The political lens on food is changing

• Committee Chair Bernie Sanders (I-Vt.) assailed the way Congress and the Food and Drug Administration allowed big corporations to profit off enticing children and adults to consume ultra-processed foods and beverages.
• Some lawmakers were also surprised that the FDA hasn't reviewed the safety of a food dye called Red 40 in more than a decade, and asked about its potential effects on behavioral health.

What they're saying: "This is the first time that I've heard anybody at that level talk about issues related to the food system in general and chronic disease in particular in a very, very long time," Marion Nestle, an emerita professor of nutrition at New York University, told Axios.

The big picture: The connection between food and chronic disease has been central to HHS Secretary-designate Robert F. Kennedy, whose Make America Healthy Again agenda has targeted everything from dyes to seed oils.

• But it's tapped into a deeper public distrust of corporate influences in public health and the belief that obesity is the top overall health threat, ahead of poor mental health, opioids and gun violence.
• Last week, a Pennsylvania teenager sued Coca-Cola and 10 other big food companies, accusing them of "engineering" ultra-processed products to be addictive and marketing them to kids.
• The surging popularity of GLP-1 drugs also reflects a belief that being overweight or having poor metabolic health is a medical condition, not a lifestyle choice.

Yes, but: There may be limited policy options short of mandates, more spending and the specter of the government dictating what we eat.

• One option could be "food as medicine" — the idea that doctors can prescribe certain foods the way they do medicines to improve patients' health. While a handful of states have tried to tap Medicaid funds for pilot programs, measuring data and getting insurers on board are obstacles, Axios Pro reported.
• Jerold Mande, former deputy undersecretary at the Department of Agriculture, told Axios policies like changing the SNAP program, regulating ultra-processed foods and investing in nutrition and prevention are finally getting attention.
• "We've been waiting for this to be a political priority, and it finally is," Mande said, adding "the messenger is imperfect here," in reference to Kennedy and MAHA.

Zoom in: In a recent op-ed in the Wall Street Journal, former Centers for Disease Control and Prevention director Tom Frieden and former New York City and Philadelphia health commissioner Thomas Farley agreed with Kennedy "that food is driving epidemics of chronic disease."

• "If Kennedy were to ask us for advice, we'd tell him this: Americans eat unhealthy food because the food system is designed to feed it to them. Changes to the system will be fought bitterly by food and agricultural companies, but the fight is worth it," they wrote.

Between the lines: At the Senate hearing, FDA officials, facing sometimes sharp questioning, confirmed they are eyeing a potential ban on Red No. 3, a food dye commonly used in candy and snack foods that has raised concerns about whether it causes behavioral problems in children.

• The FDA is also eyeing front-of-package labeling on processed foods, and intends to issue a rule updating when food makers can claim a product is "healthy," commissioner Robert Califf testified.
• He pointed to the agency's recent reorganization of its human foods program, which included creating a center to review nutrition and conduct post-market reviews of chemicals used in the nation's food supply.

• In July, the FDA moved to remove an additive that had long been used in certain sodas.

But Califf said the agency is decades behind Europe in this effort and has been limited by existing science, legal hurdles and "powerful industry forces."

• "There is good reason to be concerned about the chemicals that are routinely included in much of our food," he testified earlier this month. "The FDA has limited resources to deal with this issue."

Zoom in: Experts are critical of the lack of regulation around ultra-processed foods.

• With industry pressure from snack foods, beverages and other groceries, the current focus in most nutritional guidance in the U.S. is personal responsibility for healthier eating, experts tell Axios.
• Efforts to make ultra-processed foods pricier than healthier options or to beef up FDA scrutiny of additives and how corporations market their products would be far more effective, they say.
• "There's no question that the food that's being sold to us is injurious to health," Mande said. "And yet they don't do anything. So why don't they do anything? And it's really is because they just aren't funded to do that."

Reality check: Congress is highly unlikely to make significant moves in light of the power of the food industry, Barry Popkin, nutrition professor at the University of North Carolina, told Axios.

• "Think of the size of these companies. They dwarf the old tobacco companies," he said.
• Even as Nestle said she's been encouraged by the recent attention to processed foods, it's unclear what might happen to that effort if Kennedy isn't confirmed — or even if he does get the job.
• "Eating healthfully is very bad for business and there are huge economic forces that mitigate against trying to do anything about chronic disease," Nestle said.
• "If Kennedy wants to take on ultra-processed foods in schools, he's taking on the ultra-processed food industry. If he wants to take mercury out of fish ... that's coal-burning power plants. If he wants to get chemicals out of the food supply, he's taking on polluters," she said. "That's a lot to take on."