The Dietary Guidelines have, in the past, been largely guided by science. This year Secretary of Health and Human Services Kennedy would like them to reflect his own particular ideas about healthy food. Given the makeup of his Advisory Committee on Immunization Practices, we know Kennedy feels unrestrained by the evidence of science when it comes to public health. We’ll soon see if this is reflected in the new Dietary Guidelines.But no matter if Kennedy is able to override science to assert his own beliefs in the new Guidelines, going forward, the 2030 Guidelines, and the Report of the 2030 Guidelines Scientific Advisory Committee, which is meant to inform the Guidelines, need to be updated to address the rapid downward slide of American nutritional health that has occurred over the last 75 years. The pace of change of the Guidelines must be accelerated to address the pace of change of our food environment.Eating in America is reader-supported. To receive new posts and support EiA’s growth, please join our community as a free or paid subscriber.The last Guidelines were 160 pages long to provide detailed guidance for a host of Federal and state nutritional programs, and for policymakers and health professionals. Kennedy has promised a 4-to-6-page document this time. A six-pager, with necessarily general guidance, if issued, would present a great challenge of interpretation to the nutrition programs that depend on the Guidelines. Brevity would provide a strong focus on any changes to the Guidance, but the most important possible beneficial change, the condemnation of unhealthy ultraprocessed food in our diets, has so far been squashed by the ultraprocessed food industry and their insiders in the administration.The 2025 Guidelines’ Scientific Advisors were appointed, in the usual secretive process reflecting corporate influence, by Biden’s USDA and Department of Health and Human Services. However, all of the 2025 Advisors had true scientific bonafides.The next Dietary Guidelines Scientific Advisory Committee is due to be appointed by the Trump USDA and Department of Health and Human Services, the politicized nature of which poses the potential that it will be a sham, in the same way that the current Advisory Committee on Immunization Practices appointed by Kennedy is an embarrassment for public health and a lethal danger to Americans.With the current administration tilting toward heavy corporate influence in governance and dismissal of science as a key to American well-being, combined with a diet-based health crisis of obesity, now is the moment to strongly advocate for change in the formulation of the next Dietary Guidelines.This month I attended a panel discussion with 2025 Dietary Guidelines Scientific Advisory Committee Chair Dr. Sara Booth. When asked about public compliance with the Guidelines, Dr. Booth noted that, sadly, there is not much compliance: we have a failing grade at healthy eating in our society. Most interestingly, Dr. Booth advocated that the next Scientific Committee revisit the question of eating behaviors to address lack of public compliance to the Guidelines. This year’s Scientific Report cited the need for research of eating environment changes that can support behavioral change, giving the home as an example.That is a baby step.Eating behaviors in today’s food environment are in large measure created by the marketing and sale of lab-designed, hyperpalatable, high-profit-margin, ultraprocessed food. These products prey on our biological and psychological responses to their combinations of salt, sugar, carbohydrates, and fat – and to the manufactured sensory appeal of the food apart from the taste. Like lab rats, we feel rewarded when we see, taste, and ingest these products, and we soon want more.The 2025 Scientific Advisory Committee punted on the issue of ultraprocessed food. According to Dr. Booth, some Advisors argued that the Committee was already accounting for the effects of ultraprocessed food as they evaluated its components. This approach in isolation overlooks the fact that these foods are designed to work in combination. The successful formulation of ultraprocessed food depends on the whole being greater than the sum of the parts. That is the guiding principle of ultraprocessed food.I am never excited about eating a minimally processed baked potato with salt and butter, but I can devour a bag of McDonald’s french fries with its list of 10 to 20 ingredients, working together to trigger the reward circuit in my brain. The ultraprocessed difference for me and other consumers ends up in the quantity and quality of nutrients and the number of calories consumed.The 2030 Dietary Guidelines Scientific Advisory Report needs to account for the ultraprocessed food effects on diet that simple minimally processed food ingredients don’t elicit.The Dietary Guidelines themselves are intended to make recommendations with the end goal of our healthy eating. As Dr. Booth pointed out, decade after decade, five-year iteration to five-year iteration, the Guidelines evolve a little each time but are always healthy. And the public always gets a failing grade at eating to the Guidelines standards. However, the failure is really that of our federal and state governments who have neglected to ensure the safety and healthiness of our food environment and to protect the public.In the last half of the twentieth century our food environment underwent a technology-driven, historically unprecedented transformation, the scale of which has never been seen. Ultraprocessed food grew from a small portion of our diet to 55% of our calories, 62% when just youths ages one to 18 are considered. Now, on any given day, almost 10% of us get more than half of our calories from fast food. On any given day, one-third of us patronize a fast-food seller.When the first formal dietary guidelines were produced in 1980, the explosion of fast and other ultraprocessed food and the obesity epidemic were both just getting started. Ultraprocessed food was not even named until 2009, and the fact the U.S. and the world were in a growing obesity epidemic was not identified until the 1990s.In effectiveness, what penicillin was to infection, GLP-1s are to obesity. But unlike an antibiotic, Zepbound, Ozempic, and that class of drugs are a fix to the symptom, not to the problem. Even with a possible leveling off of the number of adults with obesity (about 40%), the obesity epidemic is not about to end – even though drugs may help hide it. And severe obesity (about 9% of adults) is continuing to increase.As Dr. Chris van Tulleken said last month in introducing the public health action paper in the new Lancet trilogy of papers on ultraprocessed food, the obesity epidemic is commercially driven. And the money is huge. The ultraprocessed food lobby is the biggest lobby in Washington by a wide margin.The Dietary Guidelines have slowly evolved while the U.S. has found itself in a food environment crisis in a new era in food history. In response to these changes, it is time for the Dietary Guidelines to reboot and grapple with ultraprocessed food. The Scientific Committee needs to investigate eating behavior, as Dr. Booth proposes, and so, of necessity, investigate the drivers of unhealthy eating behavior in our food environment.The Scientific Committee is concerned with the nutrient effects of food components and so in this cycle deferred making recommendations about ultraprocessed food, saying it required a standardized definition of ultraprocessed food that could be researched with results that could be compared across studies. A federal ultraprocessed food standard definition, while promised by RFK, Jr. and the recent Make America Healthy Again Strategy Report, may or may not come within the current administration’s term. A body of research adhering to a standardized definition is years in the future at best.A new approach for the next Scientific Committee is required, an approach focused on the biological effects of hyperpalatable foods, how those effects drive how we eat, and how the 2030 Dietary Guidelines should take those hyperpalatable foods into account. The crushing burden of chronic disease due to our unhealthy eating has been made abundantly clear, in the research and in the personal lives of Americans. Assertive action by the 2030 Dietary Guidelines Scientific Advisory Committee and by the USDA and HHS is required, with the goal of helping Americans live longer and healthier.Thank you for reading. Please subscribe if you haven’t and share Eating in America with your friends. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

The critical health and nutrition data we nearly lost this yearChances are very good you have never taken the National Health and Nutrition Examination Survey, or NHANES: only 5,000 Americans are part of it each year. But 5,000 of us, randomized carefully to represent all Americans, is enough to provide public health and nutrition scientists and policy makers solid data to accurately check:* The growth of obesity, diabetes, high blood pressure, osteoporosis, and kidney, respiratory, infectious, and sexually transmitted diseases* Use of smoking, vaping, alcohol, and drugs* Physical activity, sexual, and other health-related behaviors* How we eat and drink and our nutritional health.Mobile NHANES exam centers are deployed around the country for in-person examinations and measurements, blood and urine sample collecting, and diet and health interviews.The data is used to:* Study the spread of disease and detect factors that may be linked to diseases* Provide a solid scientific basis for health and nutrition policies* Design health and nutrition programs and inform the practice of medicine and nutritional interventions.* Inform the U.S. Dietary Guidelines, due out this month.Important NHANES revelationsNHANES had its origins in the early 1960s. Soon after adding nutrition to the survey and exams in 1971, NHANES found blood level deficiencies of iron in women, children, and older Americans, leading to federal requirements to fortify grain and cereal with iron.Then, still in the 1970’s, NHANES revealed that Americans had too much of another heavy metal in their blood: lead, dangerous at any level. The federal government subsequently de-leaded our dangerous gas and paint, and a reduction from high blood lead levels in almost everyone in the 1970s to high levels in 4% of Americans was achieved within 20 years.NHANES exams and interviews found that about 40% of Americans with high blood pressure don’t realize it.Similarly, NHANES has shown that about one-quarter of adults with diabetes don’t know they have it.Thanks for reading Eating in America! This post is public so feel free to share it.And we nearly lost the ability to collect this data?In October the Trump administration used the government shutdown as an opportunity to fire 1,300 CDC employees including 100 key NHANES team members. An uproar followed in the public health and nutrition worlds. By the end of November everyone was re-hired and paid back pay, but the lasting damage is hard to assess.Ultraprocessed food and NHANESAn example of how NHANES data should be informing public policy is demonstrated by its use in recent research of ultraprocessed food consumption and associated health risks.Ultraprocessed food creation and marketing took off in the 1950s and 1960s. I use 1953 as the start of what might be called “the era of the ultraprocessed.” 1953 was the year of the first McDonald’s franchise and the first Swanson frozen dinner.It is good to remember that many brands of ultraprocessed products that are still popular started prior to World War II, including Coca-Cola (1886), Jell-O (1897), and Crisco (1911) – still a source of toxic trans fats, by the way, even though Crisco is allowed by the FDA to say “zero grams” of trans fats on its labels. In the 1910s we got Oreos, Nathan’s hot dogs, Aunt Jemima syrup, Hellmann’s mayonnaise, and Marshmallow Fluff. The Roaring Twenties brought us Wonder Bread, Velveeta, and Kool-Aid, followed by the Great Depression of the 1930s and Spam, Kraft Macaroni & Cheese, and Ritz Crackers.These iconic brands represent whole categories of ultraprocessed foods like sugar- and artificially-sweetened beverages, packaged snacks, cookies, meat and meatless products and fish sticks, sauces and toppings, breakfast cereals, and, the bane of my diet, ice cream, all of which now fill the aisles of grocery stores that are supersized on a scale not envisioned prior to World War II.Carlos Monteiro is the most prominent name in ultraprocessed food research, having coined the term “ultraprocessed” in 2009. Using NHANES data, a team of researchers, including Monteiro, found that between 2001 and 2018, ultraprocessed food consumption increased from 53.5% of the average American adult’s calories to 57%. That 3.5% increase over 17 years may represent a recent trend toward leveling off in the consumption of ultraprocessed food. We don’t have good data for ultraprocessed food consumption in the 20th century, so we can’t put a number on how much was being consumed in the 1950s. But certainly it was a low number compared to the 53.5% of calories in 2001: on that there is consensus. So very rapid growth in the last 50 years of the century, was followed by what appears to be a tendency toward a flattened curve in ultraprocessed food consumption.That trend toward leveling off is a good thing given the mounting evidence in over 100 studies of ultraprocessed food’s association with death and chronic disease, including obesity, diabetes, high blood pressure, heart disease, stroke, kidney disease, Crohn’s disease, and depression.And the trend toward the leveling off of ultraprocessed food consumption, following its meteoric rise in the last half of the previous century, should not be surprising. Today, the average American already consumes almost 60% of their calories eating ultraprocessed food. I hope our taste buds and some human instinct to eat natural foods will end the growth in ultraprocessed food consumption.The more ultraprocessed food we eat, the more that minimally processed foods like fresh fruits and vegetables and simply prepared meats, poultry, and fish will be displaced from our diets. The study of NHANES data from 2001 to 2018 found consumption of healthier, minimally processed food decreased 6%, from 1/3 to about ¼ of out calories, while unhealthy ultraprocessed food calories consumption increased 3.5% during those 17 years.What is required for the recovery of America’s nutritional health and a subsequent substantial reduction in chronic disease are policies and programs that greatly reduce the consumption of ultraprocessed foods.Kudos to San Francisco, which this week filed suit against ultraprocessed food makers including Coca-Cola, PepsiCo, Kraft Heinz, Mondelez, Nestlé, Mars, ConAgra, and cereal manufacturers Post, General Mills, and Kellogg. San Francisco is suing on the basis of the evidence that the ultraprocessed products marketed and sold to consumers create a burden of chronic disease.The CDC’s fast food reportThe CDC’s own, in-house analysis and reporting of the NHANES data has tremendous value to public health policy and programming in America.In April the CDC’s National Center for Health Statistics reported good news, sort of. Two-thirds of Americans on a given day in 2022 or 2023 did not eat fast food. Of course, that means one-third of Americans did go to a McDonald’s, Starbucks, Chick-fil-A, to name the top three, or another purveyor of fast food. Unfortunately, 9%, almost one in ten, of survey respondents got more than half their calories in fast food that day.The CDC’s study found that adults with obesity ate 40% more fast food calories compared to adults with underweight or normal weight status.A related CDC study found that American youth are eating fast food at almost the same levels as adults, 30% of children and adolescents ages 2 to 20 have fast food on a given day, and 11% of their overall calories come from fast food, compared to 32% and 12% for adults. The good news here is that the CDC reports these rates decreased a little for both youths and adults from 2013 to 2023. We can only hope that this apparent trend continues.To this end, our neighbors to the north and south, Canada and Mexico, along with nations in Europe, Asia, and South America, do a better job limiting fast food advertising and other unhealthy food marketing that targets children. Some ban it all together.CDC’s obesity reportObesity in America was reported by the CDC in 2024 using NHANES data from 2021 to 2023. The rate among adults was 40%, without a significant difference between men and women. However, there was a big difference in severe obesity with a rate of 6.7% in men and, approaching twice as much, 12.1%, in women.The good news is that the level of obesity in adults was unchanged between 2013 and 2023, although the level of severe obesity grew considerably, from 7.7% to 9.7%, overall.I gave thanks at Thanksgiving for public health professionals. That includes the thousands of talented people at the CDC dedicated to true science and the public health. I would like to exclude, of course, those current CDC political appointees I know about from any consideration.NHANES is a key source of data and the work gathering it, reporting it, and making it available to other researchers around the world is essential to improving the well-being of Americans.Thank you for reading. Please subscribe if you haven’t and share Eating in America with your friends. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

PrefaceMicroplastics is a very challenging topic. The research I did for this piece scared me in a way that I have not been scared by research before. I came to fully understand how immersed we are in microplastics on a daily basis, but how little we know about their effects, and how little we can ever know about how much and what kinds of plastics and, importantly, plastic additives, we are exposed to. Like all of us, I want some control of what goes in me and my family. The impulse I’m feeling at the moment is to avoid all plastics, but one look around me, and I know that is quite impossible.Optimistically, when I put the issue in context, my sense is that microplastics is a long game problem, and the game has just started. There are more urgent and important food and health concerns in the near term, but we can’t ignore what is happening with plastic. The more quickly we react to the new microplastic environment we live in, the sooner we will understand the priorities for action, for us as individuals and for our society.At the end of this piece I would be quite interested in your reactions to all of this in the comments section.The storyIn 1951 an efficient way to make polypropylene and high-density polyethylene plastic was discovered by Philips Petroleum chemists searching for a way to turn Philips’ huge holdings in natural gas into a profitable product. Polypropylene and high-density polyethylene are the numbers 5 and 2 in the recycling triangles on the bottom of many containers in your kitchen. Recycling number 1 is PET and is found on the bottom of soda bottles and prepared food containers. PET is a polyester, like the fiber in clothes and rugs. Together those three plastics are the most common of the six main types.The manufacturing of plastics has been exploding since 1951, when 2 million metric tons of plastics were made, globally. In 2015, ten years ago, that annual figure was near 400 million metric tons. In 2017, half of all plastics ever made were produced in just the prior 13 years, between 2004 and 2017. And the trend keeps zooming upward.Packaging for consumer products and food is the biggest user of plastic, 40% or 50% by some estimates. Other major sectors are building and construction and textiles.Plastics production grew so quickly from the 1950s that by 2004, marine biologist Richard Thompson reported on the vast quantity of plastic waste in the ocean and the presence of something he termed “microplastics.” In the space of 50 years the developed world had created a global plastics crisis.What exactly are microplastics, and how about nanoplastics?Microplastics are primarily shed from larger pieces of plastic, although some are manufactured at a micro or nano level, such as microbeads used in personal care and cosmetic products. Microplastics are defined as ranging from 5 millimeters (a little less than ¼ inch) to 1 micron (or one-millionth of a meter) in length. Nanoplastics are all the smaller particles down to the limits of detection technology, below 100 nanometers. Nanoplastics can easily pass through the lungs and intestinal lining to enter the bloodstream, where they can travel to and enter our organs, but microplastics are found in our organs as well. Secretary of Health RFK, Jr. has correctly identified that these micro- and nanoplastics can be “…found in samples of human tissue: in the brain, the liver, the kidneys, the colon, the placenta, and testicles.” Nanoplastics are small enough to enter into individual cells.Where do microplastics come from?Breakdown of waste plastic creates 22% of microplastics in the oceans. Worldwide, in research where a brand on plastic waste could be identified, of the top 10 sources of plastic pollution in 2023, six were ultraprocessed food companies: Coca-Cola (perennially the top source of plastic pollution), Nestlé, PepsiCo, Mondelēz, Mars, and Danone. Two other top sources, Unilever and Procter & Gamble, specialize in body care and other products. The last two sources in the top ten were tobacco companies: Altria Group and British American Tobacco. The cigarette culprits are the filters in the butts thrown on the ground.There are three main paths into our bodies from packaging plastics like soda bottles and baby food containers. First, particles are released into the environment and then we eat or drink them in our food and water. Second, we inhale them. Third, our food and water packaging releases microplastic directly into the food and water we are preparing to eat and drink. Additionally, nanoplastics from personal care and cosmetic products can enter through pores and abrasions in the skin and have been shown to cause skin cell damage, but skin contact is a minor entry point compared to the mouth and nose. Fortunately, one source of micro-and nanoplastics intended for skin contact, microbeads, were banned from certain personal care products like toothpaste and facial scrubs, first in 29 state laws and then in federal law in 2015.Other major sources of microplastics in the environment include vehicle tire wear particles, which are bearers of toxins from the tires, and microfibers from laundry water after the washing of synthetic fiber clothes. City dust, a mix of plastic particles, is another leading source.A team of scientists in China wrote somewhat poetically about the sources of microplastics: “The presence of microplastics can be detected from the Tibetan Plateau to the Marianas Trench and from the houses we live in every day to the untouched skies over the Pacific Ocean.” Their analysis, along with analyses by others, found drinking water, food, and inhaled air were the major sources of microplastics in humans.Research published by the National Academy of Sciences estimated that a one-liter bottle of water contained over 100,000 plastic particles, 90% of them nanoplastics.Our poetic Chinese scientist friends estimated that of the microplastics counted in the body, 45% came from water, 33% from fruits and vegetables, and 21% from indoor and outdoor air, but more from indoor.The quantities estimated to come into the body on average from food, water, and air might vary greatly depending on the methods of different researchers, and they will vary for each individual according to their environment. The consistent finding is that micro- and nanoplastics are everywhere, and we eat, drink, and breathe them.Why are micro- and nanoplastics harmful?Microplastic particles are rough and irregular in shape and porous. They gather pollutants like bacteria, viruses, heavy metals, PCBs, pesticides, and carcinogenic polycyclic aromatic hydrocarbons, which are the products of the incomplete combustion of coal, oil, gas, wood, and tobacco. Once in your body these free riders can be released.The rough particles can act like splinters and damage tissue.And then there are the additives. The global plastic additives market approached $50 billion in 2020.The most worrisome effects of microplastics in the body are from the release of the chemicals added to them when they are made. Of 13,000 additives to plastic, over 3,000 are concerning because they are persistent, accumulate in tissue, or are known or potential toxins. Many more of the chemicals might be toxic, but they haven’t been studied.Some of the worst chemical additives that we know about include:* Bisphenol A, or BPA, which is used in metal cans, plastic food containers, reusable water bottles, and water pipes. BPA can be regarded as a potential human carcinogen. It’s an endocrine disrupter, a reproductive toxin, can pass through the blood-brain barrier, and is linked to nervous system disorders and degeneration. BPA has toxic genetic and epigenetic effects. It’s not good for your DNA.* Phthalates are used to make plastic flexible. Phthalates are linked to endocrine, reproductive, respiratory, and nervous system problems.* Styrene, a building block of plastics, is a known carcinogen in California and a reproductive toxin.* Brominated flame retardants, including PBDEs, are used in recycled plastics for household goods and toys and are a concern for nervous and reproductive systems.* Other known toxic chemicals released by microplastics include PFAS, PFOS, and triclosan, a germicide used in toys and kitchen utensils, and in toothpaste in the U.S. until about six years ago. Triclosan is a reproductive toxin and endocrine disrupter.* Finally, microplastics in carotid artery plaque or in brain tissue are associated with a higher risk of stroke or dementia, respectively.What does RFK, Jr. say?In September 2023 presidential candidate Robert Kennedy had a list of ten almost idealistic promises to reduce plastics in our lives. These promises embraced and then went far beyond the Democratic supported Break Free from Plastic Pollution Act of 2023, which failed to pass in either chamber of Congress.Kennedy promised to:* Support an international plastics treaty* Restrict toxic plastics and chemicals* Prfomote a national bottle bill* Require producers to take responsibility for their pollution* Upgrade recycling facilities and systems* Limit new plastic production facilities* End subsidies for plastics producers* Order a major national study to evaluate all sources of plastic waste* And, most radically, to ban fracking, which provides most of the natural gas America produces, and thus the raw material for the plastics produced hereWere the promises ever to be enacted a huge reduction in plastic production and use would follow, along with reduced release of microplastics and reduced plastic contaminants and pollution. Of course, the fossil-fuel friendly Trump is never going to ban fracking, nor would most of the other proposals seem likely to be approved by the business-friendly Trump.In fact, Kennedy’s ambitions about plastics have been greatly scaled back. At a meeting in April with representatives of packaging manufacturers, Secretary Kennedy simply asked industry to voluntarily reduce plastic use.While Secretary Kennedy has otherwise been somewhat silent on microplastics, at the same meeting he said, quite accurately: “We don’t know the effects of microplastics in the human body, but we have disturbing studies that link microplastics to cancer, dementia, and reproductive problems.”Kennedy’s Make American Health Again Strategy Report, released in September, made one mention of microplastics, but only in a long list of other health risks to be researched prior to action:“[Health and Human Services], in collaboration with NIH and EPA, will complete an evaluation of the risks and exposures of microplastics and synthetics, including in common products such as textiles.”What to do about it on a personal level?We are exposed to plastic, microplastics, and nanoplastics from all directions every day, and no individual can know how best to reduce their plastic-related health risks or even what those risks are, if any.At one end of the long list of possible action items is going to Europe for a $10,000 microplastic blood filtering treatment – yes, that’s a thing! But I prefer to start by throwing out my plastic spatulas.There’s actually some consensus on a best first step, which you likely already know: avoid heated plastic, especially when it contains food. As of 2024, U.S. manufacturers have phased out their use of PFAS to grease-proof paper and paperboard containers used to contain food, so take-out containers are less concerning now than they were. However, I’m still trying to figure out what to do about hot take-out food, since even paperboard containers are still usually lined with plastic or wax. There is no really good answer beyond giving up take-out, but that is not going to happen soon in my house.Here are some other solid, low- or no-cost, steps, though.* Check your tea bags. Some well-known brands still use plastic bags, which can release 11 billion microplastics and 4 billion nanoplastics into one cup of hot tea. Maybe hold the sugar after that! Brands that don’t use plastic bags include Republic of Tea, Numi, Yogi, Pukka, Bigelow, Stash, Traditional Medicinals, and more lately, Lipton, and Twinings.* No plastic should go in the microwave. Cover foods in glass bowls with a plate or use a silicone vented-cover during microwaving. Just know, silicone is a polymer, as are plastics, and, like plastic polymers, has additives that can migrate out. Most of what migrates out of silicone are siloxanes, the building blocks of silicone. Several siloxanes are listed by the European Union as “substances of very high concern,” due to potential carcinogenic or mutagenic risks. Nonetheless, silicone compared to plastic is more stable and heat resistant and considered safer, especially compared to plastic when heated.* Wash and dry synthetic fabrics (polyester, nylon, acrylic, and spandex) on the cool cycle and maybe lean toward natural fibers in new clothes. Microplastic fibers can come loose in the laundry and may stay on your clothes and be available for you to inhale. But most of them will end up in the ocean.* Stainless steel or protected glass water and hot beverage containers are recommended over BPA-free plastic.* Wood cutting boards are preferred over plastic, especially because of the knife action on the surface.EpilogueIn recent decades, our civilization has invented a very large number of new substances and, using these substances, new products, many with a wealth of undeniable benefits. Much of our amazing, life-saving medical technology depends on plastic, for example. But downstream from all of this invention, we often learn of associated health risks, which unfold over time.As these worrisome risks become revealed, some people tend to shy away from the related substances and products. Take Teflon for example.My office is my front porch, where I take breaks from Eating in America to check out the birds visiting the birdbath and to say hello to the neighbors.It was 38 degrees Fahrenheit this morning, and I was sitting here in my three jackets and warm blanket writing this article, the fresh air helping the coffee to wake me up and keep me going. I turned on my new radiant heat lamp to “high” to keep my fingers warm enough to type.At the suggestion of a reader, I was checking the status of Teflon (or PTFE, the chemical abbreviation for Teflon), still for sale 11 years after the toxic chemical PFOA was removed from Teflon in new frying pans and other products in the U.S. My heater began to give off a noxious smell – just as I found in my research that radiant heat lamp bulbs in heaters such as mine are often coated in Teflon to make them more shatter-resistant. The off-gassing of PTFE from such bulbs kills poultry when used to warm the birds…So now my hands are cold as I wait to hear back from the heater company about whether their bulbs are coated in Teflon.Ironic! I was researching a toxicity in the kitchen that we might want to avoid while I was possibly inhaling the same toxicity from a completely unexpected source. Not just ironic but a case in point for the state of our personal environments. We are surrounded, and if we turn from one chemical or substance, we will encounter another to reckon with.By the way, there is evidence that DuPont’s replacement of the toxin PFOA in Teflon with another PFAS they called GenX, may be worse. GenX causes cancer in lab animals. Our non-stick pans are going in the trash.In fact, 3M, DuPont, and other PFAS manufacturers knew in the 1940s, soon after Teflon began to be used in products, that PFAS chemicals were linked to health risks. They hid their knowledge from the public until a lawsuit forced their disclosure.This may feel gloomy, and I’m sorry. Maybe I should start a microplastics-worry support group.Figuring out how much exposure we have to micro- and nanoplastics is a massive scientific challenge, and knowing any associated risks approaches impossible at this point. Microplastics are tiny and tasteless so, perhaps for now, make yourself a nice cup of tea or pour yourself a Chardonnay to go with your Thanksgiving leftovers, and damn the microplastics. I hope you had a great holiday. At our house we gave thanks for true science, public health professionals, and healthy food!And I give thanks to Jennifer Rappaport, a reader and experienced health writer, for advice about Teflon.And thank you for listening. Please subscribe if you haven’t and share this and other Eating in America posts. If you care to start a microplastics support group in the comments, or just offer your thoughts about microplastics, please do.Eating in America is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

There are so many facets to the revolution in weight loss and control that is being led by the new GLP-1 class of drugs. Today I touch on a few of the many important aspects of GLP-1s. What I don’t get to today, I’ll try to return to soon.The headline this week: Price cuts and wider coverage for GLP-1sOn Thursday, as you have probably heard, President Trump announced GLP-1 pricing will be lower for self-payers and Medicare and Medicaid coverage will be wider in a new deal with Eli Lilly and Novo Nordisk, makers of Zepbound, Wegovy, Ozempic, Mounjaro, and their upcoming oral versions, for weight loss and diabetes. Given this is a Trump deal, the devil is in the details, such as whether the cost savings for injectables will include the convenient and painless pen versions or be for the vials only. Bring your own syringe, if it is just for the vial versions. More certainly, barriers to expanding GLP-1 access in Medicare include that Medicare Part D drug plan pricing for next year is already fixed – without the large additional cost of GLP-1 coverage for obesity worked in. Also, it is currently against the law for Medicare to cover pharmaceuticals for control of obesity. Offering GLP-1s for obesity as part of a pilot program is proposed as the work-around for the legal issue. Nonetheless, this deal is perhaps two steps forward, after Trump took a step backward in April and nixed Biden’s proposed expanded Medicare coverage of GLP-1s.On the same day as the GLP-1 deal, the FDA gave priority slots for quick reviews of Eli Lilly’s Orforglipron and Novo Nordisk’s oral semaglutide, the pill versions of Zepbound and Wegovy for weight loss. The lower cost of the pill versions along with likely higher consumer acceptance of pills vs injectables, could have a major impact on uptake of GLP-1s by Americans. These pill versions are likely to be a huge step forward.GLP-1s and understanding that weight loss struggles are all about biologyFirst, the basics. GLP-1 is a gut-produced hormone, glucagon-like peptide-1. The GLP-1 class of popular weight loss and diabetes control drugs mimic the natural hormone and amplify its effects. Zepbound and Wegovy are GLP-1s indicated for weight loss and the lower dose versions, Mounjaro and Ozempic, are indicated for diabetes. GLP-1s are linked to reduced risk of stroke, heart attack, Alzheimer’s, and kidney disease. GLP-1s help with sleep apnea and some lung conditions. There is evidence of reduced cancer risk, increased control of substance disorders, and benefits for a number of other conditions. These drugs are sometimes quietly acclaimed by researchers and personal doctors, and often loudly acclaimed by users, who don’t have a professional reputation at stake, as miracle drugs. The main miracle is that these hormone-mimicking drugs easily override a patient’s hard-wired biology and make them lose weight.Before GLP-1s came along scientists had begun to understand that body weight wasn’t controlled so much by behavior and willpower as by biology. I hope that widening familiarity with the effectiveness of GLP-1s will increase popular understanding that biology is the biggest factor in the weight gain and weight loss equations and thus reduce stigma both around excess weight and the use of GLP-1s, which are biological agents, to control unhealthy weight.The profitability of Americans believing in willpowerFood manufacturers along with diet profiteers, including influencers and sellers of weight control programs, apps, books, and magazine articles, would like you to believe that you don’t need any remarkable willpower so much as their product and their advice. Inherent in their business model is to keep us thinking as long as possible that insufficient willpower is the barrier to weight loss.However, studies have found that for most people, neither willpower nor dieting aids work in the long term. Weight regain is common. The body’s aversion to weight loss, programmed into our DNA, is too strong. One study which brought data together from many studies found that 75% of weight lost is regained. Weight lost through dieting or deprivation is met with the body’s strong biological response to restore the lost weight.Meanwhile, profits in the dieting sector are being reduced by the popularity of GLP-1s even as attitudes are slow to change. Diet nutrition provider Jenny Craig Inc. fell first, and Weight Watchers International went out of business in April.American attitudes about GLP-1s seem to depend on whether it’s about health or (perceived) vanityAccording to a February 2024 Pew Research survey, 53% of Americans, a little more than half, believed GLP-1s were good options for losing weight for obesity and weight-related health conditions. Only 19% believed GLP-1s were not good options for losing weight for obesity and weight-related health conditions. However, a slim 12% thought GLP-1s were good options simply to lose weight and 62% thought GLP-1s were not good options simply to lose weight. A year later, in January 2025, an AP-NORC survey, found the same results, showing remarkable stability in attitudes about GLP-1s even as their popularity was still rapidly increasing.Many folks tend to regard using a GLP-1 to lose weight without an obvious health reason, as a shortcut. It’s not clear why this stigmatizing attitude is so common, while latitude is given to GLP-1 users who have more severe obesity or weight-related chronic disease. True, it is easy to find Hollywood stars who appeared previously to have a perfectly healthy weight but who then more recently seemed to have gotten thinner. One guesses that the Ozempic that Jennifer Coolidge on the Emmys and others joke about was responsible in these cases. But the number of stars using GLP-1s does in fact make a case for how difficult it is to lose weight by sheer behavioral changes and willpower. Actors are generally highly motivated to have the most marketable body possible. If Hollywood can’t do it without Ozempic, it’s unreasonable to think the rest of the world is going to be more successful, when its only health at stake and not even a movie part.I use Zepbound.There are many things in our culture which were heavily stigmatized not so long ago but are now seen as quite normal and accepted: divorce, mental health treatment, tattoos. I can claim to be normal around two of these items. Not yet tattoos, but I have plans. I hope stigma around the use of GLP-1s fades away in the same way that the stigma around mental health treatments like Prozac is fading. I am lucky to be able to use Zepbound to lessen my health risks and improve my ability to lead a healthy life. I was among the 31% overweight and 42% obese Americans before using Wegovy and Zepbound.RFK Jr. is right: the health of our nation depends on defeating the obesity epidemicI fully agree with Kennedy that our nation’s health is weakened by the obesity epidemic and the many chronic diseases linked to unhealthy weight. And Kennedy is right in some things he says about our food environment and why we as a nation don’t eat well. (Kennedy is of course quite off the mark and irresponsible in some other ideas about how to eat healthy. He has no business being the top leader of our nation’s health, on the basis of his nutrition misconceptions alone.)The cure? Fixing our sick food environment.RFK, Jr. says that the GLP-1 deal “…is going to have dramatic effects on human health in this country.” Let’s hope so. But while these hormone mimickers are miraculous, the best way, and really the only way in the long term, to control obesity and overweight in our society is to cure our sick food environment. Big Food, i.e., the ultraprocessed food industry, is big because it has gone to the laboratory and created products that are hyperpalatable – meaning we can’t get enough – and manufactured and marketed these food products to a trusting American people, including me. When suspicions have been raised about the health implications of these products, Big Food and the ultraprocessed food lobby, our country’s biggest lobby by far, exert their power over government, and too often over science, funding research to quiet or cast doubt on worries. In response, government regulation is required to protect America’s citizens from food corporations and the agricultural powers who have been allowed to harm our health for their profits.Let’s have a chuckle to concludeAddressing the press after Trump’s announcement of the GLP-1 deal, RFK, Jr., head of the Department of Health and Human Services, claimed “The American public, because of this agreement, will lose 125 million pounds by this time next year.” Not to be outdone, Dr. Mehmet Oz, Head of the Centers for Medicare and Medicaid, contradicted Secretary Kennedy, saying he had an update. “We thought it would be 125 million pounds. Mr. President, our estimate, based on the company numbers as well, is Americans will lose 135 billion pounds by the midterms.” The midterms, huh? Apparently, the political meaning of this GLP-1 deal might be more important than the health benefits. But you have to have voters to make politics mean anything. By Dr. Oz’s reckoning the American electorate would evaporate!To get to the goal of losing 135 billion pounds, every man, woman, child, and infant American would need to lose 388 pounds. Seems like a lot. I think they need to hire those statisticians back at Health and Human Services.Thank you for reading. Your support is important … and appreciated. To receive new posts and support Eating in America, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

East Coast, Gulf Coast, and the Heartland: Food pantries feel the fear, and good people stepping upThe SNAP crisis and food security: I talk to people on the front linesFood security is fundamental to the life of every human. Thankfully, many of us don’t have to worry about it, but knowing where our next meal is coming from allows us to work on building and protecting our families: to provide shelter, clothing, the ability to be employed, to go to school.As Eating in America reported in September, Trump’s USDA has cancelled the annual U.S. Food Security Report, which for 30 years has provided actionable data on the level of food security around the nation and helped increase the efficiency of food assistance funding and program implementation. The last report, for 2024, was due out in October but has not been issued.Many of us have never had to worry about our food security, but in 2023 one in seven households, 41 million Americans, experienced food insecurity. Five percent of households had very low food security, skipping meals or reducing food intake.And we are at a point of rising food insecurity. The 2008 recession saw food insecurity climb to 15%, after which it dropped by 1/3 to 10.5% by 2019. However, food insecurity has been rising since 2022 due to inflation and, when last reported, was 13.5% in 2023.What is the impact of food insecurity?Food insecurity is linked to poor physical and mental health and negative economic effects. In children, food insecurity is associated with behavioral and developmental issues and poor school performance.Right now one out of eight Americans are enrolled in the USDA’s Supplemental Nutrition Assistance Program, or SNAP, to reduce their food insecurity. Other USDA programs improve the food security and nutritional health of women and children, seniors, and school children.As this is being written, the availability and duration of SNAP funds for November and going forward is in question. While judges have ordered the program to be funded during the current government shutdown, the Trump administration’s full compliance and the timing and duration of the restoration of funds are uncertain.All of this has created extra stress and disruption on top of the ever-present stress of food insecurity for tens of millions of Americans.Today on Eating in America, I spoke with food pantries on the East Coast, Gulf Coast, and in the Heartland.First, states, cities, and towns throughout America have been stepping forward in the face of this food crisis. I spoke withAlissa Ebel, Healthy Communities Coordinator for Somerville, Massachusetts, who has been helping that city communicate to its residents what is going on with SNAP benefits and where they may be able to obtain food in the time of SNAP uncertainties. Ebel has experience at the street level helping to manage a local food pantry.“Many folks who use SNAP are dealing with other forms of insecurity and worries about making ends meet. SNAP is something they can usually rely on, which makes this unprecedented delay so damaging. Retroactive benefits won’t erase the stress and sense of instability the delay has caused for participants. This is compounded by the confusion of the delay and the implementation of the cuts passed earlier this year. Although these cuts will roll out over the next year and more, and only affect some SNAP households, we’re hearing from people concerned that the whole program has been eliminated.”Ray Chavaree [sha (a as in mat)-vahr-ray] helps run the Long Beach Community Food Pantry, a pantry associated with Saint Thomas Catholic Church in Long Beach, near Biloxi, Mississippi. The Long Beach Pantry is open Monday, Wednesday, and Friday for 4-1/2 hours each day. Chavaree told me he had seen a surprising uptick in both pantry customers and donations:“Today we had seven new people sign up who are losing their SNAP benefits.” They come from all walks of life according to Chavaree: “It doesn’t matter. We have all sorts of demographics. We have all sorts of ages. We have people who are housed. We have the unhoused. We run the whole gamut here.”“Donations today, from members of the church community and the community in general, started when we opened and haven’t stopped. We are getting our shelves stocked to overflowing at this time. Hopefully we’ll have enough to make it through.”Like Long Beach, Mississippi, Wellfleet, Massachusetts on Cape Cod is a coastal community with vacation homes, second homes, and retirees. Wellfleet is a community with a high average household income, but the Wellfleet Food Pantry serves a spectrum of people in need. According to Sandra Galvin, President of the pantry, “We’ve been serving over 200 families. We have retirees who thought they would be secure but now their finances are not sufficient. We have seasonal workers. We have a lot of shellfish and fishing families. The people that we’ve been seeing at the pantry don’t expect that they’re going to find jobs anywhere on the Outer Cape here. There are not many prospects, and they are just trying to exist and stay here. Housing is hard to find and housing costs are ridiculously expensive.”“We have basically a food desert here. We have 2 supermarkets. The food is extremely expensive. But we provide food. People come in, and they’re anxious now, much more anxious. We hear the stories. They need money for their gas, for their heating, for food, for everything.”From the heartland of America, I spoke with Deanna Wagner, manager of the Bellevue Food Pantry in Nebraska:“We’ve already seen a large increase in numbers of people seeking food assistance in Sarpy County with the government shut down. We saw an increase in people coming from Offutt Air Force Base, and then we’ve also just seen people affected by having their jobs furloughed, or people that are already anticipating cuts to their SNAP benefits. So, October was our busiest month ever, and we’re anticipating the rest of the year to be similar to that.”“A lot of people are uncertain about why this is happening or what the future holds for them, and there are quite a few people that rely on SNAP benefits, just to supplement what they’re already buying. So not having that, that leaves them trying to figure out where they’re going to be able to feed their families throughout the month.”I spend the first Saturday morning of each month in Revere, Massachusetts, outside Boston, where this month the Free Produce Market coincided with the first day in a pause of USDA funding for SNAP benefits. As usual, market customers from Revere and surrounding cities began to line up before I and other market volunteers arrived, hours before the market opening at 10:00 am. Anticipating increased fear of hunger due to the SNAP crisis, the organizer, Cambridge Health Alliance, a large health care provider, increased the number of free produce bags provided to 600 bags, up from 525 in September.Thank you for reading. Your support for Eating in America is appreciated and helps this effort grow. Please subscribe and give us your likes!Photo credits: the pantries and Ric Bayly, Revere Free Produce Market. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

As you may have read or heard in last week’s Trick-or-Treat Eating in America post or podcast, the PEZ dispenser packages I bought to give away at Halloween contained Red Dye No. 3 in the candy, so I took them back. Too bad. It was an otherwise great treat idea.Red No. 3, banned in Europe and North America because it can give cancer to rats, must be all gone from U.S. food shelves in 2027 and from U.S. medicine in 2028.I have searched hard for Red Dye No. 3 in many candies and ultraprocessed food products, like cake mix and frosting, Jell-O, salty snacks, soft drinks, sports drinks, powdered drink mixes, pre-cooked meat products, and breakfast cereals for children. I even checked maraschino cherries, long famous for red dye. PEZ was the only place I found Red No. 3.Most products I checked did have other artificial dyes: plenty of Red No. 40 as well as Yellow Dyes 5 and 6 and Blue Dyes 1 and 2.RFK, Jr. pronounced in April that he has an understanding with Big Food that synthetic dyes will go voluntarily. As has been pointed out by the Center for Science in the Public Interest, Kellogg, whose synthetic dye containing products include Froot Loops; Mars, maker of M&Ms and Skittles; and Walmart, maker of many private brand products, have previously promised to end the use of synthetic dyes.In fact, Big Food is taking two approaches to the synthetic dye problem. On the one hand, some ultraprocessed food manufacturers have acknowledged that the time has come to cut out synthetic dyes and have begun to eliminate them in their products. Perhaps the primary driver here is that upwards of 20 states have started initiatives to ban the dyes, and it is difficult to sell food with different safety standards in different states. In lieu of a national standard, these manufacturers are taking a broad approach to cutting synthetic dyes.On the other hand, some manufacturers and organizations, like the Consumer Brands Association, representing a who’s who of manufacturers, including Nestlé, Mondelēz, Coca-Cola, PepsiCo, General Mills, and Kellogg, have defended dyes.Walmart however, this month has again pledged to do away with synthetic dyes, along with 30 other food additives including the food whitener titanium dioxide, in its private brand products. While Walmart’s press release bragged that 90% of its private brand products are already free from synthetic dyes, I was a little shocked: you’re saying 10% of Walmart products currently contain synthetic dyes!?Three other die-hard dye surprisesThe first surprise, in two ways, was that, in my very limited survey, PEZ was the only product I found containing Red Dye No. 3. That’s a good surprise overall, but a bad surprise that a product meant solely for children would be a Red Dye No. 3 holdout.The second surprise was that titanium dioxide is an additive to Walgreens’ Nice brand candy covered peanuts. Yes, the same titanium dioxide that can be found elsewhere in Walgreens as a sunblock agent.The litany of issues with titanium dioxide is long. Titanium dioxide is a potential carcinogen and is banned in food in Europe. It is linked to genetic damage; cell death; neurological, heart, and lung disease; elevated blood glucose; and disruption of gut hormones and the body’s own GLP-1, the hormone Glucagon-Like Peptide 1, which is key to the weight and diabetes control drugs Zepbound, Wegovy, and Ozempic.The third surprise is the amount of caramel coloring in colas. Caramel color is not a synthetic dye in the sense that it is made from petroleum, but given the chemical process used to make it, I regard it as clearly artificial. Caramel coloring made from sugar and ammonium compounds is the most widely used food dye, by weight, by a large margin. I found caramel coloring was the second ingredient in sugar-free Coke and Pepsi, coming after water, and the third ingredient, coming after high fructose corn syrup, in the sugared versions. It was also in the ginger ales I checked, as a lesser ingredient. While most caramel dye is consumed in colas, it is also found in baked goods, beers, and sauces. In the manufacturing of ammoniated caramel coloring 2-methylimidazole and 4-methylimidazole, which cause cancer in mice, are produced. The Center for Science in the Public Interest reports that in 2007 the U.S. made a finding that these compounds have links to cancer, and the World Health Organization later labeled the compounds as possibly carcinogenic in humans.California played the hero in 2012, requiring food containing ammoniated caramel coloring at levels above 29 micrograms per serving, like colas, to have a cancer warning label. Coca-Cola and Pepsi consequently reduced their caramel coloring levels from as high as 150 micrograms to 4 micrograms per serving, first in California and then nationally.The Center for Science in the Public Interest recommends avoiding colas altogether, given that the FDA has a limit for food additives that contain carcinogens that is 10x as strict as California’s – meaning the amount of 4-methylimidazole in these colas may well exceed the FDA limits.The FDA, meanwhile, incredibly, still allows ammoniated caramel coloring to be exempt from regulation as a food dye and to have Generally Recognized As Safe, or GRAS, status, meaning the FDA is still taking the manufacturers’ word for the safety of the additive. Please read or listen to the Eating in America post or podcast about GRAS for more details about how the FDA is failing to protect Americans with the GRAS system.As of 2020 the FDA was in a review of 4-methylimidazole, but an FDA food additive review can be a black hole with a due date of infinity and beyond, so I have no expectations of FDA action on that account. I do hope RFK, Jr. will try to add caramel coloring to his hit list of other artificial dyes and provide cover for some action within his department. I also hope Kennedy makes good on his pledge to get rid of the GRAS system.Let’s be clear about caramel dye risks. It’s the sugar in colas that is the biggest health risk by far, but given the dye is there solely for looks, wouldn’t the best approach be “when it doubt, throw it out”? When there’s a risk, based on evidence, that something might be bad for humans, and we know caramel coloring does nothing positive for humans (only for the food manufacturers and marketers), wouldn’t it make sense if the FDA said “nah,” Coca-Cola, people can live without it? But that is a discussion for another day.Back to PEZ…The PEZ story is a perfect example of the way food manufacturers with vision saw, in the 50s and 60s, how to create commercial success by combining post-war food manufacturing and additives with modern mid-century marketing and growing affluence and consumerism. In the mid-1950s PEZ was a tiny but vivid harbinger of the meteoric rise in highly- and ultra-processed food that was to follow.If you caught the Trick-or-Treat episode last week, forgive me for quickly reheating the history of PEZ and serving it again. This time it has a surprise ending.Eduard Haas III invented PEZ as a mint in Vienna in 1927 and marketed it as an aid for quitting smoking. The dispenser was designed in 1949 by a product engineer who had, fittingly, designed cigarette lighters. And that lighter flicking motion is mimicked in the PEZ dispenser. Haas imagined he was going to help his customers occupy both their cigarette-less mouth and their fingers.Unfortunately, when Haas left post-war Austria to come to America in 1952, he discovered Americans didn’t want to quit smoking. In an absolute brilliant pivot, Haas changed the mint candies to fruit flavors and colors and added little figures to the dispensers, like Disney characters, witches for Halloween, and Santa Claus for Christmas. PEZ has also made dispensers for 38 of the 46 U.S. Presidents. Barack Obama is the last President to be so honored. I expect that when Donald Trump finds this out, he will turn his attention from campaigning for the Nobel Peace Prize to making sure he has a PEZ dispenser issued with his likeness. The candies, of course, will need to be golden.Thank you for reading!Your subscription of any type supports the growth of Eating in America. Thank you. Your paid subscription supports the research and keeps me supplied with PEZ dispensers. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

For 45 years, America’s most important official document on the topic of nutrition has been the U.S. Dietary Guidelines, “the cornerstone of Federal nutrition policy and … education activities, providing food-based recommendations to promote health…” according to its authors, RFK, Jr.’s Department of Health and Human Services and the USDA. This coming week may see publication of the 10th edition of the Guidelines, which are rewritten every five years.Never far from controversy due to the persistent influence of the agricultural lobby and Big Food, the Guidelines this year have been particularly weighed down by both politics and, new to the equation, the Trump administration’s practice of spurning science. Science, Trump has found, can be very inconvenient when it stands in the way of accruing and distributing wealth and power. And trashing science seems to resonate with many in the populace who are attracted to Trump.A wall of anti-science chaos has been built by mass firings of scientists along with large chunks of the national scientific support system, withholding of research funds, stifling of free speech, and a conveyor belt of unfounded statements from Trump, RFK, Jr., and others. Hidden behind this wall, a solid foundation has been built for transferring power from the American people and those dedicated to protecting them, into the hands of the power elite.A catalog of ethical corruptionLisa Held in Civil Eats has pieced together an exposé, cataloging Trump’s handing over of Brooke Rollins’ USDA, Robert Kennedy’s Health and Human Services, the EPA, and the FDA, a Health and Human Services agency, to the tentacles of corporate interests through their close ties to 26 federal appointees and nominees, including Rollins and Kennedy. The ethical stench is overpowering.The most shocking case is the nomination of Casey Means, sister of Kennedy’s Special Advisor Calley Means, as Surgeon General. Dr. Means has been called unqualified to serve as Surgeon General by two former Surgeons General, Dr. Richard Carmona and Dr. Jerome Adams. Both cite Means’ complete lack of public health experience, among other factors. Adams was Surgeon General in the first Trump administration.Means has many corporate ties, but the real shockers are her investments in Philip Morris and Altria, two of the world’s biggest tobacco companies. A Surgeon General candidate having financial interests in these tobacco companies, with their anti-public health histories, is mind boggling. According to the CDC, nearly a half-million Americans die from smoking every year. Tobacco is the leading cause of preventable death, disease, and disability. Means’ Senate nomination hearing will occur this coming week with Means appearing by Zoom from Hawaii.So what about the Dietary Guidelines?The news is that RFK, Jr., who has been public about his meat-centric, “carnivore” diet, will go against long-standing scientific evidence, including that cited in the 2025 U.S. Dietary Guidelines Advisory Committee Scientific Report. Kennedy will publish Guidelines that recommend increasing the saturated fat in our diets. This will make U.S. red meat and dairy producers, and their friends in the USDA, happy.In an article in The Guardian about Kennedy’s reportedly pro-saturated fat Guidelines, Hannah Harris Green cites Ronald Krauss, a saturated fat researcher, who regards saturated fat as health neutral. Despite judging saturated fat to not be a health risk, Krauss feels moving away from current guidelines is premature. Other nutrition experts widely agree with the current guidelines recommending consumption of saturated fat be limited to 10% of calories and that, generally, saturated fat should be replaced with unsaturated fats, like olive oil.It must be noted that Krauss’s big research paper finding that saturated fat is not harmful was authored by him and many others with strong ties to the dairy and beef industries.This year’s Dietary Guidelines Scientific Report recommended increased reliance on plant protein, as found in whole grains, beans, nuts, seeds, and soy. If Kennedy’s opinions hold sway over the science, we may instead see the increased plant protein recommendation disappear or even be replaced by a recommendation for increased consumption of meat.Last month Eating in America described how the setting of the Dietary Guidelines has a history of corporate influence and how RFK, Jr.’s fight against ultraprocessed food got crushed in last month’s MAHA Strategy Report. It appears unlikely that ultra-processed foods will re-emerge with recommendations in the coming Dietary Guidelines.The Dietary Guidelines are fundamental to national policy and practice on nutrition, setting standards for programs including School Lunches, SNAP, and WIC, the nutrition for Women, Infants, and Children program. They are widely adopted by health and nutrition programs and professionals throughout America. Warping the Guidelines to reflect commercial or personal interests hurts the health of Americans.Wait, go back, RFK, Jr. is setting the U.S. Dietary Guidelines?When I consider Kennedy’s qualifications to lead the updating of this most important nutrition document I think about his dead brain worm, probably ingested. And I ponder his health recommendations to drink raw milk and eat red meat and increased saturated fat, although his own CDC says raw milk poses a serious health risk and recommends limiting saturated fat intake and there is a lot of strong evidence about the heart, stroke, diabetes, and cancer risks of red meat consumption, along with evidence of risk of cognitive decline with eating red meat. And I remember that Kennedy eats, in his words, “a ton of vitamins”, but no unprocessed fruits or vegetables; and that for a period of time he obsessively ate so much tuna and perch that his blood had 10x the EPA recommendation for mercury, causing him memory loss.Kennedy also has a misguided plan to make this edition of the Guidelines easy-to-read and only 4 to 6 pages long so that people can read and understand it. Unfortunately, the reason the American people don’t abide by the Guidelines is not because they are too long and difficult to read. Americans don’t follow the Guidelines because our health policy leaders have for decades let commercial interests essentially control, through formulation of hyperpalatable foods and product marketing, what Americans want to eat and can afford. The Guidelines need to contain a lot of clear and detailed information for health and nutrition professionals and policy makers to act on. A summary-style Guidelines will be inadequate.RFK, Jr. is inadequate and unfit to be in charge of the Health and Human Services Department, just as a person who profits from smoking is unfit to be Surgeon General. It looks likely to be another interesting week in D.C.Thank you for reading.I appreciate your support. To receive new Eating in America posts, please become a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

I love Halloween, especially now that my three trick-or-treaters have grown up, and I am not the parent coping with the giant bag of candy at the end of the night. But we are getting a dwindling number of trick-or-treaters each year. Our numbers have been low…sad, single-digit low.Halloween is a competitive event, of course, with children competing for the biggest bag of candy, and our house and the other houses on the street competing to have children come ring the bell. It is not a zero-sum game on the street. We benefit if our neighbors have popular treats and our neighbors benefit as we attract customers. Clearly there are good treats streets, dead streets, and must-see streets full of decorations. This year I am determined to do my bit to make our street competitive in the treat department. Trick-or-treating has been reaching extinction levels in our neighborhood.Last week in the store, I noticed a display of PEZ dispensers in the shape of pumpkin goblins and witches with two little packs of stacked candies per dispenser. Brilliant! Kids love PEZ, not so much for the candies, which are tiny, but for the toy! At $2.49, each pack was way more than we have ever spent per trick-or-treater, but with as little as six kids coming by, this would be not only affordable but likely a great hit with the children.I bought 16 PEZ dispenser packages, expecting full well, and accepting, that the colorful candy would turn out to have artificial dyes. I just didn’t know which dyes.From anti-smoking aid to a not-so-innocent candy…PEZ was invented by the baking powder maker Eduard Haas III in Austria in 1927. PEZ was a mint Haas marketed to people to assist with quitting smoking or overeating.The PEZ dispenser, created by a product engineer who had experience designing cigarette lighters — it shows in the design he came up with (think BIC lighter) — didn’t appear until 1949.PEZ was introduced to America in 1952, but Americans at that time were not very interested in quitting smoking. PEZ didn’t sell well.However, Haas, creating a brilliant success story that can still be found in marketing courses, quickly dropped the adult smoker as his target consumer. In 1955 PEZ added its first two figured dispensers, a robot and a full-body Santa Claus.Haas changed the candy from mint to fruit flavors and began marketing to children.Today, the PEZ factory in Connecticut makes 15 billion candies annually for the U.S. and Canada. Billions of dispensers with over 1,500 different figures have been sold around the world: Disney, Star Wars, Republican elephants, Democratic mules, Ninja Turtles, Miss Piggy, Sponge Bob, superheroes. You name it, if it is a character that can be licensed, PEZ has made it. PEZ has stayed so in tune with the times it made Psychedelic Flowers and Psychedelic Hands dispensers in 1968!An unscientific poll…I asked some people about their Halloween treat offerings. There was unanimity on two things:* Leftover candy has to be enjoyable, so a lot of chocolate treats that are attractive to adults are in the bowl for the kiddies.* There is no good candy from a nutrition or health perspective, but it is a once-a-year event, so what-the-heck?On the latter point, Jessica Daniels pointed out the obvious: kids love, love Halloween. Everyone loves Halloween. It is a very special couple of hours when children can go up to their neighbors’ and even to strangers’ doors and ask for and be given candy, safely, with joy. And the kids have fun costumes! And Halloween yard decorations seem to be in a competition with Christmas for most holiday spirit and every year are adding more to the festive spirit.So, yes, what-the-heck!But this is a Substack about healthy eating…Yeah, about those artificial dyes…It turns out that one of them is Red Dye No. 3. Of course, Red 40, Yellows 5 and 6, and Blue 2 are on RFK, Jr. and MAHA’s hit list for dyes to do in, but Red No. 3 is already officially scheduled for extinction in America in 2027 due to its association, at high levels, with cancer in rats. Europe, Canada, California, and now the U.S. as a whole have banned Red No. 3.So my 16 PEZ packages contained a little bit of Red No. 3 in each strawberry flavor pack. Twelve tiny candies ready to be ejected into delighted mouths by pumpkin goblins and scary witches.A little worried for my reputation, I took them back to the store for a refund.What to do? What do you do?Here is where your help and opinions are needed. Now, a couple of people I asked have seen their kids, or themselves experienced, getting books as treats, and loving it. Other folks gave me ideas for other, much less pricey, non-candy treats like sticky fingers, gel vinyl window stickers, and glow sticks. But generally people just said, “What the heck? Let them eat candy!”Maybe I should set out both candy and toys for the kids. Good to win favor for next year with both the parents as well as the kids and get the numbers up.What about the parents’ dilemma?What about that big bag of candy? I got several reports of parents permitting all the candy you can eat for one night and one night only. The remainder of the candy always disappeared mysteriously either overnight or over the course of a few days.What about you and your household?Please share your thoughts and Halloween practices in the comments. Thanks to everyone who shared their Halloween practices for this piece.Photo credits: PEZ archive except PEZ Giveaway, photographer unknown, and Pumpkin Head PEZ, Ric Bayly. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

This is a free preview of a paid episode. To hear more, visit www.eatinginamerica.coWhat Would Jesus Eat? Or for that matter what would Moses or Buddha or Mohammed eat? Let’s just say, they, in their divine wisdom and knowledge, might be a little upset at what we are eating today.These holy men ate healthy, even though they all spent time on the road, and, as we know, eating well when traveling can be challenging.In fact, there was deprivation. After fleeing Egypt, Moses and the Israelites were starving in the wilderness until God rained down the bread, “manna from heaven.” Buddha found spiritual strength, but few calories, fasting on one grain of rice and one sesame seed. Jesus famously fed 5,000 hungry followers with five loaves of barley bread and two small fishes.But for Jesus and the others, when the food was available, recorded history and archeology tell us it was healthy: melons, figs, dates, grapes, olives, vegetables, whole grain barley and wheat, almonds, pistachios, fish. Chickens and eggs were a part of daily life. Herding was common, providing milk and cheese from sheep, cows, and goats. Because of scarcity and lack of refrigeration, meat would have been reserved for special occasions. Cane sugar was not yet developed, but there was honey, a special treat for the prosperous.And, though Americans today might gag, grasshoppers and rodents were fine sources of protein, energy, and micronutrients, and welcome on the menu – as they still are in some places!As the Apostle Paul put it: “Your body is a temple.” Our bodies are precious, said Buddha. But since Buddha’s time, with advances in industrialization and rapid changes in our societies, we have developed a food industry which formulates, manufacturers, and immerses us in foods which are cheaper, hyperpalatable to the point of addiction, and unhealthy.In fact, the business of food has a tarnished history. Rice was polished to make it white, and Asian populations got beriberi. Midwest milled corn was highly refined to ship it to the American South for the poor farmers and mill workers in the early 20th century who couldn’t afford anything else. With the niacin refined out of the corn, the farmers and factory workers developed an epidemic of pellagra and suffered dermatitis, diarrhea, dementia, and death.Lately, a more drastic, deadlier trend has appeared. Over 50% of our calories come from ultraprocessed food. Our eating habits have been shaped by ultraprocessed food engineering and marketing, creating a global epidemic of obesity and overweight. In America, obesity is a leading cause of preventable death.Millennia went by with our species thriving on the food that people could find or grow, all minimally processed and nutritionally diverse. Communities and their leaders figured out how to keep their food healthy and nutritionally complete. The rabbis writing the Old Testament or Torah saw trichinosis larvae infecting their people and simply forbade eating pork, the primary way the parasite entered humans. Allah, in the Islamic Quran, banned pork as not halal. Africans and the first Americans learned to combine plant foods like beans and rice to make complete proteins where meat and fish were scarce.What made modern leaders allow such a weird, industrialized, and unhealthy food environment as we now inhabit? (Yes weird. Exhibit A is Quorn, a pretend meat made from mold, available in your Whole Foods freezer section. Exhibit B is Froot Loops, available at all more affordable supermarkets.)

RFK, Jr., the Make America Healthy Again would-be-goliath, campaigned against ultraprocessed (UPF) food, but that campaign has stalled out in the Trump administration. The new U.S. Dietary Guidelines, which are due this month according to Kennedy, were undercut by September’s MAHA Strategy Report and are unlikely to make UPF recommendations. Kennedy’s MAHA Report punts on UPF, as did the Dietary Guidelines Scientific Advisory Report before it, asking first for a federal definition of UPF before action is taken.Meanwhile, California has surged ahead of the Federal government and has a new law to kick ultraprocessed food out of schools. I have read the signed legislation. It provides a clear definition of UPF and allows for three categories. “Ultraprocessed foods of concern” and “restricted school foods” would essentially be phased out by 2032. Ultraprocessed foods that are not in these first two categories would, by default, be allowed, addressing the argument that not all UPF is necessarily unhealthy.The long timeframe of the legislation will allow almost three years, until June 2028, for University of California scientists to carefully weigh the scientific evidence about UPF substances in question and to consider if other jurisdictions have banned or restricted those products. This is a reasonable amount of time for the job at hand. The scientists will then determine for the purpose of California school food regulations if those substances are in a category to be phased out.Interestingly, California had already, in 2024, set artificial dyes to be phased out of school food by the end of 2027.California’s new law, the Real Food, Healthy Kids Act, is a positive and concrete step forward with a reasonable process to achieve a goal that the U.S. should be working toward on the national level with commitment and speed. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Farming districts, which tend to be heavily Republican and pro-Trump, have been buffeted in the quickly changing tariff, food stamp, Farm Bill, and farm subsidy winds of the Trump administration and Congress, as Eating in America pointed out recently. But agribusiness’s support for Trump has not been forgotten, as we are reminded in news about the way the Labor Department sets farm minimum wages to protect American farm workers.In affirmation of a long-standing prediction by economists and reiterated in Eating in America last week, the Labor Department has warned that the new shortage of immigrant farm workers, due to Trump’s anti-immigrant policies, threatens a rise in food prices. This alarm, in the text of a Labor Department rule posting which revised the methodology for setting farm wages, was reported by the Washington Post.Given the drop in migrant farm labor, the Labor Department foresees “imminent economic harm” with the potential for billions of dollars in lost farm operator revenue. The Labor Department, in the rule, states that American workers are unwilling to take the farm jobs migrants are leaving, citing the physical demands, long hours, and exposure to extreme weather.Ironically, the Labor Department’s sudden switch to new methodology to calculate farm wage rates is required because the USDA in August killed the annual USDA Farm Labor Survey, the most reliable indicator of farm wage levels paid to Americans and, previously, the basis for setting required farm wages. The set rates varied by state but were, in general, considerably higher than state and federal minimum wages. Replacing the Farm Labor Survey with a less accurate method proposed by the Labor Department will have the effect of allowing farms and ranches to pay workers much less, increasing farm and livestock producer profits.When the first Trump administration tried to kill the Farm Labor Survey in 2020, the move was knocked down by the courts, since the resulting mis-estimation of farm wage levels would indeed have lowered required wages. Farm workers, Americans and migrants both, would have seen $171 million taken from their pockets and put in the hands of farm operators. When Trump’s USDA killed the survey again last month, farm groups rejoiced. The expectation was that many farm operators and livestock producers will be able to lower wages, especially those paid to foreign workers.This scenario, of course, depends on farms being able to hire foreign workers, who, in fear of ICE, have left farms in great numbers this year. Trump is trying to redress this shortage by making it easier, since the beginning of October, for farm operators to apply for H2-A temporary farm worker visas. 315,000 such visas were issued last year, but it is estimated that the farm worker population has diminished by 155,000 this year due to immigration enforcement.The number of H2-A visas that may be issued is uncapped, and almost all farm operator applicants are granted visas for use by workers. The hope is that if the application process is easy enough, the number of visas used by migrant workers will be greatly increased.Ironically, Trump pretends to be protecting American workers’ wages by getting rid of migrants. Instead, in the case of agricultural workers, he is choosing to allow wages for Americans to drop as exploitative wages are accepted by H2-A visa workers. Lower wages will make farm operators richer and, the hope is, by enabling sufficient farm staffing, still protect farm production levels and prevent food prices from zooming, which would cause wide dissatisfaction among American voters.With the killing of the Farm Labor Survey, we again see American workers thrown under the bus by Trump and two federal departments moving in opposite directions, with the Department of Labor trying to comply with the law protecting American wages and the USDA complying with the wishes of farm and livestock operators and their lobbying groups by paving the way for lower wages.Thank you for reading. Your comments, likes, and dislikes are highly appreciated. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Editor’s note: Eating in America officially launches today, so we’re celebrating something most of us love – coffee! Or tea, of course, if you prefer. The voices of 11 Eating in America readers are heard in the audio/podcast version of today’s Eating in America, making it a very good day to try the audio version, if that is not your usual choice. Thank you for being a part of Eating in America as we officially launch!I propose that the Nobel Prize for Science should be given posthumously to the goatherd Kaldi, who, 1,300 years ago in Ethiopia, observed his goats were getting very happy after eating the berries off what turned out to be a coffee bush. Kaldi’s discovery of coffee was a great leap for humankind and probably directly responsible for much of the scientific discovery to follow. To paraphrase the G.O.A.T. (that is, Greatest Of All Time) physicist Albert Einstein and the mathematician Alfréd Rényi, who was the first to say it, people are just machines to turn coffee into intelligible thought.In even the briefest history of coffee, it is important to identify the heinous role of enslavement. It is horrible that, as with two other addictive substances, sugar and tobacco, the explosion of coffee consumption in the Western world was enabled by the kidnapping and enslavement of people from Africa. Outright slavery was used in large producing countries like Haiti and Brazil, and the coercive semi-enslavement of indigenous people made Central American coffee planters rich.On the positive side, according to many studies, brightening our minds and our days with coffee or caffeinated tea does not seem to bring a health penalty, on balance, for most moderate users. Some studies show coffee linked to a possible reduced risk of some cancers, although one study shows an association with an increased risk of lung cancer. A study reported this past summer but not yet peer reviewed and published found a modest association between coffee drinking and healthy aging, although the study only involved women who were white. A good review of caffeinated beverage consumption published this summer covers not only biological effects but the societal framework of caffeine beverages, globally. That study examined the potential negative effects of caffeine consumption but still concluded the physical and cognitive performance benefits, as well as modest associations with the reduction of chronic disease risk, favored caffeine consumption for many people.That all said, what we really need to know about coffee and tea is within the stories we keep in our memories and tell our friends. I received 19 coffee and tea stories to share from 12 people, all of whom are represented here. Together they reaffirm who we are and help reveal what we make of coffee and what coffee makes of us. And these stories open windows so we can see what we share with others. Here are the stories told to Eating in America.If you’re a coffee drinker, the first two stories will likely strike a note of familiarity.Joan Higbee in Maryland wrote:“We went to visit my husband’s family who were all big drinkers. I didn’t drink much that evening and went to bed early. The next morning, I developed a huge headache like a hangover, and I couldn’t figure out why – I barely drank. The next morning the same thing. It was only after breakfast I found out that my sister-in-law had been serving us decaf coffee. I was mad. The rest of them deserved hangovers. I didn’t.”Mary Waters was in California in grad school, working long hours, trying to produce a book. Having developed a terrible headache and worried she might have a brain tumor, she was referred to a specialist.[Mary’s voice]“So I got to go to the neurologist, and he did this whole workup on me. At one point he asked me, after he had done a lot of tests, do you drink coffee? And I was like, yes. Like how many cups? I said, well, I don’t know how many cups, but I make three pots. And he’s like, and when do the headaches start? And I was like, you know, after I drink three pots of coffee.”Needless to say, the doctor told Mary she didn’t have a brain tumor but she really had to cut down on the coffee.Chris Williams grew up mostly in Oklahoma and Columbia, South America, the daughter of an Air Force pilot, and reports her story from Texas. Chris found out, as she went off to sophisticated San Francisco to study to be a sociologist – someone whose job it is to understand cultural differences, that the coffee you drink, and how you drink it, can be a signal of differences between people:[Chris’s voice]“My coffee stories are both about culture. My first coffee story is about when I started graduate school, and I was very poor. But I also was very unsophisticated in my taste. So I got a job working at the Berkeley Journal of Sociology, and I brought my little hot pot and my Nescafé with me. My little jar of Nescafé, and I just thought that was normal. All of my fellow graduate students just thought I was the most exotic human being ever. Very unsophisticated. Like I just rolled in off the turnip truck or something like that. Meanwhile, they are all drinking these giant cups of Peet’s coffee that seemed to be half, half and half.”“And you know, I did the calculation, and I figured that was a dollar a day. And that was huge. But you know, the culture, the cultural message was that I was doing something very taboo. So I quickly learned to invest the dollar on the giant cups of Peet’s coffee. And indeed it was more delicious.”Chris’s San Francisco had the heritage of being the western U.S. coffee center from the start of the mid-1800s coffee boom, with Folgers Coffee there making leaps in the quality of beans bought from Central and South America. Folgers also led the way in the packaging of pre-roasted coffee, coffee previously having been roasted in the consumer’s kitchen just prior to brewing. Founder James Folger basically invented the consistently good cup of coffee. Ironically, the attitude about Nescafé that Chris found in San Francisco, the epicenter of the coffee explosion in America, was the opposite of what she had encountered growing up in Columbia, the source of fine quality coffee beans:[Chris’s voice]“Well, I lived in Columbia when I was a high school student and a lot of people there drank Nescafé, which was kind of surprising. So there I think the class meaning of Nescafé was different than it was in the States, more like a class marker that you were kind of at a higher level.”Chris’s time in Columbia was in the mid-1970s when Nestlé’s, the manufacturer of Nescafé, was using grossly unethical and deceptive marketing practices to convince women in low- and middle-income countries, including Columbia, to feed their babies powdered Nestlé’s formula mixed with water instead of breast milk. By 1981, in places around the world where the drinking water was unclean, over 200,000 more babies died per year than in places with clean water. Nestlé’s, with full knowledge of the danger, was selling formula in places where few homes had a washing facility to clean a bottle and no clean water source. I’ve been to some of these places, and seen many of these homes, and it is still an issue. But a mother spending money on formula was seen as a sign she was doing the best for her baby, despite the cost.It is no surprise that, with the giant marketing effort Nestlé’s was making in places like Chris’s Columbia, drinking Nescafé, instead of delicious Columbian coffee, was also seen as a marker of prosperity.A 2023 series of papers on breastfeeding in the respected medical journal, The Lancet, reports that sales of formula to low- and middle-income nations continues, at a pace of $55 billion, annually. Today, less than half of infants and children around the world are breastfed as recommended by the World Health Organization.Nestlé’s flipped the script in Columbia, turning Nescafé, a product made in a factory from cheap beans, into a food favored by Columbians over their beautiful native coffee beans. Moreover, Nestlé’s manipulated millions of mothers into feeding their babies formula, when scientists and international health organizations have been loud and clear mothers should breastfeed, as is possible for the vast majority of mothers. These two examples shine a bright light on what has happened here in America, where Nestlé’s and the rest of Big Food have convinced us to eat highly processed food which isn’t healthy for us.I think of Starbucks as a place to grab a good-tasting black coffee at the airport. As I sip, I feel close to the mountains of Columbia. In reality, Starbucks is more of an ultraprocessed food giant akin to Nestlé’s than our friendly partner with a mission to wake us up, gently and deliciously. The revenue drivers for Starbucks are its blended beverages with long lists of ingredients with chemical names. Nestlé’s, by the way, is the worldwide distributor of Starbucks products outside of Starbucks cafes.Sandy Waxman from Illinois reached a point when what coffee she drank became a badge for who she was…and Sandy is with me now in grabbing a coffee before getting on the plane at the airport:[Sandy’s voice]“When I turned 40, I thought I’m 40, I’m at a really big turning point in my life, I am going to stop doing things that I just don’t love, and that always make me feel bad. One was wearing shorts, and the other is drinking airline coffee. And I stopped, and it was really liberating, and I loved that.”Wayne Quillan grew up in Upstate New York and related his coming of coffee age story:[Wayne’s voice]“When I was probably 10 or 11 years old, was the first time that I tasted coffee. There was some kind of event at the school auditorium. They had opened the cafeteria, so coffee was being served. And a friend of mine, Robbie, who was already a very excitable character, got himself a cup of coffee at the ripe old age of 10 or 11 and insisted that I try it. And I tried it, and I remember spitting it out thinking it was the most vile thing I had ever tasted, even though he had added copious amounts of sugar to it. And of course the next day, Robbie missed school. So I felt somewhat vindicated that I had had the good sense to not consume this awful stuff.”Wayne went on to relate that he got all the way through late nights studying at college drinking only water, still repulsed by the idea of drinking vile coffee, even when he spent his Junior year in France living with a family who served café au lait every morning, which he didn’t touch. Only his first job after college, spending all day looking for errors in computer program printouts, drove Wayne to coffee.[Wayne’s voice]“It enabled me to get through the day without falling asleep, so that is where I became addicted to coffee and have been ever since.”Coffee can be at the center of the culture of a whole community. Rocio Calvo, who grew up in Spain, where she developed her love of her “morning fix”, began to understand this while living in a small community in the mountains of Guatemala:[Rocio’s voice]“The time I spent in Guatemala, in a community that grew the coffee, collected it, to see the whole process … not only of the coffee [production] itself, but how the life of the community revolved around coffee. I learned how to appreciate the drink and the coffee besides my morning fix.”Melissa Hernandez-Jasso from Mexico City was just a girl when her eyes were opened to what coffee could mean to some other girls:[Melissa’s voice]“My favorite coffee story is when I was a kid, I was in my grandparent’s village in Mexico along the southern border with Guatemala. It’s a small town called Guatimoc. You can Google that. I was once looking at children coming back from the mountains, they were collecting coffee. And they were carrying these big bags of coffee that weighed, I don’t know, how many pounds. And I was just so surprised to see people my age carrying that and working that way when, yeah, I just had a very different life in Mexico City with my parents. And my grandfather told me you should try to carry that. And so I did. I tried. I couldn’t even lift any single, like, centimeter. And I was just so surprised. And I guess that always stuck with me of how effort and work there is involved in coffee. And it also instilled a high sense of class consciousness in me.”Like Melissa’s story, the most poignant stories involved childhood memories and parents or grandparents and put coffee and tea in the center of family traditions and culture. Paul Blackborow recalled:[Paul’s voice]“I grew up in England, so primarily a nation of tea drinkers when I grew up there. But my mother was ornery about such matters, and she only drank coffee. But back in the 60s when I first became aware of this, there was really no ground coffee that anybody drank, certainly not in our social stratum. And so she drank instant coffee. Nescafé Gold Blend if we could afford it. Otherwise, it was the supermarket brand, Sainsbury’s, I think. Us kids would make her coffee when we made a cup of tea. And that involves spooning a spoon of Nescafé into a cup, boiling the water in the kettle and on the stove, of course, because electric kettles hadn’t been invented. And then she drank the coffee, gratefully.”Steve Bussolari, who grew up in Connecticut, remembers a piece of advice from his father:[Steve’s voice]“When I was in my early teens, starting to drink coffee, my father counseled me to only drink it black, to learn how to drink it black because, the way he put it, you’re going to be at meetings. People are going to be searching for cream and sugar, not going to find it. They’re going to be all upset. But you’re going to be happy. You’re just going to go up to the coffee urn, get a nice cup of black joe, and be happy. To this day, I tell him that was the only piece of advice that I found actually useful.”Martin Button remembered his family’s ritual of sharing tea when he was growing up in New Zealand:[Martin’s voice]“Tea is not really tea unless it’s brewed in a pot. This idea of tea bags, where I think everybody drinks tea out of tea bags these days, that doesn’t really count as tea. There’s a ritual about making tea that involves a good teapot, perhaps a very pretty tea cozy to keep the teapot warm while the tea is steeping, putting boiling water into the teapot before the tea goes in so that the teapot is hot and not cold when the tea goes in. Of course, leaf tea out of a container with a teaspoon in it to measure one teaspoon per person, one for the pot. And then the water is boiled and added to the pot. The lid goes on, the cozy goes on, the appointed amount of time elapses, and three minutes later, the tea is poured out, cups lined up.”“That’s the way to make perfect tea. Growing up, when we would visit grandparents or aunts and uncles, that’s just how tea was made. I didn’t really know about tea bags until I came to this country.”Jessica Daniels shared a coming of coffee age story from growing up in New York with her grandparents from Poland nearby:[Jessica’s voice]“When I was young, my grandmother used to give me little sips of coffee, but on the other hand, my grandparents also told me that drinking coffee would stunt my growth, and I’ve never been taller than five-four. So, there you go.”Bahaa Fam’s grandmother was Egyptian. Bahaa’s memory of her roasting coffee, says it all:[Bahaa’s voice]“My best memory of coffee is that when I was about three years old, my grandmother lived with us. She was a very lovely woman, very smart and very small in stature. And every morning she would get up, and she would fry coffee beans on the stove. It would fill the apartment with this incredibly wonderful smell, which I remember to this day. And when I got married, I told my wife about this experience. And we went out, and we bought a coffee roasting machine. We run it every other day and roast coffee. And when I smell that smell, I think of the warmth I felt with my grandmother in the house with us and the delicious odor of roasting coffee in our little apartment.”There is so much that could be said about coffee and tea. We heard from our guests about the way they used and enjoyed, or maybe at first didn’t enjoy, coffee and how coffee and tea helped bind them into their families and the communities they were a part of. To wrap up by returning to the goat theme, the G.O.A.T., again Greatest Of All Time, baroque musician Johann Sebastian Bach, said, “Without my morning coffee, I am just like a dried-up piece of goat.”Thank you for listening. Please add your coffee, tea, or any caffeinated beverage story in our comments below! Links to facts used in this podcast are in the text version. Remember, you can’t buy happiness, but you can buy coffee and tea, and those are pretty close! This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

We are a nation with some big superpowers – like military might, for example. One of our greatest superpowers is agriculture. America is the world’s leading single nation food exporter. (The European Union in aggregate is a larger exporter.) We produce enough food to feed the U.S. population and a third more.Why can’t America put healthy food on every plate?Why, as an agricultural superpower, do we not as a nation simply do what it takes to make healthy food affordable to all Americans and central to American eating habits? Secretary of Health RFK, Jr. is right that we can’t be as strong as we should be, individually and as a nation, unless our food is healthy.Subsidies are not helping put healthy food on our platesOur agricultural policies are often directed away from healthy solutions. The vast majority of our agricultural subsidies go to commodity farmers, producers of corn, wheat, cotton, rice, and soy. Only 1% goes to growers of fruits, and 1% goes to growers of vegetables. Corn production, America’s most heavily subsidized commodity, is for animal feed (46%), ethanol for gas (43%), and ultraprocessed food (10%.)And who gets the subsidies?Ten percent of commercial farmers get three-fourths of the subsidies. Many of these farm operators have annual incomes over $1 million.What would a good king do?As U.S. agricultural policy expert Parke Wilde has said, people tend to think about American agriculture by taking the “benevolent monarch” approach to fixing problems: what would I do if I were Queen or King? But our agricultural policy has been shaped by the influence of multiple constituencies, all with their own priorities, making it difficult, in normal times, to change anything.Who are the players?The most important and by far the most powerful constituency is agribusiness, from the wealthy and industrial plantation end of farming and its large suppliers to the small, struggling farmers. Agricultural policy reporter Helena Bottemiller Evich recently pointed out that due to the modern-day efficiency of farming methods, actual farmers are only about 1% of voters. They may not be a big voting block, but farm operators punch far above their weight in political power. Farming, including ranching, is the at-home job of 5% of Congressional Representatives and 8% of Senators.Other stakeholders, as described by Wilde, include farm workers; food manufacturers; input suppliers like seed, fertilizer, and equipment manufacturers; anti-hunger advocates and nutrition advocates, two distinctly different constituencies; environmentalists and climate activists; and agricultural product trading partners internationally.I would add American food shoppers to Wilde’s list. Consumers, while not well represented by lobbyists, get angry and loud when food prices rise, and prices have been outpacing inflation in recent years.Don’t touch the Rubik’s CubeWith all these players jostling for a place at the table, creating change in agricultural policy has been a Rubik’s Cube of twisting pieces into place to find a solution. Once a solution has been found, most agricultural stakeholders are not eager to start the puzzle over.Nutrition in the realm of chaosAs the traditional balance in U.S. government power dynamics has collapsed into chaos, two things happened this summer that signaled a shift of power in the world of agriculture.Nutrition funding moves to the Big Beautiful BillFirst, the nutrition piece of the Farm Bill was tucked away into Trump’s Big Beautiful Bill which was signed into law in July. In doing so, the Republicans in Congress made heavy cuts into the biggest piece, by far, of the nutrition money: SNAP, or Food Stamp, benefits. SNAP was cut by 20%: $186 billion over the next ten years. SNAP is relied on to put food on the tables of 12.5% of our population, 41 million Americans. Between 2 to 5.3 million Americans will lose some or all of their SNAP benefits under the new cuts, and all benefits will be reduced.Bipartisanship: a long-standing tradition in the fight against hungerSince 1969 when Republican President Richard Nixon got the anti-hunger ball rolling with the first White House Conference on Food, Nutrition, and Health [note: the Wikipedia page linked here was authored by me and Katrina Sarson with subsequent anonymous contributors], fighting hunger has been a fully bipartisan issue.Nevertheless, in 2025, hunger has still not been solved. Twenty percent of children are living with the stress and fear of food insecurity, 50% in some rural counties. Yet even before the Big Beautiful Bill SNAP cuts were passed, Trump cut $1 billion in food for school lunches and food pantries, both critical sources of food for children and families in need.Let’s hope the decimation of SNAP in the Big Beautiful Bill does not signal the end of the bipartisan agreement that hunger has no place in America.Thanks for reading Eating in America! Subscribe for free to receive new posts and support my work.But what about the Farm Bill?Traditionally, the Farm Bill is massive and complex, with a confusing array of subsidies and protections for farmers. The Farm Bill has always stood on its own as a piece of legislation. Changes have been made incrementally on a five-year cycle, avoiding the great difficulty of constructing a new Farm Bill from the ground up.However, with nutrition pulled out, nutrition and food security having been 81% of Farm Bill spending, the rest of the Farm Bill, mainly the subsidies, is in limbo, and the outcome a question mark. The Democrats required to help the Republicans meet the 60% threshold for Farm Bill passage in the Senate have little appetite to engage.The cutting of SNAP, school lunch, and food pantry assistance signals a power shiftClearly, the voices of anti-hunger advocates and nutrition advocates on both sides of the aisle have been quieted or ignored by the unprecedented power grabbing of Trump. But these nutrition and anti-hunger cuts also represent significant reductions in American agricultural purchases.In the past, food and nutrition programs have had a symbiotic, quid pro quo relationship with agriculture. The reason food and nutrition and agriculture are losing out together is because of Trump’s overriding desire to help fund trillions in tax cuts for the wealthy and hundreds of billions for ICE to deport immigrants. He needs the anti-hunger funds for these priorities even if it hurts his strongly pro-Trump farm constituents.How agribusiness and Big Food fared in the MAHA Strategy ReportThe second marker of a power shift favors agriculture. RFK, Jr.’s Make America Healthy Again initiative took aim at pesticides, an agricultural issue, and ultraprocessed food, a food issue. While the MAHA Assessment report released in May contained a hearty indictment of pesticides, agribusiness successfully lobbied pesticide restrictions out of the MAHA Strategy report issued in September.The success of agribusiness stands in contrast to Big Food’s considerably less than complete victory with the MAHA Strategy report. The September report pledged an ultraprocessed food definition instead of action, a major let off. On the other hand, the report presented the link between highly processed food and chronic disease prominently; promoted front-of-package labels for saturated fat, salt, and sugar; proposed marketing guidelines for children-targeted food; and pledged to at least partially close the Generally Recognized As Safe food loophole through which many toxic substances are added to our food supply without our knowledge.JFK, Jr., the X factorBig Food, although the largest lobby in America, was outperformed in Washington this year by the agribusiness lobby. The X factor was RFK, Jr., who, although his success in nutrition policy has been very limited so far, has brought significant issues to the forefront for discussion.Is getting ICE off the farms a win for agricultural power?Perhaps a third marker of agricultural power in this environment of chaos is how quiet ICE has been on the farms recently. Over 40% of farm workers are migrants without authorization to work. In June Trump proposed backing off the targeting of farm workers, and, judging by the news since then, ICE may be largely doing that.Does the fleeing of farm workers spell trouble for Trump?Despite Trump’s musings about calling ICE off the farms, farm employment dropped 7% between March and July, with many workers worried about being detained by ICE. The increasing farm labor shortage this year could portend an impending crisis for Trump. Without enough farm workers to tend and harvest crops and animals, food prices will continue to increase, to the great dissatisfaction of American voters. Trump knows to worry about this. He quite possibly would not have won the 2024 presidential election without voter dissatisfaction over rising food prices.Where’s the nutrition superhero?If Trump completes his quest for autocracy, he is not going to amend the agricultural system and be a nutrition hero, nor will JFK, Jr. While at least Kennedy might be headed toward getting a small piece of MAHA’s nutritional agenda enacted (not all of which is actually healthy), he has a long way to go on any of these proposals. And it is easy to envision that in a normal political environment that was not susceptible to fantasy science, the limited nutritional reforms on the table could just as easily be enacted without an RFK, Jr. Meanwhile, solving America’s Rubik Cube of a food system to provide healthy food for all, will require political will beyond what MAHA can bring. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Zero parts per billion is the safe level of lead in the water we drink. Any lead, at all, is unsafe. Who agrees? The EPA, CDC, World Health Organization, and the American Academy of Pediatrics all concur.How much lead is in our water? According to EPA data reported by the NRDC, the National Resources Defense Council, between 2021 and 2024 community water systems serving over 250 million Americans had tap water with more than the American Academy of Pediatrics recommended level for school children of one part per billion of lead. That is 81% of the households getting their water from community systems. Worse, 44 million Americans have water now with at least 10 parts per billion of lead, the level at which, beginning in 2027, systems will be mandated by the EPA to take corrective measures. Again, the EPA is clear that the only safe lead level is zero:“Lead is very dangerous to human health. For children, lead exposure can cause irreversible and life-long health effects, including affecting IQ, focus, and academic achievement.”In comments to Eating in America, the world’s most cited nutrition scientist, Dr. Walter Willet of the Harvard School of Public Health, noted the gaping omission when this month’s Make Our Children Healthy Again Strategy Report didn’t mention lead. Willett told me, the report:“…left out lead in water, which has demonstrated adverse effects on cognitive development and is a real problem in the U.S., especially in communities with older water systems.”Willett noted that due to Trump administration budget cuts:“programs at the EPA for monitoring lead and other heavy metal contamination have already been disrupted and or eliminated.”Willett further pointed out that instead of providing leadership on childhood lead exposure, which it failed to even mention:“the report focused water concerns on fluoride, which has major benefits for the prevention of dental caries…”Given Trump’s recent moves to control economic data, and the killing of the Household Food Security annual report, which could potentially reveal the hardships caused by the massive new Food Stamp cuts and Trump’s cuts to school food and food distributed to food pantries, it should be no surprise if national collection of data on the widespread lead contamination in our water supplies is soon discontinued.What about lead in your water?Your municipal records might tell you if the water pipe coming into your house or building from the street is lead or you can usually look at it where it enters in the basement to tell. Better yet, test your tap water in the kitchen, first thing in the morning. The Safe Drinking Water Act banned new lead in plumbing in 1986, but lead joints, solder, or fixtures installed prior to 1986 might be leaching lead into your tap water. Some states and utilities offer free tests. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

September 23, 2025On Saturday the USDA gave notice it would no longer collect survey data on food insecurity, saying:“For 30 years, this study…failed to present anything more than subjective, liberal fodder.”In fact, through Republican and Democratic administrations, the USDA reported on food insecurity with a consistent, unbiased, scientific process.Commenting to Eating in America, economist Parke Wilde, an expert on the history of the government’s research on food security, said:“For many years, USDA's annual report reflected a bipartisan interest in improving food security in the United States. Everybody -- Democrats and Republicans -- wanted to see a lower prevalence of food insecurity and hunger.”Canceling the evidence won’t cancel the problem, but it will go a long way to hiding it.And the problem is both persistent and, lately, growing rapidly. The 2023 Household Food Security report found 13.5% of households, with 47 million adults and children, were food insecure, indicating stress and difficulty providing enough food at times. That’s compared to a 20-year low of just over 10% in 2021. Over 5% of households, over 16 million adults and children, had very low food security in 2023, usually experiencing hunger at times, sometimes with no food all day, due to bare cupboards.Thanks for reading Eating in America! Subscribe to receive new posts and support my work.The final Household Food Security report under the Trump administration is due out in October and will report on the numbers for 2024. Meanwhile, new Food Stamp cuts to 4 million people and Trump’s cuts to school food and to food distributed to food pantries will create impacts on struggling Americans in 2025. However, this year’s data will go uncollected and the effect of these cuts on food insecurity will remain unknown, for the first time in 30 years.Dr. Wilde, a professor at the Friedman School of Nutrition Science and Policy at Tufts University and former scientist at the USDA, pointed out that while some advocated addressing food insecurity with safety net programs and others urged focusing on supporting a robust labor market:“…everybody agreed that the United States could provide a road to prosperity for all people. This household food security report is not partisan; it is something we all need to understand how well our country is meeting basic needs.”Your reactions to this podcast are welcome. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

The Food and Drug Administration’s oversight of food safety has a giant loophole, really a series of giant loopholes, allowing cancer- and chronic-disease causing food ingredients to reach American plates every day. Secretary of Health and Human Services Robert F. Kennedy, Jr., who has oversight of the FDA, made clear his dismay about this back in March:“For far too long, ingredient manufacturers and sponsors have exploited a loophole that has allowed new ingredients and chemicals, often with unknown safety data, to be introduced into the U.S. food supply without notification to the FDA or the public.”RFK, Jr. is right. He is talking about the “Generally Recognized As Safe”, or “GRAS”, status: the heart of a broken food additive oversight system. In 1958 Congress passed a law meant to streamline approval of common ingredients that were already in use, in order to focus on new ingredients. The 800 or so ingredients on the initial GRAS list included household substances like salt and sugar, along with lab-produced chemicals like the artificial sweetener cyclamate.FDA’s oversight during this period, worked, sort of. In 1970 the FDA banned cyclamate on the basis of contested evidence that it might cause cancer in humans. On the other hand, strong evidence has accumulated about the health harms of too much salt or sugar, but the FDA so far refuses to take up the question of revoking the GRAS status of these substances when consumed in levels beyond those recommended by the science.What has appalled RFK, Jr. and nutrition scientists and policy makers alike is the direction that food additive oversight took at the FDA in 1997. That is the year in which the FDA turned over the responsibility for assessing the safety of new food ingredients to the food manufacturers themselves, without them being required to turn over any safety data to the FDA. Consequently, for the last 27 years, food ingredient creators could make their own, private determination of GRAS, using any method they chose, without letting anyone know they were adding a new ingredient to the food supply.Since 1997 about 1,300 notices of new GRAS ingredients have been provided voluntarily to the FDA but without any safety evidence. Incredibly, if the FDA flagged any concerns with such a notice, the manufacturer was free to withdraw the notice and introduce the ingredient into the food supply anyway! And it is likely that hundreds or thousands of products have been declared GRAS by manufacturers and introduced into the food system without any notice at all to the FDA or public. Since there is no public notice of these new ingredients, there is no way of knowing how many there are or what they are.This is the mess Kennedy would like to clean up, and so on March 10th he instructed the FDA to explore how to eliminate the GRAS pathway to introducing a new substance into the food supply.But is GRAS really all that bad? Let’s look at some examples.The FDA maintains a database of the 1,300 or so ingredients that food additive manufacturers have notified the FDA that they, the manufacturers, have self-affirmed as GRAS. Most of the ingredients, especially those added more recently, have chemical and scientific biological names consumers won’t recognize. A recent example is “Algal oil (≥40% docosahexaenoic acid) from Aurantiochytrium limacinum H Sc-01”. The notice for this oil, submitted by a Chinese intermediary company, is for a mix of triglycerides containing 40% or more of a beneficial omega-3 fatty acid, DHA. Theoretically good for you.This oil is manufactured from micro-algae – the green stuff on ocean rocks and in waters and wet surfaces everywhere – and is intended as an additive for baby formula. The FDA responded to this notice in June, saying it was not judging safety, which was the responsibility of the manufacturer to determine, but that the FDA had no questions, case closed. I’m not in a position to judge whether there is anything scary about this particular manufacturer’s notice of a food additive they are making from algae to be sold for baby consumption. However, it is certainly scary that this notice and hundreds more like it have been filed with no offering by the manufacturers of any evidence of safety and no safety review by the agency in charge of food safety, the FDA.Mycoprotein is made from mold, a fungis, and is on supermarket shelves as Quorn, a meat substitute. The creator of Quorn, Marlow Foods, asked the FDA to approve it as a food additive, but when the FDA did not make a decision, Marlow withdrew the petition, declared they had determined Quorn was GRAS, and started to sell it. Since 2002 over 2,900 reports of allergic and gastrointestinal reactions to Quorn have been recorded by the Center for Science in the Public Interest. Among these reports was that of an 11-year old boy with a known mold allergy and asthma who died after eating Quorn. When he stopped breathing, he could not be revived by an EpiPen and had no pulse. Paramedics arrived and brought back his heart beat, but the boy died in the hospital the next morning. After eating Quorn, a 16-year old Swedish girl with asthma died following two days of effort to revive her in the hospital. Many other hospitalizations were reported as well.As with cyclamate, some GRAS determinations have been revoked, but not before plenty of harm was done. Partially-hydrogenated oils, or trans-fats, were very popular and used widely at home and in restaurants. However, scientists calculated that trans-fats had been causing 50,000 heart attack deaths each year. In 2013, the FDA finally revoked the GRAS status and in 2015 banned trans-fats.Of the GRAS products we know about – and, remember, all of the undeclared GRAS substances are an unknown unknown – there are many for which scientists have found evidence they are, or may be, unsafe. Consumer Reports’ top candidates for GRAS revocation include, and sorry for all the chemical names, I’ll hurry through them:* brominated vegetable oil, used in sports drinks and sodas, is linked to nervous system, thyroid, heart, liver, developmental, and reproductive problems* potassium bromate, a flour improver, is linked to cancer* propylparaben, a preservative, is linked to reproductive issues* titanium dioxide, a food coloring, is the mineral that makes paint white and that is used in sun block for our skin; titanium dioxide is linked to DNA and cell damage and cancer; a recent study found titanium dioxide nanoparticles omnipresent in human, animal, and infant formula milk.What are the prospects for elimination of the GRAS system, for needed FDA funding for oversight in the face of massive job cuts this year, and for the removal of politics and commercial influence in what should be scientific and health protection decisions?RFK, Jr. has taken a baby step towards eliminating the GRAS system, but its replacement is in question. Congress and Trump are unlikely to restore FDA funding Trump removed, let alone increase it to appropriate levels. FDA Commissioner Marty Makary lied, or failed to examine the cuts he made in his department, when he said no scientists were fired in the 2,000 jobs abruptly axed in April. And political and commercial control over science has become overt in the Trump administration and Kennedy’s Health and Human Services department so little hope of improvement there.However, there are a couple of sparks of hope. In August, Former FDA Commissioner David Kessler filed a 60-page petition full of scientific evidence that the sugars, flours, starches, and additives used in ultraprocessed food are unhealthy in ultraprocessed food and therefore cannot be GRAS. This is a petition that should be making RFK, Jr. happy. If the FDA follows it own rules, the ultraprocessed food industry would suffer a great blow. However, the ultraprocessed food industry spent $1.15 billion on lobbying, 1998 to 2020, the most of any group in America, so, in my mind, the odds are good the FDA will never respond to the GRAS questions involved.The more promising spark of hope are the moves by California, New York, and Illinois to ban specific food additives like propylparaben, or even, in New York’s case, to require evidence supporting GRAS status before a new ingredient could be sold in the state. In 2023, California banned Red Dye No. 3, along with three other food additives. Perhaps spurred by the California ban, in January the FDA banned the use of Red Dye No. 3 in food and drugs.A functional, funded food safety system could make a significant difference in our nation’s health, because so much of our chronic disease is associated with what we are sold on eating. If only the FDA picks the big targets: salt, sugar, and refined flour and starch, in combination with the additives to ultraprocessed food.Thanks for reading Eating in America! Please subscribe to receive new posts and support my work. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

Today we’ll catch up a bit on the news about one thing we need in our diet, lithium, and two we may love: alcohol and sugar.Lithium, mood, and dementiaThe element lithium found in the water we drink every day supports a positive mood and may reduce the risk of dementia. That is good. But don’t let ultraprocessed food deprive you of lithium’s benefit!Lithium found in trace amounts in drinking water is related to reduced risk of: dementia, death by Alzheimer’s Disease, and suicide. The higher the lithium intake from water, the less the risk.However, a new study has found that eating ultraprocessed food can be related to a reduced level of lithium in the blood. It might be that the higher levels of salt commonly found in ultraprocessed food cause the kidneys to excrete excess sodium, taking out beneficial levels of lithium along the way.On the other hand, patients prescribed high levels of lithium for mood regulation – common for the control of bipolar disorder – may be advised by their doctor to have a steady but moderate intake of salt to maintain a not-too-high, but still therapeutic, level of lithium.Our takeaway from the new study is the possibility that ultraprocessed food can be making our bodies get rid of lithium that can help regulate our mood and maintain our brain function. This is just another compelling reason for us to avoid food that is formulated and packaged and, typically, ultraprocessed. And, the evidence about the reduction of the body’s lithium in an ultraprocessed food diet is another great reason for Make America Healthy Again leader RFK, Jr. and Secretary of Agriculture Brooke Rollins to include recommendations for limits on ultraprocessed food in the upcoming U.S. Dietary Guidelines. Sadly, though, indications are Kennedy and Rollins may barely mention ultraprocessed food in the 2025 Guidelines.Alcohol and cancerThe bad news is that a new National Academies of Sciences study, a 2025 Surgeon General report, and a new article in the Journal of the American Medical Association summarizing all the evidence, make very clear that drinking alcohol can cause cancer: breast, liver, mouth, throat, voice box, esophagus, and colon and rectal cancer.U.S. Surgeon General:“Alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity.”As we await the government’s presentation of the 2025 U.S. Dietary Guidelines, I’ll note that the alcohol lobby was the next biggest spender after the tobacco lobby in the U.S. from 1998 to 2020, with over a half-billion dollars spent on lobbying by alcohol vs. three-quarters of a billion by tobacco. The 2025 Dietary Guidelines Scientific Committee punted on alcohol recommendations in their report, in deference to the (then) coming National Academies of Sciences report and another report being finished by Kennedy’s Health and Human Services Department. The chance of the new Guidelines presenting stronger language about limiting the use of alcohol because of cancer and other health consequences do not seem hopeful to me.Nonetheless, this recent focus on alcohol and cancer in science and the media could be, and should be, huge: impactful to our drinking culture and to the alcohol industry. We’ll return to the topic soon here in Eating in America.Thanks for reading Eating in America! Subscribe for free to receive new posts and support my work.Coke vs. Coke. Loser vs. loser.The absurd news is that Donald Trump and his Secretary of Health, Robert Kennedy, are bragging about making Coca-Cola use cane sugar in Coke in the United States. Coke is expected to provide cane sugar Coke this fall in addition to the high fructose corn syrup version they switched to in the early 1980s to save costs.Coke with sugar, no matter corn or cane, is not a healthy drink.Cane sugar is sucrose, which is half glucose and half fructose, two other sugar molecules bonded together in the sucrose molecule. High fructose corn syrup is typically 55% fructose and 45% glucose, so about the same chemical balance as cane sugar. Once either high fructose corn syrup or cane sugar is absorbed to your blood, your body can’t tell the difference, so the health outcome is essentially the same.It will take the sucrose a little longer to be absorbed because the bonds between the fructose and glucose molecules have to be broken down first. But both high fructose corn syrup and cane sugar are associated with obesity, diabetes, heart disease, fatty liver, tooth cavities, and cancer.How about the taste? Trump seems to prefer the cane sugar Coke.Trump is not alone. Many people, including me, prefer the less-sweet cane sugar taste. I no longer drink Coke like when I was young, but it still makes me feel better when I am sick.Coke bottled in Mexico with cane sugar is available in glass bottles at Home Depot. With all the plastic and plastic chemicals in our bodies these days, perhaps more than the taste, the use of a glass container over plastic may be the best reason to choose cane sugar in a Mexican bottle of Coke over high fructose corn syrup in a plastic American bottle. But the plastics story is for another time, coming up soon, on Eating in America.What’s been your relationship to sugar-sweetened beverages in your life?Thanks for listening. As always you can check the text version of this podcast for links to the science and factual sources of information I used.And please support this source of factual information by joining as a free or paid subscriber. Thank you. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

A draft of the Make America Healthy Again (MAHA) Strategy report has been leaked, causing a big stir and considerable disappointment in the MAHA camp and among most others who advocate for better nutrition for Americans.In place of strong action on ultraprocessed food and pesticides, the report has recommendations for more research. Ultraprocessed food is mentioned only once, with the report saying there is a need for a definition of ultraprocessed food.I’ll discuss the MAHA strategy report more in future posts, and the finished report may come very soon. But the leak of the overdue MAHA Strategy Report reminds us that the 2025 U.S. Dietary Guidelines, mentioned in the leaked draft, are also overdue.It largely escaped public attention in July when Secretary of Health Robert Kennedy pushed back the promised date for the publication of the new Dietary Guidelines from July to October. This key document for the American food system is still under review—and likely being negotiated with special interests—by Kennedy’s Health and Human Services Department and Secretary Brooke Rollins’ Agriculture Department, the two departments responsible for jointly writing the Guidelines.It is hard to overstate the magnitude of the lobbying power of the food industry, and much of this lobbying has historically been directed at influencing the Dietary Guidelines. From 1998 to 2020, ultraprocessed food (UPF) was the top lobbying industry in the U.S., according to a peer-reviewed report. The UPF sector spent $1.15 billion lobbying the federal government during this period. Next on the lobbying list was gambling, then tobacco at $755 million. Alcohol was fourth at $541 million.Keep that $1.15 billion in mind when considering what the MAHA strategy report and the Dietary Guidelines are likely to say (or rather, not say) about ultraprocessed food.When he originally announced the July date for the Guidelines, RFK, Jr. may have underestimated the strength of the Big Food machine defending Kennedy’s food system targets, particularly ultraprocessed food and pesticides. It might be taking the HHS and USDA, and their Secretaries, more time than anticipated to resolve the complaints and requests about the proposed Guidelines from outside interests.And there are potentially inter-departmental discussions to be resolved. USDA Secretary Rollins is among those pushing back against any proposed restrictions on pesticides.By law, the Dietary Guidelines are researched and rewritten every five years. They are the U.S. standard on how we should eat and for critical nutrition programs, like School Lunches, SNAP, and WIC for new moms and small children. They’re the basis for policies, education, and food labeling initiatives. They are the source of what doctors tell their patients. The Guidelines are highly influential to American health.But with influence comes economic power, and the Guidelines have a bottom-line impact for corporations in the food, agriculture, weight control, and, increasingly, pharmaceutical industries. Think weight control drugs.Players from these sectors are lobbying HHS and the USDA, for protection of their interests in the coming Dietary Guidelines. The influence of these industries likely helped shape the secretive selection of the 2025 Dietary Guidelines Scientific Advisory Committee (DGAC), early in this process.Nine out of 20 DGAC members have been identified by the watchdog group U.S. Right to Know as having a medium or high risk of a conflict of interest due to funding or some other relationship with a food, agricultural, weight control, or pharmaceutical company or association.So, given that some of the DGAC members might have come to the evaluation of the science with some biases favorable to interested industries – where do things stand with the 2025 Dietary Guidelines Advisory Committee Scientific Report that was issued in December?The report has two big failures, both of which will have pleased many in the industry. First, the report describes what the DGAC believes is the way we can eat to maintain or achieve a healthy weight. Unfortunately, the DGAC doesn’t acknowledge the evidence that shows that few of us who have lost our most healthy weight (i.e., we have put on the pounds) can get our weight back down on a permanent basis by dieting. Our human biology is wired to pull us back up to our previous weight.CDC data shows three-quarters of us are overweight or obese. Is this a failure of will power, the ability to do something our bodies tell us they don’t want us to do? Please, it is not the hundreds of millions of us overweight Americans that are the problem. It is our food system that is at fault and in need of fixing. It would be very helpful, both for consumers and for policy makers who want to take action to move the needle on obesity and other chronic disease, to redirect the responsibility and blame from us overweight eaters. The blame, and power, belongs to the corporations selling the food. The DGAC does not provide even a hint of this direction.Second, the DGAC agreed the evidence from its systematic review of ultraprocessed food showed a relationship between eating ultraprocessed food and obesity. More UPF means more weight. Sixteen out of 16 studies included in the review said so.This is an improvement from the 2020 Report which had only one glancing mention of “ultra-processed food”, in quotes, in 845 pages of report!However, in its 2025 recommendations, the DGAC did not rise to protect Americans from health outcomes connected through obesity to ultraprocessed food. The DGAC did not recommend the Guidelines advise limiting the consumption of ultraprocessed food. The Committee excuses itself from this responsibility only by pointing out that the 16 studies used different definitions of ultraprocessed food. However, quoting the report:Despite this inconsistency, most of the foods categorized as ultra-processed were higher in saturated fat, sodium, and added sugars, as well as other food additives and preservatives.By not recommending a limit in consumption of ultraprocessed food, defined as best as the DGAC could, the Committee provided an escape clause for HHS and USDA. Sure enough, the leaked draft of the MAHA Strategy uses the “no-definition” excuse to say just one sentence about ultraprocessed food:USDA, HHS, and FDA will continue efforts to develop a … definition for “Ultra-processed Food” (UPF) to support potential future research and policy activity.When the Dietary Guidelines are released in October it will be surprising if they recommend any limit on consumption of ultraprocessed food, even though Health Secretary RFK, Jr. is an opponent of UPF.On the positive side? The recommended guidelines demote meat, poultry, and eggs in our diet, and elevate beans, peas, and lentils, recategorizing these legumes as protein sources rather than vegetables. In other words, the DGAC scientists put a strong emphasis on encouraging plant-based protein. Check mark for science.Whether the Dietary Guidelines will reflect a re-ordered priority of plants over meat when they are issued is another question. USDA Secretary Rollins’ mission includes supporting agriculture, and beef is the biggest sector in agriculture. Moreover, Secretary Kennedy goes against the science and favors meat-based saturated fat over plant oils and is not worried about red meat in our diet.So who will win out, ultraprocessed food and the other commercial interests, the science, or the opinions of RFK, Jr.? None of them will entirely win, but none will entirely lose. And that’s the problem.The Dietary Guidelines should be solely about protecting the health of the people. That commercial interests are having any say in shaping the Guidelines is sadly wrong. Let the policy negotiations, and the reality of implementing changes, come after the best science in the interest of the people is firmly established.As for Kennedy and his opinions? His directorate includes two of the top scientific health organizations in the world, the NIH and the CDC. He should be a scientist, at least in spirit if not in training. There should be zero tolerance for his personal opinion replacing the scientific facts. Unfortunately, malformed ideas from Kennedy are a new ingredient in the recipe for Dietary Guidelines this year, and they are likely to leave a bad taste in the mouths of those who believe in actual facts.Thanks for reading Eating in America! Subscribe for free to receive new posts and support my work.I’d love to hear your thoughts…Articles about the influence of Big Food on the Dietary Guidelines:* Access to Nutrition Initiative, 2022. ATNI Spotlight on Lobbying 2022. Access to Nutrition Initiative.* Aubrey, A., Godoy, M., 2016. New Dietary Guidelines Crack Down On Sugar. But Red Meat Gets A Pass, Morning Edition, The Salt. NPR. January 7, 2016.* Callahan, A., 2023. Food Industry Influence Could Cloud the U.S. Dietary Guidelines, a New Report Says, NY Times. October 4, 2023.* Chung, H., Cullerton, K., Lacy-Nichols, J., 2024. Mapping the Lobbying Footprint of Harmful Industries: 23 Years of Data From OpenSecrets. Milbank Q 102(1), 212–232.10.1111/1468-0009.12686* Gostin, L., 2016. The Influence of “Big Food” Promotes Healthy Profits but not Healthy Consumers. JAMA Forum Archive A5(1).10.1001/jamahealthforum.2016.0030* McKiegan, A., 2024. The Federal Government Have Breached Their Duty to the American Public by Promoting Dietary Recommendations Causing Killer Diseases. N.Y.U. American Public Policy Review.* Reinhardt, S., 2020. New Dietary Guidelines Cater to Alcohol and Soda Industries, The Equation. Union of Concerned Scientists. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe

RFK Jr. says seed oils like canola and soy are “poisoning” us and driving obesity. He says we should cook with meat fat instead. The science says otherwise to all this. The real issue is the ultraprocessed food the oils are found in, not the oil itself.Seed oils do contain trace amounts of hexane, a neurotoxin, but scientists are comfortable seed oils are still safe and better for you than beef tallow and other fats. As for the idea that the omega-6 fatty acids in seed oils cause excess inflammation, that, too, has been debunked. Omega-6 and omega-3 fatty acids both aid in creating inflammation for the healthy purpose of fighting infections and injuries, and they both also help decrease bad chronic inflammation. Seed oils are a healthy addition to our diet. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.eatinginamerica.co/subscribe