Category: Healthcare

The country is trying to deal with the CDC breakdown this last week, with limited COVID vaccination access and important CDC personnel quitting because they refuse to lie or to issue recommendations they know are bogus and harmful.

This follows the tragic shooting at the CDC by a man who bought into the lies about the COVID vaccination. A police officer was killed in the shooting…an event the President still has not acknowledged.

Now, thanks to Secretary Kennedy (RFK Jr) many people who could get the new COVID  vaccinations can’t, because they’re only allowing the vaccinations for those over 65 or those who are at higher risk. Kids under 5 can get a vaccination if their pediatrician approves. In my own state of Georgia, which has a requirement that vaccines be recommended by the Advisory Committee on Immunizations (ACIP) and the CDC, you can’t get  the new COVID vaccination without a prescription at any pharmacy regardless of your age and health.

Normally ACIP would have met by now, but RFK Jr has fired all previous members, and now Senator Cassidy doesn’t want the meeting to happen at all because he’s concerned about what happens to vaccines once a group of quacks get their hands on them. Perhaps he should have considered this before voting to confirm RFK Jr to head the HHS.

The situation with COVID vaccinations, and vaccinations in general, is chaotic. But wait…there’s more.

The Dietary Guidelines for Americans

Every five years, the USDA and the HHS release a document, the Dietary Guidelines for Americans. The document is updated and revised from previous releases based on recommendations from a federal advisory committee made up of nutritional and medical experts.

The committee’s recommendations for the new guidelines, due to be published this year, were delivered to RFK Jr and then just…disappeared.

The Guideline recommendations are in limbo, and one member of the recommending committee, Christopher Gardner, believes it’s because the recommendations didn’t tackle ultra-processed foods. But there’s reasons for this and one reason is that not all ultra-processed foods have an affordable replacement. Telling schools they have to use tomato sauce that contains no HFCS and costs twice as much, as compared to tomato sauce that has a small amount of HFCS is a tough sell with schools with tight budgets. Especially when those budgets have been cut by the current administration.

And try telling people on a fixed income who live in neighborhoods that are food deserts that they should be eating only whole grains, fresh fruits and vegetables, and lean meats or fish. A goal for a lot of people is they just don’t want to go to bed hungry—a situation neither of the wealthy-born RFK Jr and Trump has ever had to face.

Another reason the guidelines don’t focus on ultra-processed foods is not all ultra-processed foods are bad. It really depends on what you mean by ‘ultra-processed’.

There is a classification of foods based on their processing: The NOVA Food Classification System. It lists foods as minimally processed (Group 1), processed culinary (Group 2), processed (Group 3), and ultra-processed (Group 4). The latter is differentiated by the others by combining multiple ingredients, including those from Group 2, and incorporating additives to enhance flavor or shelf life. It also typically uses enhanced food production techniques.

Think corn, corn oil, canned corn, and corn chips. It’s the chips that are the bad guys.

But, wait a sec…if corn oil is ‘OK’ what about corn syrup? Or the baddy of all, high fructose corn syrup (HFCS)?

Then this is where things start to get a bit trickier. It’s not just the ingredients, but how those ingredients are manufactured that can make the difference between  Group 2 processed (corn syrup) and Group 4 ultra-processed (HFCS)). The latter is considered ultra-processed because some of the glucose from corn starch used to create corn syrup is enzymatically converted to fructose.

So, it’s not just the ingredients but also the processing that’s being targeted.

Well, not quite.

The Kessler Petition

Early in August, a former FDA chief, David Kessler, petitioned the FDA to revote GRAS, or “generally recognized as safe” designation from certain refined, processed food products to force the makers to either successfully petition to continue using the product or remove it, entirely. Specifically, he targeted refined carbohydrates.

One of the ingredients Kessler wants to dump is corn syrup, yet corn syrup is considered a Group 2 processed food in the NOVA classification, not Group 4 ultra-processed. It’s corn from the minimally processed food group (Group 1) that is further refined using milling. It’s definitely something you can buy, and use, from the grocery store.

And this is where things get confusing, because Kessler is fine with people buying corn syrup in the store. So, on the one hand, I can use corn syrup when making bread at home; on the other, I can’t buy commercially made bread that uses corn syrup as an ingredient.

Kessler also targeted refined flours and starches using extrusion technology. The problem with removing GRAS on this food technique is it’s also used to incorporate vitamins and minerals into flour and starch products, such as vitamin enriched breads. One use of extrusion is being explored as a way of making rice more nutritional, since rice is such a main staple throughout the world. It’s also the primary technology behind plant-based milks, which have become a popular nutritional replacement for dairy milk. In fact, extrusion can make dairy milk healthier.

This demonstrates that the problem with going after ‘ultra-processed’ foods is we don’t really understand what this term encompasses, and by its very nature, it’s too vague to be useful. Because of this vagueness, we might get rid of ‘bad’ food, but we also could eliminate good food, too.

Though it’s been crippled by budget cuts and firings, the National Institutes of Health still maintains a medical library that carries a paper by Allen Levine and Job Ubbink. Published in the Obesity Science and Practice journal it touches on the complicated problems with defining ultra-processed foods based solely on the processes used.

Group 4 products are not necessarily unhealthy. Infant formula, an often‐quoted example… can sustain newborn babies in the first half year of their lives, when breast milk is unavailable and is considered safe and nutritious. The verdict on the health impact of meat analogs based on plant proteins is still out, as many are formulated with high salt and saturated fat contents but there is no reason they cannot be formulated with acceptable amounts of salt and saturated fats next to a high protein and fiber content and thus fit in a healthy diet in addition to being animal friendly and more sustainable than meat.

This confusion about ultra-processed and what it means and when is it good versus bad is why the Dietary Guidelines for Americans don’t incorporate restrictions against ultra-processing; preferring to focus more on clear food choices organizations and people can easily understand.

Kessler’s recommendations are a mashup of NOVA categorized processed and ultra-processed foods, some based on their use, others based on how they’re created, and even others based on whether the use is personal or commercial. Except that he’s incorporating a procedure (a petition to revoke GRAS designation) that would result in a catastrophic and sudden undermining of our food system with seeming little concern for the short or even long-term consequences.

And all indicators show he has a receptive audience in RFK Jr.

Ominous nutritional clouds on the horizon

I mention the Kessler petition because I believe that RFK Jr is going to use this petition to give credibility to his own ideological biases to redefine The Dietary Guidelines for Americans. And this will not be a good thing.

RFK Jr ignored the advisory committee’s recommendations and has claimed the new Guidelines will only be a few pages, four at most. The problem is, the Guidelines themselves are not intended for a general audience, they’re intended to provide the scientific basis for all of the recommendations. In other words: they’re not used by parents to determine what milk to buy for their kids, but for schools as justification for the type of milk they serve. It is the summaries contained within the guidelines that are released to the public. To remove all of this in order to just provide a simplified push for a few foods removes all transparency to any decision made in the guidelines.

Why is this harmful? After all, we’ve had years of ignoring the Guidelines and can continue doing so.

It’s harmful in how the Guidelines can impact on what foods are accessible. For instance, the Guidelines can be used to define what food can be purchased with SNAP funds, or that schools have to serve for meals. Eliminating ‘ultra-processed’ foods, especially when we don’t have a clear understanding of what this term even means will eliminate a whole lot of affordable food options for most folk. That school tomato sauce purchase is a good example.

And what about ‘good’ ultra-processed foods, like some forms of yogurts, enriched flour, or plant-based meats and milks? These can be nutritionally superior to minimally processed alternatives but the processes used for them would become taboo.

I suspect even something as essential as the peanut-based paste used to feed kids in starving countries would fail any ultra-processed test RFK Jr would provide.  And the sensible recommendations for listing beans, peas, and legumes as a protein source will die a quick death in favor of raw milk and beef fat.

The impact on the Dietary Guidelines could be bad, but worse would be for RFK Jr to actually act on Kelling’s petition. Combined with the Trump immigration effort’s impact on the food industry and the Congressional budget cuts for SNAP, we could be heading into times when price of eggs is the least of our concerns.

Will we survive?

Will we survive RFK Jr’s interventions on vaccinations and food? The short answer is yes. The longer answer is yes, but it won’t be easy and will be a battle every day until he’s gone. And the sadder answer is yes, but not all of us.

We can be reasonably sure that any food producer impacted by an RFK Jr version of dietary guideline or GRAS reversal would tie any such decision in court for years. It’s one thing to ask ice cream companies to remove artificial dyes from ice cream; it’s another to completely toss plant-based milks, baby formula, corn syrup, or foods with shelf stabilizers.

And it’s impossible to turn an entire populace back into primitive hunter/gatherers.

And therein is our tiny path to salvation: RFK Jr’s “my way or the highway” form of decision making will undermine whatever he attempts. He’s a fruitcake with fruitcake ideas and absolutely no guardrails to stop him. Trump isn’t stopping him, Congressional Republicans aren’t stopping him, and the talking heads are just chanting “Go Bobby Go!”

But it’s the obvious badness about his arbitrary decisions we can use, both as a target to fight and a rallying cry.

In the last few days, blue states like New Mexico, Illinois,  and others are looking at what they can do to ensure citizens have access to COVID vaccinations:

Pritzker’s health department in Illinois is currently exploring the possibility of purchasing Covid-19 vaccines in bulk straight from manufacturers in response to the mess in Washington, a senior Illinois health official confirms to me. Meanwhile, a coalition of mostly-blue states led by Massachusetts Governor Maura Healey is planning to coordinate on the purchase and distribution of pediatric vaccines, should the federal government restrict access to them, according to a source familiar with ongoing discussions. This will likely include big states like New York and Pennsylvania.

Unfortunately, though, the fact that only blue states are acting leaves significant numbers of people living in red states that will offered something like ivermectin, instead, and a whole lot of folk will end up dying.

Like I said RFK Jr can be survived…but not by everyone.

 

header image courtesy heaute.at via CC by 4.0