Physicians, Scientists Weigh In on RFK, Jr’s Food Policies

Deregulate raw milk. Take fluoride out of water. Challenge vaccine safety. Create a registry of autistic people. US Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr, promotes many ideas that much of the scientific community finds concerning. 

Unlike other positions held by Kennedy — most notably, unsubstantiated concerns about vaccine safety, fluoride, or the plan to deregulate raw milk — his focus on food safety and nutrition enjoys the support of many physicians and experts. Among the preferred targets of his proposed interventions are food dyes, additives, and ultra-processed foods, which he blames for the dramatic rise in chronic childhood conditions.

Whether health experts agree with the way he’s getting there, however, is a different story. 

“[Kennedy] has the right diagnosis but the wrong prescription,” said Robert Lustig, a professor emeritus of pediatrics at the University of California, San Francisco (UCSF).

A Welcome Focus on Nutrition

Some credit Kennedy for shining a brighter spotlight on some food and nutrition issues that have long been recognized by experts in the field. Jerold Mande, an adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health, Boston, and a former federal policy official, said interest in nutrition issues has gone from nearly “nonexistent” to a very high level since Kennedy took over at HHS. At this point in Kennedy’s tenure, he sees an important focus on the priorities he shares.

“It’s extraordinary that MAHA [Make America Healthy Again] is here, that Kennedy is on these food, nutrition, chronic disease issues and has made it a political priority because it hasn’t been,” Mande said, referring to Kennedy’s MAHA plan.

Longtime nutrition advocates see this as an encouraging step toward valuing the role of food in health, an idea that is not always embraced by physicians. “There’s really good evidence that the medical training that we’re giving to doctors includes very little on diet,” said Emily Broad Leib, director of the Center for Health Law and Policy Innovation and the Food Law and Policy Clinic at Harvard Law School, Cambridge, Massachusetts. 

Anna Herby, a nutrition education specialist at the Physicians Committee for Responsible Medicine, a nonprofit research and advocacy organization based in Washington, DC, agreed that diet is overlooked in medical training and noted that “it sometimes gets ignored [in favor of] medications and surgeries and procedures.”

Yet some question the focus of Kennedy’s priorities on nutrition. While many health experts agree on the need to combat chronic disease, focusing on food additives and dyes “are not the things we should spend our time and energy on,” said Eric Shulze, an adjunct professor of nutrition at the Harvard T. H. Chan School of Public Health and a former senior policy official at the US Food and Drug Administration (FDA) and the US Department of Agriculture. 

UCSF’s Lustig thinks Kennedy’s program is unlikely to have much impact because it will not improve the nutritional quality of available food, something Lustig sees as the priority to improve the American diet. “[Kennedy] knows that the nutritional quality of the food is the problem,” he said. “He knows it, but he’s not doing anything about it.”

The Issue of Ultra-Processed Foods

Experts agree that ultra-processed foods are a major health concern for Americans but stress that any type of federal intervention must be based on sound science. While many processed foods, such as those containing meats and animal fats, are harmful, it is not a good idea to demonize all of them, said Neal Barnard, a cardiologist and adjunct professor of medicine at the George Washington University School of Medicine in Washington, DC. “What people are often missing…is that some processed foods are associated with health benefits,” he said. For example, an unprocessed breakfast of steak and egg is less healthy than a breakfast of processed cornflakes and soy milk.

Others say that blanket bans on ultra-processed foods may be counterproductive. “We have to feed 1src billion people by the year 2src5src, and we don’t have enough land and ocean to do it,” said Lustig, who consults for an international food company working to produce nutritionally healthy processed foods. “Ultra-processed food is a fact of life, and it’s not like we can just wish it away as much as I would like to.”

A Change of Philosophy

Many welcome what seems to be an overall philosophical shift toward a more cautious approach when it comes to regulating and allowing substances and products, more similar to what happens in peer countries, for instance, in the European Union.

One example is Kennedy’s intention to reform the Generally Recognized as Safe process, which allows food companies to introduce ingredients without undergoing a formal FDA review if they are considered safe by experts or have been used for some time and enjoy broad support.

A more conservative approach, which is what Kennedy has been proposing so far, adopts the opposite perspective: Substances have to be proven safe before they can be added to foods or drugs. This finds broad support among many experts. Diana Zuckerman, the president of the National Center for Health Research, Washington, DC, and a former congressional investigator of the HHS, welcomes this shift. “There is more of that precautionary principle, which has been mostly rejected in this country,” she said. 

Shulze, however, defends the FDA’s existing philosophy as the best suited to a country that wants to pursue innovation. “Risk-based systems work effectively,” he said, while “precautionary principle-based systems are extremely restrictive and promote tradition over any innovation.”

Implementation Without Regulation? 

Whether Kennedy can transform his plans into effective policy remains to be seen. Mande said that a Republican administration seems less likely to introduce new regulations or funding for new programs that have been levers for implementing health policies.

“It’s a big mismatch of theories of governance: All of these things require more regulation, and you’re in an administration that across the board is saying we want less regulation,” said Leib. When it came to chemical food dyes, for instance, the food industry agreed to phase out several by 2src26, but no regulation was introduced to force them. This leaves open the possibility of not complying, and some companies have already announced their intention to continue using dyes.

“I do think that asking industry to self-regulate or self-police is not going to get the job done,” said Dana Ellis Hunnes, a senior dietitian supervisor at Ronald Reagan UCLA Medical Center in Los Angeles. “I think governmental regulation has a place, and especially when it comes to trying to make foods healthier for all.”

Still, most are taking a wait-and-see attitude. Even skeptics recognize that something is moving, and the message that food is inextricably tied to chronic disease and health is becoming mainstream. “The fact that you’re calling me about this and we are talking about food is already a change, isn’t it?” said Lustig.