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The FDA has not done nearly enough to hold food manufacturers accountable for their part in the increase of obesity and diabetes in the U.S., Sen. Bernie Sanders (I-Vt.), chair of the Senate Health, Education, Labor, & Pensions Committee, said at a committee hearing Thursday.

"For decades, Congress and the FDA have allowed large corporations to make huge profits by enticing children and adults to consume ultraprocessed food and beverages loaded up with sugar, salt, and saturated fat," he said. "There is growing evidence, including testimony before this committee, that these foods are deliberately designed to be addictive -- similar to cigarettes and alcohol -- and lead to a higher risk of type 2 diabetes."

Billions on Advertising

"The food and beverage industry is spending $14 billion a year on advertising to push these unhealthy products onto the American consumer," Sanders said, adding that one study found that ultraprocessed foods make up 73% of the nation's food supply. "Last year, for example, Coca-Cola spent $327 million on advertising in the United States alone while it raked in more than $9.5 billion in profits."

However, he continued, "Not one of their ads will tell you that a 20-ounce bottle of Coke contains more than 15 teaspoons of sugar -- over twice the recommended daily limit for kids. ... What has the FDA done to address these epidemics which have impacted the health of millions of Americans and cost us hundreds of billions of dollars every year? As far as I can tell, not much."

Sanders pointed out that in June 2023, the FDA said that by no later than October 2023 it would issue a proposed rule to require food and beverage companies to put nutrition labels on the front of their products. The FDA missed that deadline, as well as subsequent deadlines of June 2024 and October 2024. "I have been told that on Nov. 21, 2024 ... the FDA finally sent this proposed rule to the Office of Management and Budget for their review, but it has still not been made public," he said. "That is absolutely unacceptable."

FDA Commissioner Robert Califf, MD, told the committee in his opening testimony that "the FDA is trying to do its part, but successful change depends on reaching societal consensus that we will do this together ... Meaningful change can only happen with serious action by Congress, the industry, and multiple state and federal agencies."

But Sanders was not satisfied with that answer. "But the problem is, the issue we're talking about today is not a new issue," he said. "The rate of childhood obesity in America has tripled since the 1970s. And from where I'm standing, the FDA has not responded in any way to the urgency of the crisis."

Judicial Roadblocks

Califf said one big problem was the judicial system. "Let's talk about tobacco. We were instructed to [regulate] that many years ago. We have lost in court on that issue, [although] we're finally winning now ... But what sounds simple, given the current state of judicial affairs, First Amendment rights, and the fact that corporations have the same rights as individuals, every little thing we do, unless specifically [outlined] in detail by Congress -- it's not just that we lose in court, but we lose years."

Other members of the committee had various topics on their minds. Sen. Tommy Tuberville (R-Ala.) asked what FDA was doing about getting red dyes out of food. "Has this been a priority?" he asked Califf. "Because we hear constantly about the dyes. I mean, dyes are just coloring. It has nothing to do with the taste or anything like that." Califf said the dyes were a priority but "we don't have data in humans that [Red Dye] No. 3 causes cancer," although that has been seen in laboratory animals. "To demonstrate that a substance that people eat causes cancer, you have to study a large number of people over a long period of time ... We have a very small staff that can do this based on the budget. We have repeatedly asked for better funding for chemical safety."

Sen. Lisa Murkowski (R-Alaska), expressed concern about healthy food deserts. "In parts of rural America, certainly in places in my state, healthy food is hard to come by," she said. "It's expensive, and it is just a real challenge to make sure that people are getting the good, healthy, nutritious diet that they need." For example, "when you have a 24-pack of Costco water costing $99 ... in a community that lacks good, solid, safe drinking water, this contributes to [getting] your liquids from somewhere else, and when it's cheaper to drink pop, we know what we're going to see. So that is something that I think we need to do a better job in addressing."

Plant-Based Food Labeling

Sen. Tammy Baldwin (D-Wisc.), whose state has a large number of dairy farmers, asked why the FDA hasn't done more to address the misuse of terms like "milk" and "butter" on plant-based foods. "I repeatedly asked the agency to enforce standards and even secured funding for the FDA to dedicate to this purpose," she said. "I'm very disappointed by the lack of progress made at the FDA."

Baldwin said that in 2023, "the FDA published draft guidance that enables misleading product labels to remain on store shelves. The update merely provides voluntary guidance on nutritional labeling to plant-based processors ... It's hard to believe that plant-based alternatives would willingly highlight the nutritional disadvantages of their products compared to real milk."

Jim Jones, the FDA's deputy commissioner for human foods, responded that although labeling a plant-based product as just "milk" isn't allowed, "the law doesn't prohibit the term 'milk' in the labeling of such products, so long as the name itself is not misleading. And we have a compelling amount of research that consumers are not misled by using terms such as 'soy milk' or 'oat milk.' They understand that it is not milk. They are purposefully seeking such products because they are not milk."

As to the issue of nutritional labeling, although the draft guidance "encourage[s] manufacturers of these products to identify that they are not nutritionally equivalent to the dairy product ... We have gotten a fair amount of comment that that is not adequate. We are taking that comment under consideration ... The nutritional equivalence issue is very much on our radar."

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