Eating in America Podcast

The 2025 Dietary Guidelines are finally here. Revealing them took a lot longer than Bobby Kennedy expected.

It turns out that, working in secret, Brooke Rollins’ USDA and RFK Jr.’s Department of Health and Human Services went to the trouble of writing a whole new science report to replace the one that didn’t say what they, and their friends in the cattle, pork, and dairy industries, wanted it to say.

To create the report, Secretaries Rollins and Kennedy secretly appointed a whole new committee with blatant, strong ties to the industries whose products they were primarily writing about. Creating science takes time, even when it is preordained science, but the secret committee did write a tremendous amount in a very short period.

We’ll get back to the report in Part 2 of this podcast.

Part 1: Biggest takeaways

* One of the most important recommendations in the new Guidelines is to consume no added sugar. This recommendation is for everyone but is also repeated explicitly for children under the age of eleven. The Guideline’s position is clear, direct, and could be – maybe not under Trump but down the road – the basis for policy and program changes that would eventually make a difference in American health and fitness. Excellent progress.

* The other big recommendation is to reduce consumption of unhealthy categories of ultraprocessed food, called here “highly processed food.” Highly processed foods are condemned and warned against and that is a pleasant surprise and a political win for Kennedy, who had been shut down on ultraprocessed food in the Make America Healthy Again Strategy Report of September. Regardless of the politics this was excellent progress.

* The promoting of red meat is the biggest negative in the new recommendations. The link between red meat and cancer is removed in this version. Big win here for the cattle and pork industries and a step back for healthy food.

* The saturated-fat-friendly language relative to meat and dairy is a very bad message for the public, but, for the dieticians and program planners, the retention of the 10% limit on fat calories from previous Guidelines makes adding more red meat and whole fat dairy to the meals they plan a challenge. But, in essence, a big win here for cattle, pork, and dairy.

* The alcohol language is watered down. Drink limit recommendations are left out, as is the warning about how any amount of alcohol consumption is linked to cancer. The alcohol lobby is popping their most expensive champaign to toast their win on this.

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These Guidelines shift from the previous approach of focusing on a precise standard addressed to dieticians and policy and program designers. The old Guidelines needed subsequent interpretation for the public, while the new Guidelines directly address the public. They are readable, concise, and largely clear. They’ll have to be interpreted back in the other direction – for use by dieticians, policy makers, and program designers. However, the more the public understands what is required, the more they can advocate for the massive change in policies that will allow Americans to achieve healthy diets.

The bottom line: the newly issued Dietary Guidelines for Americans, 2025, will do real harm around red meat, alcohol, and saturated fat, but, given that the Guidelines push hard on two important points about sugar and ultraprocessed food that have needed hard pushes, these Guidelines might, on balance, do some real good in the long run. This will depend, however, on if and when valid, true science returns to being an imperative when federal nutrition messaging and health policy are made.

Regardless, with the new language in the Guidelines about sugar and highly processed foods, there is no going back. A barrier has been cleared that might allow going forward from a policy standpoint.

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Part 2: Pseudo-science, propaganda, pyramids, and how it all breaks down

Pseudo-science and propaganda

We knew the new Guidelines would ultimately be controlled by ideology and big money influence and not by science. Unfortunately, Kennedy and Rollins went to the trouble of having a group of industry-entwined scientists do their bidding and find science to match Kennedy and Rollins’ personal ideas of truth - and provide talking points for their propaganda lies about the old and new Guidelines. If you look in their new Dietary Guidelines upside-down-science report (the conclusions were clearly dictated ahead of time and the science was filled in to support them) you can find a disclosure of Conflicts of Interest that makes Kennedy and Rollins’ complaining about previous industry influence in the Guidelines utter, outrageous hypocrisy. Seven out of nine of the Kennedy/Rollins scientists have strong ties to cattle, pork, dairy, supplement and meal substitute peddlers, Big Food, grain farmers, or GLP-1 business interests.

That wacky food pyramid – again?

While the official use of the USDA food pyramid is 15 years in the past – it was replaced by the MyPlate graphic in 2011 – its simplicity in depicting the supposedly best way to eat has kept it present in nutrition discussions to the present day. Now RFK, Jr. and USDA Secretary Rollins have officially resurrected it.

However, like the prior two food pyramids from 1990 and 2005, this reincarnation is awkward and unrealistic, and, since the pyramid is now standing on its tip, to me it is disconcertingly unbalanced. Grains are now at the bottom (the narrow upside-down tip), essentially making the pyramid represent a low carb diet, which very few Americans are going to agree to adopt any time soon.

But wait, the food items are drawn such that the ones lower in the pyramid very slightly hide the items above. Seen this way, the pyramid is like a rack of billiard balls on a pool table, the balls at the tip slightly hiding the balls behind.

In this perspective it’s ambiguous as to what is the top and what is the bottom: all of the food items can be seen as on the same nutritional level and contributors to a healthy diet. I like that perspective, intended or not. And it is a clean, attractive graphic, especially compared to the weird 2005 version.

The images of frozen peas and canned green beans are quite legible in the new pyramid. I like their inclusion because it acknowledges that frozen and canned vegetables, which are more affordable, can be just as nutritious, and sometimes more so, than fresh ones. And for Americans to incorporate a lot more produce into their diets, it is going to have to be more affordable. And you can see a big slab of healthy salmon up near the top (below a fat-rippled slab of steak, of course!)

Oh, and I like the motto that comes with these Guidelines: “Eat Real Food.” This is adapted from Michael Pollan’s mantra: “Eat food. Not too much. Mostly plants.” Kennedy was sure to leave out the “mostly plants” part, but “Eat real food” is still an good motto to promote.

The new versus the old recommendations – what went right and what went wrong

Protein

The 2025 Guidelines push protein, saying eating twice as much as previously recommended. These Guidelines are friendly to red meat where the 2020 Guidelines encouraged fish and vegetable proteins and discouraged meat that was processed.

Americans generally get enough protein. Doubling intake is not necessary under normal conditions.

However, increasing protein is, by itself, fine – more protein is, in moderation, nutritionally harmless and, if done as a substitute for refined carbohydrates, provides calories that are metabolized much more slowly, a good thing. The caution would be in adding red meat as part of that increased protein because of red meat’s links to heart disease and cancer.

Also, some fish have such high levels of mercury that they should be avoided or eaten sparingly. RFK, Jr. himself had mercury poisoning from frequent eating of tuna. I can’t let it go unsaid that unfortunately, while Kennedy railed against mercury in the environment prior to becoming Secretary of Health, he has had tight lips as Trump has begun rolling back mercury-emission regulations.

Dairy

The 2025 Guidelines want us to include full fat dairy, but exclude dairy that has added sugar. The 2020 guidelines specified drinking no-fat or reduced-fat milk and omitted any mention of added sugar.

The 2020 Guidelines pointed out that 90% of Americans do not consume enough dairy.

In that light, the consumption of saturated fat in whole milk and other dairy products could be weighed by the individual against consumption of other sources of saturated fat, like red meat, the goal being to increase milk consumption with its nutrients like calcium and added Vitamin D.

Recommending exclusion of added sugar from milk is good. Other ways must be found to increase milk consumption in kids apart from adding sugar in flavored milk.

Gut health

Gut health appears in the new Guidelines for the first time.

They point out that highly processed foods are disruptive for the trillions of bacteria in our colons and that this microbiome of organisms plays a key role in our health. Vegetables, fruits, and fermented and high fiber foods are recommended for gut health.

Vegetables and fruit

The essential message in the new Guidelines remains the same: Eat lots of vegetables and fruits, and canned (without sugar) and frozen vegetables and fruits are just fine. The more detailed 2020 Guidelines took care to point out that 90% of Americans don’t eat enough vegetables and 80% not enough fruit.

The new Guidelines recommend 3 servings of vegetables and 2 of fruit. This is more or less the same as the 2020 recommendations, but those were expressed in cups. Cups are nice and precise for dieticians planning meals for schools or the military, but don’t communicate well with the public who would rather just know they can grab an apple or put a pile of carrots on their plate to begin to meet their health needs.

Any uptick in fruit and vegetable consumption on the part of the public would be a win but still leave consumers far from meeting the fruit and vegetable recommendations. And these Guidelines are all about the public. The dieticians and program planners are going to have to interpret them for their own specific purposes.

Healthy fats

The 2025 Guidelines claim, against the evidence, that saturated fats in meat and dairy are healthy and advocate for their use. However, the 2025 Guidelines still stick to the recommended 10% limit on saturated fat consumption from previous Guidelines and call for more research into healthy fats.

Seeds are still identified as good sources of healthy fats in 2025, but, per RFK, Jr.’s personal beliefs, healthy seed oils like canola, soybean, and corn, don’t get a mention.

Whole grains and refined carbohydrates

The new Guidelines say to prioritize whole grains and reduce highly refined grains in a way that is stronger than the previous Guidelines.

More than two-thirds of our bread, a major source of grain in the American diet, is white, and 23% is a mix of white and whole grain. I like the simple dictum of the 2025 Guidelines: switch from highly refined grains to whole grains. This is a stronger approach for the public than the previous Guidelines’ advice to limit refined grains to 50% of grain consumption, which is an almost impossible calculation to make or goal to achieve for the average American consumer whose highly refined grain consumption is way more than 50%.

There are a few additional considerations in the whole grains crusade that always go unmentioned. We often have the wrong idea how much whole grain versus refined flour is in our bread, pasta, frozen waffles, or breakfast cereal labeled as multigrain or as made with whole grains. These products can be mostly refined flour. Where is the acknowledgement of that?

And where is the acknowledgement that most of the time to make whole wheat flour, the wheat berry is milled to separate the endosperm (the source of the white flour), from the germ and bran, which are then all separately ground down fine and recombined to qualify for the term “whole wheat” on the label or in the name? This type of whole wheat bread has a palatable, smooth consistency. It just doesn’t have all the nutrients, phytochemicals, and structurally intact fiber that were in the original wheat berries and that are retained in whole wheat flour made by grinding down the wheat berries without separating their three parts. Phytochemicals have very important antioxidant, anti-inflammatory, and antimicrobial effects in our system.

Grain products with added fiber similarly are missing vitamins, nutrients, and phytochemicals.

Real food in the form of grain is not highly refined. Policy is needed at the federal level to reduce the use of nutrient- and fiber-deficient refined grains in favor of whole grains, and the Guidelines have yet to provide real impetus for that change.

Ultraprocessed food

The new Guidelines call for “a dramatic reduction in highly processed foods laden with refined carbohydrates, added sugars, excess sodium, unhealthy fats, and chemical additives…”

No argument from me.

Sugar

On average according to the USDA, Americans eat and drink 34 teaspoons of sugar a day. That’s 544 calories worth.

The 2025 Guidelines say, “While no amount of added sugars or non-nutritive sweeteners is recommended or considered part of a healthy or nutritious diet, one meal should contain no more than 10 grams of added sugars.” I won’t bore you with the math, but this is way less sugar than the old 10% of calories recommendation.

The sugar language is perhaps the most important improvement in the Guidelines. Basically, it says don’t eat added sugar, and if you have to, cut down a lot from the average. The sugar recommendation is even stronger for children. Previously the recommendation was that children under 2 should not have added sugar. The new Guidelines say no added sugar before age 11.

My hope is that this new sugar language can be a bit of a turning point and momentum can build from here toward political action and regulation aimed to eventually returning control of our sugar-contaminated food environment to the people.

Salt

The 2025 Guidelines are basically the same as before but specifically recommend avoiding highly processed foods high in sodium.

Alcohol

In a big reversal, the 2025 Guidelines say, weakly, “Consume less alcohol.” The 2020 Guidelines said limit alcohol to two drinks for men, one for women and that alcohol in any amount is associated with cancer.

The alcohol industry is the 4th largest lobby in America, after ultraprocessed food, tobacco, and gambling. Alcohol’s big money lobby, and the Trump administration’s level of susceptibility to big money influence, likely explain why alcohol had a huge win in diluting the alcohol recommendations in the new Guidelines.

The basis for the watered-down language was provided by a new National Academies of Sciences report on the health effects of alcohol. According to the National Academies’ report, if you are drinking moderately, as within the limits previously stipulated by the Dietary Guidelines, you’re not increasing your risk of death and may be decreasing it. However, there’s no evidence supporting doing away with a moderate drinking limit in the Guidelines and the evidence linking alcohol to the risk of cancer and heart and liver disease continues to strengthen.

I guess a reluctant tip of the glass to the alcohol lobby is in order.

A proposal for 2030

In 2030 when the next Guidelines are due, I would like to propose the name of the document be changed to “Dietary Guidelines for America,” not “Americans.” The guidelines are meant to inform policy formation, but their title implies it is the sole responsibility of Americans as individuals if they want to eat healthy food in line with the Guidelines. However, obesity and malnutrition are diseases, and malnutrition in America is caused not only by inability to get sufficient calories but also by being overfed but still badly nourished. Curing these diseases depends on our government taking responsibility for cleaning up the food environment to make it healthy.

Kennedy and Rollins’ introduction to the new Guidelines lays part of the blame for the ongoing devastation of diet-related chronic disease on past federal policies. This is more than true. The worst food environment in American history can only move toward healing and rehabilitation if policy changes are made and new policies formulated.

The USDA, Kennedy’s Health and Human Services Department, the larger administration, and Congress should all be working in favor of the people when the people’s interests collide with those of Big Food and Big Agriculture.

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We toss over 10% of our national food supply out of our homes each year, based on new statistics and methods from the 2025 Food Waste Report by ReFED, a leading non-profit using hard evidence to push for a reduction in food waste. That thrown-away food not only has a significant environmental impact but costs us consumers $262 billion. That is a lot of grocery money: $62 a week on average for a family of four. “Cash in the trash”, the EPA says.

The product’s date label is often the only thing we check in deciding whether to chuck food we suspect is too old.

In my household we have a range of approaches to dates on a food container. Some of us will not touch a product with a date that has passed, no matter if the label says “Best by,” “Sell by,” or “Use by.” Those products are mostly thrown away around here. Some of us will open a product with a date that has passed, take a look, give it a smell, have a little taste, and, if no alarms are raised, eat it.

The confusion and widely differing ideas about date labels stem from the fact that there are fifty states, Puerto Rico, D.C., and other entities and no standard for food date labeling across them. By one estimate there are fifty different terms like “Freshest before,” “Expires on,” and “Sell by” used on products in the U.S.

I wondered if Americans all over the country grapple, like me, with the question of what the heck the date on a food product actually means? Are the terms we see on products about safety or quality? And who decides what date to use?

Because I have been told the people in Odessa Texas are very nice, and I know the people in food banks and pantries are really nice, I decided to call Libby Stephens, the CEO of the West Texas Food Bank, serving the urban areas of Midland and Odessa Texas plus 19 very rural counties which together are the size of the state of Maine.

I asked Stephens if she understood food date labels.

“Well, I mean, I think so, just because I’ve been in the food banking world for 15 years. So, there are expiration or “best by” dates, but also from the USDA we do get some different dates that let us know when we can or cannot continue to pass out donated food or salvage and reclamation food that we pick up from grocery stores.”

Ok. So the USDA provides some safety guidance – the federal government has no rules or requirements for food dates – and a food bank or pantry can use that guidance in determining when it is still okay to offer food to customers. Stephens again:

“We have charts hanging up in all of our processing rooms at the Midland and the Odessa campuses that tell us whether milk is after expiration or not after expiration. Bottled water is up to a year. We really don’t like to take sodas, but those are 9 months. If you get to juices, it’s 6 months past the date. So it just depends on what the commodity is.”

Sounds complicated to have to depend on dates, even for the professionals, who in the case of the West Texas Food Bank are taking a date on the product and adding on a recommended margin, which might be quite large but is still regarded as safe. The Food Bank of course wants to be very sure its customers are safe but also wants to make sure they aren’t hungry. Any food bank or pantry is going to want to maximize the amount of safe food it can pass through from donors to those in need.

Lots of folks, 43% of us according to a 2025 survey, toss out food close to or past the date on the container.

And states are confused as well as consumers. About 20 states ban sales or donations of past-date products. That is good, healthy food that cannot go to a food bank.

Economists, nutritionists, environmental scientists, and politicians have been worried for years about the costs to consumers, the environment, and those in need that occur when good food is thrown away because of confusion around food date labels.

California again gets honors for stepping up, as California so often does, with an answer. It’s a law that is quite tidy and very easy to understand. As of July 2026 all food products sold in California that have a date must also have the words “Best if used by” or “Use by” in front of the date. Only those terms. No other terms are allowed. If a retailer or distributor wants to have a “sell by” date so they know when to pull a product off the shelves, that date will have to be coded so a consumer can’t read it. And, as in the past, the use of food date labels is not required by the California law.

For the consumer this means that if there is a “use by” date, it can be understood to be the last day on which the food packer guarantees the product will not have spoiled. If there is a “Best if used by” date, that marks the end of the estimated period of peak freshness. And remember, freshness is something that deteriorates tiny bit by tiny bit from the minute the product is packed, canned, or bottled to days, weeks, months, and often years past the date on the food container. I trust my senses, including my common sense, along with some basic food safety rules when it comes to things like meat and seafood, to tell me what to do as a product passes its printed date.

The USDA backs me up in this:

“If the food date label passes during home storage, the food product (except for infant formula) should still be safe and wholesome if handled properly until the time spoilage is evident. Spoiled foods will develop an off-odor, flavor, or texture due to naturally occurring spoilage bacteria. If a food has developed such spoilage characteristics, it should not be eaten.”

Neither terminology allowed in the California law, “Best if used by” nor “Use by”, provides a date a product needs to be thrown out. The USDA is clear:

“Food date labels are not indicators of food safety.”

By the way, it is the manufacturers and packers who decide the dates, often running shelf-life tests to help choose a date for the label. The dates you find on labels might or might not be a sort of science-y choice.

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The food dating issue is very big for us a society when you add in the various costs involved in the production and transportation of the food to the consumer: the land, fuel, crop treatments, and a lot of water used for irrigation. And the story doesn’t end with the consumer’s cash in the trash. When the food waste leaves the home, 96% goes to landfills, incinerators, or into the sewer system. The landfill waste decomposes, releasing methane gas, which contributes to the buildup of heat trapped in our atmosphere. All these are reasons why bipartisan legislation, along the lines of what has been enacted in California, has been introduced in Congress to bring federal standards to food date labeling.

Meanwhile, when you go to the supermarket, ignore “Sell by”: that is just for the retailer. And remember “Best if used by” is an indicator of freshness and “Use by” is just an indicator of a spoilage timeframe.

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I wish you lots of love, kindness, good eating, and good health for 2026.

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The fascinating and despicable colonial history of our most beloved drug’s most beloved delivery agent, I’m talking about caffeine and the way we most like to take it, that is in coffee, is told in Coffeeland by Augustine Sedgewick.

You could argue that sugar is actually our most beloved drug. David Kessler explains how sugar triggers our reward circuits and is addictive in Diet, Drugs, and Dopamine. I wonder what we can learn about the addictive qualities of ultraprocessed food and why we are not to blame for the eating behaviors brought on by our food environment, and so David Kessler’s book is essential reading. The GLP-1s like Zepbound and Ozempic hold a lot of promise as a fix, although not a cure, for obesity, and they offer benefits for other chronic diseases and disorders. Kessler, a GLP-1 user like me and a doctor, discusses the drugs from a clinical perspective.

On the topic of the biological workings of healthy and unhealthy food, Julia Belluz and Kevin Hall provide a valuable and digestible look at the science in the new book Food Intelligence. I like that I’m in harmony with them in singing the hymn that it is not our lack of willpower that is causing endemic unhealthy eating, it is the food system working as Big Food designed it.

I am fascinated how three addictive substances on the milder side have so taken over the behaviors of so many people over centuries and have parallel histories involving human slavery or near-slavery: tobacco, sugar, and coffee. We might be a little familiar with tobacco and sugar slavery. They were a part of U.S. history. The Central American coffee plantations of the late 19th century bound indigenous people to the work of the plantation by keeping them in hunger. Only if they worked on the plantation could they get fed. Sundays in that Catholic society were not just a day of rest, they were a day of hunger.

I talk in Eating in America about how and why we consume tobacco, sugar, and coffee today, but I feel compelled to understand how the global addiction to them was made possible by the millions of people brutally enslaved or bound to plantations to produce them. Sugar slavery is an immense part of Cuba’s history, so I’m reading Ada Ferrer’s An American History of Cuba.

And also my brother teaches in Cuba (and throughout South America) every year. His new book Working with Actors is in my stack because Stephen Bayly is my wonderful brother and the book is great.

Chef José Andrés’ Change the Recipe, seems to be about how cooking and serving food are acts of love and generosity but more importantly metaphors for how to live a life of love and generosity and efficacy.

John Green’s The Anthropocene Reviewed is interesting…

The new 2025 Dietary Guidelines are due out this month, according to RFK Jr.

Significant changes may be coming!

The Dietary Guidelines have, in the past, been largely guided by science. This year Secretary of Health and Human Services Kennedy would like them to reflect his own particular ideas about healthy food. Given the makeup of his Advisory Committee on Immunization Practices, we know Kennedy feels unrestrained by the evidence of science when it comes to public health. We’ll soon see if this is reflected in the new Dietary Guidelines.

But no matter if Kennedy is able to override science to assert his own beliefs in the new Guidelines, going forward, the 2030 Guidelines, and the Report of the 2030 Guidelines Scientific Advisory Committee, which is meant to inform the Guidelines, need to be updated to address the rapid downward slide of American nutritional health that has occurred over the last 75 years. The pace of change of the Guidelines must be accelerated to address the pace of change of our food environment.

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The last Guidelines were 160 pages long to provide detailed guidance for a host of Federal and state nutritional programs, and for policymakers and health professionals. Kennedy has promised a 4-to-6-page document this time. A six-pager, with necessarily general guidance, if issued, would present a great challenge of interpretation to the nutrition programs that depend on the Guidelines. Brevity would provide a strong focus on any changes to the Guidance, but the most important possible beneficial change, the condemnation of unhealthy ultraprocessed food in our diets, has so far been squashed by the ultraprocessed food industry and their insiders in the administration.

The 2025 Guidelines’ Scientific Advisors were appointed, in the usual secretive process reflecting corporate influence, by Biden’s USDA and Department of Health and Human Services. However, all of the 2025 Advisors had true scientific bonafides.

The next Dietary Guidelines Scientific Advisory Committee is due to be appointed by the Trump USDA and Department of Health and Human Services, the politicized nature of which poses the potential that it will be a sham, in the same way that the current Advisory Committee on Immunization Practices appointed by Kennedy is an embarrassment for public health and a lethal danger to Americans.

With the current administration tilting toward heavy corporate influence in governance and dismissal of science as a key to American well-being, combined with a diet-based health crisis of obesity, now is the moment to strongly advocate for change in the formulation of the next Dietary Guidelines.

This month I attended a panel discussion with 2025 Dietary Guidelines Scientific Advisory Committee Chair Dr. Sara Booth. When asked about public compliance with the Guidelines, Dr. Booth noted that, sadly, there is not much compliance: we have a failing grade at healthy eating in our society. Most interestingly, Dr. Booth advocated that the next Scientific Committee revisit the question of eating behaviors to address lack of public compliance to the Guidelines. This year’s Scientific Report cited the need for research of eating environment changes that can support behavioral change, giving the home as an example.

That is a baby step.

Eating behaviors in today’s food environment are in large measure created by the marketing and sale of lab-designed, hyperpalatable, high-profit-margin, ultraprocessed food. These products prey on our biological and psychological responses to their combinations of salt, sugar, carbohydrates, and fat – and to the manufactured sensory appeal of the food apart from the taste. Like lab rats, we feel rewarded when we see, taste, and ingest these products, and we soon want more.

The 2025 Scientific Advisory Committee punted on the issue of ultraprocessed food. According to Dr. Booth, some Advisors argued that the Committee was already accounting for the effects of ultraprocessed food as they evaluated its components. This approach in isolation overlooks the fact that these foods are designed to work in combination. The successful formulation of ultraprocessed food depends on the whole being greater than the sum of the parts. That is the guiding principle of ultraprocessed food.

I am never excited about eating a minimally processed baked potato with salt and butter, but I can devour a bag of McDonald’s french fries with its list of 10 to 20 ingredients, working together to trigger the reward circuit in my brain. The ultraprocessed difference for me and other consumers ends up in the quantity and quality of nutrients and the number of calories consumed.

The 2030 Dietary Guidelines Scientific Advisory Report needs to account for the ultraprocessed food effects on diet that simple minimally processed food ingredients don’t elicit.

The Dietary Guidelines themselves are intended to make recommendations with the end goal of our healthy eating. As Dr. Booth pointed out, decade after decade, five-year iteration to five-year iteration, the Guidelines evolve a little each time but are always healthy. And the public always gets a failing grade at eating to the Guidelines standards. However, the failure is really that of our federal and state governments who have neglected to ensure the safety and healthiness of our food environment and to protect the public.

In the last half of the twentieth century our food environment underwent a technology-driven, historically unprecedented transformation, the scale of which has never been seen. Ultraprocessed food grew from a small portion of our diet to 55% of our calories, 62% when just youths ages one to 18 are considered. Now, on any given day, almost 10% of us get more than half of our calories from fast food. On any given day, one-third of us patronize a fast-food seller.

When the first formal dietary guidelines were produced in 1980, the explosion of fast and other ultraprocessed food and the obesity epidemic were both just getting started. Ultraprocessed food was not even named until 2009, and the fact the U.S. and the world were in a growing obesity epidemic was not identified until the 1990s.

In effectiveness, what penicillin was to infection, GLP-1s are to obesity. But unlike an antibiotic, Zepbound, Ozempic, and that class of drugs are a fix to the symptom, not to the problem. Even with a possible leveling off of the number of adults with obesity (about 40%), the obesity epidemic is not about to end – even though drugs may help hide it. And severe obesity (about 9% of adults) is continuing to increase.

As Dr. Chris van Tulleken said last month in introducing the public health action paper in the new Lancet trilogy of papers on ultraprocessed food, the obesity epidemic is commercially driven. And the money is huge. The ultraprocessed food lobby is the biggest lobby in Washington by a wide margin.

The Dietary Guidelines have slowly evolved while the U.S. has found itself in a food environment crisis in a new era in food history. In response to these changes, it is time for the Dietary Guidelines to reboot and grapple with ultraprocessed food. The Scientific Committee needs to investigate eating behavior, as Dr. Booth proposes, and so, of necessity, investigate the drivers of unhealthy eating behavior in our food environment.

The Scientific Committee is concerned with the nutrient effects of food components and so in this cycle deferred making recommendations about ultraprocessed food, saying it required a standardized definition of ultraprocessed food that could be researched with results that could be compared across studies. A federal ultraprocessed food standard definition, while promised by RFK, Jr. and the recent Make America Healthy Again Strategy Report, may or may not come within the current administration’s term. A body of research adhering to a standardized definition is years in the future at best.

A new approach for the next Scientific Committee is required, an approach focused on the biological effects of hyperpalatable foods, how those effects drive how we eat, and how the 2030 Dietary Guidelines should take those hyperpalatable foods into account. The crushing burden of chronic disease due to our unhealthy eating has been made abundantly clear, in the research and in the personal lives of Americans. Assertive action by the 2030 Dietary Guidelines Scientific Advisory Committee and by the USDA and HHS is required, with the goal of helping Americans live longer and healthier.

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The critical health and nutrition data we nearly lost this year

Chances are very good you have never taken the National Health and Nutrition Examination Survey, or NHANES: only 5,000 Americans are part of it each year. But 5,000 of us, randomized carefully to represent all Americans, is enough to provide public health and nutrition scientists and policy makers solid data to accurately check:

* The growth of obesity, diabetes, high blood pressure, osteoporosis, and kidney, respiratory, infectious, and sexually transmitted diseases

* Use of smoking, vaping, alcohol, and drugs

* Physical activity, sexual, and other health-related behaviors

* How we eat and drink and our nutritional health.

Mobile NHANES exam centers are deployed around the country for in-person examinations and measurements, blood and urine sample collecting, and diet and health interviews.

The data is used to:

* Study the spread of disease and detect factors that may be linked to diseases

* Provide a solid scientific basis for health and nutrition policies

* Design health and nutrition programs and inform the practice of medicine and nutritional interventions.

* Inform the U.S. Dietary Guidelines, due out this month.

Important NHANES revelations

NHANES had its origins in the early 1960s. Soon after adding nutrition to the survey and exams in 1971, NHANES found blood level deficiencies of iron in women, children, and older Americans, leading to federal requirements to fortify grain and cereal with iron.

Then, still in the 1970’s, NHANES revealed that Americans had too much of another heavy metal in their blood: lead, dangerous at any level. The federal government subsequently de-leaded our dangerous gas and paint, and a reduction from high blood lead levels in almost everyone in the 1970s to high levels in 4% of Americans was achieved within 20 years.

NHANES exams and interviews found that about 40% of Americans with high blood pressure don’t realize it.

Similarly, NHANES has shown that about one-quarter of adults with diabetes don’t know they have it.

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And we nearly lost the ability to collect this data?

In October the Trump administration used the government shutdown as an opportunity to fire 1,300 CDC employees including 100 key NHANES team members. An uproar followed in the public health and nutrition worlds. By the end of November everyone was re-hired and paid back pay, but the lasting damage is hard to assess.

Ultraprocessed food and NHANES

An example of how NHANES data should be informing public policy is demonstrated by its use in recent research of ultraprocessed food consumption and associated health risks.

Ultraprocessed food creation and marketing took off in the 1950s and 1960s. I use 1953 as the start of what might be called “the era of the ultraprocessed.” 1953 was the year of the first McDonald’s franchise and the first Swanson frozen dinner.

It is good to remember that many brands of ultraprocessed products that are still popular started prior to World War II, including Coca-Cola (1886), Jell-O (1897), and Crisco (1911) – still a source of toxic trans fats, by the way, even though Crisco is allowed by the FDA to say “zero grams” of trans fats on its labels. In the 1910s we got Oreos, Nathan’s hot dogs, Aunt Jemima syrup, Hellmann’s mayonnaise, and Marshmallow Fluff. The Roaring Twenties brought us Wonder Bread, Velveeta, and Kool-Aid, followed by the Great Depression of the 1930s and Spam, Kraft Macaroni & Cheese, and Ritz Crackers.

These iconic brands represent whole categories of ultraprocessed foods like sugar- and artificially-sweetened beverages, packaged snacks, cookies, meat and meatless products and fish sticks, sauces and toppings, breakfast cereals, and, the bane of my diet, ice cream, all of which now fill the aisles of grocery stores that are supersized on a scale not envisioned prior to World War II.

Carlos Monteiro is the most prominent name in ultraprocessed food research, having coined the term “ultraprocessed” in 2009. Using NHANES data, a team of researchers, including Monteiro, found that between 2001 and 2018, ultraprocessed food consumption increased from 53.5% of the average American adult’s calories to 57%. That 3.5% increase over 17 years may represent a recent trend toward leveling off in the consumption of ultraprocessed food.

We don’t have good data for ultraprocessed food consumption in the 20th century, so we can’t put a number on how much was being consumed in the 1950s. But certainly it was a low number compared to the 53.5% of calories in 2001: on that there is consensus. So very rapid growth in the last 50 years of the century, was followed by what appears to be a tendency toward a flattened curve in ultraprocessed food consumption.

That trend toward leveling off is a good thing given the mounting evidence in over 100 studies of ultraprocessed food’s association with death and chronic disease, including obesity, diabetes, high blood pressure, heart disease, stroke, kidney disease, Crohn’s disease, and depression.

And the trend toward the leveling off of ultraprocessed food consumption, following its meteoric rise in the last half of the previous century, should not be surprising. Today, the average American already consumes almost 60% of their calories eating ultraprocessed food. I hope our taste buds and some human instinct to eat natural foods will end the growth in ultraprocessed food consumption.

The more ultraprocessed food we eat, the more that minimally processed foods like fresh fruits and vegetables and simply prepared meats, poultry, and fish will be displaced from our diets. The study of NHANES data from 2001 to 2018 found consumption of healthier, minimally processed food decreased 6%, from 1/3 to about ¼ of out calories, while unhealthy ultraprocessed food calories consumption increased 3.5% during those 17 years.

What is required for the recovery of America’s nutritional health and a subsequent substantial reduction in chronic disease are policies and programs that greatly reduce the consumption of ultraprocessed foods.

Kudos to San Francisco, which this week filed suit against ultraprocessed food makers including Coca-Cola, PepsiCo, Kraft Heinz, Mondelez, Nestlé, Mars, ConAgra, and cereal manufacturers Post, General Mills, and Kellogg. San Francisco is suing on the basis of the evidence that the ultraprocessed products marketed and sold to consumers create a burden of chronic disease.

The CDC’s fast food report

The CDC’s own, in-house analysis and reporting of the NHANES data has tremendous value to public health policy and programming in America.

In April the CDC’s National Center for Health Statistics reported good news, sort of. Two-thirds of Americans on a given day in 2022 or 2023 did not eat fast food. Of course, that means one-third of Americans did go to a McDonald’s, Starbucks, Chick-fil-A, to name the top three, or another purveyor of fast food. Unfortunately, 9%, almost one in ten, of survey respondents got more than half their calories in fast food that day.

The CDC’s study found that adults with obesity ate 40% more fast food calories compared to adults with underweight or normal weight status.

A related CDC study found that American youth are eating fast food at almost the same levels as adults, 30% of children and adolescents ages 2 to 20 have fast food on a given day, and 11% of their overall calories come from fast food, compared to 32% and 12% for adults. The good news here is that the CDC reports these rates decreased a little for both youths and adults from 2013 to 2023. We can only hope that this apparent trend continues.

To this end, our neighbors to the north and south, Canada and Mexico, along with nations in Europe, Asia, and South America, do a better job limiting fast food advertising and other unhealthy food marketing that targets children. Some ban it all together.

CDC’s obesity report

Obesity in America was reported by the CDC in 2024 using NHANES data from 2021 to 2023. The rate among adults was 40%, without a significant difference between men and women. However, there was a big difference in severe obesity with a rate of 6.7% in men and, approaching twice as much, 12.1%, in women.

The good news is that the level of obesity in adults was unchanged between 2013 and 2023, although the level of severe obesity grew considerably, from 7.7% to 9.7%, overall.

I gave thanks at Thanksgiving for public health professionals. That includes the thousands of talented people at the CDC dedicated to true science and the public health. I would like to exclude, of course, those current CDC political appointees I know about from any consideration.

NHANES is a key source of data and the work gathering it, reporting it, and making it available to other researchers around the world is essential to improving the well-being of Americans.

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Preface

Microplastics is a very challenging topic. The research I did for this piece scared me in a way that I have not been scared by research before. I came to fully understand how immersed we are in microplastics on a daily basis, but how little we know about their effects, and how little we can ever know about how much and what kinds of plastics and, importantly, plastic additives, we are exposed to. Like all of us, I want some control of what goes in me and my family. The impulse I’m feeling at the moment is to avoid all plastics, but one look around me, and I know that is quite impossible.

Optimistically, when I put the issue in context, my sense is that microplastics is a long game problem, and the game has just started. There are more urgent and important food and health concerns in the near term, but we can’t ignore what is happening with plastic. The more quickly we react to the new microplastic environment we live in, the sooner we will understand the priorities for action, for us as individuals and for our society.

At the end of this piece I would be quite interested in your reactions to all of this in the comments section.

The story

In 1951 an efficient way to make polypropylene and high-density polyethylene plastic was discovered by Philips Petroleum chemists searching for a way to turn Philips’ huge holdings in natural gas into a profitable product. Polypropylene and high-density polyethylene are the numbers 5 and 2 in the recycling triangles on the bottom of many containers in your kitchen. Recycling number 1 is PET and is found on the bottom of soda bottles and prepared food containers. PET is a polyester, like the fiber in clothes and rugs. Together those three plastics are the most common of the six main types.

The manufacturing of plastics has been exploding since 1951, when 2 million metric tons of plastics were made, globally. In 2015, ten years ago, that annual figure was near 400 million metric tons. In 2017, half of all plastics ever made were produced in just the prior 13 years, between 2004 and 2017. And the trend keeps zooming upward.

Packaging for consumer products and food is the biggest user of plastic, 40% or 50% by some estimates. Other major sectors are building and construction and textiles.

Plastics production grew so quickly from the 1950s that by 2004, marine biologist Richard Thompson reported on the vast quantity of plastic waste in the ocean and the presence of something he termed “microplastics.” In the space of 50 years the developed world had created a global plastics crisis.

What exactly are microplastics, and how about nanoplastics?

Microplastics are primarily shed from larger pieces of plastic, although some are manufactured at a micro or nano level, such as microbeads used in personal care and cosmetic products. Microplastics are defined as ranging from 5 millimeters (a little less than ¼ inch) to 1 micron (or one-millionth of a meter) in length. Nanoplastics are all the smaller particles down to the limits of detection technology, below 100 nanometers. Nanoplastics can easily pass through the lungs and intestinal lining to enter the bloodstream, where they can travel to and enter our organs, but microplastics are found in our organs as well. Secretary of Health RFK, Jr. has correctly identified that these micro- and nanoplastics can be “…found in samples of human tissue: in the brain, the liver, the kidneys, the colon, the placenta, and testicles.” Nanoplastics are small enough to enter into individual cells.

Where do microplastics come from?

Breakdown of waste plastic creates 22% of microplastics in the oceans. Worldwide, in research where a brand on plastic waste could be identified, of the top 10 sources of plastic pollution in 2023, six were ultraprocessed food companies: Coca-Cola (perennially the top source of plastic pollution), Nestlé, PepsiCo, Mondelēz, Mars, and Danone. Two other top sources, Unilever and Procter & Gamble, specialize in body care and other products. The last two sources in the top ten were tobacco companies: Altria Group and British American Tobacco. The cigarette culprits are the filters in the butts thrown on the ground.

There are three main paths into our bodies from packaging plastics like soda bottles and baby food containers. First, particles are released into the environment and then we eat or drink them in our food and water. Second, we inhale them. Third, our food and water packaging releases microplastic directly into the food and water we are preparing to eat and drink. Additionally, nanoplastics from personal care and cosmetic products can enter through pores and abrasions in the skin and have been shown to cause skin cell damage, but skin contact is a minor entry point compared to the mouth and nose. Fortunately, one source of micro-and nanoplastics intended for skin contact, microbeads, were banned from certain personal care products like toothpaste and facial scrubs, first in 29 state laws and then in federal law in 2015.

Other major sources of microplastics in the environment include vehicle tire wear particles, which are bearers of toxins from the tires, and microfibers from laundry water after the washing of synthetic fiber clothes. City dust, a mix of plastic particles, is another leading source.

A team of scientists in China wrote somewhat poetically about the sources of microplastics:

“The presence of microplastics can be detected from the Tibetan Plateau to the Marianas Trench and from the houses we live in every day to the untouched skies over the Pacific Ocean.”

Their analysis, along with analyses by others, found drinking water, food, and inhaled air were the major sources of microplastics in humans.

Research published by the National Academy of Sciences estimated that a one-liter bottle of water contained over 100,000 plastic particles, 90% of them nanoplastics.

Our poetic Chinese scientist friends estimated that of the microplastics counted in the body, 45% came from water, 33% from fruits and vegetables, and 21% from indoor and outdoor air, but more from indoor.

The quantities estimated to come into the body on average from food, water, and air might vary greatly depending on the methods of different researchers, and they will vary for each individual according to their environment. The consistent finding is that micro- and nanoplastics are everywhere, and we eat, drink, and breathe them.

Why are micro- and nanoplastics harmful?

Microplastic particles are rough and irregular in shape and porous. They gather pollutants like bacteria, viruses, heavy metals, PCBs, pesticides, and carcinogenic polycyclic aromatic hydrocarbons, which are the products of the incomplete combustion of coal, oil, gas, wood, and tobacco. Once in your body these free riders can be released.

The rough particles can act like splinters and damage tissue.

And then there are the additives. The global plastic additives market approached $50 billion in 2020.

The most worrisome effects of microplastics in the body are from the release of the chemicals added to them when they are made. Of 13,000 additives to plastic, over 3,000 are concerning because they are persistent, accumulate in tissue, or are known or potential toxins. Many more of the chemicals might be toxic, but they haven’t been studied.

Some of the worst chemical additives that we know about include:

* Bisphenol A, or BPA, which is used in metal cans, plastic food containers, reusable water bottles, and water pipes. BPA can be regarded as a potential human carcinogen. It’s an endocrine disrupter, a reproductive toxin, can pass through the blood-brain barrier, and is linked to nervous system disorders and degeneration. BPA has toxic genetic and epigenetic effects. It’s not good for your DNA.

* Phthalates are used to make plastic flexible. Phthalates are linked to endocrine, reproductive, respiratory, and nervous system problems.

* Styrene, a building block of plastics, is a known carcinogen in California and a reproductive toxin.

* Brominated flame retardants, including PBDEs, are used in recycled plastics for household goods and toys and are a concern for nervous and reproductive systems.

* Other known toxic chemicals released by microplastics include PFAS, PFOS, and triclosan, a germicide used in toys and kitchen utensils, and in toothpaste in the U.S. until about six years ago. Triclosan is a reproductive toxin and endocrine disrupter.

* Finally, microplastics in carotid artery plaque or in brain tissue are associated with a higher risk of stroke or dementia, respectively.

What does RFK, Jr. say?

In September 2023 presidential candidate Robert Kennedy had a list of ten almost idealistic promises to reduce plastics in our lives. These promises embraced and then went far beyond the Democratic supported Break Free from Plastic Pollution Act of 2023, which failed to pass in either chamber of Congress.

Kennedy promised to:

* Support an international plastics treaty

* Restrict toxic plastics and chemicals

* Prfomote a national bottle bill

* Require producers to take responsibility for their pollution

* Upgrade recycling facilities and systems

* Limit new plastic production facilities

* End subsidies for plastics producers

* Order a major national study to evaluate all sources of plastic waste

* And, most radically, to ban fracking, which provides most of the natural gas America produces, and thus the raw material for the plastics produced here

Were the promises ever to be enacted a huge reduction in plastic production and use would follow, along with reduced release of microplastics and reduced plastic contaminants and pollution. Of course, the fossil-fuel friendly Trump is never going to ban fracking, nor would most of the other proposals seem likely to be approved by the business-friendly Trump.

In fact, Kennedy’s ambitions about plastics have been greatly scaled back. At a meeting in April with representatives of packaging manufacturers, Secretary Kennedy simply asked industry to voluntarily reduce plastic use.

While Secretary Kennedy has otherwise been somewhat silent on microplastics, at the same meeting he said, quite accurately: “We don’t know the effects of microplastics in the human body, but we have disturbing studies that link microplastics to cancer, dementia, and reproductive problems.”

Kennedy’s Make American Health Again Strategy Report, released in September, made one mention of microplastics, but only in a long list of other health risks to be researched prior to action:

“[Health and Human Services], in collaboration with NIH and EPA, will complete an evaluation of the risks and exposures of microplastics and synthetics, including in common products such as textiles.”

What to do about it on a personal level?

We are exposed to plastic, microplastics, and nanoplastics from all directions every day, and no individual can know how best to reduce their plastic-related health risks or even what those risks are, if any.

At one end of the long list of possible action items is going to Europe for a $10,000 microplastic blood filtering treatment – yes, that’s a thing! But I prefer to start by throwing out my plastic spatulas.

There’s actually some consensus on a best first step, which you likely already know: avoid heated plastic, especially when it contains food. As of 2024, U.S. manufacturers have phased out their use of PFAS to grease-proof paper and paperboard containers used to contain food, so take-out containers are less concerning now than they were. However, I’m still trying to figure out what to do about hot take-out food, since even paperboard containers are still usually lined with plastic or wax. There is no really good answer beyond giving up take-out, but that is not going to happen soon in my house.

Here are some other solid, low- or no-cost, steps, though.

* Check your tea bags. Some well-known brands still use plastic bags, which can release 11 billion microplastics and 4 billion nanoplastics into one cup of hot tea. Maybe hold the sugar after that! Brands that don’t use plastic bags include Republic of Tea, Numi, Yogi, Pukka, Bigelow, Stash, Traditional Medicinals, and more lately, Lipton, and Twinings.

* No plastic should go in the microwave. Cover foods in glass bowls with a plate or use a silicone vented-cover during microwaving. Just know, silicone is a polymer, as are plastics, and, like plastic polymers, has additives that can migrate out. Most of what migrates out of silicone are siloxanes, the building blocks of silicone. Several siloxanes are listed by the European Union as “substances of very high concern,” due to potential carcinogenic or mutagenic risks. Nonetheless, silicone compared to plastic is more stable and heat resistant and considered safer, especially compared to plastic when heated.

* Wash and dry synthetic fabrics (polyester, nylon, acrylic, and spandex) on the cool cycle and maybe lean toward natural fibers in new clothes. Microplastic fibers can come loose in the laundry and may stay on your clothes and be available for you to inhale. But most of them will end up in the ocean.

* Stainless steel or protected glass water and hot beverage containers are recommended over BPA-free plastic.

* Wood cutting boards are preferred over plastic, especially because of the knife action on the surface.

Epilogue

In recent decades, our civilization has invented a very large number of new substances and, using these substances, new products, many with a wealth of undeniable benefits. Much of our amazing, life-saving medical technology depends on plastic, for example. But downstream from all of this invention, we often learn of associated health risks, which unfold over time.

As these worrisome risks become revealed, some people tend to shy away from the related substances and products. Take Teflon for example.

My office is my front porch, where I take breaks from Eating in America to check out the birds visiting the birdbath and to say hello to the neighbors.

It was 38 degrees Fahrenheit this morning, and I was sitting here in my three jackets and warm blanket writing this article, the fresh air helping the coffee to wake me up and keep me going. I turned on my new radiant heat lamp to “high” to keep my fingers warm enough to type.

At the suggestion of a reader, I was checking the status of Teflon (or PTFE, the chemical abbreviation for Teflon), still for sale 11 years after the toxic chemical PFOA was removed from Teflon in new frying pans and other products in the U.S. My heater began to give off a noxious smell – just as I found in my research that radiant heat lamp bulbs in heaters such as mine are often coated in Teflon to make them more shatter-resistant. The off-gassing of PTFE from such bulbs kills poultry when used to warm the birds…So now my hands are cold as I wait to hear back from the heater company about whether their bulbs are coated in Teflon.

Ironic! I was researching a toxicity in the kitchen that we might want to avoid while I was possibly inhaling the same toxicity from a completely unexpected source. Not just ironic but a case in point for the state of our personal environments. We are surrounded, and if we turn from one chemical or substance, we will encounter another to reckon with.

By the way, there is evidence that DuPont’s replacement of the toxin PFOA in Teflon with another PFAS they called GenX, may be worse. GenX causes cancer in lab animals. Our non-stick pans are going in the trash.

In fact, 3M, DuPont, and other PFAS manufacturers knew in the 1940s, soon after Teflon began to be used in products, that PFAS chemicals were linked to health risks. They hid their knowledge from the public until a lawsuit forced their disclosure.

This may feel gloomy, and I’m sorry. Maybe I should start a microplastics-worry support group.

Figuring out how much exposure we have to micro- and nanoplastics is a massive scientific challenge, and knowing any associated risks approaches impossible at this point. Microplastics are tiny and tasteless so, perhaps for now, make yourself a nice cup of tea or pour yourself a Chardonnay to go with your Thanksgiving leftovers, and damn the microplastics. I hope you had a great holiday. At our house we gave thanks for true science, public health professionals, and healthy food!

And I give thanks to Jennifer Rappaport, a reader and experienced health writer, for advice about Teflon.

And thank you for listening. Please subscribe if you haven’t and share this and other Eating in America posts. If you care to start a microplastics support group in the comments, or just offer your thoughts about microplastics, please do.

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There are so many facets to the revolution in weight loss and control that is being led by the new GLP-1 class of drugs. Today I touch on a few of the many important aspects of GLP-1s. What I don’t get to today, I’ll try to return to soon.

The headline this week: Price cuts and wider coverage for GLP-1s

On Thursday, as you have probably heard, President Trump announced GLP-1 pricing will be lower for self-payers and Medicare and Medicaid coverage will be wider in a new deal with Eli Lilly and Novo Nordisk, makers of Zepbound, Wegovy, Ozempic, Mounjaro, and their upcoming oral versions, for weight loss and diabetes.

Given this is a Trump deal, the devil is in the details, such as whether the cost savings for injectables will include the convenient and painless pen versions or be for the vials only. Bring your own syringe, if it is just for the vial versions.

More certainly, barriers to expanding GLP-1 access in Medicare include that Medicare Part D drug plan pricing for next year is already fixed – without the large additional cost of GLP-1 coverage for obesity worked in. Also, it is currently against the law for Medicare to cover pharmaceuticals for control of obesity. Offering GLP-1s for obesity as part of a pilot program is proposed as the work-around for the legal issue.

Nonetheless, this deal is perhaps two steps forward, after Trump took a step backward in April and nixed Biden’s proposed expanded Medicare coverage of GLP-1s.

On the same day as the GLP-1 deal, the FDA gave priority slots for quick reviews of Eli Lilly’s Orforglipron and Novo Nordisk’s oral semaglutide, the pill versions of Zepbound and Wegovy for weight loss. The lower cost of the pill versions along with likely higher consumer acceptance of pills vs injectables, could have a major impact on uptake of GLP-1s by Americans. These pill versions are likely to be a huge step forward.

GLP-1s and understanding that weight loss struggles are all about biology

First, the basics. GLP-1 is a gut-produced hormone, glucagon-like peptide-1. The GLP-1 class of popular weight loss and diabetes control drugs mimic the natural hormone and amplify its effects.

Zepbound and Wegovy are GLP-1s indicated for weight loss and the lower dose versions, Mounjaro and Ozempic, are indicated for diabetes.

GLP-1s are linked to reduced risk of stroke, heart attack, Alzheimer’s, and kidney disease. GLP-1s help with sleep apnea and some lung conditions. There is evidence of reduced cancer risk, increased control of substance disorders, and benefits for a number of other conditions.

These drugs are sometimes quietly acclaimed by researchers and personal doctors, and often loudly acclaimed by users, who don’t have a professional reputation at stake, as miracle drugs. The main miracle is that these hormone-mimicking drugs easily override a patient’s hard-wired biology and make them lose weight.

Before GLP-1s came along scientists had begun to understand that body weight wasn’t controlled so much by behavior and willpower as by biology. I hope that widening familiarity with the effectiveness of GLP-1s will increase popular understanding that biology is the biggest factor in the weight gain and weight loss equations and thus reduce stigma both around excess weight and the use of GLP-1s, which are biological agents, to control unhealthy weight.

The profitability of Americans believing in willpower

Food manufacturers along with diet profiteers, including influencers and sellers of weight control programs, apps, books, and magazine articles, would like you to believe that you don’t need any remarkable willpower so much as their product and their advice. Inherent in their business model is to keep us thinking as long as possible that insufficient willpower is the barrier to weight loss.

However, studies have found that for most people, neither willpower nor dieting aids work in the long term. Weight regain is common. The body’s aversion to weight loss, programmed into our DNA, is too strong. One study which brought data together from many studies found that 75% of weight lost is regained. Weight lost through dieting or deprivation is met with the body’s strong biological response to restore the lost weight.

Meanwhile, profits in the dieting sector are being reduced by the popularity of GLP-1s even as attitudes are slow to change. Diet nutrition provider Jenny Craig Inc. fell first, and Weight Watchers International went out of business in April.

American attitudes about GLP-1s seem to depend on whether it’s about health or (perceived) vanity

According to a February 2024 Pew Research survey, 53% of Americans, a little more than half, believed GLP-1s were good options for losing weight for obesity and weight-related health conditions. Only 19% believed GLP-1s were not good options for losing weight for obesity and weight-related health conditions. However, a slim 12% thought GLP-1s were good options simply to lose weight and 62% thought GLP-1s were not good options simply to lose weight.

A year later, in January 2025, an AP-NORC survey, found the same results, showing remarkable stability in attitudes about GLP-1s even as their popularity was still rapidly increasing.

Many folks tend to regard using a GLP-1 to lose weight without an obvious health reason, as a shortcut. It’s not clear why this stigmatizing attitude is so common, while latitude is given to GLP-1 users who have more severe obesity or weight-related chronic disease.

True, it is easy to find Hollywood stars who appeared previously to have a perfectly healthy weight but who then more recently seemed to have gotten thinner. One guesses that the Ozempic that Jennifer Coolidge on the Emmys and others joke about was responsible in these cases.

But the number of stars using GLP-1s does in fact make a case for how difficult it is to lose weight by sheer behavioral changes and willpower. Actors are generally highly motivated to have the most marketable body possible. If Hollywood can’t do it without Ozempic, it’s unreasonable to think the rest of the world is going to be more successful, when its only health at stake and not even a movie part.

I use Zepbound.

There are many things in our culture which were heavily stigmatized not so long ago but are now seen as quite normal and accepted: divorce, mental health treatment, tattoos. I can claim to be normal around two of these items. Not yet tattoos, but I have plans.

I hope stigma around the use of GLP-1s fades away in the same way that the stigma around mental health treatments like Prozac is fading. I am lucky to be able to use Zepbound to lessen my health risks and improve my ability to lead a healthy life. I was among the 31% overweight and 42% obese Americans before using Wegovy and Zepbound.

RFK Jr. is right: the health of our nation depends on defeating the obesity epidemic

I fully agree with Kennedy that our nation’s health is weakened by the obesity epidemic and the many chronic diseases linked to unhealthy weight. And Kennedy is right in some things he says about our food environment and why we as a nation don’t eat well. (Kennedy is of course quite off the mark and irresponsible in some other ideas about how to eat healthy. He has no business being the top leader of our nation’s health, on the basis of his nutrition misconceptions alone.)

The cure? Fixing our sick food environment.

RFK, Jr. says that the GLP-1 deal

“…is going to have dramatic effects on human health in this country.”

Let’s hope so. But while these hormone mimickers are miraculous, the best way, and really the only way in the long term, to control obesity and overweight in our society is to cure our sick food environment.

Big Food, i.e., the ultraprocessed food industry, is big because it has gone to the laboratory and created products that are hyperpalatable – meaning we can’t get enough – and manufactured and marketed these food products to a trusting American people, including me.

When suspicions have been raised about the health implications of these products, Big Food and the ultraprocessed food lobby, our country’s biggest lobby by far, exert their power over government, and too often over science, funding research to quiet or cast doubt on worries.

In response, government regulation is required to protect America’s citizens from food corporations and the agricultural powers who have been allowed to harm our health for their profits.

Let’s have a chuckle to conclude

Addressing the press after Trump’s announcement of the GLP-1 deal, RFK, Jr., head of the Department of Health and Human Services, claimed

“The American public, because of this agreement, will lose 125 million pounds by this time next year.”

Not to be outdone, Dr. Mehmet Oz, Head of the Centers for Medicare and Medicaid, contradicted Secretary Kennedy, saying he had an update.

“We thought it would be 125 million pounds. Mr. President, our estimate, based on the company numbers as well, is Americans will lose 135 billion pounds by the midterms.”

The midterms, huh? Apparently, the political meaning of this GLP-1 deal might be more important than the health benefits. But you have to have voters to make politics mean anything. By Dr. Oz’s reckoning the American electorate would evaporate!

To get to the goal of losing 135 billion pounds, every man, woman, child, and infant American would need to lose 388 pounds. Seems like a lot. I think they need to hire those statisticians back at Health and Human Services.

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East Coast, Gulf Coast, and the Heartland: Food pantries feel the fear, and good people stepping up

The SNAP crisis and food security: I talk to people on the front lines

Food security is fundamental to the life of every human. Thankfully, many of us don’t have to worry about it, but knowing where our next meal is coming from allows us to work on building and protecting our families: to provide shelter, clothing, the ability to be employed, to go to school.

As Eating in America reported in September, Trump’s USDA has cancelled the annual U.S. Food Security Report, which for 30 years has provided actionable data on the level of food security around the nation and helped increase the efficiency of food assistance funding and program implementation. The last report, for 2024, was due out in October but has not been issued.

Many of us have never had to worry about our food security, but in 2023 one in seven households, 41 million Americans, experienced food insecurity. Five percent of households had very low food security, skipping meals or reducing food intake.

And we are at a point of rising food insecurity. The 2008 recession saw food insecurity climb to 15%, after which it dropped by 1/3 to 10.5% by 2019. However, food insecurity has been rising since 2022 due to inflation and, when last reported, was 13.5% in 2023.

What is the impact of food insecurity?

Food insecurity is linked to poor physical and mental health and negative economic effects. In children, food insecurity is associated with behavioral and developmental issues and poor school performance.

Right now one out of eight Americans are enrolled in the USDA’s Supplemental Nutrition Assistance Program, or SNAP, to reduce their food insecurity. Other USDA programs improve the food security and nutritional health of women and children, seniors, and school children.

As this is being written, the availability and duration of SNAP funds for November and going forward is in question. While judges have ordered the program to be funded during the current government shutdown, the Trump administration’s full compliance and the timing and duration of the restoration of funds are uncertain.

All of this has created extra stress and disruption on top of the ever-present stress of food insecurity for tens of millions of Americans.

Today on Eating in America, I spoke with food pantries on the East Coast, Gulf Coast, and in the Heartland.

First, states, cities, and towns throughout America have been stepping forward in the face of this food crisis. I spoke with

Alissa Ebel, Healthy Communities Coordinator for Somerville, Massachusetts, who has been helping that city communicate to its residents what is going on with SNAP benefits and where they may be able to obtain food in the time of SNAP uncertainties. Ebel has experience at the street level helping to manage a local food pantry.

“Many folks who use SNAP are dealing with other forms of insecurity and worries about making ends meet. SNAP is something they can usually rely on, which makes this unprecedented delay so damaging. Retroactive benefits won’t erase the stress and sense of instability the delay has caused for participants. This is compounded by the confusion of the delay and the implementation of the cuts passed earlier this year. Although these cuts will roll out over the next year and more, and only affect some SNAP households, we’re hearing from people concerned that the whole program has been eliminated.”

Ray Chavaree [sha (a as in mat)-vahr-ray] helps run the Long Beach Community Food Pantry, a pantry associated with Saint Thomas Catholic Church in Long Beach, near Biloxi, Mississippi. The Long Beach Pantry is open Monday, Wednesday, and Friday for 4-1/2 hours each day. Chavaree told me he had seen a surprising uptick in both pantry customers and donations:

“Today we had seven new people sign up who are losing their SNAP benefits.” They come from all walks of life according to Chavaree: “It doesn’t matter. We have all sorts of demographics. We have all sorts of ages. We have people who are housed. We have the unhoused. We run the whole gamut here.”

“Donations today, from members of the church community and the community in general, started when we opened and haven’t stopped. We are getting our shelves stocked to overflowing at this time. Hopefully we’ll have enough to make it through.”

Like Long Beach, Mississippi, Wellfleet, Massachusetts on Cape Cod is a coastal community with vacation homes, second homes, and retirees. Wellfleet is a community with a high average household income, but the Wellfleet Food Pantry serves a spectrum of people in need. According to Sandra Galvin, President of the pantry, “We’ve been serving over 200 families. We have retirees who thought they would be secure but now their finances are not sufficient. We have seasonal workers. We have a lot of shellfish and fishing families. The people that we’ve been seeing at the pantry don’t expect that they’re going to find jobs anywhere on the Outer Cape here. There are not many prospects, and they are just trying to exist and stay here. Housing is hard to find and housing costs are ridiculously expensive.”

“We have basically a food desert here. We have 2 supermarkets. The food is extremely expensive. But we provide food. People come in, and they’re anxious now, much more anxious. We hear the stories. They need money for their gas, for their heating, for food, for everything.”

From the heartland of America, I spoke with Deanna Wagner, manager of the Bellevue Food Pantry in Nebraska:

“We’ve already seen a large increase in numbers of people seeking food assistance in Sarpy County with the government shut down. We saw an increase in people coming from Offutt Air Force Base, and then we’ve also just seen people affected by having their jobs furloughed, or people that are already anticipating cuts to their SNAP benefits. So, October was our busiest month ever, and we’re anticipating the rest of the year to be similar to that.”

“A lot of people are uncertain about why this is happening or what the future holds for them, and there are quite a few people that rely on SNAP benefits, just to supplement what they’re already buying. So not having that, that leaves them trying to figure out where they’re going to be able to feed their families throughout the month.”

I spend the first Saturday morning of each month in Revere, Massachusetts, outside Boston, where this month the Free Produce Market coincided with the first day in a pause of USDA funding for SNAP benefits. As usual, market customers from Revere and surrounding cities began to line up before I and other market volunteers arrived, hours before the market opening at 10:00 am. Anticipating increased fear of hunger due to the SNAP crisis, the organizer, Cambridge Health Alliance, a large health care provider, increased the number of free produce bags provided to 600 bags, up from 525 in September.

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Photo credits: the pantries and Ric Bayly, Revere Free Produce Market.

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As you may have read or heard in last week’s Trick-or-Treat Eating in America post or podcast, the PEZ dispenser packages I bought to give away at Halloween contained Red Dye No. 3 in the candy, so I took them back. Too bad. It was an otherwise great treat idea.

Red No. 3, banned in Europe and North America because it can give cancer to rats, must be all gone from U.S. food shelves in 2027 and from U.S. medicine in 2028.

I have searched hard for Red Dye No. 3 in many candies and ultraprocessed food products, like cake mix and frosting, Jell-O, salty snacks, soft drinks, sports drinks, powdered drink mixes, pre-cooked meat products, and breakfast cereals for children. I even checked maraschino cherries, long famous for red dye. PEZ was the only place I found Red No. 3.

Most products I checked did have other artificial dyes: plenty of Red No. 40 as well as Yellow Dyes 5 and 6 and Blue Dyes 1 and 2.

RFK, Jr. pronounced in April that he has an understanding with Big Food that synthetic dyes will go voluntarily. As has been pointed out by the Center for Science in the Public Interest, Kellogg, whose synthetic dye containing products include Froot Loops; Mars, maker of M&Ms and Skittles; and Walmart, maker of many private brand products, have previously promised to end the use of synthetic dyes.

In fact, Big Food is taking two approaches to the synthetic dye problem. On the one hand, some ultraprocessed food manufacturers have acknowledged that the time has come to cut out synthetic dyes and have begun to eliminate them in their products. Perhaps the primary driver here is that upwards of 20 states have started initiatives to ban the dyes, and it is difficult to sell food with different safety standards in different states. In lieu of a national standard, these manufacturers are taking a broad approach to cutting synthetic dyes.

On the other hand, some manufacturers and organizations, like the Consumer Brands Association, representing a who’s who of manufacturers, including Nestlé, Mondelēz, Coca-Cola, PepsiCo, General Mills, and Kellogg, have defended dyes.

Walmart however, this month has again pledged to do away with synthetic dyes, along with 30 other food additives including the food whitener titanium dioxide, in its private brand products. While Walmart’s press release bragged that 90% of its private brand products are already free from synthetic dyes, I was a little shocked: you’re saying 10% of Walmart products currently contain synthetic dyes!?

Three other die-hard dye surprises

The first surprise, in two ways, was that, in my very limited survey, PEZ was the only product I found containing Red Dye No. 3. That’s a good surprise overall, but a bad surprise that a product meant solely for children would be a Red Dye No. 3 holdout.

The second surprise was that titanium dioxide is an additive to Walgreens’ Nice brand candy covered peanuts. Yes, the same titanium dioxide that can be found elsewhere in Walgreens as a sunblock agent.

The litany of issues with titanium dioxide is long. Titanium dioxide is a potential carcinogen and is banned in food in Europe. It is linked to genetic damage; cell death; neurological, heart, and lung disease; elevated blood glucose; and disruption of gut hormones and the body’s own GLP-1, the hormone Glucagon-Like Peptide 1, which is key to the weight and diabetes control drugs Zepbound, Wegovy, and Ozempic.

The third surprise is the amount of caramel coloring in colas. Caramel color is not a synthetic dye in the sense that it is made from petroleum, but given the chemical process used to make it, I regard it as clearly artificial. Caramel coloring made from sugar and ammonium compounds is the most widely used food dye, by weight, by a large margin. I found caramel coloring was the second ingredient in sugar-free Coke and Pepsi, coming after water, and the third ingredient, coming after high fructose corn syrup, in the sugared versions. It was also in the ginger ales I checked, as a lesser ingredient. While most caramel dye is consumed in colas, it is also found in baked goods, beers, and sauces. In the manufacturing of ammoniated caramel coloring 2-methylimidazole and 4-methylimidazole, which cause cancer in mice, are produced. The Center for Science in the Public Interest reports that in 2007 the U.S. made a finding that these compounds have links to cancer, and the World Health Organization later labeled the compounds as possibly carcinogenic in humans.

California played the hero in 2012, requiring food containing ammoniated caramel coloring at levels above 29 micrograms per serving, like colas, to have a cancer warning label. Coca-Cola and Pepsi consequently reduced their caramel coloring levels from as high as 150 micrograms to 4 micrograms per serving, first in California and then nationally.

The Center for Science in the Public Interest recommends avoiding colas altogether, given that the FDA has a limit for food additives that contain carcinogens that is 10x as strict as California’s – meaning the amount of 4-methylimidazole in these colas may well exceed the FDA limits.

The FDA, meanwhile, incredibly, still allows ammoniated caramel coloring to be exempt from regulation as a food dye and to have Generally Recognized As Safe, or GRAS, status, meaning the FDA is still taking the manufacturers’ word for the safety of the additive. Please read or listen to the Eating in America post or podcast about GRAS for more details about how the FDA is failing to protect Americans with the GRAS system.

As of 2020 the FDA was in a review of 4-methylimidazole, but an FDA food additive review can be a black hole with a due date of infinity and beyond, so I have no expectations of FDA action on that account. I do hope RFK, Jr. will try to add caramel coloring to his hit list of other artificial dyes and provide cover for some action within his department. I also hope Kennedy makes good on his pledge to get rid of the GRAS system.

Let’s be clear about caramel dye risks. It’s the sugar in colas that is the biggest health risk by far, but given the dye is there solely for looks, wouldn’t the best approach be “when it doubt, throw it out”? When there’s a risk, based on evidence, that something might be bad for humans, and we know caramel coloring does nothing positive for humans (only for the food manufacturers and marketers), wouldn’t it make sense if the FDA said “nah,” Coca-Cola, people can live without it? But that is a discussion for another day.

Back to PEZ…

The PEZ story is a perfect example of the way food manufacturers with vision saw, in the 50s and 60s, how to create commercial success by combining post-war food manufacturing and additives with modern mid-century marketing and growing affluence and consumerism. In the mid-1950s PEZ was a tiny but vivid harbinger of the meteoric rise in highly- and ultra-processed food that was to follow.

If you caught the Trick-or-Treat episode last week, forgive me for quickly reheating the history of PEZ and serving it again. This time it has a surprise ending.

Eduard Haas III invented PEZ as a mint in Vienna in 1927 and marketed it as an aid for quitting smoking. The dispenser was designed in 1949 by a product engineer who had, fittingly, designed cigarette lighters. And that lighter flicking motion is mimicked in the PEZ dispenser. Haas imagined he was going to help his customers occupy both their cigarette-less mouth and their fingers.

Unfortunately, when Haas left post-war Austria to come to America in 1952, he discovered Americans didn’t want to quit smoking. In an absolute brilliant pivot, Haas changed the mint candies to fruit flavors and colors and added little figures to the dispensers, like Disney characters, witches for Halloween, and Santa Claus for Christmas. PEZ has also made dispensers for 38 of the 46 U.S. Presidents. Barack Obama is the last President to be so honored. I expect that when Donald Trump finds this out, he will turn his attention from campaigning for the Nobel Peace Prize to making sure he has a PEZ dispenser issued with his likeness. The candies, of course, will need to be golden.

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For 45 years, America’s most important official document on the topic of nutrition has been the U.S. Dietary Guidelines, “the cornerstone of Federal nutrition policy and … education activities, providing food-based recommendations to promote health…” according to its authors, RFK, Jr.’s Department of Health and Human Services and the USDA. This coming week may see publication of the 10th edition of the Guidelines, which are rewritten every five years.

Never far from controversy due to the persistent influence of the agricultural lobby and Big Food, the Guidelines this year have been particularly weighed down by both politics and, new to the equation, the Trump administration’s practice of spurning science. Science, Trump has found, can be very inconvenient when it stands in the way of accruing and distributing wealth and power. And trashing science seems to resonate with many in the populace who are attracted to Trump.

A wall of anti-science chaos has been built by mass firings of scientists along with large chunks of the national scientific support system, withholding of research funds, stifling of free speech, and a conveyor belt of unfounded statements from Trump, RFK, Jr., and others. Hidden behind this wall, a solid foundation has been built for transferring power from the American people and those dedicated to protecting them, into the hands of the power elite.

A catalog of ethical corruption

Lisa Held in Civil Eats has pieced together an exposé, cataloging Trump’s handing over of Brooke Rollins’ USDA, Robert Kennedy’s Health and Human Services, the EPA, and the FDA, a Health and Human Services agency, to the tentacles of corporate interests through their close ties to 26 federal appointees and nominees, including Rollins and Kennedy. The ethical stench is overpowering.

The most shocking case is the nomination of Casey Means, sister of Kennedy’s Special Advisor Calley Means, as Surgeon General. Dr. Means has been called unqualified to serve as Surgeon General by two former Surgeons General, Dr. Richard Carmona and Dr. Jerome Adams. Both cite Means’ complete lack of public health experience, among other factors. Adams was Surgeon General in the first Trump administration.

Means has many corporate ties, but the real shockers are her investments in Philip Morris and Altria, two of the world’s biggest tobacco companies. A Surgeon General candidate having financial interests in these tobacco companies, with their anti-public health histories, is mind boggling. According to the CDC, nearly a half-million Americans die from smoking every year. Tobacco is the leading cause of preventable death, disease, and disability. Means’ Senate nomination hearing will occur this coming week with Means appearing by Zoom from Hawaii.

So what about the Dietary Guidelines?

The news is that RFK, Jr., who has been public about his meat-centric, “carnivore” diet, will go against long-standing scientific evidence, including that cited in the 2025 U.S. Dietary Guidelines Advisory Committee Scientific Report. Kennedy will publish Guidelines that recommend increasing the saturated fat in our diets. This will make U.S. red meat and dairy producers, and their friends in the USDA, happy.

In an article in The Guardian about Kennedy’s reportedly pro-saturated fat Guidelines, Hannah Harris Green cites Ronald Krauss, a saturated fat researcher, who regards saturated fat as health neutral. Despite judging saturated fat to not be a health risk, Krauss feels moving away from current guidelines is premature. Other nutrition experts widely agree with the current guidelines recommending consumption of saturated fat be limited to 10% of calories and that, generally, saturated fat should be replaced with unsaturated fats, like olive oil.

It must be noted that Krauss’s big research paper finding that saturated fat is not harmful was authored by him and many others with strong ties to the dairy and beef industries.

This year’s Dietary Guidelines Scientific Report recommended increased reliance on plant protein, as found in whole grains, beans, nuts, seeds, and soy. If Kennedy’s opinions hold sway over the science, we may instead see the increased plant protein recommendation disappear or even be replaced by a recommendation for increased consumption of meat.

Last month Eating in America described how the setting of the Dietary Guidelines has a history of corporate influence and how RFK, Jr.’s fight against ultraprocessed food got crushed in last month’s MAHA Strategy Report. It appears unlikely that ultra-processed foods will re-emerge with recommendations in the coming Dietary Guidelines.

The Dietary Guidelines are fundamental to national policy and practice on nutrition, setting standards for programs including School Lunches, SNAP, and WIC, the nutrition for Women, Infants, and Children program. They are widely adopted by health and nutrition programs and professionals throughout America. Warping the Guidelines to reflect commercial or personal interests hurts the health of Americans.

Wait, go back, RFK, Jr. is setting the U.S. Dietary Guidelines?

When I consider Kennedy’s qualifications to lead the updating of this most important nutrition document I think about his dead brain worm, probably ingested. And I ponder his health recommendations to drink raw milk and eat red meat and increased saturated fat, although his own CDC says raw milk poses a serious health risk and recommends limiting saturated fat intake and there is a lot of strong evidence about the heart, stroke, diabetes, and cancer risks of red meat consumption, along with evidence of risk of cognitive decline with eating red meat. And I remember that Kennedy eats, in his words, “a ton of vitamins”, but no unprocessed fruits or vegetables; and that for a period of time he obsessively ate so much tuna and perch that his blood had 10x the EPA recommendation for mercury, causing him memory loss.

Kennedy also has a misguided plan to make this edition of the Guidelines easy-to-read and only 4 to 6 pages long so that people can read and understand it. Unfortunately, the reason the American people don’t abide by the Guidelines is not because they are too long and difficult to read. Americans don’t follow the Guidelines because our health policy leaders have for decades let commercial interests essentially control, through formulation of hyperpalatable foods and product marketing, what Americans want to eat and can afford. The Guidelines need to contain a lot of clear and detailed information for health and nutrition professionals and policy makers to act on. A summary-style Guidelines will be inadequate.

RFK, Jr. is inadequate and unfit to be in charge of the Health and Human Services Department, just as a person who profits from smoking is unfit to be Surgeon General. It looks likely to be another interesting week in D.C.

Thank you for reading.

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