Inflammation

MAHA Fact and Fiction

We have all lately heard a lot about MAHA (Make America Healthy Again) from Robert F Kennedy Jr. Some of the things he is advocating probably would improve the health of Americans, but many would not only not improve health, but would make it worse. In this post I’m going to try to identify the good parts and debunk the rest.

Food Dyes

Kennedy wants to eliminate “synthetic” food dyes except for “natural” ones. Food dyes have no nutritional value and many have never been adequately tested in humans. That does not mean they are toxic or cause disease. The only food dye that has been shown to be possibly toxic to humans is red dye #3 also known as erythrosine. It has already been banned in food and cosmetics. For other food dyes we simply do not know how safe they are for human consumption. . The FDA has recently approved 3 plant based food dyes:

  • Galdieria extract blue, a blue color derived from the unicellular red algae Galdieria sulphuraria.
  • Butterfly pea flower extract, a blue color that can be used to achieve a range of shades including bright blues, intense purple, and natural greens. This dye is produced through the water extraction of the dried flower petals of the butterfly pea plant
  • Calcium phosphate, a white color approved for use in ready-to-eat chicken products, white candy melts, doughnut sugar, and sugar for coated candies.

We don’t know any more about the safety of long term use of these plant-based dyes in food than we know about synthetic dyes. Just because they are extracted from plants does not make them safer. The drug digoxin was originally extracted from the foxglove plant. Taking too much of that can kill you. The most conservative thing to do is to ban food dyes, period. That would take congressional action, which is most unlikely in the current congress.

There is no evidence, by the way, that any currently used food dyes cause cancer or other diseases. There is just very little evidence about whether they are safe or not.

Emulsifiers

Emulsifiers are added to foods to prevent separation of oil and water in foods. They also can increase shelf life. Some are natural products like guar gum and some are synthetic. Emulsifiers are not new and have been used for hundreds of years. There is some evidence that certain emulsifiers may adversely affect the gut microbiome. Most of this work has been done in mice, so it is not clear whether emulsifiers have the same effect in humans. Emulsifiers are used most extensively in processed and ultra-processed foods. Unprocessed foods do not contain emulsifiers. Once again, the jury is out on whether emulsifiers have adverse effects in humans, but they might have an effect on the gut microbiome and promote inflammation and they might not. Kennedy is opposed to all emulsifiers in food. This is not exactly a nuanced perspective, as is the case with all his recommendations and obsessions.

Other Food Additives

There are hundreds of substances added to foods. Here is a link to an FDA list of all substances added to foods that are approved by the FDA or are GRAS (generally recognized as safe): Substances Added to Food. This list is 80 pages long! I have to say that I agree with Kennedy on this one. Already, all of these additives have to be listed on the contents label. If there are more than three things on the contents label that you don’t recognize, leave it on the shelf!

Seed Oils

Kennedy (who is a lawyer, not a health expert, by the way) parrots many so called “natural” food advocates who say that seed oils have toxic by products and the wrong ration of omega 6 to omega 3 fatty acids. They maintain that seed oils cause inflammation and thus increase the risk of heart disease and other conditions like obesity and diabetes. The evidence does not support these claims.

What are seed oils anyway?

  • Canola (rapeseed) oil
  • Corn oil
  • Cottonseed oil
  • Soybean oil
  • Sunflower oil
  • Safflower oil
  • Grapeseed oil
  • Rice Bran oil

All of these are polyunsaturated (as opposed to saturated oils like animal fats, palm oil and coconut oil , which are not good for you in more than moderate amounts). They are more refined than cold pressed oils and a chemical process is used in the refining process. These chemicals, including hexane are volatile and completely evaporate during the refining process. There are no toxic by products in refined seed oils.

Health effects of seed oils – The evidence

Seed oils contain linoleic acid which is an omega 6 fatty acid. Multiple studies show that linoleic acid intake decrease the risk of heart disease and decreases , not increases inflammation. The best way to use these or any oil as a beneficial part of a healthy diet is stir frying vegetables, oven roasting fish, or crafting homemade salad dressings.

The correct ration of omega 6 to omega 3 fatty acids is not clear. To get both eat omega 3 fatty acids which are found in high amounts in walnuts and fatty fish. A good summary of the evidence on the good health effects of seed oils can be found on this Massachusetts General website: Seed Oils: Facts and Myths.

Beef Tallow

Kennedy thinks that using beef tallow for frying is healthier than seed oils. While beef tallow does make for delicious french fries, it is 100% saturated fat. Saturated fat can be healthy as a small part of your total fat intake, but eating exclusively animal fat vs unsaturated fat markedly increases the risk of heart disease, obesity and diabetes. Multiple studies over the years have confirmed increased risk from eating exclusively or large quantities of saturated fats. Kennedy has a video of him frying a whole turkey in beef tallow while saying that this is cooking the MAHA way. Here is a link to that video. In my opinion this is the height of irresponsibility.

Water Fluoridation

Kennedy cites studies that show decreased IQ in children who are exposed to fluoridated water. I have a previous post about the safety of water fluoridation. See this link. The bottom line is that these studies were done in countries and locales that had very high natural fluoride levels. There was no effect in these studies on the very low fluoride levels that are used in water supplies to prevent cavities in children. Banning water fluoridation will lead to excess tooth decay in the most vulnerable children.

Limiting foods that can be purchased with SNAP benefits

SNAP stands for Supplemental Food Assistance Program. It used to be called the food stamp program. Benefits are applied to a card that can be used like a credit card to purchase food. As of now households whose gross income is 130% or less of the federal poverty and whose net income is below the federal poverty level are eligible for SNAP benefits. The amount is determined by the number of people in the household. The federal government pays all of the benefits and 50% the administrative costs. The state pays the other half of the administrative costs. The Big Beautiful Bill Act will make substantial cuts to the SNAP program. More about that later.

People can use their SNAP benefits to purchase food, but not alcohol or cigarettes. Texas and Louisiana have just passed laws that also prevent using SNAP benefits to purchase soft drinks or candy. Kennedy has praised these new state laws. While it is true that soft drinks and candy are not healthy foods, excluding these from SNAP benefits is just a way to make lawmakers feel virtuous about limiting the food choices poor people make. It is not going to improve their nutrition because like non-SNAP households foods households buy on SNAP benefits tend to be ultra-processed foods. Healthy unprocessed foods are more expensive and require time to prepare and cook as well as requiring working appliances and cooking equipment. Families at or below the poverty level, who are often renting sub-standard housing are unlikely be able to afford to purchase or to have the time, and equipment to prepare and cook unprocessed foods. Non-SNAP households don’t do much better. See this link from the USDA: Foods typically purchased by SNAP households .One more MAHA recommendation that will likely not improve health!

What makes this even worse are the cuts to the SNAP program in the Big Beautiful Bill Act. Here is a summary of the cuts and when they will kick in:

  • Shifting SNAP costs to states by:
    • Requiring states to pay a portion of SNAP benefits for the first time in program history, up to 15%, based on their payment error rates, beginning in October 2027. Final negotiations in the Senate resulted in a temporary implementation delay for up to two years for states with high error rates. 
    • Increasing the state’s share of administrative costs from 50% to 75%. 
       
  • Restricting future adjustments to the Thrifty Food Plan, which will include cuts to SNAP benefits as well as benefit levels for The Emergency Food Assistance Program (TEFAP), SUN Bucks/Summer EBT benefits, and the Nutrition Assistance Program block-grant to Puerto Rico. 
     
  • Increasing the number of individuals subject to time limits on their SNAP benefits, including, for the first time ever, parents of school-aged children over 14 and older adults age 55 through age 64 by expanding work requirements and restricting waivers. 
     
  • Adds a time limit on benefits for veterans, currently homeless individuals and former foster care youth.
  • Eliminating funding for the SNAP Nutrition Education program. 

SNAP is (or was) the most effective hunger relief program in the U.S.

All of the above information on the changes to SNAP benefits comes from the Harvesters Community Food Network .

Vaccines

With no evidence whatever, the MAHA report calls current childhood vaccination schedules “overmedication.” It emphasizes exceedingly rare adverse effects of vaccines and promises to do “randomized trials” of current vaccine schedules. Randomized trials are routinely done before new vaccines are approved and repeating them will be inordinately expensive and delay vaccine approval. The result of this MAHA policy will mean that we will see serious childhood diseases again, some of which will result in hospitalization and some totally avoidable childhood deaths. We have already seen a resurgence of measles cases in 40 states. See my previous post about Vaccine risks in perspective.

Bottom Line

Kennedy has legitimate concerns about the unhealthy ultra-processed foods that most Americans eat. The concerns about food additives are also reasonable but overblown. These legitimate concerns are mixed in with conspiracy theories about toxic byproducts in seed oils, health benefits of beef tallow, and vaccines as a cause of autism. He completely ignores the fact that most poor people cannot afford to buy, prepare or cook healthy unprocessed foods. He is overall a danger to public health.

Chronic Inflammation and the Respiratory System

The respiratory system, which includes the trachea, the bronchi and the lungs can be a source of chronic inflammation that not only affects the respiratory system itself, but can affect other organs as well. The inflammatory process in the respiratory system involves activation of the immune system just like chronic inflammation in any part of the body. It includes pro-inflammatory cytokines, macrophages and lymphocytes.

Causes of respiratory system inflammation

Nitrogen Oxides

Nitrogen oxides, particularly nitrogen dioxide (NO2) is a respiratory irritant that causes inflammation of the bronchi. Exposure to NO2 can cause or exacerbate asthma.  In addition, several epidemiological studies have demonstrated associations between NO2 exposure and premature death, chronic lung disease, heart disease, stroke, decreased lung function growth in children, respiratory symptoms, emergency room visits for asthma, and intensified allergic responses. A comprehensive review of the health effects of NO2 exposure, both acute and chronic, can be found at this website: The Health Impacts of NO2 Pollution. The biggest outdoor source of NO2 is  through reactions between nitric oxide (NO) and other air pollutants (mostly from automobile exhaust) that require the presence of sunlight. The biggest source of NO2 in home air is the use of unvented natural gas stoves.

Particles

In addition to gases like NO2, air pollution also contains particles. Large and medium size particles lodge in the nose and upper airways and are usually cleared by the airway protective system which includes mucus and cilia that move these particles up and out of the airways. Fine and ultra fine particles (those that are 2.5 microns and smaller) can get all the way down to the alveoli (the air exchange sacks) in the lungs. These tiny particles bypass the lung protective system and cause inflammation in the lungs. They can also sometimes get directly into the circulation and can cause damage in the heart and other organs. According to the EPA, a large body of scientific evidence shows that exposure to fine and especially ultra fine particles can cause heart attacks, heart failure, and strokes, which results in hospital admissions, emergency department visits, and, in some cases, premature death. The scientific evidence shows exposure to fine and ultra fine particles is also likely to cause respiratory effects, including asthma attacks, reduced lung development in children, and increased respiratory symptoms such as coughing, wheezing, and shortness of breath. Prolonged exposure can cause chronic lung disease such as COPD and pulmonary fibrosis. There is more limited scientific evidence for developmental and reproductive effects, lung cancer and other cancers.

Sources of fine and ultra fine particles

Outdoor sources of fine and ultra fine particles come primarily from automobile exhausts as well as some factories. They tend to be much higher in cities, particularly inner city neighborhoods.

Indoor sources are tobacco smoke, wood burning fireplaces, gas space heaters and natural gas stoves. The way food is cooked can also produce fine and ultra fine particles. Frying in hot oil or broiling generates lots of these particles even on electric ranges. Boiling or steaming generates many fewer particles. Air fryers also generate very few particles.

Reducing Indoor Air Pollution

Natural gas is 99% methane, so burning it in a stove in addition to generating dangerous levels of NO2 and fine and ultra fine particles, is also the most potent greenhouse gas. That means that not only are gas stoves bad for your health, they are also bad for the environment. If you have a gas stove, the best option is to replace it with at electric stove with an induction cooktop. Induction cooking is much more efficient than a traditional electric burner. It uses only 60% as much electricity and heats the pot directly rather than the burner itself. Heating with induction burners are actually faster than heating with gas burners. This is of course not practical for everyone. Replacing a stove is expensive and requires an electrician to install a 220 volt outlet if you don’t have one. It is also impossible for renters. If you can’t replace your gas stove and it has a hood that vents to the outside, turn it on high every time you cook. If the hood is not vented to the outside, then opening a window helps substantially decrease NO2 and particles. Whether you have either kind of stove, using a portable air fryer is much safer than frying in hot oil on the stove. Another much less expensive option is to purchase an induction hot plate. Good ones range from 60 to 200 dollars and can plug into a regular 110 volt outlet. Induction burners only work with pots that a magnet will stick to. That includes cast iron skillets and most stainless steel cookware. Inexpensive induction compatible cookware is available at a very reasonable cost from almost all big box stores such as Walmart and Target.

Reducing Outdoor Air Pollution

There is nothing an individual can do by themselves to reduce outdoor air pollution. Working to promote affordable electric vehicles is the only long term solution for automobile exhaust pollution in cities.

Bottom Line

Chronic inflammation of the respiratory system results from air pollution both outdoors (especially in inner cities) and indoors. Smoking tobacco is also a major cause of chronic inflammation of the respiratory system. Chronic inflammation of the respiratory system leads to many chronic lung diseases as well as heart disease and possible lung cancer. Indoor air pollution is caused primarily by unvented natural gas stoves as well as gas space heaters and wood burning fireplaces. The major causes of lung inflammation are nitrogen dioxide (NO2) and fine and ultra fine particles. Indoor pollution can be mitigated by ventilation using either a hood connected to outside or opening a window while cooking. Using electric induction burners are safer and heat even more quickly than gas. Portable electric air fryers are much safer than frying in oil on any kind of stove top. Purchasing an induction hot plate is a much less expensive way to do induction cooking. Reducing outdoor air pollution requires societal change.