Fixing Food: A New Start for FDA

One of the lessons from our recent national election is that we are a nation of individuals, not demographics. We change over time and with the circumstances. That’s not only true of our political philosophies, but true of health as well. This has tremendous implications for public health and highlights why health and safety regulatory agencies aren’t succeeding as much as they should. I talked about this issue specifically as it relates to FDA in my book shown above, Fixing Food.

FDA’s Outdated Approach to Food Regulation

FDA’s Human Foods Program began 120 years ago, when we more or less assumed that a policy or recommendation made by experts was appropriate for all. The sciences behind nutrition and food safety were in their infancy. Today, use of up-to-date science is what troubles FDA, not their cumbersome management structure.

Start with nutrition since it’s by far the biggest issue with food. It’s not going to be solved by universal advice. A recent study found that even identical twins shared about the same bacteria in their gut (37%) as unrelated people do (35%). Given the same foods, the twins had different reactions in their blood sugar, insulin levels, and triglycerides. That means that their genes were not the primary explanation for reactions; in fact, it was their environments, health conditions, epigenetics, sex, and microbiomes. What this means is that the one-size-fits-all nutrition advice associated with food labels, MyPlate, and the Dietary Guidelines is outdated.

But FDA is doubling down on food labels, trying to put them on front of food packages despite the three decades of failures of the existing labels. FDA, CDC, and USDA continue to use nutrition science, the worst of all sciences in terms of data and poor practices to make recommendations. They continue to enforce century-old recipes and food standards as well.      

Personalizing Food and Health Policy

What’s needed is a move to precision nutrition. Moving to precision nutrition will encompass “a comprehensive continuum spanning from the measurement of dietary intake to the development of intervention strategies based on individual variability.” This is what will move us forward in our confrontation of obesity and non-communicable chronic disease.

FDA can also play a role in validating key biomarkers and that data that inform them. For example, FDA can help to protect private health data to dispel doubts people might have in sharing data essential to improve health outcomes. That data will power the necessary monitoring and analytical tools necessary to create individualized dietary advice. If we can monitor what people eat and pair that with real time monitoring of health, key biomarkers, and food preferences, people will have real-time advice that can change behavior.

That advice will be in personal medical devices which, like models, are wrong, but some are useful.”  “Useful” is what we’re after—not perfection—because we won’t know that until we have had a lot more experience. These devices only have to be more useful for individuals than current federal government advice (and some of those terrible nutrition books). We also need to eliminate two bad ideas, fat shaming and fat acceptance. With 3 out of 4 adults either overweight or obese, we cannot allow these fictions to continue.

When it comes to food safety, we need to explore safer ways to grow and produce food. These practices are being implemented around the world, and we need to make a welcoming regulatory structure for them here. For a start, FDA has recently moved away from regulating chemicals by assuming lower is better when it comes to chemicals in rules like “Closer to Zero.” One way to improve the regulatory structure is to use modern risk analysis that takes into account exposure, costs, and risks of alternatives. 

We also have new technologies like genetic modification, which is a safer and more effective way to create foods than traditional breeding or radiation dosing. Other technologies we need to employ includes robotics, blockchain for traceback, smart sensors, 3D printing, smart packaging, and precision fermentation.

The Need for New Thinking in Food Regulation

FDA has been around for over 100 years and even people that love FDA’s food polices have found their “new” management plans to be “underwhelming and elementary.” We are long past the early days of inspectors easily finding food safety problems in plants, like rats running over meat, and intentionally adding obvious poisons to foods. Our problems require new thinking and new solutions—but nothing new ever seems to come out of FDA. Personalized nutrition for individuals and innovative food technology are necessary. It may require a new organization to get there.