President-elect Donald Trump’s pick to helm the Department of Health and Human Services has said he wants sweeping changes to how the United States approaches health and food, going so far as to suggest that the Food and Drug Administration should eliminate its nutrition operations.
But the agency may be more aligned with Robert F. Kennedy Jr.’s goals than he’s made it seem.
Just one day after Trump announced Kennedy as his pick for HHS secretary, FDA Commissioner Robert Califf published an op-ed in STAT calling for action on diet-related chronic diseases — an area that Kennedy has emphasized.
Such action would include “pushing for high-quality nutrition research related to ultra-processed foods” and “supporting and strengthening ongoing efforts focused on increasing consumption of nutritious foods that are limited in sodium, added sugars and saturated fat,” Califf wrote in an op-ed he co-authored with Jim Jones, the deputy commissioner of the Human Foods Program, and Haider J. Warraich, who is senior clinical adviser for chronic disease.
Those views seem to align with some of Kennedy’s stances. After dropping out of the presidential race and endorsing Trump, Kennedy spent the past few months linking the prevalence of ultraprocessed foods to the burden of chronic disease in the United States and sounding the alarm over added chemicals in the food supply. His concerns are serious enough that he called for a radical restructuring of the FDA earlier this month, before his nomination as HHS secretary.
“In some categories there are entire departments, like the nutrition departments at FDA, that have to go, that are not doing their job. They’re not protecting our kids,” he said during an interview with NBC.
Susan Mayne, the former director of the FDA’s Center for Food Safety and Applied Nutrition, said the agency shares Kennedy’s stated goal of reducing chronic disease in the United States. But she said rather than gutting parts of the agency, the FDA needs more resources and congressional support to achieve its goals.
“They share the same goal that RFK has expressed, which is trying to reduce diet-related chronic diseases,” she said. “Some of the key actions that have been undertaken by the nutrition program … are probably preventing hundreds of thousands of deaths from chronic disease.”
Peter Lurie, the president of the Center for Science in the Public Interest, a science-based consumer advocacy group, said Kennedy’s comments indicate a misunderstanding of how the FDA is structured. He highlighted that the FDA is a 17,000-person agency and the majority of its staff remain in place during administration changes.
“The institution has its own personality, and you don’t alter it by lopping off its head,” he said. “It just doesn’t really work that way.”
Reorganization
Kennedy’s suggestion of overhauling the agency comes months after the FDA began implementing dramatic structural changes to how it regulates food.
The agency in October completed a revamp of its food oversight system, a two-year process that involved combining functions of the Center for Food Safety and Applied Nutrition with its Office of Food Policy and Response to create a Human Foods Program, currently led by Jones. The organization established the Nutrition Center of Excellence, which reports to the deputy commissioner and is tasked with reducing diet-related chronic disease, improving health equity and securing the infant formula supply, according to the FDA’s organization chart.
The restructuring came amid reports of long-standing issues with how the agency made decisions on food safety and nutrition. A 2022 Politico investigation revealed structural obstacles between the two top food officials that hindered decision-making and delayed agency action.
FDA’s food operations became even more public during its response to the 2022 infant formula shortage stemming from contamination issues at an Abbott Nutrition facility in Sturgis, Mich. Lurie said the reorganization, while overdue, was the appropriate response to the deep-seated issues and in fact was an attempt to address many of the issues with nutrition that Kennedy laid out on the campaign trail.
“This was an honest attempt to rectify it, and it should be good news to him,” Lurie said.
In a statement, the FDA said it “has continually upheld its mission to protect and promote public health across numerous administrations.”
“The agency remains guided by science and the law for products within its oversight,” the statement read.
View from the Hill
Kennedy’s views on food and nutrition have emerged as an area of unexpected bipartisan support. Democrats on the Hill seemed more open to his views on nutrition compared to his other health-related views.
Sen. Cory Booker, D-N.J., took to X, formerly known as Twitter, on Monday to back Kennedy’s view of the food system, painting large agriculture companies as the enemy and opining over chemicals in foods.
“Our food system is designed to support and subsidize ultraprocessed junk foods and not the foods that our doctors are telling us that we should eat most of,” he said in a video statement retweeted by Kennedy.
Oregon Democrat Ron Wyden, who chairs the Senate Finance Committee, told CQ Roll Call that organic food could be an area where he finds common ground with Kennedy.
“I’ve known Bobby for years, and there’s some issues that I agree with him on,” he said. “Organic food is an area that he’s championed; tobacco control, I know he’s championed. But there are certainly a number of issues that I don’t agree with him [on].”
Jeff Hutt, spokesperson for the Make America Healthy Again PAC, a pro-Trump organization that backs Kennedy’s nomination, told CQ Roll Call in an email that he expects Kennedy to focus on making regulatory changes if he formally joins the administration.
“As he has said, he has spent a lifetime fighting and brings an unique understanding of the inner workings of federal agencies,” Hutt wrote.
Looking ahead
The FDA has several food-related items on its to-do list before the end of the Biden administration, including finalizing the definition of the term “healthy,” which is currently under review at the Office of Management and Budget. The rule would raise the standard for which foods can be labeled as “healthy” to reflect the current federal Dietary Guidelines for Americans.
The agency is also working on a proposal for front-of-package labeling but has not yet issued a proposed rule.
Califf said at the Friends of Cancer Research annual meeting earlier this year that he’d like to at least put out the proposed rule before the end of the Biden administration.
Speaking on “Fox & Friends” in late October, Kennedy said he wants food dyes removed from food, claiming that they cause cancer and attention-deficit/hyperactivity disorder. There have been some clinical studies that link hyperactivity in children to food dyes, but there is no direct evidence that food dyes cause ADHD.
Mayne pointed out that the arm of FDA that oversees food dye isn’t housed within its nutrition program, which has led to confusion. The FDA is currently reviewing a request to remove Red 3 from the list of additives allowed in the food supply, a push stemming from consumer groups.
Mayne said the administration should focus on market forces to get consumers to demand healthier foods.
She pointed to the FDA’s rule to mandate that trans fats be added to the nutrition facts label. She said trans fat consumption dropped by 80 percent after the rule was implemented.
“I do not see the incoming administration moving to ban ultraprocessed foods,” she said. “It’s at least 60 percent of our food supply.”
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