Senate Hearing Recap: FDA and its Role in Addressing America’s Diabetes and Obesity

December 16, 2024

The Senate Committee on Health, Education, Labor, and Pensions (HELP) questioned FDA’s lack of urgency amidst America’s health crises.

On December 5, 2024, the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a hearing titled “What is the FDA Doing to Reduce the Diabetes and Obesity Epidemics in America and Take on the Greed of the Food and Beverage Industry?” The hearing, led by Sen. Bernie Sanders, aimed to address the FDA’s role in combating diet-related chronic illnesses and its response to concerns about harmful food chemicals. Witnesses included Robert Califf MD, the current FDA Commissioner, and Jim Jones, Deputy Commissioner for the Human Foods Program, who fielded questions from senators on both sides of the aisle. The focus ranged from the FDA’s regulatory efforts to the challenges posed by the food and beverage industry’s practices.

Main Concerns Raised by the Senate

A significant concern raised during the hearing was the addictive nature of ultra-processed foods (UPFs). Dr. Robert Califf, FDA Commissioner, pointed out that many foods are specifically designed to trigger the brain’s reward systems, making them difficult to resist. He compared the effect of UPFs on the brain to addiction, noting that the food industry has learned to combine ingredients like sugar, salt, and fat in ways that make us crave more. While the FDA claims they do not currently have the data to definitively label these foods as “addictive,” the impact on consumer behavior is clear.

Safety concerns over food additives like Red 3 and Red 40 were also raised. Sen. Tuberville of Alabama questioned why chemicals linked to potential carcinogenic risks are still approved for food products, while Mr. Jones admitted, “We have not evaluated Red 40 in over a decade, so over a decade ago, that was the evaluation.” However, he also mentioned that Red 3 is currently being re-evaluated with plans of it being banned in the next few weeks. The European Union’s more rigorous post-market review system was cited as a model for the U.S., which currently lacks a statutory mandate for such reviews despite some progress towards implementing post-market chemical assessments.

Additionally, the senators discussed the need for front-of-package (FOP) labeling. Sen. Kaine advocated for clearer labels that would help consumers quickly identify healthy foods on the shelves. The lack of emotional appeal in FDA food guidance was also a topic of concern. Dr. Califf noted that the FDA is restricted from using emotionally persuasive techniques in food marketing, despite the fact that emotional appeals have been used successfully in areas like tobacco regulation to change behavior. This disparity between food and tobacco regulation, as well as the challenge of updating food labeling, was a point of contention throughout the hearing.

Senators also expressed concern over the influence of the food industry, particularly in the form of misleading advertisements targeting children and vulnerable populations. Sen. Hassan highlighted that food companies spend over $1.5 billion annually marketing unhealthy foods to children, often using misleading health claims like “all-natural” for products high in sugar and other unhealthy ingredients. This practice also misleads parents into thinking that these products are a nutritious option for their children, contributing to poor dietary habits.

FDA Struggles to Act: A Resource Problem

Throughout the hearing, FDA officials emphasized that many of their challenges stem from limited resources and structural limitations within the agency. Dr. Califf explained that, while the FDA is committed to addressing the public health crises of obesity and diabetes, they are constrained by the laws passed by Congress. The FDA can only act within the framework of existing regulations, and without clearer laws or updated mandates, their ability to tackle issues like misleading food marketing or the addictive nature of processed foods is limited.

A key barrier to effective action is the lack of funding and personnel. Dr. Califf noted that the FDA has struggled to fill inspector positions, which has hindered their ability to oversee food safety and enforce regulations. While some leftover funding was directed to state and local food safety programs, he acknowledged that the FDA needs more inspectors to meet the demands of a growing and increasingly complex food system. Senators like Sen. Smith pointed out the need for robust funding to ensure that food safety inspections are carried out effectively at both the federal and state levels. Without proper funding, the FDA’s ability to respond quickly to food contamination or recall situations is severely restricted.

In addition to staffing shortages, the FDA faces legal restrictions, particularly around the sharing of commercial confidential information. For example, food companies that have done in-depth research on food chemicals are not mandated to share such information with the FDA, leaving the FDA out of the loop. The FDA cannot exchange critical information about food contamination with the state agencies due to confidentiality laws, which could delay responses to public health threats. Dr. Califf made a plea for Congress to address these issues, advocating for legislation that would allow more information to flow between the food and beverage industry, state and local governments, and the FDA to ultimately improve food safety.

The Path Forward

The hearing concluded with a call for decisive action. Some senators agreed that the FDA’s effectiveness could be significantly improved with clear legislative support from Congress. Dr. Califf stressed that the FDA needs more explicit laws to empower the agency to act on issues like misleading food marketing, FOP labeling, and regulating harmful ingredients. He emphasized that when Congress provides clear mandates, the FDA can more easily defend its actions in court, making enforcement more effective.

Dr. Califf also stressed that meaningful change requires action from all stakeholders – Congress, federal and state agencies, consumers, and the food and beverage industry itself. The FDA’s efforts alone are insufficient, especially in a consumer-driven market where economic pressures often outweigh public health concerns. Dr. Califf brought in the example of when Froot Loops removed synthetic dyes from its cereal in response to health concerns, sales dropped, forcing the company to reintroduce the dyes.

Sen. Sanders summed up the urgency of the situation, noting that the U.S. faces a public health crisis with millions of children and adults suffering from obesity and diabetes. He stressed that real change requires courage from Congress to stand up to the powerful lobbying forces of the food industry, which profits from the sale of unhealthy, addictive products. As the Senate and FDA continue to address these issues, the path forward will require stronger collaboration, updated legislation, and a concerted effort to protect public health from the influence of the food industry.

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