Let’s hope an administration unattached to the status quo can make progress where others have failed
Recent news that Robert F. Kennedy Jr. may lead health policy in a second Trump administration has generated understandable concern among medical professionals, particularly given his history of spreading misinformation about vaccines and other public health issues. However, as an integrative medicine physician focused on helping patients achieve optimal health, I find myself intrigued by one specific aspect of Kennedy's proposed agenda: reforming America's food system.
In a recent Wall Street Journal essay, former New York City health commissioner Thomas Farley and former director of the CDC Tom Frieden outlined how Americans' unhealthy diets reflect a slew of health policy choices that the new administration will have control over, including how foods are designed, sold, and marketed. They urge RFK Jr. and Trump to take on “Big Food” in specific areas where they themselves have previously tried and failed.
I absolutely support those efforts. As an emergency medicine physician, I saw first-hand the results of decades of bad food policy in the chronic diseases that showed up every day in the emergency room. And as an integrative medicine physician now at Dignity Integrative, I see every week how daily how processed foods, excess sugar, and sodium contribute to chronic diseases that diminish quality of life and drive up healthcare costs.
The statistics are sobering. As Farley and Frieden note, "nearly half of Americans have high blood pressure, three-quarters are obese or overweight, and 15% have type-2 diabetes." These conditions don't emerge in isolation – they're a direct consequence of a food system that prioritizes profits over public health.
Through my practice focusing on nutrition, movement, sleep, and mental resiliency, I've witnessed how dietary changes can dramatically improve health outcomes. But individual action, while important, isn't enough. When it comes to making good food choices easy we are definitely ‘swimming upstream’ based on our current system. We do need systemic change.
Some of Kennedy's ideas align with what many public health experts have long advocated for:
Reducing ultra-processed foods in school meals
Addressing the overuse of sugar and sodium in processed foods
Improving SNAP benefits to encourage healthier food choices
Re-examining agricultural subsidies that incentivize unhealthy food production
Take that last point, for example. At Bella Vita Farm, which my wife Amy and I have been running for many years, we grow dozens of kinds of fruits and vegetables that should be a pillar of any healthy diet. We get no subsidy from the government for growing vegetables. Yet big agribusinesses growing wheat, soy, and corn take billions of dollars in subsidies from the federal government each year.
These incentives have led to so much over-production of corn that it’s spawned multiple entrenched sub-industries to make use of that overproduction: refined high fructose corn syrup that damages our health; animal feed industries that give corn to cows who prefer to eat grass; and a corn ethanol biofuel industry that causes more carbon emissions than traditional gasoline.
I would prefer to redirect those subsidies to say, healthy greens.
None of RFK Jr.’s ideas about food should really be partisan issues—they're public health imperatives. Nevertheless, any time a government at any level proposes to alter financial incentives, politics is inevitable.
When Farley and Frieden led initiatives like the National Salt Reduction Initiative and attempts to limit sugary drinks, they encountered fierce resistance from industry groups, notably the companies that make Coke and Pepsi, as well as their trade group the American Beverage Association. Even when they won small victories, such as a surcharge on soda in Cook County, Illinois, the trade groups successfully lobbied the next board of commissioners to repeal the initiative.
Going up against an American institution like Coca-Cola is always going to be fraught for politicians. And it’s true that sometimes it takes an outsider, someone unattached to traditional political alignments, to challenge entrenched interests.
That said, I harbor no illusions. The last Trump administration proved it could challenge some entrenched ideas but not others, though which of those challenges ultimately benefited our country’s health is still a matter for debate (operation Warp Speed, for example, undoubtedly saved lives; boosting ivermectin as a response to COVID undoubtedly cost them).
Meanwhile, many of Kennedy's views on health and medicine are deeply problematic and potentially dangerous. Still, in our polarized political climate, we must be willing to support beneficial policies even when we strongly disagree with their proponents on other issues.
Food policy reform represents a rare opportunity for progress. Whether through warning labels on ultra-processed foods which have shown promising results in Chile. Currently, four other South American countries have adopted Chile’s food warning label system with others in the process of implementing. Additionally, incentives for healthier school meals, or strategic use of SNAP benefits to encourage better nutrition, there are evidence-based solutions waiting to be implemented.
While I'm certain I'll disagree with many health policies a second Trump administration might pursue, sometimes those most unattached to the status quo can achieve progress where others have failed. Food policy profoundly influences our collective health, and even incremental improvements could positively impact millions of Americans' lives. That's an opportunity worth pursuing, regardless of political affiliation.
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