US Pushes for Stricter Junk Food Rules Amid Chronic Disease Surge

Watching a football game this weekend, I was bombarded with commercials promoting a wide array of unhealthy foods. It reminded me that Secretary of Health and Human Services, Robert F. Kennedy Jr., has said he wants to crack down on junk food ads, particularly those targeting children. But thus far, Kennedy has offered few concrete policy solutions. One avenue he could try and pursue is adding mandatory warning labels on certain foods and beverages for sale which could also be applied to advertisements on television, radio, online and in print media. Other countries are doing this. Chile, for example, now has easily recognizable stop-sign-like warning labels-mandatory for products high in salt, sugar, saturated fat and calories-which have had a positive impact on consumer habits.

The Centers for Disease Control and Prevention say that six out of every ten adults in the United States have at least one chronic disease, and about four in ten have two or more chronic diseases. The critical role of nutrition in chronic disease is well-recognized. Poor diet often underlies development of many chronic conditions, including obesity, cardiovascular disease, hypertension, stroke, type 2 diabetes and a number of cancers.

A recently released report from the Make America Healthy Again commission identifies the rise in diet-related chronic disease as being driven by a food environment that is increasingly composed of highly processed foods. Judging from many of the foods and beverages advertised on TV and other media, Americans are indeed exposed to the consumption of numerous items that are highly processed or contain unhealthy levels of specific nutrients and additives. Perhaps the U.S. could draw lessons from the experiences of other countries that include nutrient warnings and impose restrictions on advertising.

Since 2016, five countries-Chile, Israel, Mexico, Peru and Uruguay-have passed legislation requiring nutrient warnings, with the goal of addressing obesity and other diet-related chronic diseases. These policies focus on products with what are considered excessive levels of unhealthy nutrients. Products are required to display front-of-package warning labels such as "WARNING: High in added sugar" or "WARNING: High in sodium."

Passed in 2016 in Chile, the Law of Food Labeling and Advertising, included the introduction of mandatory, stop-sign-like front-of-package nutrient warning labels alerting consumers to products high in sugar, salt, saturated fat and calories. Lawmakers argued that such messages can inform consumers and help them make healthier choices.

What's more, the legislation included marketing restrictions aimed at preventing children from viewing commercials that include foods with ultra-processed ingredients and high levels of saturated fats, sugars and sodium. This has led to a 73% drop in Chilean children's ad exposure for such products. There have also been significant decreases in purchases of products high in "nutrients of concern."

Whether such warning labels would be feasible in the U.S. remains to be seen. It took passage of the Nutrition and Labeling and Education Act in 1990 for there to be a requirement that most foods bear nutrition labeling. And now, it would require Congressional authority for the HHS Secretary to add warnings to labels and impose advertising restrictions.

The MAHA movement has claimed minor successes, including the announcement by Walmart on Oct. 1 that it is eliminating synthetic dyes from store brands by 2027. Tyson Foods said last month that it will soon eliminate high fructose corn syrup from its products by the end of 2025. And Coca Cola has made it known that starting soon, consumers in the U.S. will have the option to buy its soda sweetened with cane sugar instead of high fructose corn syrup.

Additionally, the Consumer Brands Association, a U.S. trade group representing the food industry, announced its plan to encourage food and beverage companies to stop manufacturing products with artificial food dyes by the end of 2027.

Could the Department of HHS go further and propose adding warnings to certain food and beverage labels as well as ads on television or online? Maybe. Naturally, this would encounter opposition from business interests in the food and restaurant industry. Furthermore, a "Please eat responsibly" message may not go over well.

And there's the issue of freedom of commercial speech. In the past, health warning policies in the U.S. have encountered legal challenges from industry on First Amendment grounds. Warnings are often considered "compelled commercial speech," meaning that to be legally viable they must meet certain requirements. One such necessary condition is that warnings must be "reasonably related to government interests." Presumably this refers to public health.

We already see instances of this being applied with respect to the regulation of alcoholic beverages, which contain warnings on the products being distributed and sold and in commercials.

Perhaps nutrient warnings could also apply to specific food and non-alcoholic beverages. Evidence from countries that have implemented nutrient warning policies supports the effectiveness of such messages.