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Eating in America Podcast

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by Ric Bayly

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Eating in America is about the food on our table and who's in charge of keeping it healthy. <a href="https://www.eatinginamerica.co?utm_medium=podcast">www.eatinginamerica.co</a>

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May 26, 2026

Survivor, Surgeon General: who will be voted off next?

Elon Musk and Joe Rogan, eat your hearts out.In today’s game, three doctors walk into a Fox TV studio for a taping of Survivor, Surgeon General. Two of them work for Fox. Two of them got their medical degrees at schools in the Caribbean. One of them lies about her qualifications. Two of them are selling supplements. One of them isn’t really a doctor and is a recent stockholder in tobacco. Two of them are not completely pro vaccine. Which of these three are qualified to be the U.S. Surgeon General? Who will be voted out? You decide, because you are a whole lot more qualified than the President who nominated them.Candidate #1To recap our game so far, Donald Trump named Dr. Janette Nesheiwat as his nominee for Surgeon General two weeks after being elected to his second term. In his statement, the President-Elect repeated Nesheiwat’s lies about being double-board certified and a graduate of the University of Arkansas School of Medicine. In fact, her medical degree is from a Caribbean university, which as a group are best known for accepting those who fail to get accepted into a U.S. medical school. For many though, the Fox commentator’s real fault was that she was pro vaccine and science. People who wanted someone who could be trusted to speak the truth about everything, not just vaccines and science, objected to the nomination, and everyone else wanted someone who would not speak the truth about science, so they objected, too.“YOU’RE FIRED!”Warming our hearts with his famous Apprentice reality TV show catchphrase, in May 2025 the President told Nesheiwat, “You’re fired!” as the Surgeon General nominee.Candidate #2Next up, vaccine skeptic, supplement seller, tobacco investor, and not-an-actual-doctor Casey Means was the second nominee for the nation’s top doctor. Means is a darling of the MAHA movement, and they love everything about her -- except MAHA folks didn’t mention her holdings in tobacco giants Altria Group and Philip Morris.With everything else to complain about with Means, the tobacco investments did not get much attention, but to me it was a serious red flag. Surgeons General through the years have played a huge role in turning public attitudes about smoking toward the negative, but there is still a long way to go with tobacco. Smoking remains the leading preventable cause of death in America with a half-million deaths annually. We can’t have a Surgeon General nominee who profits from tobacco.“YOU’RE FIRED!”But it was the not-a-real-doctor thing and her vaccine skepticism that tanked Means’ nomination in her confirmation hearing. Trump said, “You’re fired!”Candidate #2Trump’s third nominee hoping to be named “Survivor, Surgeon General,” is Dr. Nicole Saphier. Like Nesheiwat, Saphier both graduated from a Caribbean medical school, yup, and was a commentator on Fox News. Like Means, Saphier sells supplements and has expressed ambiguity about vaccines.Let me be clear, ambiguity about FDA- and, more importantly these days, W.H.O.-approved vaccines is completely inappropriate in a Surgeon General. But since Eating In America is about what we consume in our bodies, I will object to Saphier on the basis that she is yet another snake oil selling nominee, who claims science where there is none, makes health promises where there is no or insufficient evidence or expert scientific consensus, and takes money for products where there is no proven efficacy but there are serious concerns about safety.Outrage #1: Saphier proposed as Snake Oil GeneralSaphier, in addition to her job as a radiologist and work on Fox, is a maker and vendor of a line of wellness supplements. Her company, Drop Rx, sells four elixirs, she calls them tinctures, for about $10 an ounce. They are named “Focus,” “Calm,” “Soothe,” and “FemmeX.” Saphier makes unsupported health claims for these formulations of unquantified herbs and ultraprocessed ingredients and one of them contains an ingredient, kava, that is banned in the U.S. military.I will come back to this outrage, and the even bigger outrage of the way the U.S. handles supplements, in a moment.Don’t mess with the Chinese sea snakeWe all may have become familiar with the term “snake oil salesman” by watching American Westerns where men in bowler hats sold cure-all elixirs out of the back of a covered wagon. There is a surprising origin story to these early wellness hucksters.180,000 <a target="_blank" href="https://www.smithsonianmag.com/innovation/how-snake-oil-became-a-symbol-of-fraud-and-deception-180985300/">Chinese laborers brought the oil</a> of the Chinese sea snake, the extremely venomous black-banded sea krait, when they came to build railroad lines in the American West in the mid-1800s. This <a target="_blank" href="https://pharmaceutical-journal.com/article/opinion/the-history-of-snake-oil">traditional medicine is very rich in eicosapentaenoic acid</a>, or EPA, an anti-inflammatory omega-3 oil. The snake oil might have provided <a target="_blank" href="https://www.scientificamerican.com/article/snake-oil-salesmen-knew-something/">some relief for aches</a> from pounding stakes into railroad ties all day and the other difficult and dangerous work these men were doing. There is some evidence that EPA can help with joint pain. But I can’t help speculating if the crates of snake oil didn’t also contain some bottles of snake venom wine, also a traditional Chinese medicine and a more powerful treatment for pain than snake oil.The Rattlesnake KingIn any case, inspired by the widespread Chinese use of sea snake oil, a man named <a target="_blank" href="https://www.npr.org/sections/codeswitch/2013/08/26/215761377/a-history-of-snake-oil-salesmen">Clark Stanley showed up in Chicago in 1893</a> dressed as a cowboy and carrying live rattlesnakes and bottles of supposed snake oil that actually contained only mineral oil, beef fat, red pepper, turpentine, and Stanley’s false claims of healing powers. But Stanley was a good hawker, and the snake oil business took off.Snake oil elixir, a new law, and a $20 fineA surge in snake oil and other elixir sales was part of the reason for the passage of the Pure Food and Drug Act of 1906. That law was the basis in 1917 for fining Stanley $20 for his false health claims. The fine didn’t hurt Stanley, but the bad publicity resulted in him having to shut down his factories and, in fact, his whole operation.Defining a supplement: food, drug, or a little of neither?Skipping ahead to 1994, the new Dietary Supplement Health and Education Act categorized supplements as food, not drugs. As a subcategory of food, supplement makers don’t have to prove their products work or are even safe before putting them on the market. Further, while food items aren’t allowed to make unapproved health claims, food supplements are given a lot more leeway. They are not supposed to make health claims, but, well, they do.The American snake oil supplement systemThe system we have is deficient. Americans spend $60 billion a year on supplements that are not reviewed for their health claims or safety.Some of these supplements are meant to be nutritional, like vitamins, minerals, omega-3 fatty acids, or whey powder protein, for example. These should be regulated like food and held to the same strict FDA standard for food health claims.Other supplements are, in essence, over-the-counter drugs. These include products containing psychoactive ingredients. Some supplements in this group are meant to calm us, like bacopa monniera, or make us alert, like ginseng. The other supplements in this group are advertised as being associated with a range of health benefits such as stress relief, inflammation reduction, or soothing digestive issues. Like any drug with a health claim, these should be treated by the FDA as over-the-counter medications and verified for safety and the validity of their claims.Surgeon General hopeful Saphier’s supplementLet’s check one of Surgeon General nominee Saphier’s Drop Rx products, “Calm.” “Physician formulated. A clean product you can trust. Experience the power of nature, backed by science.”So, a doctor designed it, Drop Rx says we can trust its safety, and science says it works. Well yes, there is some <a target="_blank" href="https://www.mdpi.com/2077-0383/11/14/4039">science</a> that supports the psychoactive calming effect of ingredients, including kava, in Calm. But there hasn’t been the rigorous testing that should accompany any psychoactive product that is, in essence, a drug.Kava, unfit for serviceBut, worse, the science also points to kava’s risk of liver damage, which is the reason the U.S. military, UK, France and Switzerland have banned kava, and the FDA published advisories about its potential toxicity in 2002 and 2020.There is some confusion about the kava in Calm. In two places the Drop Rx website shows the presence of kava in Calm and in two other places on the website the kava is missing in favor of another psychoactive ingredient. But regardless of the quality, safety, and efficacy of Saphier’s elixirs, the fact that she is selling supplements is the basic issue.What we need in a Surgeon GeneralWe need a Surgeon General who is deeply committed to solidly scientific approaches to saving lives and improving our health, with a desire to communicate about the effectiveness and safety of vaccines, the need to control tobacco and addictive substances including ultraprocessed food, along with addictive media and digital and instantaneous gambling, the need to treat unhealthy weight in Americans, and the urgent need for diligence in the face of new global health threats due to both climate change and the ease of pandemics to spread.As long as Trump puts forward candidates as inappropriate and unqualified as Saphier, we can only hope the game of Survivor, Surgeon General will go on. But, for better or worse, it seems that the lack of an actual Surgeon General is not going to stop the Surgeon General’s office from issuing Surgeon General advisories. This past week RFK, Jr. went ahead and signed and released a Surgeon General’s report warning about excessive screen time for kids.Thank you for reading. Please support Eating in America by subscribing for free or as a paid subscriber to help me keep up the level of research required to make this publication one that can be counted on not just for facts, but for new perspectives and analyses.Game show image created with Gemini AI. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit <a href="https://www.eatinginamerica.co/subscribe?utm_medium=podcast&utm_campaign=CTA_2">www.eatinginamerica.co/subscribe</a>

May 17, 2026

A horror story from long ago about industry-funded research that is still paying off today.

Here’s a story that is so scary and sobering that only a science fiction writer could make it up. Only it is not fiction.And while a mere epidemiologist like me could not have conceived this story – it is too outrageous given what we know today – the story does provide us, and by us, I mean scientists including epidemiologists, media, and the public, at least several sobering lessons.I love food history stories. They can be so informative. Here we go.The <a target="_blank" href="https://www.tastingtable.com/948507/the-first-butter-was-invented-by-accident-and-it-didnt-come-from-a-cow/">butter part of this story started</a> maybe 10,000 years ago, perhaps when some nomads put goat milk into a bladder, and as the nomads walked the bladder bounced around and churned the milk into butter.Butter has been loved ever since.The margarine story started in France in 1869. It was not love at first taste. <a target="_blank" href="https://www.ebsco.com/research-starters/history/margarine">Napoleon III wanted a cheap, hardy alternative to butter</a> to send to sea with the Navy and to feed the bottom ranks of the working class. The resulting margarine didn’t work out for the Emperor. Neither the Navy nor the poor wanted it. But the idea of a cheap butter substitute was too good to throw away, and in 1901 a chemist invented partially-hydrogenated vegetable oil. Crisco, which was 100% partially-hydrogenated vegetable oil, came on the market ten years later in 1911, and by 1930 margarine was made with partially-hydrogenated vegetable oil.Let’s pause for a reminder. Partially-hydrogenated vegetable oil is a horror story of its own. It is toxic with trans fats, and trans fats can increase the risk of death by a third. 34% to be exact. <a target="_blank" href="https://www.who.int/news-room/fact-sheets/detail/trans-fat">Trans fats raise the risk of heart attack, stroke, Alzheimer’s, and cancer</a>.Nutritional epidemiologist <a target="_blank" href="https://doi.org/10.1016/0140-6736(93)90350-P">Walter Willet and others</a> found solid evidence that trans fats were bad for the first time in 1990. However, the FDA, with its cumbersome process combined with pressure from the ultraprocessed food industry, took until 2015 to <a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8452362/">revoke the GRAS, or Generally Recognized As Safe, status</a> of industrially made trans fats, banning them from food only eight years ago, in 2018. And yes, partially-hydrogenated vegetable oil can be seen as a very early poster child of the ultraprocessed food industry.Back to our story, the butter shortages during World War II conditioned the American public to eating margarine, and the <a target="_blank" href="https://www.ers.usda.gov/amber-waves/2016/july/butter-and-margarine-availability-over-the-last-century">gap between butter and margarine consumption</a> narrowed. In the post-war years, the margarine industry saw a bright future.Convincing the public of margarine’s healthiness with biased-science and mediaIn the most audacious industry funding of research I know of, around 1945 <a target="_blank" href="https://doi.org/10.1001/jama.1948.02890230028006">the National Association of Margarine Manufacturers gave funding to three scientists</a> at the University of Chicago and the University of Illinois to compare the health effects of margarine versus butter.That grant in itself was not audacious, but it might have been innovative. We think of industry funded research as part of the <a target="_blank" href="https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2011.300292">playbook written by the tobacco industry</a>, which passed the practice on to the ultraprocessed food, opioid, cannabis, and gambling industries. But, in fact, this was a case of the ultraprocessed food industry funding research eight years before the tobacco industry started its massive effort in 1953 to co-opt the science linking smoking to cancer.Of course, no matter who conceived of the idea of funding science to get advantageous and respectable-seeming results, or, in the case of tobacco, just to cast doubt on the good science coming out, the priorities were always the same, profits before science before health.The audacious piece is what the Chicago scientists were paid to do. Previously all the research on the healthiness of margarine versus butter was done on animals, almost always lab rats. This grant was to do human research.To put this in context, this money was delivered three years before German doctors were put on trial in Nurenberg for their concentration camp <a target="_blank" href="https://ori.umkc.edu/facilities-compliance-and-commercialization/compliance/irb/history-of-research-ethics.html">medical experiments on prisoners</a>. This money came in the middle of the 40-year course of the Tuskegee Syphilis Study which withheld antibiotics from infected men who were Black. This was nine years before the <a target="_blank" href="https://doi.org/10.1097/01.NAJ.0001008420.28033.e8">NIH became the first institution to require a review</a> of human subjects research it conducted. By the way, the NIH review program was only to provide itself legal protection, not primarily as a matter of ethics.Here’s the thing. The doctors in Chicago were paid to conduct their <a target="_blank" href="https://doi.org/10.1001/jama.1948.02890230028006">research on orphans</a> in two orphanages. One orphanage ate butter and the other ate margarine. The research went on for two years and was done on 350 children from 2 to 17 years old. They were weighed monthly and their heights were recorded, with blood draws to measure their red blood cell count and hemoglobin. Medical records were checked only to see if one orphanage was seeing a difference in health compared to the other. In their resulting paper the doctors seemed strangely excited the margarine eating children were much healthier than those that ate butter, although they took care to say in the paper that the very good health was certainly not “simply because” of the margarine.It was a poor study with a poor design, written up with bias in favor of its funder, but of course the outrageous, nowadays unthinkable aspect is that forcing this study on these children was seen as acceptable. Children cannot give their consent to being subjects of research. Furthermore, these toddlers and kids and teenagers were wards of the state and in an institution where one might imagine they were experiencing some level of trauma or emotional distress on a daily basis. The margarine research equated them to lab rats with human metabolisms.Having no consciousness about the possible harms of this research to its subjects paid off for everybody but the children. Especially the margarine industry, which saw a favorable paper, “Margarine And The Growth Of Children,” published in the Journal of the American Medical Association, one of the world’s top medical research journals. The very influential <a target="_blank" href="https://time.com/archive/6785117/medicine-butter-v-margarine/">TIME Magazine picked up the story,</a> quoting the scientists’ conclusion that “Margarine is a good source of table fat in growing children…”Within a couple of years as much margarine was being eaten as butter. Margarine continued to grow in popularity, becoming consumed twice as much as butter by 1970.Today, Institutional Review Boards, or IRBs, in the U.S., or their equivalent in Europe and elsewhere, but not China or Russia, carefully screen all proposed research plans at universities or any organization doing federally funded research or FDA regulated trials, to ensure strict ethical standards are met. The margarine study would not have passed IRB review.Are our problems with unethical research solved in the U.S.? Apparently not in RFK, Jr.’s department, home to the FDA, NIH, and CDC, three agencies that fund or review a lot of human subjects research.At the end of 2025 it was revealed that the CDC had given a no-bid contract to Danish researchers to test the effect of hepatitis-B vaccines on newborns vs. 6-week old babies in Guinea-Bissau in Africa. The <a target="_blank" href="https://www.theguardian.com/us-news/2026/jan/15/hepatitis-b-vaccines-study-africa-cancel">researchers are friendly with anti-vaxxers</a> aligned with RFK, Jr. Kennedy has strongly praised one of the researchers. A leaked protocol for the study points to an intention on the part of the researchers to show that withholding the vaccine for six weeks is safer than giving it at the same time as other newborn vaccines. The World Health Organization is clear that withholding the hepatitis-B vaccine at birth is dangerous, risking the long-term development of serious illness and death due to transmission of hepatitis-B from the mother during birth. 18% of adults in Guinea-Bissau have hepatitis-B.In sum, Kennedy disregarded procedure to give a contract to researchers who designed a study to exploit the high prevalence of a disease in an African nation. The leaked protocol revealed that their intent was to support the CDC’s dismissal under Kennedy of the hepatitis-B vaccine recommendation for newborns. There was no review by an IRB at the CDC of this research. The study has been <a target="_blank" href="https://www.who.int/news/item/13-02-2026-statement-on-the-planned-hepatitis-b-birth-dose-vaccine-trial-in-guinea-bissau">decried as unethical by the World Health Organization</a> and research ethicists and scientists, and it has been likened to the Tuskegee Syphilis Study. As of March 2026 the study was on permanent hold.Thanks for reading Eating in America. This post is public so feel free to share it.While this began as a horror story about industry-funded, completely unethical research that found that margarine was as healthy as butter, again not true, we ended with another scary story of highly unethical research. Only this latter study was funded by a government politician, RFK, Jr., who happened to be in charge of a group of prestigious scientific agencies and yet had the goal of supporting his own dangerously wrong and unscientific ideas about vaccines. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit <a href="https://www.eatinginamerica.co/subscribe?utm_medium=podcast&utm_campaign=CTA_2">www.eatinginamerica.co/subscribe</a>

May 14, 2026

Car or bus to get groceries? Easy choice, if it’s even a choice.

This month Lela Nargi in an article in The <a target="_blank" href="https://www.theguardian.com/environment/2026/may/03/bus-public-transport-cuts-groceries-snap">Guardian</a> wrote about one of the studies I led that, together, examined, among other things, the use of cars vs. buses vs. walking to shop for healthy food. I told Ms. Nargi that I thought buses were a terrible way to have to go to get groceries, at least compared to going in a car.As part of the access to healthy food research, we surveyed community leaders in the three communities in Rhode Island where the data collection took place.One woman’s response spoke for many bus users and made a lasting impression on me. She was a shopper who uses a wheelchair, but her comments apply equally to those fully able to walk:If you are allowed to take a small travel cart onto the bus often you have trouble getting it on and off the bus and are in the way of other patrons, so a lot of bus drivers will refuse you service if you try. Many of the bus routes do not go to where there are less expensive markets, and if you want to go to one of them you have to walk quite far. If you find sales in different locations, it’s not worth the effort and extra expense of travel time. Also, the weather is a factor – rain, snow, extreme heat – keeps many people from making the hike to the bus. Sometimes bus routes are a couple of blocks away. If this is the only choice you have, making your way to the market usually means going two-three times a week. There are many people who have to take taxis just to get their groceries home, which is expensive. Most often we are elderly or disabled and must shop on our own, consuming much of our day. When I’m told how lucky I am to be on a bus route, I like to tell people what I must go through to get a few days of groceries, and I prefer to use my electric wheelchair and lug my groceries home on the footrest of my chair.Please support Eating in America and share this post with someone who might be interested.As one community member lamented, the food system was “designed for drivers.”There are a number of studies that measure physical access to food by car, but not many that attempt to measure access by transit bus. It’s difficult, and no one had figured out how to accurately estimate the number of people who could reasonably access a given supermarket or other location (like a health center, for example) by bus. It’s important for policy and planning to see how many people can get to a service location or potential location in a reasonable amount of time. But it’s very tricky to do that.To use a bus, the shopper has to walk to the stop, wait for the bus, ride, and then get off and shop. This assumes there is a bus stop close to the supermarket, which is often the case. Coming back the shopper has a wait for the bus, ride, and walk home from the stop. Walking takes a fairly standard amount of time; bus stop waiting times range from none at all to who knows, depending on the spacing between buses and when exactly the shopper arrives at the stop; and usual bus speeds vary according to the time of day, usually being slowest during rush hours. There aren’t any great software tools to put all these segments together to give the best estimate of how far away a supermarket or pantry could be for a shopper on a time budget, so I had to invent a new method. I won’t bore you with the details, but to see how many people in a community live close enough to reach a supermarket in a reasonable amount of time, you have to figure out what a reasonable amount of time is.For this we depended on a group of community leaders who told us that, if you have a car, a round trip of 18 minutes is reasonable. Let me stop right here for a spoiler alert.Basically, in all three communities, anyone with a car for shopping was within reach of at least one affordably priced supermarket and one healthier food pantry, given a time budget of 18 minutes for the round trip driving. If you had a car, physical access to affordable food for most people was no problem.For those using a bus, the community leaders said a reasonable time budget for the traveling part of the shopping excursion was 36 minutes. This makes sense in these urban or semi-urban communities. It is mostly a given that using a bus is going to take longer than driving a car for food shopping.What doesn’t make sense, when you think about it, is doing the calculation for how accessible food is by bus for a community when you start with the assumption that bus users have twice the time budget to do shopping. I don’t think bus users can be assumed to have more time on their hands than car drivers, but that is the approach taken by other studies like ours, and that is the way we did it. Ours was an inherently inequitable, unequal measure for comparing healthy, affordable food access by car versus by bus. I led the research, and I own that flaw in equity. As you will see, if we had analyzed the data using the same time budget for shopping by bus as for shopping by car, the result would have been dramatic. Perhaps it is dramatic enough to find that given a 36 minute round trip, only half of the people in the three communities had access to an affordable supermarket. Only one out of five could reach a food pantry that offered produce.However, if we had cut the bus round trip budget by half to the 18 minutes allowed for a car round trip, the estimate of the number of people in each community with access to healthy food would have fallen to zero. All of the 18 minutes would have been consumed by walking to and from the bus stop and waiting for the bus on each end, leaving no time to actually ride on the busThere is no perfect method for assessing food access, but the grand lesson is that, apart from all the hassles of using the bus, the time required for shopping by bus is never going to be the same as for driving, no matter how little time you have for shopping because the adults in your household have multiple jobs or you have multiple children to manage.We found out some other interesting stuff. First, supermarkets and some food pantries were the only sources of a reasonable amount of healthy food in our study area. The seventy convenience, corner, and dollar stores in the three communities, and we surveyed them all, did not come close to clearing our low bar for having enough healthy food.Second, the results of our cost analysis of shopping at the accessible supermarkets was a shock. We priced a selection of produce and dry and can goods at each store. The food we checked at the most expensive store cost twice what the same food did in the least expensive store. Shoppers who could access one of the three discount supermarkets could buy twice as much food compared to those who only had access to the most expensive store. The ability to make the food dollar go twice as far makes a world of difference to a family on a limited income, and about 10% of the population of the three communities lives in povertyBuses can be somewhere between tolerable and great for commuting to work. When I was in college, I got up at 4 am every morning for a two-hour ride on two buses to get to my summer job in a cardboard box factory. Even that was tolerable, if just for a summer. But grocery shopping by bus can be hard. What are the grocery shopping solutions for people who don’t have a car, don’t live within a short walk of a supermarket, and can’t afford delivery or a car service for their shopping? Unfortunately, I don’t think there are any easy, global solutions with something so unwieldy as transit systems, but maybe there are some smaller scale solutions, custom fit for the needs of local communities.Maybe it sometimes involves government encouragement of retail food outlets, something that is already in action in several American cities, in addition to <a target="_blank" href="https://www.vitalcitynyc.org/government-is-already-in-the-grocery-business/">myriad government programs</a> that are already in the food business, like assisting or funding food banks, pantries, farmers markets, indoor markets, military commissaries, soup kitchens, taxi voucher programs, and food deliveries for shut-ins.Eating in America is reader-supported. To receive new posts and support my work, consider becoming a free or paid subscriber.Thanks for reading.What are your thoughts about bus access to healthy food? This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit <a href="https://www.eatinginamerica.co/subscribe?utm_medium=podcast&utm_campaign=CTA_2">www.eatinginamerica.co/subscribe</a>

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What is Eating in America Podcast?: Eating in America is about the food on our table and who's in charge of keeping it healthy. <a href="https://www.eatinginamerica.co?utm_medium=podcast">www.eatinginamerica.co</a>
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