The wait had alarmed consumer watchdogs and public health advocates, who have long feared that nutrition would suffer under a White House that has championed industry deregulation and criticized concerns about child obesity. But in a speech that seemed designed to signal that nutrition is still a priority at President Trump’s FDA, Gottlieb said his agency would launch a comprehensive, multi-year package of nutrition initiatives this summer, with the goal of tackling health conditions such as obesity and heart disease.
“I’m committed to advancing our work in nutrition as one tool to help reduce health disparities and improve the lives of all Americans,” Gottlieb told a gathering of industry representatives, consumer watchdogs and academics in Washington, “and to help every family live more free from the burden of preventable illness.”
The FDA initiatives announced Thursday are part of what Gottlieb has termed the agency’s “Nutrition Innovation Strategy.” Many of them continue programs begun under the Obama administration, such as menu labeling and sodium reduction.
In 2016, for instance, the FDA announced plans to nudge the food industry toward cutting salt, releasing voluntary two-year and 10-year sodium reduction targets for more than 150 foods, including snacks and frozen pizza. While not required, the reduction targets would put significant public pressure on food manufacturers.
Those plans stalled over objections from the food industry officials and some lawmakers in Congress who have argued that it is difficult to cut salt from recipes and that the science on sodium and health is unsettled. Earlier this month, the Salt Institute, an industry group, asked the FDA to reconsider that science as it develops the 2020 Dietary Guidelines for Americans.
But on Thursday, Gottlieb signaled loudly that the agency would work to reduce sodium in the food supply, calling salt reduction the “single [most] effective public health action related to nutrition.” The FDA will release new, short-term sodium reduction targets in 2019, Gottlieb said, and will continue to advocate for longer-term reductions to prevent health conditions linked to overly salty diets, such as high blood pressure.
Americans eat an estimated 3,400 milligrams of sodium each day on average, though the government recommends consuming no more than 2,300 milligrams.
“I can't discuss a meaningful nutrition initiative without exploring what can be done to encourage the reduction of sodium in foods,” Gottlieb said.
The FDA is committing to other Obama-era policies, as well. On May 8, Gottlieb said, chain restaurants and grocery stores will be required to display calorie and other nutrition information on their menus, following a one-year delay the agency granted at the behest of industry last year, shortly after Trump took office.
Foodmakers will also have until January 2020 to roll out the new Nutrition Facts panel, including information about added sugars and emphasizing calorie counts in bold letters. The FDA had delayed the panel, championed by former first lady Michelle Obama, after industry groups complained they did not have enough time to make the changes. But Gottlieb implied that there would be no further extensions, noting that some food companies have already rolled out the new panels.
“Consumers are starting to have access to an updated label that's based on current science and provides more information to empower them to choose healthful diets,” he said.
In addition to the Obama policies, Gottlieb is considering new nutrition policies. The agency is debating a voluntary, front-of-pack labeling system, the commissioner said, that would give consumers clearer information about a product’s healthfulness.
The FDA is also evaluating food manufacturers’ use of health and science marketing claims, including the term “healthy,” and will seek to make ingredient information clearer, Gottlieb said. Food companies may soon print “vitamin B6” on their labels instead of “pyridoxine,” for instance.
And the agency may revisit its regulations on the content of processed foods to make it easier for companies to make their recipes more healthful. Current regulations require that cheese contain a certain amount of sodium, for instance, which makes salt reduction difficult.
Gottlieb emphasized that many of the new initiatives are designed to nudge food companies to voluntarily make their products healthier and to reward the ones that do so. That differs slightly from the approach under the Obama administration, experts in the audience said, but they described themselves as relieved and reassured that the Trump FDA appears to be pursuing similar goals.
Margo Wootan, the vice president for nutrition at the Center for Science in the Public Interest, has criticized the FDA's delays on menu labeling and the new Nutrition Facts Panel, as well as a decision last year by Agriculture Secretary Sonny Perdue to delay scheduled sodium reductions in school lunches. She is among a number of public health advocates who have warned that an industry-friendly administration bent on rolling back regulation could do serious damage to nutrition.
Aside from the delays, some advocates have criticized the FDA for discontinuing in December its Food Advisory Committee, an independent expert panel that advised the agency on emerging food safety and nutrition issues. And others have accused the agency of giving some companies a pass on added-sugar labels, allowing them to explain in small print why products such as maple syrup and cranberry juice have such high added-sugar numbers.
But on Thursday, Wootan said she was “encouraged” by Gottlieb's remarks and optimistic about the FDA's direction. Next comes the task of implementing these ideas in accordance with current science, she said.
“This commissioner does seem to have an interest and understanding of the importance of nutrition,” Wootan said. “ 'Progressive' is a relative term, but I think [he is], compared to what we're up against in other agencies.”