The average American eats a junk-food diet; about 60 percent of our calories come from ultraprocessed foods. But if you’re in the minority that tries to eat healthy, you’ve probably struggled trying to make sense of food labels. It can be overwhelming. Some of them might as well be written in another language. You shouldn’t need a nutritional biochemistry degree to decipher the ingredients label on a protein bar or a cup of yogurt. Have you ever read a food label and wondered what the heck mono- and diglycerides are? Or why carrageenan, maltodextrin, and soy lecithins are in so many processed foods?
These emulsifiers and chemical additives are a big red warning sign to drop the package and run. If you can’t pronounce an ingredient, it’s probably not something you want to put in your body. Unfortunately, most people don’t take the time to read the ingredient lists, which are usually buried on the back of food packages and written in fine print. And the other important source of information, the “nutrition facts” panel, is more confusing. Most people don’t know what a “percent daily value is,” or whether the serving sizes listed under the nutrition facts are realistic (they are not).
The FDA regulates food labels, and they’re a prime example of how the agency is failing the public. They are allowed to be deliberately misleading and confusing, which serves the interests of Big Food rather than those of consumers. As Jerold Mande, a nutrition expert who worked on food labels at the FDA and the USDA, explained it to me, many food companies do not want you to know what’s in their products, so they deliberately make their ingredients hard to read. “A lot of companies use all capital letters and they squish them together and use a very small size, about 1/16-of-an-inch letter,” he said. “The result is that you look at most food packages and it’s very hard to read the ingredient list.”
Companies are required to list ingredients in the order of their predominance. But that doesn’t tell you how much is in the package. If sugar is the second ingredient listed on a package, that doesn’t tell you if it makes up 30 percent of the food or 5 percent.
Have you ever picked up a jar of strawberry jam at the supermarket and looked at its ingredient list? A jar of Smucker’s strawberry jam lists strawberries as the first ingredient, and then the second, third, and fourth ingredients are as follows: high-fructose corn syrup, corn syrup, and sugar. This tactic is very common. The reason companies often use several sweeteners in one product is so they don’t have to list “sugar” as the first ingredient. As Mande explained, “What we know from some investigations is that companies often use five different sugars in their products so that they don’t show up high on the list.”
In addition to regulating food labels, one of the FDA’s top responsibilities is ensuring the safety of the food supply. Under a federal regulation passed in 1958 called the Food Additives Amendment, any substance that the food industry intentionally adds to its products is considered a food additive. All food additives are theoretically subject to premarket review and FDA approval. Food additives are only exempted from this rule if they are GRAS, which stands for generally recognized as safe. The GRAS system was designed to apply to ingredients that have been dietary staples for generations, like cinnamon, vanilla, baking powder, salt, pepper, olive oil, vinegar, caffeine, butter, and a variety of natural extracts and flavorings.1 In other words, things our grandparents would recognize.
But thanks to aggressive industry lobbying, the FDA has ceded much of its regulatory power over food additives to food manufacturers. It’s a blatant case of the fox guarding the henhouse. In many cases the FDA has allowed chemical industry trade groups like the Flavor and Extract Manufacturers Association to declare new food chemicals GRAS without any scientific explanation at all.2 In 2013, a study published in JAMA Internal Medicine found that the GRAS review process lacked integrity because many of the GRAS committee members who make safety determinations have strong industry ties. “Between 1997 and 2012,” the authors concluded, “we found that financial conflicts of interest were ubiquitous in determinations that an additive to food was GRAS. The lack of independent review in GRAS determinations raises concerns about the integrity of the process and whether it ensures the safety of the food supply.”3
Today more than 10,000 additives are allowed in food—43 percent of them are GRAS additives and fewer than 5 percent have actually been tested for safety.4 The average American consumes 3 to 5 pounds of these additives every year. Consumer watchdog groups have repeatedly urged the FDA to step up its oversight of these additives. In 2015, the Natural Resources Defense Council, the Center for Science in the Public Interest, the Environmental Working Group, and other organizations filed an eighty-page report with the FDA, laying out exactly how its failure to vet new chemicals violates the law. The report listed a number of additives that cause cancer. In a very strange statement, the FDA said those additives were not harmful even if they caused cancer in animals, but they were removing them anyway because of the law.5
Even more disturbing is that many chemicals and medications used in agriculture are banned in Europe and other countries, but they are still allowed to be used in the United States. Just a few of the many examples:
Potassium bromate and azodicarbonamide. These are used in baked goods. Subway got outed for use of a yoga-mat chemical in their bread in 2014 (more on this story later in this chapter). That was azodicarbonamide. It causes cancer in animals, and in Singapore if a company uses it, they are subject to a $450,000 fine and 15 years in jail!6 Potassium bromate is added to flour to make it riser faster and look nice. It has been labeled as a potential human carcinogen by the International Agency for Research on Cancer. Petitions to ban it have been at the FDA for 20 years.
BHA and BHT. BHA and BHT are used in many processed-food products as preservatives and flavor enhancers. These additives are severely restricted in Europe. BHA is actually listed by our own government as “reasonably anticipated” to be a human carcinogen.7 But that’s not a strong enough association for the FDA to protect us, or could it be the food lobby and the revolving door between the FDA and the food industry having its way?
Brominated vegetable oil (BVO). If you have ever had Mountain Dew or sports drinks, you have had BVO. Bromine is a flame retardant that causes memory loss, nerve damage, and skin problems.
Yellow food dyes no. 5 and no. 6, and red dye no. 40. If any of these dyes are used in Europe, the foods are slapped with a warning label that says “May have an adverse effect on activity and attention in children.” Studies have clearly shown that these dyes cause hyperactivity and behavior changes in children.8 They are everywhere—candy, icing, cereal, mustard, ketchup, breakfast bars, and other foods. Yellow dye no. 5 is known to cause allergies, hives, and asthma.
Farm animal drugs. Drugs used in raising livestock, including bovine growth hormone to promote milk production and ractopamine to make animals fat, are also harmful to humans.
The FDA is asleep at the wheel, at best. At worst it is doing the bidding of the food industry. And sadly, we have seen this story before. The most striking example of this is trans fats, a man-made additive that persisted in the food supply for 50 years after it was found harmful and after it was known that it caused millions of heart attacks. Yet because trans fats were designated safe, Americans turned their backs on butter, tallow, and lard and ate margarine and shortening instead. It was only in the 1990s that well-designed studies demonstrated that even slight increases in trans fat consumption promoted heart disease, giving scientists their smoking gun. It took 50 years from the time scientists found that trans fats were harmful for the FDA to remove it from the GRAS list, and even then it was only after a lawsuit. Why? Trans fats were one of the main building blocks of processed and fast food. The food industry did what it usually does: It tried to downplay the science and fought against regulations.
But in a positive twist, the public health community banded together and worked hard to get trans fats out of the food supply. The beginning of the end for trans fats came in 2006, when New York City banned trans fats in restaurant food. The food industry aggressively opposed the measure, but other cities and states across the country—from Massachusetts and Vermont to Maryland and California, among others—soon followed suit. Then, finally, after years of dragging its feet, the FDA announced in 2015 that it was banning trans fats and removing them from the GRAS list. The FDA ultimately did the right thing. But it should have acted sooner. New York City’s bold and early action on trans fats paid dividends: A study of its 2006 trans fat ban found that in just a few years it led to a nearly 7 percent citywide drop in hospital admissions for heart attacks and strokes.9
By now, you may be thinking, What can I really do about any of these problems in the food industry? Well, in fact, you can do a lot. My friend Vani Hari proves it.
Vani Hari might be the single most influential food activist in America today. She has taken down Big Food companies and spurred more food industry reforms than any other person I know. She’s forced multibillion-dollar corporations to remove unhealthy additives and disclose potentially harmful ingredients in their products. Her words and actions are so powerful that in 2015 Time magazine named her one of its 30 Most Influential People on the Internet. She’s written two eye-opening and inspiring books, the most recent of which is Feeding You Lies: How to Unravel the Food Industry’s Playbook and Reclaim Your Health.
Long before she became the self-proclaimed Food Babe and a household name, Hari was just your average person eating a junk-food diet like the vast majority of other people on this planet. As the daughter of Indian immigrants who came to the United States to pursue the American Dream, Hari was raised to believe that the American food system was among the best in the world. But eating the American diet made her sick and fat. She had asthma, eczema, acne, stomach problems, and severe allergies. Then she started reading about diet and realized her food was making her sick. She changed her diet to whole foods and her health problems and the excess weight disappeared.
She started sharing her experiences on a blog, Food Babe, and exposing the chemical and harmful ingredients in most fast and processed foods. She started with Chick-fil-A, which listed 100 ingredients in a chicken sandwich including MSG and TBHQ (a derivative of butane, an ingredient in gasoline). Chick-fil-A invited her to their headquarters and not only listened, but also made changes. In 2013, the company announced that it was removing artificial dyes, high-fructose corn syrup, and TBHQ from its products. The company also said it would begin using only antibiotic-free chickens. For Vani, it was a huge victory, and one that would turn out to be the first of many.10
She took on Chipotle, outing them for using trans fats and GMO ingredients while claiming to be a healthy restaurant. They were forced to be transparent and became the first national chain to remove GMO ingredients from their food after thousands signed Vani’s petition.11 Kraft was next in her sights for using artificial dyes and preservatives in their mac and cheese in the United States but not in the UK, where they are prohibited. Using her Food Babe Army to garner hundreds of thousands of signatures and camping out at their offices, she ultimately forced them to remove the chemicals.12 Next on her list was Subway, whose slogan “Eat Fresh” was misleading. Why? They used a yoga-mat ingredient called azodicarbonamide in their bread in the United States but not in other countries, where it was banned. Hari got Subway to stop using it and also agree to source only antibiotic-free meat. Many of the biggest fast-food chains across the globe followed suit. McDonald’s, Wendy’s, Jack in the Box, Chick-fil-A, and White Castle, among others, all removed azodicarbonamide from their products too!13 Starbucks was called out for using a carcinogenic caramel color in their pumpkin spice latte and removed it. General Mills and Kellogg’s agreed to stop using the toxic preservative BHT.
Big food companies are turning their supertanker ships slowly, pivoting to healthier product lines and encouraging better agricultural practices, often after being forced to do so by consumer demand. Not too long ago I met with the head of Nestlé USA and toured their factory in Cleveland. What I saw impressed me. The company is on a mission to remake their products so they have less junk in them. Nestlé has divested itself of its candy business, is removing additives and processed ingredients from many of its foods, and has quit the GMA because it opposed policies to improve the food system such as soda taxes and labeling of GMOs. Nestlé started the Sustainable Food Policy Alliance along with Unilever, Danone, and Mars. While these companies have legacy products that are bad for you and the planet, they are working to adapt to consumer demand.
From what I could see, Nestlé is trying hard to make real food. The company still has a long way to go. But the fact that the world’s largest food company is moving in this direction is an encouraging sign—and it’s people like Vani Hari who are responsible for helping to push the industry in a new direction.
Antibiotics are a multibillion-dollar category of drugs that save many lives. But the majority of antibiotics aren’t prescribed by doctors and used by sick patients—they’re fed to livestock on factory farms. Antibiotics are widely used in industrial agriculture to reduce the spread of nasty infections caused by overcrowding, filth, and other cruel and unsanitary conditions in concentrated animal feeding operations, or CAFOs. The drugs are used to alleviate some of the horrible consequences of factory farming, like preventing cows’ stomachs from exploding as a result of the excess gas produced by fermenting corn in their rumens, the first chamber of a cow’s stomach.
For the food industry, a welcome side effect of stuffing animals with antibiotics is that it accelerates their growth. It makes them bigger and fatter with less food, so they are more profitable.14 As a result, antibiotics have become a staple in industrial farming. But this comes at a terrible cost to societal health.
The spread of antibiotic-resistant diseases is a rapidly growing threat across the globe, contributing to the deaths of 700,000 people worldwide each year, and it’s predicted that by 2050 this global epidemic will kill more people than cancer.15 No one disputes what is driving this epidemic: It’s the overuse of antibiotics. Two major factors contribute to this. One is the misuse of antibiotics in hospital settings, where the drugs are widely overprescribed, often for viral infections, for which they are useless. The other major factor is the excessive use of antibiotics in food animal production. The drugs reduce the infection rate in farm animals, but a small number of bacteria invariably survive and then mutate into drug-resistant germs.
According to the CDC, “Use of antibiotics on the farm helps to produce antibiotic-resistant germs. All animals carry bacteria in their intestines. Giving antibiotics to animals will kill most bacteria, but resistant bacteria can survive and multiply. When food animals are slaughtered and processed, these bacteria can contaminate the meat or other animal products. These bacteria can also get into the environment and may spread to fruits, vegetables or other produce that is irrigated with contaminated water.”
The CDC reports that at least half a dozen multistate outbreaks of food poisoning have been linked to drug-resistant bacteria since 2011, including one that sickened 634 people in 29 states. Nearly half of those people were hospitalized. Consumer Reports testing found that meat from conventionally raised animals is twice as likely to contain superbugs as meat from animals that are raised without antibiotics.16
It’s not just meat eaters who have to worry. One outbreak of E. coli that killed three people in 2006 was linked to spinach that had been contaminated by pig and cow manure from a nearby farm.17 Experts have found that the drug-resistant bacteria that spawn from the indiscriminate use of antibiotics on farms can spread to people in many ways:
Farmworkers can be infected while handling animals and manure and then pass superbugs to other people.
Superbugs can be spread to crops and groundwater through the use of contaminated fertilizer.
Manure and urine slurries containing antibiotics are often spread on fields, killing the microbiology of the soil the same way antibiotics harm our own microbiome.18
Drug-resistant bacteria can even be spread throughout communities by the wind. One study of people living near farms in rural Pennsylvania found that they were nearly 40 percent more likely to contract MRSA infections than people who lived farther away.19
The economic price of overusing antibiotics is likely to be staggering as well. RAND Europe, a nonprofit research organization, looked at the impact of the overuse of antibiotics in agriculture on labor productivity. Hold on to your hats. Globally, between now and 2050, the cost of antibiotic resistance is estimated to climb as high as $124.5 trillion. That doesn’t even include any associated health care costs, so this is likely a big underestimate.20 The Union of Concerned Scientists estimates that in the United States alone the public health costs are $2 billion a year.21
With so much at stake, you might think that the FDA would take aggressive action to protect the public. The agency has the power to clamp down on the use of antibiotics in animal feed. It can tightly regulate them, forcing drug companies and factory farms to be more circumspect about using antibiotics. And the FDA could track their usage more closely, so that health authorities could prevent drug-resistant outbreaks or contain them more quickly when they occur. But in fact, the use of antibiotics in livestock has increased in the past decade. In 2009, the FDA estimated that 29 million pounds of antibiotics were used in this country.22 Twenty-four million pounds were used to prevent disease in livestock in overcrowded conditions.23 Today that number is estimated to be 32 million pounds.24
How could that be? Because the FDA allows the food industry to police itself. In 2013, the FDA announced that it wanted drug companies to change the way veterinary antibiotics are sold and labeled. It asked drug companies to remove indications for weight gain and growth promotion, and it said that antibiotics should only be fed to animals with a veterinarian’s approval. That means that in theory the drugs should not be prescribed specifically to make animals bigger and fatter.
But the FDA made the plan completely voluntary. No regulation, no legislation. It just politely advised Big Ag not to use antibiotics, advice which was promptly ignored. Not a surprise when the deputy commissioner of the FDA from 2010 to 2016, Mike Taylor, was the former vice president of public policy for Monsanto. Another major loophole is that the food industry can continue to indiscriminately use antibiotics and then claim they are doing so for reasons other than growth promotion. Even when the FDA placed a “ban” on using antibiotics for growth promotion on factory farms in 2017, it had little impact. The food industry continues to pump animals full of these drugs. Now it just says it is doing so to prevent disease.
I once asked Peggy Hamburg, the former FDA commissioner, why the FDA didn’t mandate clearer food labels, restrict toxic food additives, and end the use of antibiotics for growth and disease prevention in animal feed. She was honest. When the FDA tries to implement stricter regulations, she said, Congress (in the pocket of Big Food and Big Ag) threatens to shut down funding and programming at the FDA. Our own Congress has become the bully for the food industry. The other problem is the revolving door between industry and the FDA, where many key appointees at the FDA have worked for Big Food, Big Pharma, and Big Ag.
As consumers we have to push for change at the state and local levels. We can support groups like the US Public Interest Research Group (PIRG), a consumer watchdog group that has been leading the charge on this issue. The advocacy group helped California and Maryland pass laws banning their states’ factory farms from routinely using medically important antibiotics. Thanks to California and Maryland leading the way on this issue, many more states are now looking to enact similar measures. Doing so will go a long way toward protecting the public from lethal superbugs.
Even the WHO has called on the agriculture industry to stop giving antibiotics to healthy animals.25 It’s important that we all support the following solutions proposed by PIRG, the WHO, and other prominent authorities and health experts.
1. Implement an outright ban on antibiotics for “disease prevention” in livestock. The use of antibiotics on factory farms must be limited to cases of animal sickness or direct disease exposure only.
2. Stop factory farms from using antibiotics that are especially valuable to human medicine, including fluoroquinolones, glycopeptides, macrolides, and third- and fourth-generation cephalosporins. The WHO describes these antibiotics as critically important for humans.
3. Bring in qualified veterinarians. Implement requirements that they oversee the administration of antibiotics to animals on factory farms, and that antibiotics be administered only in cases where these veterinarians have directly assessed the animals.
4. Promote and apply good practices at all steps of production and processing of foods from animal and plant sources. Ideally, transitioning from factory farms to regenerative agriculture and practices will solve this problem. (More on this in Part 5.)
5. Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare.
6. Reduce the need for antibiotics altogether by adopting new technologies (for example, vaccines) to improve animal health and prevent disease.26
7. Track the misuse of antibiotics. The USDA and FDA don’t effectively track the use of antibiotics in livestock production. The drug and agriculture industry refused to release any data until 2003 and now releases only limited data. In order to track and regulate the misuse of antibiotics there must be mandatory transparency.
Thankfully, Vani Hari lays out a blueprint for how anyone can use food activism to fight for food industry reforms in her latest book, Feeding You Lies: How to Unravel the Food Industry’s Playbook and Reclaim Your Health. The book exposes the industry’s deceptive practices, its manipulation of nutrition science, its misinformation campaigns, and its label and marketing trickery. It’s an empowering book that I encourage you to check out. She maps out an action plan as someone who has taken on Big Food and won. It will not just open your eyes and educate you; it will also give you the tools to follow in Vani’s footsteps.
1. Buy your meat from a trusted local farm. Or look for meat and dairy products that have the American Grassfed Association (AGA) logo. The AGA follows sustainable and transparent practices, and it treats animals humanely. The animals are raised on pasture, are allowed to forage, and are not drugged with hormones and antibiotics.
2. Find certified grass-fed products online, for example, on Thrive Market or Amazon. Or you can go to the American Grassfed Association website and look for certified grass-fed producers in your area: americangrassfed.org/producer-profiles/producer-members-by-state/.
3. Look for labels on meat, poultry, dairy, and other foods that say hormone- and antibiotic-free.
4. Visit localharvest.org/organic-farms to find small farms in your area that do not use hormones and antibiotics. There are almost 2 million farms in the United States, and almost 80 percent of them are small farms.
5. Eat real whole food, or if you have packaged food, make sure every ingredient is something you recognize or would have in your kitchen and use in cooking. No one has azodicarbonamide, mono- or diglycerides, BHT, or carrageenan in their cupboards. An egg or almond or avocado doesn’t have an ingredient list or nutrition facts label.
6. Eat at restaurants that don’t use animal products raised with antibiotics. PIRG, along with the Natural Resources Defense Council and other groups, releases an annual “Chain Reaction” report that grades restaurant chains on their antibiotics policies for the meat they buy. In 2017, the scorecard contained A grades for only two restaurant chains: Chipotle and Panera Bread. Subway was given a B+ and Chick-fil-A received a B. Meanwhile, eleven restaurant chains received the worst grade, an F. Those that flunked included Dairy Queen, Sonic, Applebee’s, Domino’s, Chili’s, Little Caesars, Arby’s, IHOP, Cracker Barrel, and Buffalo Wild Wings. I would generally advise you to avoid these restaurants anyway. But let’s be honest: Millions of people patronize these establishments, and they aren’t going away anytime soon. It is good to see that the annual report is already making a difference. Many companies that see their low grades released to the public are motivated to improve them. In 2015, Subway had the worst grade, an F, which helped inspire the company to make dramatic improvements. The sandwich giant earned a higher grade after it started serving antibiotic-free chicken and pledged to eliminate antibiotics from all its meat and poultry products by 2025. Don’t patronize the restaurants with bad grades—and let their corporate management know exactly why you don’t eat there. Eventually, they’ll change their policies.
Vani Hari is proof that one person can start a revolution. And if many of us join her, we’ll be able to turn around these problems in our food system—for everybody’s good. With enough pressure from citizens and companies that choose to make better decisions about their ingredients, eventually the FDA will have to step up.
The FDA has a vital job to do. It’s supposed to keep our food supply safe and regulate food. But right now it gets a grade of D+, just barely passing. I propose a handful of relatively simple fixes that could vastly improve the FDA’s handling of our food system. Americans should demand these changes, putting pressure on Congress to make these reforms a reality. The FDA needs to improve in three key areas. It needs to create stronger safety standards for the use of antibiotics in our food, enforce stricter food-labeling standards, and mandate safety testing before products or additives are used in our food supply. Many countries have already shown the way. The FDA just needs to follow suit.
Here’s what the FDA can do to make food labels easier to understand, because now you have to have a PhD in nutrition to make any sense of them. Why does it say grams of sugar instead of teaspoons, especially in a country that doesn’t use the metric system? Simple. The food industry wants us confused. If the nutrition label of a 20-ounce soda said it contained 15 teaspoons of sugar, we might think twice about buying it.
1. Use the stoplight system for food labels. Similar to the GMO-labeling tactics we’ve discussed, in Chile and many European countries the food labels use a brilliantly simple system. A green logo means the food is good for you: Go ahead and buy it. Yellow means it’s essentially neutral: Not so good for you, but not necessarily bad for you either. Proceed with caution. And a red logo is the equivalent of a great big stop sign: This food could kill you, so either put it down and back away or be doubly sure that this is what you really want to put in your body or feed to your children. Front-of-package warning labels have been used very successfully in other countries such as Chile for foods that are harmful. The industry will fight back, all guns blazing, but it is the right choice. Don’t make it hard for consumers; make the right choice the easy choice.
2. List ingredients by their percentages. The United States is one of the few developed countries that uses an outdated system. As Jerold Mande explains, “Other countries actually state the percentages of those ingredients. If it’s the second ingredient, is it 30 percent or is it 5 percent? You just don’t know with our current labels. Other countries require the top ingredients and their percentages [to be] listed.” The FDA needs to require food companies to list the percentages of sugar, oil, food coloring, and other ingredients on their labels.
3. Restrict health claims on package labels. Food companies have a right to package their products in appealing ways. They can slap pictures of mountain springs and green valleys on their labels if they like. They can come up with clever brand names to entice consumers. But the FDA should put its foot down when companies make unwarranted or misleading health claims. Americans spend billions every year on cereal, bread, yogurt, and other foods that claim to be “all natural” despite containing synthetic and genetically engineered ingredients. Many foods are labeled “whole grain” even though their first ingredient is refined flour. There are foods that claim to “strengthen your immune system”—like Ocean Spray cranberry juice—even though they are loaded with sugar. And many processed foods claim to be “lightly sweetened” (like Kellogg’s Frosted Mini-Wheats) or “a good source of fiber,” even though they are nothing of the sort.27 The FDA should stop companies from slapping false claims on their labels. They should be allowed to make health claims only when they have actual evidence to back them up. The FDA allows Froot Loops to be labeled “heart-healthy” because it has no fat or cholesterol (but tons of sugar) but deems KIND bars unhealthy because they contain “fatty” nuts, even though nuts are now universally accepted to help with weight loss and prevent heart disease and diabetes.
4. Strengthen its regulation of chemical food additives. Food industry groups should not be allowed to declare new food chemicals and other additives safe without the proper scientific evidence. The FDA must enforce the current standards under the law. The safety of our food supply depends on it.
As we’ll see in the next chapter, Big Food’s influence on the FDA is not the only way we are being deceived. But we will expose their tactics and show you how everyday citizens can lead the way toward transformation.