The food and beverage industry, Food and Drug Administration and Congress all came under attack at a Senate hearing Thursday that focused on the epidemic of obesity and chronic disease in the U.S., which FDA Commissioner Robert Califf said is in the “unfortunate position” of having “the lowest life expectancy among large, high-income countries."
Califf and Jim Jones, FDA’s deputy commissioner for human foods, testified before the Senate Health, Education, Labor and Pensions Committee, which is chaired by Sen. Bernie Sanders, I-Vt., who criticized FDA for not acting quickly enough to attack the problem of obesity, which afflicts one in every five Americans aged 2 to 19, according to the Centers for Disease Control and Prevention.
Califf said FDA is working to reduce sodium in food, update “healthy” claims on food packages and strengthen the agency’s chemical safety review program, but added that FDA has “limited resources” to deal with some of these issues.
“There are years of work under each of these initiatives that are performed by highly qualified and dedicated staff in the face of multiple limitations in the existing science, extensive legal hurdles and direct opposition from powerful industry forces,” Califf said.
But “meaningful change can only happen with serious action by Congress, the industry and multiple state and federal agencies,” he added.
“According to the CDC, the rate of childhood obesity in America has tripled since the 1970s and from where I'm standing here, the FDA has not responded in any way with the urgency of the crisis,” Sanders said. “How long does it take to put a bloody label on a product?”
Sanders and Califf had somewhat testy exchanges, with Sanders asking at one point whether he had “pointed a finger at those people who are the cause of the problem? Have you had the courage to take on a very powerful food and beverage industry?”
“I think we all wish that we had gotten to the goal sooner,” Califf said. “I’m not contesting that. But I do believe in an appropriate discourse with this committee, we need to carefully reflect on the issues in play right now that would allow this to happen. And I’m really heartened to hear the bipartisan support for this because much of what we try to do, frankly, gets blocked.”
“A lot of the changes those of us who are interested in better health would like to make are blocked at the level of legislation,” Califf said.
The commissioner defended FDA as an agency that is hamstrung by limited resources and legal restrictions on its authority, and also is challenged by the lack of access to industry research. He also suggested that the Supplemental Nutrition Assistance Program (SNAP) should not allow the purchase of unhealthy foods.
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There is “some evidence to suggest that even in the same neighborhood, families that use SNAP benefits versus those who don't, the SNAP benefit purchases are generally less healthy than those who don't use SNAP benefits,” Sen. Tim Kaine, D-Va., said.
Califf also went after ultraprocessed foods, whose health impact “is at the forefront of current policy considerations.”
“The clear association between ultraprocessed food and negative health outcomes is a major concern,” he said. “While there's still much we need to understand, ultraprocessed foods are usually high in saturated fat, sodium and added sugars, and there's already substantial evidence of harm when these nutrients are consumed in excess.”
Stressing it was his own opinion, he said he believes ultraprocessed foods are "probably addictive." The food industry, he said, “has figured out that there’s a combination of sweet carbohydrate and salt that goes to our brains.”
"The way to think about this [is] if you ever tried to eat one potato chip, it's almost impossible," he said.
“I think it’s the same neural circuits that are involved in opioid addiction and other kinds of addiction,” he said, adding that while companies have studied this, FDA doesn’t have access to their research data as it does for human medical products.
Sanders focused on the food and beverage industry’s influence.
“Even now, as you’re getting out of office, are you prepared to tell us that this committee, this Congress needs to take on the food and beverage industry whose greed is destroying the health of millions of people?”
Califf said he’s not going to “castigate the people that work in the food and beverage industry” but Sanders cut him off with a terse “That is your job.” Califf responded: “No, it’s not to castigate. It’s to point out how to make progress in this area. We have an industry that if you tried to change it overnight, there are farmers all over the United States who would not be able to grow the crops they’re currently growing. So there needs to be a plan and it needs to be implemented in a mature, thoughtful way across the country.”
Califf also said FDA is limited in its ability to regulate some substances, including food dyes, unless it has “clear direction from Congress.”
“Particularly given the recent Supreme Court decisions,” Califf said, referring to the court’s Loper Bright decision that did away with Chevron deference, “it’s going to be really hard for us to mandate things."
Sen. Lisa Murkowski, R-Alaska, asked about FDA’s progress on identifying differences on labels between wild-caught and genetically engineered salmon. “I acknowledge that on the labeling, it would sure be better if we could come up with words that people can understand,” he said.
Sen. Tina Smith, D-Minn., expressed concern about potential cuts to funding for state-level food inspectors under the incoming Trump Administration. Califf said without clear agreement on what the right amount of funding is for food inspections, it can be a challenge to decide how much it will be able to send to states.
He added that restrictions the agency has when it comes to sharing commercial, confidential information can be a barrier for working with states on inspections. “This is where we need a law,” he said.
Sen. Ed Markey, D-Mass., used his time in the hearing to challenge Robert F. Kennedy Jr.’s, nomination to be the secretary of Health and Human Services. Markey said that while some might see RFK Jr.’s messaging on diet and healthy foods as reasonable, “one reasonable opinion does not qualify someone to run [HHS].” In particular, he criticized RFK Jr.’s views on vaccines and water fluoridation.
"We can agree and find value in some opinions. We can agree that greed from any industry has no place in healthcare,” Markey said before adding, "But we what we cannot do is sign off on nominees who would be a danger to the public health, and that is what my concern is.”
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