A Message to MAHA: Every American Should Have Access to a Healthy and Affordable Diet
(An earlier version of this column appeared in Food Safety News at https://bit.ly/417cLOJ)
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Preamble: The Make America Healthy Again (MAHA) movement has sparked an overdue examination of how to improve the health of Americans, particularly in terms of safe food and healthy diets. Unfortunately, this effort has devolved into an acrimonious debate among competing interests and ideologies. The rancor is likely to escalate further once the MAHA Commission Action Plan is released by the Administration sometime later this month or in September.
Before the heat builds further, FDA Matters would like to remind all parties of the primary goal and most urgent need: a plan for all Americans to have access to a healthy and affordable diet.
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We have entered into a dynamic and growing dialogue about food in America — what we should be eating, how we should prepare it, what constitutes a nutritious meal, the need for additives in food, and the role of government in regulating the food industry and defining healthy diets.[1]
Stimulating the immediate dialogue are the Make America Healthy Again (MAHA) Action Plan, originally due August 12 but now delayed; the revised dietary guidelines, scheduled for release in September; and the HHS/USDA Request for Information on defining ultra-processed food (here), which will be open for comments through September 23.
Hopefully, the result will be a more cohesive path forward for improving the food Americans eat and creating a consensus around the specifics of a healthier diet. We need government food policies that are sensible, feasible, flexible, and beneficial.
Given that food sustains us and is deeply ingrained in our lives and culture, we must proceed with caution. There is an unlimited potential for downstream consequences that we do not intend and cannot necessarily foresee.
Broad Concepts to Guide the Discussion
1. Every American should have the ability to afford a healthy diet.
Millions of Americans are food insecure. It is especially rampant among children, affecting approximately one in five American kids.
The number of food-insecure Americans is expected to increase over the next few years due to ongoing and proposed cuts to SNAP, school lunch programs, and support for food banks and other feeding programs.
Hungry people buy whatever sustenance they can afford from whoever can supply it. Quality, safety, and nutritional value become, at best, secondary considerations.
A broad reconsideration of our national food and dietary policies and guidelines is valuable. Still, it should be tempered by an awareness that increasing the cost of food will lead to millions more Americans becoming food insecure.
2. Every American should have access to a healthy diet.
Affordability is also an access issue. Beyond that, there are food deserts that leave millions of Americans isolated from a range of healthy foods. There is a risk these will expand further because many smaller and rural grocery stores are heavily dependent on serving families with SNAP benefits.
I know that many states and localities are working on encouraging supermarkets to expand into these underserved areas. That’s ideal, although it is uncertain whether this approach will be successful. Another approach is to identify and promote healthy diets that can be accessed through corner markets, bodegas, and other small groceries that are more widely dispersed but typically have a more limited range of foods.
Access is also becoming more difficult due to cuts to the Local Food Purchase Assistance Cooperative Agreement and Local Food for Schools federal programs. Those cuts saved the government about $1 billion but came at the expense of providing schools, child care centers, and food banks with fresh food from local farmers (here).
3. Every American should have access to foods that are made from safe ingredients.
Healthier diets should reduce the incidence and impact of diseases, including both acute and chronic conditions. However, there is a paucity of good research, especially on causation. A healthy diet should be built around some “better to be safe” changes but also allow for innovation and information derived from new and ongoing research.
4. Every American should have access to safe foods with minimal risk of intentional and unintentional adulteration.
A healthy diet should be compatible with maintaining food safety. Preservatives, in particular, are essential to many products and may need to remain even if they have names that people cannot pronounce. Intentional and negligent adulteration is a serious issue (my article on this topic is available here), and reducing the frequency of such incidents should also be a consideration when recommending healthy dietary choices.
5. Every American should have access to healthy and convenient foods tailored to their life stage, offering a range of choices.
There cannot be one healthy diet to the exclusion of others. Providing multiple ways to eat healthier is beneficial in itself, as it respects the fact that there are lifestyle, cultural, gender, and age differences, in addition to individual taste preferences.
A healthy diet must also allow for multiple convenient options. It is fine that some people want to cook meals made only from single ingredients they have grown or purchased themselves. However, a significant portion of the American population lacks the time, space, and/or necessary equipment to cook at home, especially given their family and work obligations and living conditions.
One size does not fit all. Recommendations for a healthy diet must provide good choices for a wide variety of situations and circumstances.
AND MOST OF ALL:
Every American — rich and poor — should be able to afford and access a healthy diet. That’s a simple standard that will be incredibly hard to achieve. Nonetheless, policymakers and stakeholders must fully embrace this challenge.
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The goal of FDA Matters is to analyze FDA policy and regulatory issues and advocate for a more effective, efficient, and fair FDA. FDA Matters doesn't cover the news....we provide analysis of what's behind the news. scribe on the website (www.fdamatters.com) or send me a note at sgrossman@fdamatters.com.
[1] This ignores (at our nation's peril) the ever-present food safety risks; we should add this to the conversation without waiting for a crisis-inducing incident (here).