August 21, 2026 5 min read

Exploding Diarrhea and Ultra-Processed Foods: Two Public Health Problems, One Common Cause

By Thomas Gremillion
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Earlier this week, Christina Jewett and Julie Creswell at the New York Times broke the story of how corporate stall tactics contributed to the summer’s Cyclospora epidemic of historic proportions. The news came on the heels of an announcement by the Department of Health and Human Services that its long touted proposal to define ultra-processed foods (UPFs) faces an indefinite hold at Russel Vought’s Office of Management and Budget. Both episodes reflect failures to protect consumers from well-documented threats. Both represent the triumph of narrow special interests over the greater public good. And both underscore the need for greater transparency and accountability, both of which are sorely lacking in the current Administration and Congress.

Even as partisan rancor has grown, food safety continues to stand out as an apolitical outlier. The Food Safety Modernization Act (FSMA) passed in 2010, was one of the last major pieces of legislation to garner significant bipartisan votes. More recently, both Republican and Democratic-led state legislatures have passed bans on artificial dyes and other food chemical safety reforms. Despite broad support, however, many critical food system reforms have languished.

There may be no better example of this than FDA’s traceability rule. Under FSMA, the rule requiring companies like Taco Bell and Taylor Farms to provide supply chain records within 24 hours should have gone into effect over a decade ago. Instead, FDA only proposed a rule after consumer advocates successfully sued the agency and a court forced it to act. FDA set the compliance date for the final rule for January of this year, but the current Administration announced it would delay implementing the rule for another two and a half years.

The consequences of this inaction became clear earlier this week, thanks to Jewett and Creswell’s reporting. Emails between public health officials and Taco Bell show how the company dragged its feet for nearly two weeks in providing supply chain records needed to pinpoint Taylor Farms de Mexico lettuce as the outbreak source. During this time, the contaminated lettuce remained on store shelves. Had Taco Bell handed over the relevant supply chain records within 24 hours of when they were first requested, on July 1st, would Taylor Farms have issued its recall before it did on July 18th? And would an earlier recall have helped some, if not many, of the tens of thousands of cyclosporiasis victims to avoid illness? No one can know for sure, but it seems likely.

That counterfactual scenario might have saved produce growers a lot of pain as well. In California, about a third of the lettuce crop was plowed under as “the worst crisis of consumer confidence since the 2006 spinach outbreak” caused sales to plummet. And of course, consumers became poorer as fear of illness turned them towards higher priced options, like farmer’s market produce, or more commonly, away from fresh produce altogether, towards ultra-processed foods.

The Administration is telling consumers to eat less ultra-processed foods, and rightfully so. The harms from UPFs go beyond merely what one would expect from their macronutrient (salt, sugar, fat, etc.) profiles, although those certainly matter too. The tepid approach to UPFs among the last Dietary Guidelines Advisory Committee was a mistake, and the new Dietary Guidelines, for all their imperfections, do well to call out “highly processed foods.” But simply telling people to “eat real food” is not enough. Reforming federal policy that has created a food system dominated by ultra-processed foods requires clear rules and standards, including a UPF definition.

The problem is that powerful, moneyed interests have a financial incentive to oppose food reforms targeting UPFs. Legacy food corporations have lobbied intensely to avoid sacrificing their business models, even as a growing consensus recognizes that these business models are causing an epidemic of diet-related disease. The same is true for traceability. Some restaurants and food distributors would rather not invest in farm to fork traceback systems, even if those costs are vastly outweighed by the benefits to California lettuce growers, salad aficionados, and myriad other businesses and consumers.

Of course, traceability and UPF rules have some important differences. Compared to the chronic diseases caused by UPFs, sprawling foodborne illness outbreaks harm stakeholders within the food industry—like lettuce growers—much more directly. Lobbyists’ triumph in putting the traceability rule on ice, despite the support of powerful industry groups like the Western Growers Association, suggests the prospects for meaningful UPF reform is bleak indeed. On the other hand, UPFs have captured the public’s attention like few other issues in recent memory. According to recent polling, large majorities of consumers across the political spectrum support policies like warning labels and child-directed advertising restrictions to curb the harms from UPFs. If Big Food is allowed to get its way, as seems more likely every day, many voters will take that into account at the ballot box.   

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