Momentum for mandatory front-of-package nutrition labeling continues to grow as new organizations are joining the effort to encourage the Food and Drug Administration to develop labels that would call attention to high levels of added sugars, sodium, and saturated fat in packaged, processed foods. And a new poll commissioned by CSPI finds strong public support for the proposal. 

The American Cancer Society Cancer Action Network, American Heart Association, American Public Health Association, Consumer Federation of America, and Consumer Reports are among 17 organizations that have filed a supportive comment with the FDA, which opened a regulatory docket in response to an August 2022 petition filed by the Center for Science in the Public Interest, the Association of State SNAP Nutrition Education Administrators, and the Association of State Public Health Nutritionists. 

“We are dismayed that the United States has become one of the nations with the greatest need for, but scantest action on, such public health nutrition interventions,” the 17 organizations wrote. “The time has come for FDA to take bold action to improve our nation’s diet and health. Please prioritize this evidence-based policy and develop a mandatory front-of-package labeling system for the United States.” 

The comment points out that the average American adult consumes 50 percent more sodium, 40 percent more added sugars, and 40 percent more saturated fat than recommended daily. Meanwhile, approximately 122 million U.S. adults have hypertension, more than 30 million Americans have type 2 diabetes, and 20 million U.S. adults have coronary artery disease. Each of these conditions is strongly linked to excess intake of added sugar, salt, or saturated fat, according to the groups. 

The idea of front-of-package labeling received a major boost late last year, when the Biden administration endorsed it as part of its National Strategy on Hunger, Nutrition, and Health. FDA is poised to begin quantitative research testing consumers’ reactions to various potential front-of-package labeling systems. 

The FDA’s docket has received over 7,700 public comments, over 5,500 of which are posted as of today. The overwhelming majority of the posted comments support the petition. These supportive comments include submissions from academics at Harvard T.H. Chan School of Public Health, the University of Pennsylvania and the University of North Carolina-Chapel Hill, and the New York City Department of Health and Mental Hygiene. 

Separately, in a new comment filed to the docket Thursday, CSPI noted that, of all the comments on the public docket, only one opposes mandatory front-of-package labeling—the joint comment of the Consumer Brands Association (the trade association formerly known as the Grocery Manufacturers Association) and the FMI-The Food Industry Association. That comment argues, among other things, that FDA may lack authority to implement front-of-package labeling.  

But CSPI’s comment in response explains how Congress gave FDA broad authority over nutrition labeling generally when it passed the Nutrition Labeling and Education Act — the law that FDA used to create mandatory Nutrition Facts labels in the first place. Congress’s intent was made clear in the report language accompanying that act when it wrote “In order to present nutrition information in a manner that facilitates the public’s understanding, the Secretary may choose among a variety of options. … This could include the use of descriptive terms such as ‘high,’ ‘medium,’ and ‘low’ or the use of universal symbols to indicate desirable or undesirable levels of particular nutrients.” Thus, FDA has the authority to require interpretive front-of-package nutrient disclosures under the NLEA. Last month, CSPI commissioned a national survey to assess public support for a mandatory front-of-package nutrition labeling policy in the United States. The survey found high levels of support across demographic groups, with 75 percent of all consumers supporting the policy, including among Democrats (83 percent) Republicans (68 percent), and Independents (73 percent). 

“It’s worth remembering that the food industry rabidly opposed Nutrition Facts labels when they were first proposed, variously claiming they would violate the First Amendment, confuse consumers, and be too expensive for the industry,” said CSPI president Dr. Peter G. Lurie. “Industry arguments against nutrition labeling on packaged foods ring as hollow today as they did 35 years ago.” 

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A year ago the Center for Science in the Public Interest urged the Food and Drug Administration to protect consumers from unprocessed poppy seeds contaminated with naturally occurring opiate residues. In a regulatory petition filed along with medical experts and six families injured by contaminated poppy seeds, we asked the agency to clean up America’s poppy seed supply by setting a maximum limit for opiate contamination and establishing controls on imported seeds.

CSPI is asking the FDA for an update on the petition. Other than issuing pro forma responses and collecting comments on a public docket, the FDA has taken no public action, despite increased interest in this issue from consumers, state officials, and members of Congress from both parties. The vast majority of the nearly 3,300 comments to the docket were submitted by individual consumers concerned that the FDA was allowing opiate-contaminated poppy seeds into the food supply.

European regulators established maximum levels of morphine and codeine in poppy seeds and baked goods last year, which are scheduled to take effect in July. In the U.S., while the Department of Justice has pursued enforcement against at least one individual distributor of poppy seeds for allegedly violating drug control laws, that enforcement has not been sufficient to block even that one company from selling seeds.

Last year, researchers at CSPI and Connecticut Poison Control Center co-authored a study documenting injuries related to poppy seed consumption. The group estimates that there have been 20 non-fatal overdoses and 19 deaths in the United States attributable to opiate-contaminated poppy seeds, most of which have occurred since 2015. In a letter to Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, CSPI said that creating standards for poppy seeds would help address the problem.

“The time is overdue for the FDA to establish standards that will protect U.S. consumers from ingesting dangerous levels of opiates through the food supply,” CSPI wrote. “Accordingly, we are requesting a meeting with you to review the evidence supporting our requests, and to receive an update on the status of our petition.”

If you would like more information from CSPI scientists or lawyers about our work in this area, or would like to talk to families injured by contaminated poppy seeds, click here.

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In recent days, the Food and Drug Administration released the 2020 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals, which showed sales levels close to those from recent years. These data have been compiled annually since 2011 as part of a regulatory reaction to the role of veterinary antimicrobial use in the development of resistance.

The report highlights that more should be done by the FDA to examine antimicrobial use in animal agriculture. The report documents a small 3 percent reduction (from 6,189,260 kilograms to 6,002,056 kg) in the weight of medically important antimicrobials in 2020 compared to 2019. This is a 38 percent reduction from the peak year of 2015 in which 9,702,943 kg of antimicrobials were sold or distributed.

Most of this reduction has been driven by reductions in tetracycline use. However, like previous reports, these numbers are not adjusted for biomass — the numbers, species and weights of the animals produced over the year. Without examining this information, a 3 percent difference in sales could indicate either an increase, no change, or a decrease in antimicrobial use. The FDA released a biomass adjuster proposal in 2017, but has not followed up since accepting public comments.

By its nature, the report only analyzes sales and distribution data. FDA is not collecting data on the purposes for which these drugs are actually being used on farms, information of vital importance to regulators, public health professionals, consumers, and the industry itself.

The FDA needs to be bolder in taking actions to monitor antimicrobial use in food producing animals and resistance. The rapid evolution of SARS-CoV-2 is an object lesson in how adaptable microorganisms can be. Antibiotic resistance is too foreseeable of a public health crisis to neglect.

About the Center for Science in the Public Interest (CSPI): The Center for Science in the Public Interest is America’s food and health watchdog, according to its mission statement. CSPI envisions a healthy population with reduced impact and burden of preventable diseases and an equitable food system that makes healthy, sustainable food accessible to all. CSPI values independence, scientific rigor, and transparency.

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President Trump’s executive order keeping meat plants open during the COVID-19 pandemic is a further threat to the health of the women and men who produce our food. The order would gut any incentive that companies do the right thing to protect the workforce, and instead push risks onto workers.

By invoking the Defense Production Act, the order would deny workers their day in court even if they get sick as a result of employer negligence.

By its failure to provide adequate personal protective equipment and to assure social distancing, the meat industry already tried ignoring the risks of COVID and workers paid the price, in at least 17 cases, with their lives. Forcing workers to come back into work will only spread the virus further.

This is certainly no time to offer special favors absolving the industry from its legal responsibilities to its workers.

To help ensure both worker safety and the continuity of the food supply, the administration should require that meat and poultry plants enforce social distancing, install workstation dividers where distancing is impractical, provide masks and other personal protective equipment, and most importantly, provide paid sick leave to workers.

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Jacobson, 73, who holds a doctorate in microbiology from the Massachusetts Institute of Technology, co-founded CSPI with two other scientists. He led the group during its successful campaigns to put Nutrition Facts labels on packaged foods. Then, to highlight that law’s failure to include restaurant meals, CSPI revealed the nutrient content of restaurant meals with high-profile studies on everything from movie theater popcorn to the fare at Chinese, Italian, Mexican, and chain restaurants.

In 1974 Jacobson created what became CSPI’s flagship publication, Nutrition Action Healthletter. The advertising-free publication remains CSPI’s principal source of revenue, with about 600,000 subscribers.

More recently, CSPI led successful legislative pushes to modernize the nation’s food-safety laws and eliminate junk food from schools, spurred the Food and Drug Administration to eliminate artificial trans fat from the food supply, and pioneered the use of litigation to stop the deceptive advertising and marketing of foods, beverages, and dietary supplements.

“Thanks to Mike Jacobson, the Center for Science in the Public Interest is the gold standard for science-based public advocacy,” said Lisa Heinzerling, the Justice William J. Brennan Jr. Professor of Law at Georgetown University and incoming chair of CSPI’s board of directors.

“For over 40 years, Mike has led the charge for giving Americans scientifically sound information about food, nutrition, and health, and for ensuring healthier and safer food. He has big shoes to fill, but his vision and commitment have built a strong and vital organization that promises to be as important in 2020, 2030, and 2040 as it is today.”

“Michael Jacobson started a movement that inspired Americans to question what was in the food they eat and to make it safer and healthier,” said former New York City Mayor Michael R. Bloomberg, who currently serves as the World Health Organization’s Global Ambassador for Noncommunicable Diseases. “Through his tireless devotion to science and public health, he helped save many lives, and the success he achieved will benefit generations to come.”

Jacobson authored numerous pioneering books on food and nutrition including “Eater’s Digest” in 1972, “Nutrition Scoreboard” in 1973, “The Fast-Food Guide” with Sarah Fritschner in 1986, and, with Jayne Hurley, “Restaurant Confidential” in 2002.

He also wrote influential pamphlets that sparked national concerns about soft drinks, “Liquid Candy: How Soft Drinks are Harming Americans’ Health” in 1998, and salt “Salt: The Forgotten Killer” in 2005).

Jacobson is the recipient of the FDA Commissioner’s Special Citation and Harvey W. Wiley Medal, the Food Marketing Institute’s Esther Peterson Consumer Service Award, and the Centers for Disease Control and Prevention Foundation’s Hero Award.

In the 1970s, Jacobson’s criticisms of cancer-causing sodium nitrite and nitrate led to sharp reductions in their use, and he successfully pushed for a ban on the dye Violet 1, another cancer-causing additive that was then used in the U.S. Department of Agriculture’s inspection mark on meat. In 1977, to bring attention to CSPI’s petition to ban ads for sugary cereals on children’s television, Jacobson delivered 170 decayed teeth to the Federal Trade Commission.

In the 1980s, Jacobson successfully urged the FDA to ban the use of sulfite preservatives, which were killing people almost instantly, on restaurant salads, potatoes, and other fresh foods, and lobbied for passage of the law requiring health warnings on alcoholic beverages.

After several years of advocacy, CSPI helped win passage of the Nutrition Labeling and Education Act of 1990, putting “Nutrition Facts” labels on all packaged foods. That year CSPI also led the effort to win passage of the federal law defining “organic” foods.

In 1994, CSPI generated headlines around the world when the group tested fettucine Alfredo from Italian restaurants, calling the high-fat, high-calorie dish a “heart attack on a plate,” and again that year when its study of movie theater popcorn found that a medium order contained roughly 900 calories and twice as much saturated fat as a Big Mac plus a large order of french fries.

In the mid-1990s, Jacobson took on the controversial fat substitute known as olestra.

“Columbus is about to become the diarrhea capital of the nation,” Jacobson told reporters at a news conference in the Ohio city that served as an early test market for the fake fat. CSPI collected thousands of reports from consumers who experienced adverse digestive symptoms after eating products made with olestra, such as low-fat — and now discontinued — Pringles.

In 2007, the threat of a CSPI lawsuit prompted Kellogg to enter into an agreement setting nutrition standards for the foods the company would advertise to children, and prompting other companies to institute similar policies.

In 2010 and 2011 the group pushed successfully for passage of the Healthy, Hunger-Free Kids Act and the FDA Food Safety Modernization Act, respectively. The Affordable Care Act, the health care reform bill that also passed in 2010, included something CSPI had spent the prior decade advancing at the state and local level — a provision requiring calorie counts on chain restaurant menus and menu boards.

Three of Jacobson’s most important targets have been trans fat, salt, and sugar, three of the biggest killers in the food supply. CSPI’s 20-year campaign to get artificial trans fat labeled and ultimately eliminated from food culminated in 2015 when the FDA determined that partially hydrogenated oil — the source of artificial trans fat — was no longer considered safe for use in food. CSPI had asked the agency to revoke the safety status of the substance 11 years earlier. The virtual elimination of trans fat is saving thousands of lives a year, as are reduced sodium, sugar and high-fructose corn syrup consumption.

“I feel so privileged to have led a public-interest group that has had an enormous impact on government policies, corporate practices, and, most importantly, people’s lives,” said Jacobson. “Once CSPI has a new executive director, I look forward to helping that person as much as I can and serving as CSPI’s chief scientist.”

In the next year, CSPI will continue its work to reduce consumption of sugar drinks — major contributors to diabetes and obesity — by means of education and special taxes, warning labels, and other policies; reduce the amounts of sodium in packaged and restaurant food; end junk-food marketing to young children; eliminate synthetic food dyes, which trigger hyperactivity in some children; and otherwise improve the food environment.

“From the trans fat ban to nutrition facts labeling, very few people have made the impact on public health the way Michael Jacobson has,” said New York City Health Commissioner Mary T. Bassett. “The New York City Health Department’s reputation for innovation owes him and Center for Science in the Public Interest a great debt. Without his tireless advocacy and support, public health efforts such as calorie posting, the trans fat restriction, and the sodium warning label — all grounded in our mission to promote and protect the city’s health — might not have been possible. As chief scientist for CSPI, I expect Michael to continue his work on behalf of New York City and the rest of the nation.”

“Mike Jacobson has been a force for progress,” said Representative Rosa DeLauro, D-CT. “From keeping pathogens off poultry and produce to putting Nutrition Facts on packaged foods and restaurant menus, CSPI has been and will continue to be an important partner to those of us in Congress who care about food and health. I’m very grateful for Mike’s leadership and look forward to working with the new leadership at CSPI.”

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