Fixing the System: How Food Policy and Agriculture Shape Public Health

At the recent panel hosted by The Food is Medicine Institute at Tufts University and Food Tank, policymakers and public health leaders examined how federal food regulation and agricultural policy are driving the rise of ultraprocessed foods—and what it will take to reverse course.

Featuring FDA Deputy Commissioner for Human Foods Kyle Diamantas and U.S. Senator Roger Marshall, MD, the panel underscored a central truth: poor nutrition is not accidental. It is the predictable outcome of how food is regulated, produced, and incentivized.

Why Nutrition Belongs on Congress’s Agenda

Senator Marshall spoke from both clinical and legislative experience. As a physician, he witnessed the rapid rise of diabetes, inflammatory disease, and pregnancy complications tied to diet. As a policymaker, he sees the fiscal consequences.

The surge in diet-related disease is recent—emerging largely over the past 35 years alongside commodity crop expansion and ultraprocessed food production. Today, the U.S. spends nearly $5 trillion annually on healthcare, yet outcomes lag behind other high-income countries.

This is not a failure of medicine alone. It’s a system that prioritizes treatment over prevention and calories over nourishment.

The GRAS Loophole and FDA Reform

A major focus of the discussion was the FDA’s GRAS (“Generally Recognized as Safe”) designation, originally intended for common foods like spices but now widely used to introduce new additives without FDA review.

As a result:

• Most new additives enter the food supply through GRAS

• Many are never reviewed by FDA

• Safety data is often privately generated and undisclosed

This loophole explains why hundreds of additives banned elsewhere remain legal in the U.S.

New bipartisan legislation aims to restore transparency and accountability—requiring public notification, FDA review, and updated safety standards that reflect modern science.

Updating Food Safety for Modern Science

Current food safety rules rely on outdated frameworks developed decades ago—before the gut microbiome, neurodevelopmental impacts, and long-term chemical exposure were understood.

Panelists emphasized that modern safety standards must assess effects on:

• Brain development and behavior

• The gut microbiome

• Metabolic and endocrine health

Anything added to food—regardless of pathway—should meet these updated criteria.

Agriculture, Soil, and Nutrition Density

The conversation extended upstream to agriculture. Senator Marshall emphasized that healthy food begins with healthy soil.

Regenerative and precision agriculture practices can improve nutrient density, environmental outcomes, and farm resilience—but adoption remains limited without market demand and financial support.

Farmers are not the barrier. They grow what the system rewards. Changing outcomes requires changing incentives.

Aligning Health, Markets, and Policy

When healthcare dollars support nutrition, and nutrition demand supports regenerative farming, the system reinforces itself:

• Health outcomes improve

• Healthcare costs decline

• Rural economies strengthen

• Environmental impacts shrink

This alignment represents a public health opportunity and an economic one. The U.S. could shift from exporting ultraprocessed foods and chronic disease to leading in nourishing, regeneratively grown food.

A Window for Change

For the first time in decades, science, policy, and public awareness are converging around the same conclusion:

Food is foundational to health.

Closing regulatory loopholes, modernizing safety standards, and investing in soil health are not radical ideas—they are overdue corrections. This moment presents a rare opportunity to realign the food system with health, equity, and long-term sustainability.

The question now is whether leaders will act quickly enough to meet the scale of the challenge.