The idea of making the U.S. more like Europe is anathema to many in the Trump administration. But that’s what the Make America Healthy Again movement says it wants — at least when it comes to food.
Health secretary Robert F. Kennedy Jr. and Food and Drug Administration chief Marty Makary frequently suggest that following Europe’s approach on artificial dyes, pesticides, and additives could improve chronic disease rates in the U.S. TikTokers and other influencers have also jumped on the pro-European food bandwagon; podcaster Joe Rogan, for example, cited Kennedy in theorizing about why Italy’s pastas and breads agree with him while glutenous products in the U.S. don’t. (He credits the heirloom wheat.) Meanwhile, Texas Gov. Greg Abbott recently signed into law a bill that will require foods like M&Ms to display warning labels noting that they contain ingredients “not recommended for human consumption” in Europe and other countries.
It’s true that Europeans have lower rates of chronic disease and longer life expectancies than Americans, and nutrition experts say that European food policies are likely one contributing factor. But if the MAHA movement really wants to imitate Europe on food, they say, its leaders should pay more attention to policies they’ve so far overlooked — such as soda taxes, color-coded food warning labels, and heavier review of new products.
“There are all of these areas where I think Europe is doing a lot of things right, but those policies haven’t been acknowledged” by the MAHA movement, said Alyssa Moran, director of policy and research strategy at the University of Pennsylvania’s Psychology of Eating and Consumer Health (PEACH) Lab.
There are also a lot of other differences between Europe and the U.S. that may contribute to the gap in chronic disease rates, Moran said — physical activity, air pollution exposure, poverty rates, and health care access among them.
“Food is one component of noncommunicable diseases,” Moran said, “but there are myriad factors that contribute to long-term health.”
How the precautionary principle shapes Europe’s food policy
Getting additives and dyes out of the food system is a central tenet of the MAHA platform — and arguably the area where the movement has so far had the most success. Industry giants like Kraft Heinz, General Mills, Nestlé, and Conagra Brands have all agreed to phase out synthetic dyes in response to government pressure. (Mars, the maker of M&Ms, is one notable holdout.) The Texas law — should it survive a slew of expected lawsuits — and a similar Louisiana law requiring disclaimers on foods that contain certain ingredients could have national implications for the way packaged foods are made in the U.S.
The reason Europe’s policies on food additives and dyes are stricter than those in the U.S. comes down to the precautionary principle — the idea that it’s better to hold off on adopting new processes or ingredients until they’ve been proven safe. Europe requires premarket reviews of new food products and substances, including food colors as well as emulsifiers, stabilizers, and sweeteners.
The U.S. has a much more laissez-faire attitude toward additives, thanks in part to the regulatory loophole known as GRAS, or “generally recognized as safe,” which allows food companies to introduce new additives without regulatory approval or even the government’s knowledge.
Moran said that, ultimately, the problems with the GRAS loophole require a fix that goes beyond targeting specific ingredients.
“What we really need is to overhaul our food regulatory system in the U.S., which means additional resources, additional staff at FDA to be able to review new substances before they come to market, and to review substances that were added to the food supply over the past many decades,” she said. So far, the agency’s staffing and resources have only been depleted by the sweeping cuts of roughly 3,500 workers this spring.
Whether, and to what extent, additives have fueled problems with chronic disease in the U.S. is a tough question to answer. Some substances banned in the E.U. but still permitted in the U.S. have been shown to potentially contribute over the long term to disease. Potassium bromate, for example, is an additive used in bread and other baked goods that’s been classified as possibly carcinogenic to humans by the International Agency for Research on Cancer (IARC). It’s currently listed as “under review” by the FDA and is among the most common targets of state legislation seeking to ban certain chemicals.
But there are also thousands of additives in the foods Americans consume every day, which makes it “very difficult to tease apart which specific additives are contributing [to chronic disease], what are their interactive effects, what are their long-term impacts,” Moran said.
Rather than try to avoid particular additives and dyes, Moran said, the safest route is for people to limit consumption of the ultra-processed foods that tend to contain them and focus on whole or minimally processed foods instead.
The benefits of eating fewer ultra-processed foods
That’s the dominant approach in countries like Italy, which boasts a strong culture of cooking from scratch and where ultra-processed foods make up just 13%-14% of daily caloric intake. But different European countries have varying relationships with ultra-processed foods. In the U.K., they account for more than half of daily intake, about as high as the U.S.
France, where ultra-processed foods make up less than a third of daily calories, is now the home of IARC nutritional epidemiologist Heinz Freisling. Since moving to Lyon from Austria, he’s noticed his colleagues not only consume more whole foods, they eat much more slowly. (Adjusting to 90-minute, multi-course lunches was quite the culture shock for him at first.)
“There’s really strong evidence that if you have a higher proportion of processed foods in your diet, that leads to weight gain and adiposity,” or obesity, Freisling said.
Many are hyper-palatable — high in ingredients like saturated fat, sodium, and added sugar. Not only can eating too much of these ingredients increase risk of heart disease and other health issues, people tend to eat salty, sugary, fatty food faster and in larger quantities. Even the artificial textures of many ultra-processed foods — a melt-in-your-mouth Cheeto puff or a crispy Kit Kat — mean that they take less time to chew and swallow, so people can eat more without getting full.
The importance of shifting American eating habits away from ultra-processed foods was a major theme of this May’s MAHA commission report, though it’s unclear how Kennedy and others in the movement plan to bring about the change. Plans for a forthcoming public awareness campaign on the links between ultra-processed food and diabetes seem to emphasize personal responsibility. But there are several other concrete steps Europe has taken to try to reduce people’s exposure to unhealthy foods.
How Europe is pushing back against ultra-processed foods
One of the most prominent efforts to keep Europeans committed to healthy food habits was the introduction of Nutri-Score warning labels on foods that are high in sodium, sugar, and saturated fat.
First introduced in France in 2017, the front-of-package food labeling system uses clear visual cues to help consumers make healthier choices — colors that range from green (“go ahead and eat it”) to dark red (“stop and think about it”), and a letter grade from A (best) to E (worst). The labeling system has been adopted by Belgium, Spain, Germany, Luxembourg, Switzerland, and The Netherlands.
The appeal of Nutri-Score is that it removes the need to scrutinize individual nutrition labels, Freisling said; a quick glance at rows of boxes in the cereal aisle will immediately let consumers know which ones are higher in calories and added sugars. “Even children understand this labeling,” he said.
Soda taxes in European countries like the U.K. are another policy lauded by many nutrition experts. Some U.S. cities have imposed soda taxes to discourage consumption. (Politician and businessman Michael Bloomberg, whose Bloomberg Philanthropies provides funding to STAT, attempted to ban extra-large servings of sodas when he was mayor of New York City and has donated money in support of soda taxes in other cities.)
The tax in the U.K., however, targets manufacturers based on the amount of sugar the drinks contain.
“It’s actually incentivized companies to formulate their drinks to be lower in sugar, so it’s shifting the food supply,” said Moran. Coca-Cola and Pepsi have slashed the sugar in some of their drinks in Europe by 30%-50% — though typically by adding alternative sweeteners that may have their own drawbacks. Research has linked the U.K.’s tax to fewer dental cavities and lower rates of obesity in some demographics.
MAHA isn’t ignoring the issue of sugar-sweetened beverages, to which a recent global study attributed 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease in 2020 alone. Agriculture Secretary Brooke Rollins has so far issued waivers to six states allowing them to restrict the use of food benefits to purchase soda along with foods like candy. But to Moran, the fact that MAHA is “talking about SNAP restrictions [on soda] but not taxes is pretty inconsistent.”
Bike paths and passeggiatas
Beyond food, Europeans’ comparatively more robust health may be linked to lots of other factors, too. Freisling said that physical activity in Europe is well established — not so much via weightlifting or pilates classes, but integrated into everyday life. European cities are designed to be walkable; his own colleagues may walk 5 miles to and from work each day, “just because it’s pleasant.”
In Italy, he said, it’s common to go for a passeggiata in the evenings — a post-dinner walk. And in Copenhagen, biking is so popular that “you have a traffic jam of bikes.” (The city has introduced traffic lights designed especially for bikes and other technological solutions in an effort to ease the problem.)
Research suggests Americans are less physically active than people in European countries: For example, walking is the chosen form of transportation for 12% of Americans’ daily trips, compared to 26% in the U.K., 24% in France, and 22% in Germany and Finland.
And there’s no overlooking the elephant in the room: Most European countries have some form of universal health care. Portugal, for example, has a life expectancy that’s four years longer than that of the U.S. despite spending just 20% of what the U.S. does on health care per person — which experts credit largely to Portugal’s free or low-cost, accessible health care and its focus on primary care.
Some critics have suggested MAHA leaders’ emphasis on issues like food dyes and additives serves as a distraction from larger health issues that have a much bigger impact on chronic disease. “Keep people focused on food dyes, so they don’t notice the plan is to cut healthcare, nutrition assistance, environmental protections, scientific research, and our public health agencies,” registered dietitian Jessica Knurick, who aims to combat health misinformation online, said in a recent post on Substack.
Last Friday, President Trump signed a tax bill that would slash Medicaid and cause an estimated 12 million Americans to lose health insurance coverage over the next decade. Kennedy shared his support for the bill on social media, saying that the Medicaid cuts will target “waste, fraud, and abuse.”
Later that weekend, Kennedy posted a clip from his recent speech in Louisiana celebrating a new law that will ban artificial dyes and certain additives from school meals, and which cited Europe as inspiration. Making America healthy, Kennedy said, is “a moral obligation.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
