Happy Friday, and welcome to Food Fix. Next week, I’m on two panels here in DC: On Monday, I’m appearing at the School Nutrition Association’s Legislative Action Conference. On Tuesday I’ll be at the Consumer Federation of America’s National Food Policy Conference. If you’re at either event, say hi!
Food Fix on air: I recently joined KCRW’s Good Food program with Evan Kleiman to talk about the Trump administration and the “Make America Healthy Again” movement.
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Alright, let’s get to it –
Helena
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Four takeaways from Marty Makary’s FDA confirmation hearing
President Donald Trump’s pick to serve as FDA commissioner, Marty Makary, appeared before the Senate Health, Education, Labor and Pensions Committee on Thursday for a two hour confirmation hearing — a crucial step towards his expected confirmation.
Makary, a pancreatic surgeon at Johns Hopkins, has flown under the radar while much attention has been paid to his soon-to-be boss, HHS Secretary Robert F. Kennedy Jr. and many of his controversial views. Makary, for his part, is known as a contrarian with a track record of challenging medical consensus (such as the recommendation for young children to get Covid boosters), but he tends to stick closer to reputable scientific evidence which makes the medical community much less nervous about him versus RFK Jr.
As I’ve previously noted, Makary has more of a record on food than any modern FDA nominee — certainly more than any commissioner I’ve covered — and it’s not close. FDA commissioner noms usually come in with a medical background and little to no (usually no) experience in food, even though the job includes jurisdiction over roughly 80 percent of the U.S. food supply. As a physician, Makary fits that typical pattern, but he’s uncharacteristically written extensively about food issues, from food allergies and nutrition to antibiotics in meat production. (If you missed it, I did a dive into Makary’s record on food issues back in December.)
Knowing Makary’s background, what does he plan to do moving forward, exactly? I watched his confirmation hearing searching for any mention of food policy issues. Here are my four takeaways from the hearing:
Food still gets lost in FDA world. First things first: A reality check! Makary may have an unusual level of interest in food issues, but food really is a lower priority issue within the broad jurisdiction of FDA (which includes drugs, medical devices, cosmetics, infant formula, even microwaves!) This has long been true, but it really comes through in hearings like this. Robert Califf, who served as FDA commissioner during the Obama and Biden administrations, was asked exactly one question about food in his 2022 confirmation hearing — and it was a plea to crack down on dairy alternative products using terms like “milk” and “cheese” (such as almond milk) at the behest of the dairy industry.
It seemed like we were on a similar trajectory this week. For the first half of the hearing, not a single senator on either side of the aisle brought up nutrition or food safety in their questioning. (Technically Sen. Ashley Moody (R-Fla.) briefly pressed Makary to reconsider an “arbitrary regulation” about the sugar content in orange juice about 45 minutes in, a rather obscure issue affecting Florida.)
Food remains a misfit issue, even though FDA has a massive role to play on both food safety and nutrition. Thankfully, a couple of senators did ask about food during the second half of the hearing, and we learned a few things…
Makary pledged action on food additives. Perhaps the most substantive takeaway, for me, was the fact that Makary clearly pledged to take a harder look at food additives writ large — though how he plans to do so remains to be seen.
“Half of our nation’s children are sick and nobody has really been doing anything meaningful on this front until we have gotten new momentum and enthusiasm from Secretary Kennedy and President Trump to finally address the root causes of these diseases, general body inflammation and generalized insulin resistance,” Makary said, in response to a question from Sen. Tommy Tuberville (R-Ala.) about food additives.
Makary argued that food plays a big role in the chronic diseases facing children. “When we eat foods with a lot of molecules that do not appear in nature — these are chemicals that the industry insists are safe, a subset of which are concerning. There’s a body of research now that suggests concern with some of these ingredients — we have to look at those ingredients and you have my commitment to do so if confirmed as FDA commissioner, these chemicals are creating an inflammatory response in the gastrointestinal tract. With an altered microbiome lining that GI tract, kids feel sick. It’s not an acute inflammatory reaction, it’s a chronic low-grade reaction and they don’t feel well.” (I’m not familiar with what evidence exists for these specific claims, but this is a devastating assessment.)
“What are we doing?” Makary pressed on, clearly fired up about the issue. “We are drugging our nation’s children at scale… we have to reassess what we’re doing because we’re not on a good path right now.”
I still have a lot of questions about how a crackdown on food additives would work in a deregulatory administration, but the fact that Makary was clear FDA needs to reassess additives is a big deal and aligns with the “Make America Healthy Again” agenda. (Sidenote: FDA may be MAHA’s best hope for any real change. Over at EPA, the administration is stacking leadership with “industry-linked deregulatory champions,” per E&E. USDA’s primary mission is to promote the agriculture industry, though Agriculture Secretary Brooke Rollins has hinted at some MAHA moves like letting states ban soda or other foods from the Supplemental Nutrition Assistance Program.)
Interest in reforming school meals. Speaking of other agencies, Makary came out strongly in favor of reforming school meals, which fall squarely under USDA, not FDA. Interestingly, Makary said he wanted to work with NIH on this — yet another alphabet soup agency that’s focused on clinical research — and he did not specifically mention USDA.
Makary said he wanted to work on a school lunch pilot program to “transition to healthier foods.” He noted he had been discussing it with Jay Bhattacharya, Trump’s pick to lead NIH, and others. “I hope that’s something we can do,” he said.
Interestingly, this comment came as Makary dodged a question about what he thinks about seed oils. The recently maligned product category, which includes canola, soy, sunflower and other oils, has caught the ire of Makary, too — on podcasts he’s called them unhealthy and recommended consumers avoid them. Asked by Sen. Tuberville, however, he said: “I don’t think it’s any one ingredient in the food supply that’s making our children sick,” he then pivoted to school meals.
“I think we have to look at the totality of every single thing in school lunch programs, in the diet of the nation’s children,” Makary said. “When we’re using tax dollars to make purchases of foods that we know make our nation’s children sick, we have to reexamine how we’re spending those tax dollars.”
A pledge to assess FDA staffing. Throughout the hearing, lawmakers pressed Makary about staff layoffs at FDA. He assured senators that he would do his own “independent assessment” of the staffing situation and suggested he preferred a more surgical approach to finding efficiencies.
“I welcome input on efficiencies at the agency,” Makary said. “At the same time, I want to make sure that the scientists and food inspectors and staff central to the core mission of the agency have all the resources they need to do their job well.”
As I reported last week, many of the staff focused on food chemical oversight have already been called back in, and now a judge has ruled that all of the DOGE probationary firings were likely illegal to begin with.
Speaking of staffing, a coalition of consumer and food industry groups this week wrote to HHS Secretary Kennedy opposing any additional cuts to resources or staffing within FDA’s foods program.
“Maintaining safe, accessible, and affordable food is a fundamental public health priority and a key component of your Make America Healthy Again platform,” reads the letter. “An under-resourced food safety agency could jeopardize your stated objectives to improve nutrition and ingredient safety for children and adults.”
What’s next: We don’t know exactly when Makary will be confirmed by the full Senate, but it’s expected in the coming weeks. I look forward to asking him more questions about the Trump administration’s food policy plans.
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What I’m reading
RFK Jr. warns vaccinating poultry for bird flu could backfire (CBS News). “Federal health agencies oppose the use of bird flu vaccines in poultry right now, Health and Human Services Secretary Robert F. Kennedy Jr. said, weighing in publicly on it for the first time in his new role. The Trump administration has been considering poultry vaccination as it seeks to combat the outbreak that is fueling a record surge in egg prices,” Alexander Tin reports. “U.S. Department of Agriculture officials said last month that they were ramping up planning on potentially deploying a vaccine for poultry, with the hopes of putting a draft of the plan before trading partners ‘as quickly as possible,’ since it could affect billions of dollars in exports. ‘There’s no indication that those vaccines actually provide sterilizing immunity and all three of my health agencies, NIH, CDC, and FDA, the acting heads of those agencies have all recommended against the use of the bird flu vaccine,’ Kennedy said in an interview on Fox News published this week.”
WV Senate passes bill banning artificial dyes in food, opponents say it’s overreach (West Virginia Watch). “The Senate overwhelmingly approved a bill banning synthetic dyes in food after Republican lawmakers stressed that it would make food healthier for West Virginians, who have some of the worst health outcomes in the country,” reports Amelia Ferrell Knisely. “The measure, House Bill 2354, which already cleared the House, would prohibit the sale of any food product with certain types of yellow, blue, green and red dyes, including Red No. 40 that helps give candy its cherry red hue. West Virginia is the first state in the country to pass a sweeping food dye ban; 11 other states are considering similar legislation. Bill supporters, including Sen. Laura Wakim Chapman, R-Ohio, say the dyes are poisonous and unnecessary, while opponents of the measure, including food corporations, argue the Food and Drug Administration should regulate food — not state lawmakers. ‘This is probably the most important bill that we will vote on in our entire careers here,’ Chapman said ahead of the Senate vote on the measure. Chapman cited West Virginia’s high obesity rate and a lack of grocery stores as a reason to support the bill, saying it will make available food healthier for families and children.”
He fought claims of harm from infant formula. Now he regulates it. (New York Times). “The new head of the Food and Drug Administration division that regulates infant formula was in recent months a corporate lawyer defending a top formula maker from claims that its product gave rise to debilitating harm to premature babies,” Christina Jewett reports. “Kyle A. Diamantas joined the F.D.A. last month to lead the food division, leaving the law firm Jones Day, which has served as a pipeline of talent to both Trump administrations. As a partner in Jones Day’s Miami office, Mr. Diamantas’s recent work included defending Abbott Laboratories in a lawsuit accusing the company of failing to adequately warn parents that its specialized formula for premature infants was associated with an elevated risk of a deadly bowel condition. Abbott lost the case and was ordered to pay $495 million. Abbott is appealing the verdict.”
President Trump eliminates two key food safety committees (Food Safety News). “The Trump Administration has eliminated two USDA food safety advisory committees that have been in place for decades,” reports Coral Beach. “The U.S. Department of Agriculture notified committee members of the move on March 6. The committees are the National Advisory Committee on Microbiological Criteria for Foods (NACMCF) and the National Advisory Committee on Meat and Poultry Inspection (NACMPI). ‘The termination of these two important advisory committees is very alarming and should serve as a warning to consumers that food safety will not be a priority at USDA in the foreseeable future,” said Brian Ronholm, director of food policy at Consumer Reports.
Perrigo to shut down Vermont facility, affecting more than 400 employees (VTDigger). “Perrigo plans to shut down an infant formula manufacturing facility that employs roughly 420 workers in Franklin County, the company confirmed Thursday,” reports Corey McDonald. “The company will phase out production at the Georgia facility through to 2027, according to a statement from Joe Shields, a senior manager of communications at Perrigo. The multinational company manufactures over-the-counter health products and has operated its plant in Georgia for more than a decade. Perrigo acquired the plant from PBM Nutritionals in 2010. Shields said that it was no longer ‘cost-effective’ for the company to invest in long-term maintenance of the facility due to its ‘age and evolving regulatory requirements.’”
Novo Nordisk to sell obesity drug Wegovy direct to patients at lower price (STAT). “Novo Nordisk will start selling its obesity drug Wegovy directly to patients at a reduced price, following a similar move from Eli Lilly as the two drugmakers compete for market share and try to draw patients away from compounding pharmacies that have been making cheaper copies of weight loss drugs,” Elaine Chen reports. “Wegovy normally carries a list price of about $1,350 a month, but Novo will sell the treatment through its new direct-to-consumer offering called NovoCare Pharmacy at $499 a month for all doses to cash-paying patients, meaning patients who are paying on their own without insurance. Lilly started to sell its obesity drug Zepbound directly to patients last year through its platform called LillyDirect, but there are notable differences in Novo’s new offering. Lilly sells all but the highest doses of Zepbound through LillyDirect, and at prices ranging from $349 to $699 a month. Meanwhile, Novo will be selling all doses of Wegovy up to the highest dose at the same price.”
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