Stock up on your Mountain Dew: Code Red, M&Ms, and Swedish Fish — while these iconic items aren’t necessarily disappearing, a relatively minor but controversial component of their chemical anatomy will be phased out by 2027: Red 40. This synthetic dye will join the ranks of brominated substances and propylparabens.
Red 40’s forced retirement comes amid growing pressure from the populace demanding elimination of the dye from food items due to safety concerns. This is an example of the free market operating as intended — the food industry responding to consumer wants and needs. But it didn’t stop here, the government couldn’t resist the opportunity to step in, intervene and oversee the ban. Two issues arose in light of this event. First, the Food and Drug Administration (FDA)’s incessant need to oversee the process, creating a regulation and granting the necessary authority to conduct inspections and audit facilities as the bureaucracy deems appropriate.
The second, and more contentious, observation is the emergence of an ideology within the health movement that seeks to model the U.S. healthcare approach after Europe. This perspective has even been touted and endorsed, at times, by Robert F. Kennedy, Jr., the newly confirmed Secretary of Health and Human Services (HHS). While it is true that certain parts of Europe generally exhibit lower rates of obesity, type II diabetes, and some psychiatric conditions, the underlying reasons for these differences are complex and multifaceted. Mirroring Europe’s heavy regulatory policies concerning health may prove moot.
The countries that comprise Europe — specifically within the context of the European Union (EU) — present a complex mosaic of health and disease. For instance, while Spain is often regarded as one of the healthiest countries in the world, Bulgaria, in contrast, has a lower life expectancy for both men and women compared to the United States. Autoimmune diseases in Europe are generally proportionate to those observed in the United States depending on region and diagnostic criteria. Conditions like Irritable Bowel Syndrome (IBS), in which the etiologies are enigmatic, have an incidence rate of approximately 10-15% in Europe, while in the United States, the prevalence is estimated to range from 10-20%. Cancer incidence rates in Europe and the study comparing data from the late 20th century found that five-year relative survival rates were notably higher in the U.S. than in Europe for several cancers to include prostate, rectum, colon, and breast. These statistics suggest that adopting European standards to restrict certain food additives or implement dietary bans may be ineffective or irrelevant.
In addition to attributing food additives to cancer risk, Robert F. Kennedy Jr. has openly criticized their potential role in conditions such as Attention Deficit Hyperactivity Disorder (ADHD). According to the Centers for Disease Control and Prevention (CDC), estimates for ADHD in the United States range from 6% to 16%; in children aged 3-17, while the prevalence of autism is approximately 2.78%. In Europe, ADHD diagnosis is estimated at around 5%, while autism rates range from .8% to 1.4% of the population. Oftentimes its lauded that the European Union enforces stricter standards and guidelines for food additives compared to the United States, implying their contribution in these psychiatric conditions. At first glance, this may seem compelling; however, before drawing conclusions, it is important to consider that the United States is a diverse ‘melting pot,’ where cultural and ethnic factors may influence diagnostic patterns. CDC data on ADHD in the United States shows considerable diagnostic variation among ethnic groups, as an example ADHD rates are as low as 4% among Asian populations. Concerning autism, there is a large state-to-state variability in reported prevalence. Additionally, the United States utilizes some of the broadest diagnostic criteria for autism globally, particularly when comparing the DSM-5 with the ICD-10/11 used in Europe — a trend that extends to many other psychiatric disorders. Because these conditions are diagnosed based on subjective symptom criteria rather than objective lab tests, they are vulnerable to both under-diagnosis and over-diagnosis — a concern that applies globally.
A popular type of ammunition supporting the pro-Europe stance is a widely circulated graph on social media highlighting America’s poor healthcare outcomes in comparison to many other countries, most of which are part of the EU. This also serves as great illustration of the complexities that encompass healthcare in a diverse and free nation. The graph highlights poor health outcomes alongside exceptionally high healthcare costs, yet it fails to account for several important factors. Americans generally face higher rates of drug-related issues, drive more frequently than Europeans — more car accidents, experience higher homicide rates, Americans love ultra-processed foods which are calorie dense and can lean to higher obesity rates compared to Europeans. To align U.S. trends with those of other countries, one might suggest a range of drastic measures: banning driving, restricting alcohol, prohibiting firearms, eliminating junk food, or even imposing heavy taxes on gasoline and implementing environmental policies to discourage car ownership, similar to Europe’s approach. Having the freedom with the risks, is better than not having the freedom at all — despite the costs.
Countless other examples could be given, but the reality remains: America is a vast country, geographically and culturally diverse. This diversity plays a significant role in the variations in healthcare outcomes between the United States and Europe. Culturally, Europeans approach mealtime, diet, and portion control in ways that differ substantially from Americans. Even their fast-food meals are portioned for caloric restriction — royale with cheese anyone? While Europeans have stricter standards regarding food components and additives, the focus on these factors may be misplaced; it could be their overall diets, rather than individual additives, that have a more significant impact on their health. This principle applies to nutrition as a whole. Europeans’ greater reliance on public transportation, walking, or cycling may be larger contributors to the general health disparities when comparing the two nations. However, Americans must recognize that emulating Europe often involves embracing significant government oversight and principles that are contrary to core American values. The most effective way for Americans to address health issues and healthcare costs is by making responsible health decisions through the power of individual freedom. Encouragingly, it appears many Americans are already taking these steps.
In closing, the market should respond to consumer demands — this is the essence of a dynamic and innovative society. While some advocate for adopting European standards as a solution, doing so would begin a step in a direction of massive government intervention into our personal freedoms, undermining the free-market principles that have long been the cornerstone of American liberty. It is precisely this freedom — the liberty to choose what we eat, how or even if we exercise — that defines our individuality. Although these choices may sometimes result in higher healthcare costs or increased risks, the ability to choose is the very backbone of what makes America great.
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