Ultra-processed foods (UPFs) are attracting scorn from would be food system reformers across the political spectrum. “Ultraprocessed foods and beverages (UPFs) pose a growing public health challenge,” says the American Heart Association. “Today’s over-reliance on UPFs is damaging the health of American children,” says the Administration’s “Make Our Children Healthy Again” assessment report, popularly known as the “MAHA report.” “There is a growing body of evidence that ultra-processed foods are deliberately designed to be addictive – similar to cigarettes and alcohol – and are major contributors to the twin epidemics of obesity and diabetes in our country,” says Sen. Bernie Sanders.
By contrast, consensus about how public policy should reduce the harms associated with UPFs has proven more elusive. The Administration appears to have little appetite for any action that does not rely on voluntary industry compliance. Meanwhile, policymakers in states as diverse as California and Louisiana are exploring more prescriptive approaches, banning “particularly harmful” UPFs from school meals, or even requiring warning labels on certain UPFs.
All of these policies have limitations. Bans on foods in school meals have limited impact. Kids mostly eat the food their parents buy in the store after all. Warning labels on a broad range of products may serve to only frustrate consumers, or lead them to simply tune out, particularly if they lack access to alternatives. Efforts to educate consumers, e.g. with dietary guidelines that recognize the significance of food processing, must proceed with a great deal of nuance. After all, many UPFs, such as popular brands of plain yogurt, are among the healthiest choices on store shelves.
Last week, former FDA Commissioner David Kessler added an innovative proposal to the policies for reducing harms from UPFs. Kessler’s citizen petition to the U.S. Food and Drug Administration asks the agency to revoke the “generally recognized as safe” or “GRAS” status of UPFs made with “processed refined carbohydrates.” This seems serendipitous given the Administration’s announcements that FDA is “[e]xploring rulemaking to require [GRAS] submissions to FDA to stop industry’s long-standing practice of introducing ingredients into the food supply without FDA knowledge or oversight.” But whether those reforms will touch on the GRAS determinations targeted by Kessler’s petition remains to be seen. Again, the Administration has shown little inclination to force the food industry to adopt any changes it is not willing to take voluntarily.
Even so, the petition makes a compelling argument that FDA’s 1970s era safety reviews of ingredients like high fructose corn syrup and maltodextrin warrant an update. Back then, for example, a select committee determined that “[o]ther than the contribution made to dental caries, there is no evidence in the available information on corn sugar (dextrose), corn syrup, and invert sugar that demonstrates a hazard to the public when they are used at levels that are now current and in the manner now practiced.”[1] The science today, not to mention rampant rates of obesity and diabetes, contradict those conclusions, according to Kessler’s petition.
The solution? Kessler’s petition requests that FDA revoke the GRAS status of “processed refined carbohydrates” in the same manner that it did for trans fat back in 2015. As many have pointed out, this would affect a lot of food. Specifically, the petition targets foods containing refined sweeteners like corn syrup, maltose, or maltodextrin; foods containing refined flour and starches subjected to food extrusion technology; and foods containing “sucrose, refined flours, or starches that are used with emulsifiers (e.g. mono- and diglycerides of fatty acids, DATEM, sodium stearoyl lactylate, polysorbates); dough conditioners and strengtheners (e.g. azodicarbonamide, L-cysteine, calcium peroxide); humectants (e.g. propylene glycol); stabilizers and gums (e.g. carboxymethylcellulose, methylcellulose); or modified starches and fillers (e.g. regelatinized starch, modified food starch, dextrins).” Any foods with these ingredients would become unlawful unless the food manufacturer could convince FDA of its safety in a food additive petition.
Conceivably, industry and public health regulators at FDA could collaborate through the food additive petition process to minimize disruptions to the food supply while shielding consumers from the most harmful “processed refined carbohydrates.” For example, the agency might grant exemptions to foods with nutrient profiles that qualify them to use a “healthy” claim on food labeling under FDA guidance. The agency might give other categories of food manufacturers additional time to reformulate, similar to the extensions it afforded to baked goods products using trans fat. But realistically, this Administration, with its “10-for-1” regulatory repeal mandate, will not likely take up action to ban any foods, much less broad categories that include everything from popular brands of breakfast cereals and ice cream to Wonder Bread.
Even so, the Kessler petition deserves attention. Federal food chemical regulators may not be up to the task, but as alluded to earlier, state policymakers are taking action to protect their constituents against UPFs. The Kessler petition suggests that states like California should seriously consider whether UPFs with “processed refined carbohydrates” are “particularly harmful” and should be, for example, banned from school meals under legislation like AB 1264.
Some consumers may also find the concept of “processed refined carbohydrates” helpful as they struggle to navigate a food landscape inundated with UPFs. For all but the most privileged consumers, avoiding UPFs entirely is not feasible. Even those with access to non-UPF alternatives typically sold in higher end grocery stores may have dietary restrictions (e.g. vegetarians) or time constraints that lend themselves to the occasional UPF. The subset of UPFs targeted by the Kessler petition may support more attainable dietary changes for consumers concerned about the growing evidence linking UPFs to disease.
Notably, consumers seeking to cut “processed refined carbohydrates” may encounter a new frustration. That’s because determining when a food manufacturer has relied on extrusion technology to create a processed refined carbohydrate is not always apparent from food labeling. This is important insofar as “the impact of extrusion on starch digestibility is profound,” as argued in the Kessler petition. Yet two foods—e.g. a bag of artisanal tortilla chips and original flavor FritosTM—may have the same ingredients (e.g. corn, corn oil, and salt) and yet fall on opposite side of the “processed refined carbohydrate” divide. This poses a challenge to food regulators, not to mention the architects of the NOVA classification system, who advise consumers to consult the ingredient list on foods to determine what is a UPF.
To be sure, the texture and other contextual clues typically make clear which foods result from extrusion processes, but how much should consumers have to develop this sort of expertise? If FDA is not inclined to grant Commissioner Kessler’s petition, an intermediate step could be updating labeling regulations to require disclosure of extruded ingredients. That could have the added benefit of facilitating state regulators who seek to protect consumers with policies like bans on certain UPFs in school meals.
[1] Food and Drug Administration. (1988). GRAS Status of Corn Sugar, Corn Syrup, Invert Sugar, and Sucrose.
U.S. Department of Health and Human Services. Federal Register, 53(215), p. 44862.