It’s Maddeningly Hard to Get Americans to Eat Better

In the world of nutrition, few words are more contentious than healthy. Experts and influencers alike are perpetually warring over whether fats are dangerous for the heart, whether carbs are good or bad for your waistline, and how much protein a person truly needs. But if identifying healthy food is not always straightforward, actually eating it is an even more monumental feat.

As a reporter covering food and nutrition, I know to limit my salt and sugar consumption. But I still struggle to do it. The short-term euphoria from snacking on Double Stuf Oreos is hard to forgo in favor of the long-term benefit of losing a few pounds. Surveys show that Americans want to eat healthier, but the fact that more than 70 percent of U.S. adults are overweight underscores just how many of us fail.

The challenge of improving the country’s diet was put on stark display late last month, when the FDA released its new guidelines for which foods can be labeled as healthy. The roughly 300-page rule—the government’s first update to its definition of healthy in three decades—lays out in granular detail what does and doesn’t count as healthy. The action could make it much easier to walk down a grocery-store aisle and pick products that are good for you based on the label alone: A cup of yogurt laced with lots of sugar can no longer be branded as “healthy.” Yet the FDA estimates that zero to 0.4 percent of people trying to follow the government’s dietary guidelines will use the new definition “to make meaningful, long-lasting food purchasing decisions.” In other words, virtually no one.

All of this is a bad omen for Donald Trump’s pick to lead the Department of Health and Human Services. As part of his agenda to “make America healthy again,” Robert F. Kennedy Jr. has pledged to improve the country’s eating habits by overthrowing a public-health establishment that he sees as ineffective. He has promised mass firings at the FDA, specifically calling out its food regulators. Indeed, for decades, the agency’s efforts to encourage better eating habits have largely focused on giving consumers more information about the foods they are eating. It hasn’t worked. If confirmed, Kennedy may face the same problem as many of his predecessors: It’s maddeningly hard to get Americans to eat healthier.

[Read: Everyone agrees Americans aren’t healthy]

Giving consumers more information about what they’re eating might seem like a no-brainer, but when these policies are tested in the real world, they often do not lead to healthier eating habits. Since 2018, chain restaurants have had to add calorie counts to their menus; however, researchers have consistently found that doing so doesn’t have a dramatic effect on what foods people eat. Even more stringent policies, such as a law in Chile that requires food companies to include warnings on unhealthy products, have had only a modest effect on improving a country’s health.

The estimate that up to 0.4 percent of people will change their habits as a consequence of the new guidelines was calculated based on previous academic research quantifying the impacts of food labeling, an FDA spokesperson told me. Still, in spite of the underwhelming prediction, the FDA doesn’t expect the new rule to be for naught. Even a tiny fraction of Americans adds up over time: The agency predicts that enough people will eat healthier to result in societal benefits worth $686 million over the next 20 years.

These modest effects underscore that health concerns aren’t the only priority consumers are weighing when they decide whether to purchase foods. “When people are making food choices,” Eric Finkelstein, a health economist at Duke University’s Global Health Institute, told me, “price and taste and convenience weigh much heavier than health.” When I asked experts about better ways to get Americans to eat healthier, some of them talked vaguely about targeting agribusiness and the subsidies it receives from the government, and others mentioned the idea of taxing unhealthy foods, such as soda. But nearly everyone I spoke with struggled to articulate anything close to a silver bullet for fixing America’s diet issues.

RFK Jr. seems to be caught in the same struggle. Most of his ideas for “making America healthy again” revolve around small subsets of foods that he believes, often without evidence, are causing America’s obesity problems. He has warned, for example, about the unproven risks of seed oils and has claimed that if certain food dyes were removed from the food supply, “we’d lose weight.” Kennedy has also called for cutting the subsidies doled out to corn farmers, who grow the crops that make the high-fructose corn syrup that’s laden in many unhealthy foods, and has advocated for getting processed foods out of school meals.

There’s a reason previous health secretaries haven’t opted for the kinds of dramatic measures that Kennedy is advocating for. Some of them would be entirely out of his control. As the head of the HHS, he couldn’t cut crop subsidies; Congress decides how much money goes to farmers. He also couldn’t ban ultra-processed foods in school lunches; that would fall to the secretary of agriculture. And although he could, hypothetically, work with the FDA to ban seed oils, it’s unlikely that he would be able to generate enough legitimate scientific evidence about their harms to prevail in an inevitable legal challenge.

The biggest flaw in Kennedy’s plan is the assumption that he can change people’s eating habits by telling them what is and isn’t healthy, and banning a select few controversial ingredients. Changing those habits will require the government to tackle the underlying reasons Americans are so awful at keeping up with healthy eating. Not everyone suffers from an inability to resist Double Stuf Oreos: A survey from the Cleveland Clinic found that 46 percent of Americans see the cost of healthy food as the biggest barrier to improving their diet, and 23 percent said they lack the time to cook healthy meals.

If Kennedy figures out how to actually get people like me to care enough about healthy eating to resist the indulgent foods that give them pleasure, or if he figures out a way to get cash-strapped families on public assistance to turn down cheap, ready-to-eat foods, he will have made significant inroads into actually making America healthy again. But getting there is going to require a lot more than a catchy slogan and some sound bites.