Whose Burden Is It Anyway? A Comprehensive Proposal to Reshape Food Safety Review by Treating Food as Medicine

With more than sixty percent of U.S. adults struggling with at least one diet-related health condition, the relationship between nutrition and public health has never been clearer. Indeed, for the first time in over a century, food has a prominent place on the national political stage and is one of the exceedingly few issues that has garnered bipartisan support. The recent rise in popularity of "Food Is Medicine" initiatives, which seek to provide medically tailored or healthy meals to vulnerable populations, underscores the critical importance of food to public health. Yet, while "Food Is Medicine" is shifting the insurance, business, and nutritional landscape, the Food and Drug Administration ("FDA") - the primary regulator in charge of both food and drug safety - treats food as anything but medicine. Known and unknown food additives, color dyes categorically banned in other countries, chemicals leaching from paper and plastic, and environmental toxins and pathogens all contaminate our food and sicken children and adults alike. All the while, the FDA acts as if it were powerless to fulfill its mission of protecting the public from unsafe food.In a time when the political will to reform our food system and rid it of harmful chemicals and ingredients is high, this article offers a blueprint for how to do so in a scientifically grounded, legally consistent, and lasting manner. Starting from the basic premise that food can be medicine, the article explores ways to bring food safety review closer to the much more demanding safety process for pharmaceuticals. Part I defends the premise that food is every bit as important to human health as medicine - both for good and for ill - and posits that food safety should be regulated just as much as (even if not in identical ways to) the safety of medical drugs. Parts II and III offer a comparison between the rigors of drug safety review, albeit with its own set of problems, and the laxity and at times utter lack of food safety review. Finally, Part IV advances a comprehensive package of both legislative and regulatory reforms, all designed to shift the de facto burden of proving the safety of food ingredients from the overtaxed FDA and the overburdened consumers to food manufacturers.