WASHINGTON — FDA Commissioner Robert Califf opened Wednesday’s National Food Policy Conference with some sobering words.
“It's all too obvious that we're in the midst of backsliding in the progress that we've made for many years,” Califf said.
The average American’s life expectancy has gone down nearly three years since 2019 and is now 76.1 years, the lowest level since 1996, he said. Six in 10 people in this country have a chronic disease, and four in 10 have more than one.
Many factors contribute to these conditions, but unhealthy diets and poor nutrition play an outsized role, Califf said. Three-quarters of people in the U.S. don’t eat enough fruits, vegetables or dairy, he said, while a majority eat too much sugar, salt and saturated fat.
But this week, he said the nation is at an inflection point in food policy.
Last month, President Joe Biden hosted the first White House Conference on Hunger, Nutrition and Health in more than 50 years. The administration released a detailed policy plan designed to end hunger in the nation by 2030, as well as reverse trends toward more diet-related diseases.
A major part of the plan also is devoted to new labeling, definitions and information that the FDA is looking to put in place to educate Americans about the nutritional content of what they’re eating.
“Make no mistake: Every American has a right to choose what they want to eat, healthy or not,” Califf said. “Our role at the FDA is to give people access to the facts so that they can make informed choices.”
Califf and Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, shared some of the plans to use policy to try to improve public health as the conference opened. The nation’s problems stemming from food are multifaceted, Mayne said, so the solutions also need to be.
“Government certainly has a role in getting healthy foods to everybody, and then making healthier choices the easier choices,” she said.
Labeling is a powerful tool the FDA can use to better inform consumers, Mayne said.
The federal government recently proposed a new definition of “healthy” that more closely aligns with the Dietary Guidelines for Americans.
Mayne said the agency is also working on a regulated front-of-package seal, which consumers can use to quickly tell when a food item meets the “healthy” standard. Additional front-of-package labeling that Mayne said the FDA plans to develop would help consumers quickly determine how nutritious food products are.
A model of this type of labeling regime has been implemented in Chile where unhealthy products have stop sign-like symbols on the package. The symbols indicate when a product is high in calories, saturated fat, sodium or sugar.
A study by researchers at the University of North Carolina at Chapel Hill, the University of Chile and the National Institute of Public Health of Mexico found daily purchases of the individual unhealthy nutrients on the warning symbols decreased significantly after the labels were implemented — by as much as 37%, researchers found.
While labeling increases transparency to consumers, Mayne said it has another function.
“It has the potential to make foods healthier because it provides an incentive for food manufacturers to reformulate,” she noted. “Our goal is to create a healthier default, so that all food options get healthier.”
Labeling initiatives have been successful in shaming manufacturers into improving their products before, Mayne said.
Trans fats first appeared on the Nutrition Facts label in 2006 as a way to show consumers when products include manmade fats that increase heart disease risks. Trans fat consumption quickly went down about 80% as consumers made different choices and manufacturers reformulated, Mayne said. Today, trans fats are essentially nonexistent in food.
The FDA also is working to reduce sodium intake, which mostly comes through processed foods.
Mayne touted the voluntary sodium reduction guidelines published last year that listed suggested average amounts of sodium for 163 different food categories. The guidelines were constructed to reduce average sodium consumption from 3,400 mg per day to 3,000 mg a day — a sizable decrease, but still more than the daily 2,300 mg of sodium recommended in the Dietary Guidelines for Americans.
Mayne said even a modest decrease in sodium intake would result in big benefits across the population, and said the FDA will continue to monitor intake and revise the guidelines over time.
Califf said the agency is working to prioritize its food responsibilities, which have often seemed to take a backseat to the FDA’s responsibilities regulating pharmaceuticals. While there is a joke among officials that the “F” in FDA — which stands for food — is silent, Califf told conference attendees that is not the case.
“There's a reason why the ‘F’ in FDA comes first,” he said. “I know that's been a topic of a lot of discussion this year, and I want to emphasize we are focused on food during my tenure this time around.”