I'm William Brangham and this is "Horizons."

In the land of plenty, a lot of what we eat is making us sick.

Ultra-processed foods make up more than half the average American diet, and they're linked to rising rates of obesity and heart disease.

Health and Human Services Secretary, Robert F. Kennedy Jr., says the administration has a solution.

President Trump and I are going to transform our food system.

Brangham: But will this plan really make America healthy again?

Coming up next.

♪ Narrator: Support for "Horizons" has been provided by Steve and Marilyn Kerman.

Additional support is provided by Friends of the News Hour.

♪ This program was made possible by contributions to your PBS station from viewers like you.

Thank you.

From the David M. Rubenstein Studio at WETA in Washington, this is "Horizons."

Welcome to "Horizons."

This is a brand new program from PBS News.

We will be covering the latest in science and health and technology.

That's everything from genetics to climate change to artificial intelligence.

This is a thrilling time, but it is also a complex and confusing one.

So we're going to try and help make sense of the rapid changes that are occurring everywhere around us.

We're going to start today talking about food.

We live in an era of abundance, but a lot of what we eat is making us sick.

Three-quarters of us have at least one chronic disease, like obesity, hypertension, diabetes.

About one in five kids in America is obese.

And the vast majority of our health care dollars are spent treating these diseases.

Health and Human Services Secretary, Robert F. Kennedy Jr., is leading the so-called MAHA movement, as they call it, to, quote, "make America healthy again."

And they're targeting, among other things, the ultra-processed foods and chemicals in the average American diet.

So, will this work?

And what would it really take to address this food crisis in America?

So, to explore that, we are joined by three people who have been researching and advocating about this issue for decades.

Marion Nestle is a giant in the field of food policy.

Professor Emerita of Food Science, Nutrition, and Public Health at New York University, she's also the author of multiple books on this topic, including "Food Politics," "Safe Food," and the recently updated "What to Eat Now."

Ashley Gearhardt studies food and addiction at the University of Michigan, where she's a professor of psychology and clinical science.

And Cindy Leung is a professor of public health nutrition at Harvard's T.H.

Chan School of Public Health.

Thank you all so much for being here.

Really appreciate you being here for the inaugural episode of "Horizons."

Marion, a delight to have you back on our show.

I want to start with you first.

Help us understand how we got here.

Before we talk about MAHA and all the plans they have, give us a quick primer on how we have built a food system that is so abundant and yet seems to be making us so sick.

Well, I think it's easy to understand if you go back 40 years and look at the Reagan era when everything got deregulated.

At the time, food production increased so that it added about 1000 more calories to the amount that were available for people to eat.

It went from about 3000 calories a day per capita to 4000.

That made it very, very difficult for food companies to be selling food because there was twice as much available as anybody needed.

The shareholder value movement was inaugurated in the early 1980s, which said that companies not only had to make a profit, but they had to grow their profit every 90 days.

For food companies, this was really, really difficult.

They had to find ways to sell food.

They created a food environment in which it was possible to have food available absolutely everywhere.

Think bookstores and libraries, for example.

Food was abundant, it was cheap, it was everywhere.

The object was to get people to eat as much as they possibly could as often as possible, everywhere as possible.

They turned out to be really good at that.

I mean, Ashley, Marion is describing basically our capitalist system has gotten us to this point.

Your research focuses specifically on addiction and food.

Some people might think that's a slightly strange connection.

I mean, people joke, "Oh, my God, "these Doritos are addictive."

That's not totally what we're talking about here.

What would you add to this conversation about how we got to where we are?

Yeah, so I would say that those sorts of market pressures combined with advances in technology to really make these products super hyper desirable played a huge role in shaping our food environment.

And part of that is because the tobacco industry got into the food supply.

Companies like Philip Morris and RJ Reynolds bought up large food companies like General Foods and Kraft.

And they used similar technologies, flavor additives, marketing strategies like going after children to really boost up their profit margins.

But the consequence of that is that many of the products that we see in the grocery store, although we call them food, actually resemble much more of something like a cigarette or an alcoholic beverage on their impact on the reward centers of the brain than they do a fruit or a vegetable.

In that they are designed to not just be nutritious and filling, but they're designed for other purposes.

Absolutely, I read a lot of food industry trade letters, and some of the things they talk about is turning cravings into corporate wins.

- Brangham: Cravings.

- Cravings.

Doing indulgence as a main profit engine for them.

So getting people to indulge even when they want to cut down.

I just read a report on how you can get people who are snacking, who want to cut down, and keep them eating your products.

To me, that sounds more like someone trying to sell a mind-altering substance than it does someone who's trying to make sure that you're well-nourished and fueled.

Cindy, the work that you do is principally in people who receive food assistance, programs like Food Snap or Food Stamps or SNAP or WIC or things like that, and trying to build those systems to make them encourage people to eat better.

I'm curious what your research shows about do people have the ability to know in the grocery store what is healthy and what is not?

And does that knowledge actually change people's behavior?

Yeah, I've been studying kind of the food landscape for lower income Americans for decades now.

And there is a general sense that people understand what things are healthy.

People know that it's healthy to eat fruits and vegetables, to eat things that don't have a lot of additives, to eat things like fish and chicken and kind of healthy sources of protein.

That has come through every time I've had a conversation with someone who's using SNAP or someone who's at risk for food insecurity, which is a USDA term for people with limited affordability or accessibility to healthy foods.

So yes, people seem to have a general understanding that eating chips and cookies and cakes are not healthy and eating fruits and vegetables and kind of minimally processed foods are.

What we also hear from people who use SNAP is that they have limited choice when they go to the grocery store.

They have a smaller food budget than maybe other Americans are working with and they have to meet the needs of all of their household members.

Sometimes children, sometimes older adults with special health conditions.

They have to make everything fit within that small budget.

And so sometimes they're sacrificing things that might take longer to cook for things that are more convenient just to fit into what they can work with for that week.

Right, because anyone that has tried to cook healthier, I mean, this is something that is... I've mentioned this before in the past, And sometimes people push back on this, but it is sometimes costlier to eat healthy.

It takes time, it takes money, it takes planning, it takes knowledge.

Leung: Absolutely.

And we know that, for people using SNAP, their benefits don't last the whole four weeks.

They usually run out by the second or third week.

So the money that they're getting from SNAP, which is based on the Thrifty Food Plan... The Thrifty Food Plan is a low-cost food plan set by the USDA that assumes that you have unlimited time to go shop, prepare, cook food, and it's really unrealistic for a lot of Americans given their busy lifestyles, given that they are parents of children, given that they are also working or they have transportation or mobility challenges.

It really is unrealistic.

And so that piece is really important.

Marion Nestle, the MAHA movement led by RFK Jr.

has a solution.

We've started to see some of their proposed changes to what they think the federal government can do to push America to do better and to eat healthier.

They put out new food guidelines, we saw this new food pyramid that came out recently.

Literally inverting that pyramid to put a lot of meat and cheese and healthier fats, as they say it, and food and vegetables up there at the top.

What do you make of their efforts, broadly speaking, to urge us to do better?

Well, there's much to love about the new dietary guidelines and pyramid.

The main message is eat real food, something that those of us in the food movement have been arguing for for decades.

And the new recommendation that they put in to reduce consumption of ultra-processed foods, they didn't call it ultra-processed, they said highly processed, but that's what they meant, seems to me to be a great step forward.

I wish that they hadn't muddled the rest of it and changed Michael Pollan's famous, "Eat food, not too much, mostly plants," into, "Eat food as much as you like, mostly meat."

[Laughing] But I really like the "eat real food" message and the "reduce ultra-processed foods" message.

Those are really important.

And if people follow those, there really is a chance that they would eat more healthfully.

What these guidelines don't do is to talk about the kind of support that people need to do that.

If you're trying to eat healthfully in today's food environment, you're fighting the entire food system on your own.

That's a lot to ask of one individual.

You can try to take personal responsibility in today's food environment, but when you're faced with all of these yummy foods that don't cost much and are easy to prepare and are really convenient.

And eating real food means you have to cook, you have to have a kitchen, you've got to have pots and knives and you've got to have time and the education about how to do it.

I'm all for teaching people how to cook, but let's get going on that.

Brangham: Right.

Okay.

So, we have three of you here who are really expert on this topic and have thought a lot about policy implications here.

So I would like to go around and each ask of you.

Ashley, starting with you, let's just say you want to put forward better solutions for how we could do this.

Taking what the federal government has offered thus far, what else do we need to be doing to help people be healthier, eat healthier?

I think Marion hit it, you know, that it's really about how does this work in real people's lives.

And I want to say it starts when you're a child.

You know, those tastes, those preferences, those memories get baked into our brains, our taste buds when we're quite little.

And there is a really great opportunity for the federal government to do that, which is through the school lunch program.

That's been a big speaking point of getting real food into schools.

California recently passed a bill to get the most high-risk, ultra-processed foods out of California schools within the next 10 years.

And the schools are going to need support.

We're going to need to be able to support the equipment they're going to need, the people they're going to need.

But if we can start to have children develop a relationship with the taste of a fresh fruit or a really nice crisp apple or the crunch of a carrot, and that becomes the norm again, that could ripple throughout their whole lives.

Cindy, what would you add to that?

Like, what would you like to see?

If... I'm going to put you in a policy position at the White House, what would you like to do?

If you could move a couple of levers, what would you like to see done?

I mean, I agree with both Marion and Ashley.

I think the message to eat real food is really compelling.

Brangham: Isn't it crazy, though, that it's taken us this long for the federal government to say something so simple?

It is, but I think we're all happy that that is the main message, to eat real, minimally processed, whole foods.

My suggestion would be to ensure that all Americans, regardless of socioeconomic status, have the means to do so.

And to do that, you have to invest in SNAP, in our food stamp program.

And so, you know, recently, USDA passed and allowed 18 states to pass waivers to restrict the sale of sugary beverages and sometimes candy.

Brangham: This is to say that if you're getting SNAP in those states, you cannot use those dollars to buy things that we know are awful for you.

Leung: Exactly.

And that is a great step in the direction to try to reduce added sugar consumption, particularly in the communities where some of those products are more heavily marketed.

At the same time, there was no kind of pairing that regulation with more investments in fruits and vegetables, so people could buy more healthy foods with their SNAP benefits.

So I think continued investment into SNAP, making sure that the dollars match what people see at the grocery store, and that it makes it easier for them to purchase these healthy, real foods that we're supposed to be eating, but are oftentimes out of reach for someone who is using SNAP.

Brangham: Okay, Marion, I'm going to give you this one as well.

What would you like to see?

I know you have long argued that the federal government subsidies to other kinds of foods are not... they're fighting against the very thing they're trying to do the opposite of.

Yeah, I'd like to see an agricultural system that is focused on food for people.

Our present agricultural system devotes half of the corn and soybeans production to food for animals, and almost the other half for producing ethanol or diesel fuels, that's crazy.

We need an agricultural system that's aimed at producing food for people, and fruits and vegetables are considered specialty crops by the Department of Agriculture.

So I want to see a complete reversal, transformation of the agricultural production system to focus on healthier foods.

And then, my other longtime favorite is restrictions on marketing ultra-processed foods to kids.

We know that marketing is enormously effective in getting kids to demand unhealthy products from their parents.

These are among the most profitable foods in the supermarket for food companies, and they really need to... if they want to please their stockholders, they've got to get kids to want these products.

Every attempt over the decades to try to put some restrictions on marketing to kids has been stopped by Congress, and I think the MAHA movement gives us an opportunity to change that.

Wouldn't that be terrific?

It would be, but, Marion, you've heard this argument before.

The industry says, "We're not holding a gun to anybody's heads.

"You go into the grocery store, you can choose "carrots and broccoli and fresh foods yourself.

"We're just providing alternatives.

"This is a consumer capitalist society.

"People have agency to choose for themselves."

Right, they also need money, they also need education, they also need to be in a society in which basic human needs are taken care of, and let me add to those housing, clean air, clean water, and a public health system that works to keep people healthy.

As... You know, I look at all of this business with dietary guidelines and saying, unfortunately, eating real food is not going to keep your kid from getting measles.

And that's the reality of the way we live these days.

So I want to see these guidelines attached to policies that will make these guidelines really work and make it easier for people to exercise personal responsibility at the grocery store.

- I'd love to add on to that.

- Please.

I think that personal choice can work well when we're really informed about the cost of what we're consuming and the impact on us.

And I can say when there's been addictive agents that have been hedonically engineered... Brangham: Hedonically engineered, help me out.

- What does that mean?

- Absolutely.

So with tobacco, you take a poisonous plant, and through processing, you can give this just right dose of nicotine through a cigarette that stimulates, but doesn't satisfy.

They amp up the speed it's delivered into the brain through the delivery mechanism and through additives, and then they hop it up with all sorts of sugars and flavor additives, and then they flood the environment with it so it's always just at arm's reach.

That's what caused the tobacco epidemic.

Brangham: Genius and diabolical.

Exactly, and that's what we've done to our food supply.

Our brains are designed to find food rewarding and appealing and salient, real food.

But when you take that same product and you process it so it is rapidly delivering unnatural levels of food reward stimulation into the brain and then heightening it with all sorts of flavor-intense additives that spike but then fade so you just want more and more and more, the human body and brain was never designed to manage that sort of food environment.

And all of a sudden, your nutritional wisdom that says, "Oh, I'm being motivated to eat," it's not driven by hunger, it's driven by cravings and emotion dysregulation.

That sort of model of profit doesn't allow us to talk to ourselves.

It actually breaks our control in ways that we may not be aware of, especially if you've been targeted for these products since you were a young child whose brain wasn't even fully developed to really understand what was going on there.

So when I look at those playbooks of what's happened with tobacco, what we're seeing with social media, sports betting, the same thing has played out in our food supply.

This is the natural consequence of that.

Brangham: Cindy, do you think that these kinds of federal guidelines can help?

Do they really penetrate?

I mean, I know that there's lots of complicated stigma related to people who are on food assistance.

It comes with a lot of baggage.

There's incredible suspicion about people who use those programs, allegations of fraud and all of that.

In that environment, it's got to be very difficult for people to also be hearing from the federal government, "You better be eating your fruits and vegetables."

Leung: Absolutely.

And what I hear, especially from parents of children who use SNAP or who report that they've experienced hunger, they feel guilt.

They feel overwhelming guilt that they can't feed their children the foods that they know are conducive to their health.

And I've had parents say, "Look, I had $5 at the grocery store.

"I could buy this $5 box "of whole-grain, high-fiber cereal, "or I could buy five $1 boxes "of really sweet, highly processed cereal.

"And I bought five boxes of the really sweet cereal "because it lasts longer "and I know my kids are going to eat it, "but it makes me feel like a terrible parent."

I've heard that narrative over and over again.

And so I think the message is great, eat whole foods.

I would love to see that translate into changes at the grocery store, where we have over 400,000 ultra-processed food items.

Brangham: 400,000?

It is very hard to shop at the grocery store when you're inundated with three out of four products being ultra-processed.

You really have to go in with a game plan, with a shopping list, with a set budget, knowing exactly what you're going to get and you can't deviate from that if you have to meet a strict food budget, especially if you're trying to avoid all these traps of what's on sale and these beautiful characters that appeal to young children and brightly colored products and things they see their friends bring to school.

So there's a lot of landmines when you're grocery shopping if you're trying to adhere to a smaller budget.

Any parent that's pushed apart through a... Nestle: Can I say something in here?

Please, Marion, go right ahead.

Yeah, and if you go to a grocery store in Mexico or Brazil or other Latin American countries, the ultra-processed foods have warning labels all over them.

Brangham: Labels that say what?

- I'm sorry?

- Labels that say what?

That say they're high in salt, sugar and saturated fat calories, sometimes artificial sweeteners and sometimes caffeine.

But these labels tell people, even people who don't know how to read, even children can see these labels and know what an ultra-processed food is.

The Food and Drug Administration is working on a warning label.

I think they need to get it out.

And do you think, Marion, I want a last question to you.

On this issue of availability that Cindy is talking about, how do we make it so that a grocery store... I mean, the industry argues the processing makes it so that we can have shelf-stable, safe foods from Maine to Florida to outer Alaska.

And that if you suddenly strip all these food, all those things out of these foods, people won't have access to food.

In the last 30 seconds or so we have, how do you respond to that?

Well, you get fruits and vegetables to be at the end of the aisles and at eye level and at all the places that food companies pay to have their products displayed in grocery stores so people will see them.

There's loads of policies that we could do that would make it easier to make healthy choices.

I would say the economic policies are by far the most important, as we've already heard here.

And I hope that the MAHA movement is going to push for those policies because we really need them.

Marion Nestle, Ashley Gearhardt, Cindy Leung, I cannot thank you enough for being here for a really wonderful conversation.

Great to have you all here.

Thank you so much.

- My pleasure.

- Leung: Thank you.

We're going to shift gears just for a second.

Before we let you go, we wanted to leave you with something hopeful.

The fate of endangered species around the world is not good.

Every year, it seems, there is a new report about how thousands of animal and plant species are being pushed to the very edge, often by us, because of climate change or deforestation or many other factors.

But conservation has been notching some victories.

The green sea turtle, which are found in warm waters all over the world, was endangered for years.

But thanks to efforts that protected their eggs and stopped them getting snared in fishing nets, they are rebounding.

Same with these guys.

Ampurta are tiny Australian predators, a key part of the outback ecosystem, but they were considered doomed because of non-native invasive species.

But thanks to some years of work, the ampurta have surged back, even amid a severe drought.

While these small victories are rare, they do give us insight into how to save other species, including perhaps us.

And as one of the researchers working with turtles said, this is not just the work for conservationists.

Wildlife ecologist Bryan Wallace told NPR, "Find something you love, close to you, "that really means a lot "and fight like hell to make sure it stays there."

That is it for this episode of "Horizons."

Thank you so much for joining us.

Narrator: Support for Horizons has been provided by Steve and Marilyn Kerman.

Additional support is provided by Friends of the News Hour.

♪ This program was made possible by contributions to your PBS station from viewers like you.

Thank you.

♪ You're watching PBS.