The Nutrition Mission at the FDA

(The Wall Street Journal) – The politics of food can be a touchy subject. On the one hand, most people care deeply about guarantees that their food is safe. On the other, not many like being told what they should and shouldn’t eat.

Issues such as these are at the heart of what the Food and Drug Administration sees as its mission. Robert Califf, commissioner of food and drugs at the FDA, and Susan Mayne,director of the FDA’s Center for Food Safety and Applied Nutrition, sat down with Matt Murray, deputy editor in chief of The Wall Street Journal, at the Journal’s Global Food Forum to discuss the challenges surrounding food and public health. Edited excerpts follow.

Healthy eating

1. MURRAY: There’s a lot of confusion or conflicting information out there. How can the FDA make things better?
2. MAYNE: We have a big public-health mission. We’re concerned about things in our food supply like too much sodium. How do we help promote health by working with industry to make a healthier food supply? Often people focus on the food-borne illness, contamination side of things, but don’t think about the chronic diseases. In our country today, the top killers are heart disease, cancer, diabetes—diet-related chronic diseases. I want to be sure people realize that healthy eating is a tool to reduce the rates of these really prevalent chronic diseases. I want consumers to be confident in the safety of produce and fruits and vegetables, and that’s one of the things we’re working on.
3. MURRAY: Are there things that have FDA approval right now that aren’t optimal?
4. MAYNE: Many industries have been trying diligently to reduce sodium in food. The question is, what are the alternatives? Industry has indicated to us there may be some challenges we might be able to help with, making sure that there are healthy alternatives.

With the updated nutrition-facts label—added sugars will now be declared—I would expect that some companies will be using fruit as a sweetener, rather than things like high-fructose corn syrup. So by putting something on a label, we can help incentivize a healthier food supply.

Food labeling

1. MURRAY: Talk a little about the redefinition of the term “healthy” and how that process is shaping up with regard to food labeling.
2. CALIFF: What’s healthy in the long run, I would bet, as we get better data, will depend somewhat on your genes and what you eat. I’ve interpreted what we’re doing at the FDA as mostly trying to nudge society in the right direction with enticement and better information. Hopefully, it’s beginning to work.

Robert Califf of the FDA, discussing consumers’ food choices, says the agency is ‘trying to nudge society in the right direction with enticement and better information.’ PHOTO:GABE PALACIO/DOW JONES

1. MAYNE: Healthy has a regulatory definition that said [the product] couldn’t exceed a certain amount of total fat, saturated fat, etc., containing beneficial nutrients as well. Some of that science has changed over time. I’ve worked in nutrition policy for almost three decades, and the monumental shift in how we look at that science is really striking. My training was in nutrition biochemistry, and the term “fat” really doesn’t mean anything. There’s polyunsaturated, monounsaturated, saturated, omega-3’s, omega-6’s. Each one of those means something specific to me.

But what’s difficult is taking that complexity and giving it to consumers in a way that they understand. What the science really shows is that the type of fat matters, and that higher-fat foods can be healthy as long as the predominant sources of fat are monounsaturated and polyunsaturated fatty acids.

So, under the old regulatory definition of healthy, certain foods would not have qualified, while the dietary guideline says these are healthy foods. That’s why the FDA wants to relook at this issue of the term healthy. What should it mean? What do people believe about that? This is again a regulation to really make sure that that reflects the most current science.

1. MURRAY: What are the things most concerning to you in the American diet?
2. CALIFF: The dietary pattern. A lot of it is tied to socioeconomics, where you have so-called food deserts where people can’t even get to a place that has generally healthy food. And it worries me a lot that there seems to be an inverse relationship between the price of food and its nutritional value. That is, the things that are best for us tend to be more expensive. So, poor people are eating much worse diets.

Good and bad calories

1. MURRAY: There’s a lot of debate about calories and the quality of calories. A lot of people say if you eat 2,000 calories of salad, that’s preferable to 2,000 calories of Twinkies.

Susan Maybe of the FDA says, ‘In our country today, the top killers are heart disease, cancer, diabetes—diet-related chronic diseases.’PHOTO: GABE PALACIO/DOW JONES

1. MAYNE: Calories are important, and FDA has done many things to try to make this really clear. The first is the update to the nutrition-facts label, where calories will be displayed much more prominently, along with serving-size information.

Other changes include menu labeling, which comes to us through the Affordable Care Act, where now menus will have to display calorie information for chain restaurants with 20 or more locations.

1. MURRAY: Isn’t the evidence that, here in New York, after Mayor Bloomberg introduced it, people ate more? That it had the opposite effect of what was intended?
2. MAYNE: There’s research around this as well, and one of the things studies have indicated is if you only give calorie information but don’t tell people what a normal amount of calories is, they have a hard time interpreting it. Putting “700 calories” on an entree didn’t mean things to people who didn’t know what normal calorie intake is. So this is being implemented.