I spent nearly a decade leading FDA’s Center for Food Safety and Applied Nutrition. That role convinced me that food safety and nutrition are interdependent in so many ways, and if we want to make our population healthier, we need to support both.
Over the past few weeks, record numbers of cases of cyclosporiasis have driven that message home broadly, including to consumers. FDA is currently investigating six cyclospora outbreaks, only one of which is currently linked to shredded iceberg lettuce.
Fresh fruits and vegetables, which nutritionists have been promoting for decades, are especially vulnerable to cyclospora contamination. In response to a diarrheal disease outbreak caused by cyclospora, the public has been advised to be cautious about consuming fresh fruits and vegetables. Social media has erupted with comments like “more pizza!” and “oreos never gave me explosive diarrhea!” Even before this outbreak, such as during outbreaks involving E. coli and romaine lettuce, I heard from many that they would rather eat “a bag of Doritos than a salad.”
FDA has long evaluated which foods are highest risk for microbial contamination and has published that list as part of work implementing the congressionally mandated FDA Food Safety Modernization Act. FDA refers to the list as a “Food Traceability List,” because these foods have additional obligations for traceability to help facilitate foodborne outbreak investigations. The list includes things like cucumbers, herbs, leafy greens, melons, peppers, sprouts, tomatoes, other vegetables, and fresh-cut fruits. It also includes other commodities such as certain cheeses. (Note that meat and poultry are also at high risk for contamination with pathogens like E. coli and salmonella but are not on the FDA list as they are regulated by USDA.)
What do these higher-risk foods all have in common? As a group, they are recommended as part of a healthy dietary pattern, and are certainly among the “real foods” being promoted by the administration for better nutrition and chronic disease risk reduction.
Having said that, the current administration is now learning the criticality of microbial food safety as they work to manage an outbreak response that will undoubtedly have ramifications for consumer perception and consumption of highly nutritious foods that are vulnerable to microbial contamination. Over the past 18 months, the administration has focused on chemicals rather than microbes in foods and has taken numerous steps that actively undermine microbial food safety:
- Losses of experienced career employees at FDA and CDC. That has direct adverse impacts at each agency and also the potential for compound effects. Interagency emergency response is complex and works best when teams of employees have relevant experience working together on prior outbreaks, including cyclospora outbreaks, which differ in many ways from bacterial outbreaks.
- Budgetary cuts at both CDC and FDA. These federal agencies help support and resource state food safety efforts and with federal budget cuts, state budget cuts follow. We have seen that states like Michigan have assumed a very heavy load responding to this outbreak. With less money, FDA will also do less proactive sampling for microbial contaminants such as cyclospora.
- Changes made to the national foodborne illness surveillance program, FoodNet, which previously tracked eight pathogens and eliminated six from federal surveillance, including cyclospora.
- Delaying the date that industry must comply with requirements to be able to trace high-risk foods from farm/manufacturer through the supply chain. That effort should be in effect now but was delayed by the administration until July 2028.
- Closing a USDA agricultural research facility in Beltsville, Md., that included laboratories working on cyclospora.
- Disbanding the National Advisory Committee on Microbiological Criteria in Food, which provided food safety advice on challenging issues to FDA and USDA, including on cyclospora.
I am often asked how a particular action is impacting food safety, but the reality is that it is the cumulative impact of these and other changes that create a diminished food safety system.
To make matters even more challenging, the administration has called climate change a “hoax” and is supporting policies that will accelerate it. Warming environments, and climate events like extreme rainfall and flooding, will increase food safety risks, and the destruction of impacted foods leads to more food waste. Food waste itself is an established contributor to global warming. The destruction of large quantities of lettuce from Mexico can be anticipated, with energy wasted in the original production/processing/international distribution of product, plus energy involved in disposal of contaminated product.
The cyclospora outbreak should be a wake-up call for all of us, and especially our federal leaders charged with protecting and promoting health. Consumers should not be faced with a trade-off between nutrition and food safety — health is made possible when food safety supports consumer confidence in fruits and vegetables. “Real foods” are vulnerable to real pathogens.
Susan Mayne, Ph.D., served as director of the FDA’s Center for Food Safety and Applied Nutrition from 2015 to 2023. She is an adjunct professor at the Yale School of Public Health. This essay first appeared on her Substack.
