There is a nutritional imbalance at the FDA

There is a nutritional imbalance at the FDA
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Ever wondered what the Food and Drug Administration spends on nutritional activities? Thanks to a Government Accountability Office report issued this week, the truth can now be told. For years, the FDA has starved its nutrition program almost to non-existence.

Believe it or not, the following is not a typo: According to GAO, only two percent of the about $1 billion FDA spent annually on food safety and nutrition between fiscal years 2011 and 2016 went to nutrition-related activities. In fiscal 2016, 127 FDA staff worked on nutrition, while the food-safety cadre reached 4,718, including inspections staff.

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Food safety is important, and my organization, the Center for Science in the Public Interest, played an important role in the passage of the landmark FDA Food Safety Modernization Act in 2010.

 

But nobody intended the enhanced focus on food safety to result in nutrition getting comparatively short shrift.

Food safety is a major public health issue in the United States. Each year, one in six Americans get sick from tainted food, and 3,000 die.

The 15 most common food-borne pathogens are estimated to cost the nation $15.5 billion annually in healthcare costs.

But two percent for nutrition? Really? More than one in three adult Americans are obese according to the Centers for Disease Control and Prevention.

Heart disease, stroke, type 2 diabetes, and some cancers are related to obesity, according to the CDC, which pegs the estimated annual medical costs associated with obesity at $147 billion in 2008 dollars.

The FDA’s tiny staff is not without its achievements, principally, the elimination of artificial trans fat from the food supply, a move that FDA said would prevent thousands of fatal heart attacks each year. It also has pushed long-anticipated updates to the Nutrition Facts Panel on packaged foods.

Most likely, those 50 to 60 nutrition-related staffers are peddling about as fast as they can. But the impact of years on a starvation diet is starting to show.

In June 2016, FDA issued draft voluntary guidance to the food industry on how to reduce sodium and set 2-year and 10-year targets.

Admittedly, it can be hard to separate budgetary constraints from deliberate policy decisions, but the agency has yet to finalize the short-term targets, and Congress is blocking final action on the long-term targets. Currently, almost 90 percent of adult Americans and more than 90 percent of children consume too much sodium.

Nutrition labeling has also proceeded at a snail’s pace during this period. Menu labeling was part of the Affordable Care Act, enacted in 2010 and finally set to go into effect in May 2017. But the FDA pulled the plug at the last moment to placate the most resistant segments of the industry. After entering into a settlement with CSPI, the initiative is set to go into effect in May of this year.

The fate of the updated Nutrition Facts label, favored by 87 percent of Americans in a recent CSPI survey, is also awaiting the final act. The FDA announced a proposed delay from July 2018 for large companies and July 2019 for small companies until January 2002 and January 2021, respectively.

When the GAO report was released, FDA Commissioner Scott Gottlieb promised an upcoming strategy “to reduce preventable death and disease through better nutrition.” We have a suggestion: Propose a budget where food safety does not outweigh nutrition by fifty to one.

Dr. Peter Lurie is the president of the Center for Science in the Public Interest and former associate commissioner at the Food and Drug Administration.