FDA Commissioner on New Nutrition Guidelines, Flu Surge

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00:00Pushing protein and cutting sugar, that is the general message from the Trump administration's

00:04new nutrition guidelines, featuring an inverted food pyramid with red meat and healthy fats right

00:10at the top. Joining us live with more, I'm pleased to say, from the FDA is FDA Commissioner Dr. Marty

00:17McCary. Dr. McCary, great to have you with us. So before we get into the specific recommendations,

00:22let's talk about the why, because the last time that these guidelines were updated was, I believe,

00:27in late 2020, which was during the first Trump administration. So what has changed in the past

00:33five, six years that led you to this update today? Well, good to be with you, Katie. There's been a

00:39revolution in nutrition science, recognizing that we have been misled with 60 years of dogma that has

00:48determined that we need to have a myopic focus on demonizing fat, for example. We now know that's

00:54not true. The field of nutrition has matured to recognize now the importance of protein. So

01:00today's new nutrition guidance increases the protein recommendation by 50 to 100 percent.

01:07It shouldn't be at a level so you just don't wither away. We want Americans to thrive. You need

01:14amino acids and you don't have protein reserves in your body like you do for glycogen and fatty acids in

01:20the liver. And so when you don't get enough protein, you have muscle wasting. Turns out that

01:25one of the best predictors of longevity is muscle mass. And so it's no wonder that we're seeing life

01:32expectancy come down and more frailty in older people with under nourishing people with protein.

01:38That's one of the new guidances, along with looking at ultra processed foods, refined carbohydrates,

01:44carbohydrates and the types of grains you got. We don't want people having grains stripped of fiber

01:49and chopped up that essentially function as sugar. Well, you mentioned ultra processed foods,

01:54and that is one of the explicit recommendations here is to cut back on that. But my understanding

01:59is that basically the government is still working on a definition of what ultra processed foods are.

02:06So with that in mind, how do you expect that this recommendation will actually get implemented?

02:10Well, I think we all know it when we see it. Ultra processed foods are the foods with

02:1620 or 50 different ingredients on the back of the package. There are things that should go bad in

02:22nature, but they last for months or years on the shelf without refrigeration. So we are at the FDA

02:29creating a more formal definition of ultra processed foods. And that could be used for education. It could

02:35be used for front of package labeling. We have put out an RFI and industry is submitting

02:40their ideas. Nobody has a perfect definition, but we want to get one that can be used for mass public

02:46education because 40% of our nation's kids have a chronic disease. America's kids are sick. It turns

02:53out that 60 to 70% of the calories kids in America get today are ultra processed foods. We're calling that

03:00out in today's new nutrition guidance, and we're setting the record straight. Well, with regards to that,

03:05and I am curious as this pyramid gets rolled out, I mean, most of us, of course, as children remember

03:11just how prominent those pyramids were in our school system. Has there already been discussions

03:16about how public schools across the nation are going to adapt their menus to these new guidelines?

03:22There are starting already starting today with the new guidance, Romaine, and that's because

03:27people are recognizing that they were misled. Remember in school when we were encouraged to

03:33drink low fat milk. Ironically, they took out natural saturated fats that are not bad for kids

03:39and they added sugar. And so we now recognize that it wasn't one single ingredient that caused our

03:47chronic disease epidemic that is saturated healthy fats. It is the ultra processed food, refined

03:53carbohydrates, lack of fiber, and the immense amounts of added sugar. Romaine, you and I were

03:59part of the first generation to have massive insulin spikes in our blood system because of the food we

04:06ate. We'd never seen that before in human history. It's no wonder that we're dealing with a diabetes

04:10and obesity epidemic. These are the root causes of so many other problems in healthcare. So in a sense,

04:17this is a healthcare reform dealing with the root cause. And I just have to ask, I mean, you think

04:23about X essentially the food pyramid, you talk about it in school and then you kind of forget it. I

04:28think that most American adults don't spend much time thinking about the pyramid when it comes to

04:33making nutrition decisions. So just more broadly speaking, how do you increase the relevance of

04:39these recommendations? We want every school district, every house of worship, every family to have a

04:46conversation about what's in our new nutrition guidance. That's why it's short. It's less than 10 pages,

04:51not like these previous guidances that were over 200 pages. It needs to be understandable. It needs

04:57to identify things like coconut oil and olive oil and the importance of healthy nuts and seeds.

05:04We have tried hard to make a couple clean messages and that is we need more protein in the body and we

05:11need to watch out for the ultra processed foods and the sugars. It turns out that ignoring that has been

05:18part of the problem. And so we're putting that back on the radar.

05:21Dr. McCary, I know this is the big topic of the day for you, but I do have to ask you

05:26about what's been going on with regards to flu cases here in the United States. We're now seeing

05:30our highest level of flu incidents in about 25 years. There have been widespread reports of people

05:37not being able to get over-the-counter medications like Tamiflu on the shelves, not being able to get

05:42prescription, flu shots. What discussions are taking place right now at the FDA about trying

05:48to curb the continued outbreak of this flu virus? Well, look, this appears to be not only a big flu

05:55season, but a flu season that's coming earlier in the year. And so this is a problem that I dealt

06:01with as a physician. You'd see an influx of patients coming into the hospital. The root cause of some

06:08people needing to come to the hospital is they don't have good underlying health. They have

06:12underlying insulin resistance and obesity. But in dealing with the issue at hand today,

06:17we want people to know about their options. The flu shot is widely available. It's not a great match

06:22this year, but this has been going on for a long time. Why isn't it a great match, Dr. McCary?

06:28Well, because to give you very sort of a technical reason, the influenza virus has two very flimsy

06:35polymerases, which allows it to mutate much faster, about 30 times, 35 times faster than the COVID

06:42virus. And so you can have a match early in the season. And then the flu essentially mutates at a

06:49point where the vaccine just doesn't work. Now, we are outlining a very clear goal at the FDA that we

06:56would like to see a universal flu shot. If it can be shown to be safe and effective, we would like to

07:01see these new promising technologies that target the stalk that is a different part of the influenza

07:08virus or that have immunity, create immunity to multiple different parts of an influenza virus,

07:18including parts that have not yet mutated. These are two ideas out there. They are actively on our

07:24radar. And we have said very openly ever since I came into office 10 months ago that we would like

07:29to see a universal flu shot that could potentially give you decades of lifelong protection.

07:35Did the lack of the synchronicity in that shot and what this influenza virus is,

07:40does that have any connection to some of the shortcomings that we've seen with regards to

07:44staffing at the U.S. health agencies? No. First of all, I think it's important for people to know

07:50there were no scientific reviewers that were laid off at the FDA. And what we saw was a consolidation

07:57of different IT departments and HR staff at the FDA. The FDA is strong and will continue to be strong.

08:05We met all of our user fee target dates this year. We have a record number of approvals in CBER last

08:12month. And I'm going to be reporting all the metrics at the upcoming JPMorgan conference next week.

08:17Yeah. But no, it's unrelated.

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