With a focus on food, RFK Jr. can actually make America healthier

How ironic. As a dyed-in-the-wool progressive who for decades led the Center for Science in the Public Interest’s campaign for healthier diets, I was disappointed when administration after administration failed to fight for effective policies.

But now in comes anti-regulatory, pro-industry, junk-food-devouring President-elect Donald Trump, who vows to let his nominee for Secretary of the U.S. Department of Health and Human Services, Robert F. Kennedy, Jr., “go wild on thefood.”

Somehow, amid his unfounded (“nutty” says former New York mayor Michael Bloomberg) concerns about vaccine safety and his cheerleading for raw (and sometimes-contaminated) milk and disproven treatments for COVID-19, Kennedy has decried the prevalence of chronic disease and the “mass-poisoning” of Americans by their food.

Hyperbolic language perhaps, but, in fact, poor diet is responsible for as many as half a million deaths per year.

“Healthy food” shouldn’t be a “partisan” issue, Kennedy said, as he promised to:

• Get ultra-processed foods out of school meals;
• Crack down on food dyes, which can trigger ADHD and possibly cancer;
• Bar the use of food stamps for buying sugary drinks.

The following is my short wish list for what Kennedy, if confirmed by the Senate, and others in the Trump administration should focus on if they really want to improve the public’s health in major ways.

For starters, sugary drinks — pure calories — are a major cause of obesity, diabetes and cardiovascular disease. The administration should demand that Congress tax soda to reduce consumption. Britain’s three-tiered system of taxation led to an almost immediate 44 percent decline in the average sugar content of soft drinks, along with less obesity in girls. Mexico’s tax led to a 10 percent drop in sales of sugar-filled drinks.

In the United States, Berkeley, Seattle, Philadelphia, and other jurisdictions have slapped taxes of one or two cents per ounce on sugary drinks. That quickly lowered consumption.

According to a recent study, obesity in children in taxing jurisdictions either dropped or did not rise as compared to the rises seen in non-taxing cities. Several jurisdictions, including Berkeley and Seattle (King County), earmark the tax revenues to expand public health programs. A national tax would raise billions of dollars that could fund health programs or simply reduce budget deficits.

Next, as Kennedy has proposed, a different department, the U.S Department of Agriculture, should bar the use of food stamps (now called Supplemental Nutrition Assistance Program, or SNAP) to purchase these sugar-filled drinks, which are currently the program recipients’ single-most-purchased item.

Judging from a 2011 estimate, SNAP recipients spend roughly $10 billion annually on sugary drinks (a direct subsidy to bottlers). Yes, limiting SNAP benefits may be, as some charge, somewhat paternalistic, but it is nonsensical for a taxpayer-funded “nutrition assistance” program to subsidize what makes people sick.

Another major problem: excess salt in diets. Americans consume half again as much sodium as is recommended by the government’s own Dietary Guidelines for Americans — boosting blood pressure and increasing the risk of heart attacks and strokes.

Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention, has said that reducing sodium consumption by one-third could save 100,000 lives per year.

After decades of delay, in 2016 the Food and Drug Administration proposed a set of recommended sodium levels in over 150 categories of food. After four years of inaction by the Trump administration, the Biden administration finalized them in 2021. But those recommendations were totally voluntary and likely have had only a minor impact on sodium consumption.

The next secretary of the Department of Health and Human Services (and FDA commissioner) should use their bully pulpits to encourage shoppers to read labels and choose lower-sodium products, publicize packaged and restaurant foods drowning in salt, pressure companies privately and convert the FDA’s voluntary targets for maximum sodium levels into mandatory limits. That would save thousands of lives annually.

In addition, smart labeling policies could promote health. Chile was a pioneer in mandating nutrition labels that are much more understandable than our current ones.

In Chile, foods with excessive calories, saturated fat, sodium, or sugar are required to bear stop-sign-like icons on their front labels. Two or more excesses trigger two or more stop signs. Mexico, Canada and other countries have followed Chile’s lead. (Israel additionally allows a “good food” logo on foods that meet certain criteria.)

That labeling, easy even for young children to understand, led many companies to reduce levels of calories and unhealthy nutrients below the labeling thresholds. For example, 74 percent of sausages were high in sodium before the law went into effect but only 27 percent shortly after. Milk and milk-based drinks high in sugar dropped from 32 percent to 2 percent.

Chile extended its labeling requirement by barring foods with stop signs from public schools, having child-friendly images on packages, and advertising them to children.

The FDA currently is studying front-of-package labeling schemes, but isn’t even considering stop-sign symbols.

Another life-saving measure would be to require labels on processed meats, like hot dogs and ham, to warn consumers that those products have been proven to cause colon cancer. They should declare: “USDA WARNING: Frequent consumption of processed meat products may increase your risk of developing cancer of the colon and rectum. To protect your health, limit your consumption of such products.”

The USDA rejected a 2016 petition from the Center for Science in the Public Interest (an organization I co-founded) calling for that notice, but the new administration should immediately revisit the issue.

Finally, alcohol abuse and alcoholism. Liquor, wine and beer account for 9 percent of the calories drinkers consume (alcoholics much more) and cause 178,000 deaths per year. Add to that the spousal abuse, destroyed careers, birth defects and other harms caused by alcohol.

The warning label required since 1989 has had little impact. And the failure to boost federal alcohol taxes since 1991 has had a downward influence on prices and upward impact on consumption. There is a crying need for bolder warnings on labels and in ads and much higher tax rates, ideally applying the revenues to bolster alcoholism treatment programs.

Ending vaccine mandates will emphatically not make America healthy — just the opposite. If the president and appointees like RFK Jr. sincerely care about Americans’ health, they should buck what will be massive opposition by the packaged-food, soft-drink, meat and alcoholic-beverage industries and their friends in Congress, and implement every one of my recommendations.

Michael F. Jacobson is the founder of the National Food Museum and co-founder and former executive director of the Center for Science in the Public Interest.