By JONEL ALECCIA, Associated Press

BETHESDA, Md. (AP) — Sam Srisatta, a 20-year-old Florida college student, spent a month living inside a government hospital here last fall, playing video games and allowing scientists to document every morsel of food that went into his mouth.

From big bowls of salad to platters of meatballs and spaghetti sauce, Srisatta noshed his way through a nutrition study aimed at understanding the health effects of ultraprocessed foods, the controversial fare that now accounts for more than 70% of the U.S. food supply. He allowed The Associated Press to tag along for a day.

“Today my lunch was chicken nuggets, some chips, some ketchup,” said Srisatta, one of three dozen participants paid $5,000 each to devote 28 days of their lives to science. “It was pretty fulfilling.”

College student and research subject Sam Srisatta pedals a stationary bicycle as part of an exercise session during a study on the health effects of ultraprocessed foods at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

Examining exactly what made those nuggets so satisfying is the goal of the widely anticipated research led by National Institutes of Health nutrition researcher Kevin Hall.

“What we hope to do is figure out what those mechanisms are so that we can better understand that process,” Hall said.

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Hall’s study relies on 24/7 measurements of patients, rather than self-reported data, to investigate whether ultraprocessed foods cause people to eat more calories and gain weight, potentially leading to obesity and other well-documented health problems. And, if they do, how?

At a time when Health Secretary Robert F. Kennedy Jr. has made nutrition and chronic disease a key priority, the answers can’t come soon enough.

Kennedy has repeatedly targeted processed foods as the primary culprit behind a range of diseases that afflict Americans, particularly children. He vowed in a Senate confirmation hearing to focus on removing such foods from school lunches for kids because they’re “making them sick.”

Ultraprocessed foods have exploded in the U.S. and elsewhere in recent decades, just as rates of obesity and other diet-related diseases also rise.

The foods, which are often high in fat, sodium and sugar, are typically cheap, mass-produced and contain added colors and chemicals not found in a home kitchen. Think sugary cereals and potato chips, frozen pizzas, sodas and ice cream.

Studies have linked ultraprocessed foods to negative health effects, but whether it’s the actual processing of the foods — rather than the nutrients they contain or something else — remains uncertain.

A small 2019 analysis by Hall and his colleagues found that ultraprocessed foods led participants to eat about 500 calories a day more than when they ate a matched diet of unprocessed foods.

The new study aims to replicate and expand that research — and to test new theories about the effects of ultraprocessed foods. One is that some of the foods contain irresistible combinations of ingredients — fat, sugar, sodium and carbohydrates — that trigger people to eat more. The other is that the foods contain more calories per bite, making it possible to consume more without realizing it.

Teasing out those answers requires the willingness of volunteers like Srisatta and the know-how of health and diet experts who identify, gather and analyze the data behind the estimated multimillion-dollar study.

During his month at NIH, Srisatta sported monitors on his wrist, ankle and waist to track his every movement, and regularly gave up to 14 vials of blood. Once a week, he spent 24 hours inside a metabolic chamber, a tiny room outfitted with sensors to measure how his body was using food, water and air. He was allowed to go outside, but only with supervision to prevent any wayward snacks.

“It doesn’t really feel that bad,” Srisatta said.

Food labeled and prepared for college student and research subject Sam Srisatta sits on a tray in a kitchen during a study on the health effects of ultraprocessed foods at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

He could eat as much or as little as he liked. The meals wheeled to his room three times a day were crafted to meet the precise requirements of the study, said Sara Turner, the NIH dietitian who designed the food plan. In the basement of the NIH building, a team carefully measured, weighed, sliced and cooked foods before sending them to Srisatta and other participants.

“The challenge is getting all the nutrients to work, but it still needs to be appetizing and look good,” Turner said.

Results from the trial are expected later this year, but preliminary results are intriguing. At a scientific conference in November, Hall reported that the first 18 trial participants ate about 1,000 calories a day more of an ultraprocessed diet that was particularly hyperpalatable and energy dense than those who ate minimally processed foods, leading to weight gain.

College student and research subject Sam Srisatta pedals on a stationary bicycle as part of an exercise session during a study on the health effects of ultraprocessed foods at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

When those qualities were modified, consumption went down, even if the foods were considered ultraprocessed, Hall said. Data is still being collected from remaining participants and must be completed, analyzed and published in a peer-reviewed journal.

Still, the early results suggest that “you can almost normalize” energy intake, “despite the fact that they’re still eating a diet that is more than 80% of calories from ultraprocessed food,” Hall told the audience.

Not everyone agrees with Hall’s methods, or the implications of his research.

Clinical research nurse Monica Falcon prepares to draw blood from college student and research subject Sam Srisatta as part of a study on the health effects of ultraprocessed foods at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

Dr. David Ludwig, an endocrinologist and researcher at Boston Children’s Hospital, criticized Hall’s 2019 study as “fundamentally flawed by its short duration” — about a month. Scientists have long known that it’s possible to get people to eat more or less for brief periods of time, but those effects quickly wane, he said.

“If they were persistent, we would have the answer to obesity,” said Ludwig, who has argued for years that consumption of highly processed carbohydrates is the “prime dietary culprit” and focusing on the processing of the foods is “distracting.”

He called for larger, better-designed studies lasting a minimum of two months, with “washout” periods separating the effects of one diet from the next. Otherwise, “we waste our energy, we mislead the science,” Ludwig said.

From left, cook Jeff Tait, nutrition research manager Merel Kozlosky, and research dietitian Sharonne Waters prepare a meal for college student and research subject Sam Srisatta in a kitchen as part of a study on the health effects of ultraprocessed foods at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

Concerns about the short length of the studies may be valid, said Marion Nestle, a nutritionist and food policy expert.

“To resolve that, Hall needs funding to conduct longer studies with more people,” she said in an email.

The NIH spends about $2 billion a year, about 5% of its total budget, on nutrition research, according to Senate documents.

v sits on a tray in a kitchen during a study on the health effects of ultraprocessed foods at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

At the same time, the agency cut the capacity of the metabolic unit where investigators conduct such studies, reducing the number of beds that must be shared among researchers. The two participants enrolled now at the center and the two planned for next month are the most Hall can study at any one time, adding months to the research process.

Srisatta, the Florida volunteer who hopes to become an emergency room physician, said participating in the trial left him eager to know more about how processed foods affect human health.

“I mean, I think everyone knows it’s better to not eat processed foods, right?” he said. “But having the evidence to back that up in ways that the public can easily digest,” is important, he said.

A metabolic chamber outfitted with sensors to measure how a subject uses food, air and water is seen at the National Institutes of Health in Bethesda, Md., on Thursday, Oct. 31, 2024. (AP Photo/Mark Schiefelbein)

HHS officials didn’t respond to questions about Kennedy’s intentions regarding nutrition research at NIH. The agency, like many others in the federal government, is being buffeted by the wave of cost cuts being directed by President Donald Trump and his billionaire aide Elon Musk.

Jerold Mande, a former federal food policy advisor in three administrations, said he supports Kennedy’s goals of addressing diet-related diseases. He has pushed a proposal for a 50-bed facility where government nutrition scientists could house and feed enough study volunteers like Srisatta to rigorously determine how specific diets affect human health.

“If you’re going to make America healthy again and you’re going to address chronic disease, we need better science to do it,” Mande said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By ALANNA DURKIN RICHER and ERIC TUCKER

WASHINGTON (AP) — Prosecutors in the Justice Department section that handles public corruption cases have been told the unit will be significantly reduced in size, and its cases will be transferred to U.S. attorney’s offices around the country, two people familiar with the matter said Tuesday.

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The discussions about shrinking the public integrity section come weeks after the unit’s leadership resigned when a top Justice Department official ordered the dropping of corruption charges against New York Mayor Eric Adams.

At the end of the Biden administration, there were about 30 prosecutors in the section, which was created in 1976 following the Watergate scandal to oversee criminal prosecutions of federal public corruption cases across the country.

Prosecutors have been told they will be asked to take new assignments in the department and as few as five lawyers may remain in the unit, said the people, who spoke on the condition of anonymity because they were not authorized to publicly discuss the move. U.S. attorney’s offices around the country are expected to take on the cases that the section was prosecuting, the people said.

A Justice Department spokesperson said Tuesday that leadership is “taking a broad look” at the agency’s resources but no final decisions have been made about the future of the public integrity section.

The move appears to be part of a broader Trump administration effort to weaken or altogether dismantle guardrails designed to protect good government and fair play in business and politics.

The Justice Department has already paused enforcement of a decades-old law that prohibits American companies from bribing foreign governments to win business and moved to wipe away high-profile public integrity cases like those against Adams and former Illinois Gov. Rod Blagojevich, both Democrats.

In addition to prosecuting misconduct by public officials, the section oversees the department’s handling of election crimes like voter fraud and campaign finance offenses. Under the Biden administration, it was also home to the election threats task force, which was launched to combat a growing number of threats of violence against election workers.

The section has been without leadership since five supervisors resigned last month amid the turmoil over the Adams case. Its acting chief, three deputy chiefs and a deputy assistant attorney general in the criminal division who oversaw the section resigned last month after the order to drop the case from then-Deputy Attorney General Emil Bove.

Bove then convened a call with the prosecutors in the section and gave them an hour to pick two people to sign onto the motion to dismiss, saying those who did so could be promoted. After prosecutors got off the call with Bove, the consensus among the group was that they would all resign. But a veteran prosecutor stepped up to sign the motion out of concern for the jobs of the younger people in the unit.

It has for decades been one of the department’s most prestigious sections, with a roster of prominent alumni including former Attorney General Eric Holder, former Deputy Attorney General Rod Rosenstein and Jack Smith, who led the unit years before being appointed special counsel to investigate President Donald Trump.

The section took a reputational hit with the botched prosecution of late Alaska Sen. Ted Stevens, a case that was dismissed in 2009 by a federal judge who found that prosecutors had withheld from defense lawyers evidence that was favorable to their case.

Smith was appointed in 2010 to rebuild the section and led the unit during the course of a series of high-profile but not always successful corruption prosecutions, including against former Virginia Gov. Bob McDonnell, a Republican, and former Democratic Sen. John Edwards of North Carolina.

By JONEL ALECCIA, Associated Press

In the Trump administration’s quest to “Make America Healthy Again,” there may be no bigger target than ultraprocessed foods.

Robert F. Kennedy Jr., the nation’s new health secretary, has cited “highly chemically processed foods” as a chief culprit behind an epidemic of chronic disease in the U.S., including ailments such as obesity, diabetes and autoimmune disorders.

Such foods are “poisoning” people, particularly children, Kennedy said during Senate confirmation hearings. He has vowed to work to remove such foods from federal programs such as the Supplemental Nutrition Assistance Program, or SNAP.

“I will do everything in my power to put the health of Americans back on track,” he told lawmakers.

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Key to that goal, however, could be making sure that consumers understand basic facts about ultraprocessed foods and the role they play in daily meals.

From sugary cereals at breakfast to frozen pizzas at dinner, plus in-between snacks of potato chips, sodas and ice cream, ultraprocessed foods make up about 60% of the U.S. diet. For kids and teens, it’s even higher — about two-thirds of what they eat.

That’s concerning because ultraprocessed foods have been linked to a host of negative health effects, from obesity and diabetes to heart disease, depression, dementia and more. One recent study suggested that eating these foods may raise the risk of early death.

Nutrition science is tricky, though, and most research so far has found connections, not proof, regarding the health consequences of these foods.

Food manufacturers argue that processing boosts food safety and supplies and offers a cheap, convenient way to provide a diverse and nutritious diet.

Even if the science were clear, it’s hard to know what practical advice to give when ultraprocessed foods account for what one study estimates is more than 70% of the U.S. food supply.

The Associated Press asked several nutrition experts and here’s what they said:

What are ultraprocessed foods?

Most foods are processed, whether it’s by freezing, grinding, fermentation, pasteurization or other means. In 2009, Brazilian epidemiologist Carlos Monteiro and colleagues first proposed a system that classifies foods according to the amount of processing they undergo, not by nutrient content.

At the top of the four-tier scale are foods created through industrial processes and with ingredients such as additives, colors and preservatives that you couldn’t duplicate in a home kitchen, said Kevin Hall, a researcher who focuses on metabolism and diet at the National Institutes of Health.

“These are most, but not all, of the packaged foods you see,” Hall said.

Such foods are often made to be both cheap and irresistibly delicious, said Dr. Neena Prasad, director of the Bloomberg Philanthropies’ Food Policy Program.

“They have just the right combination of sugar, salt and fat and you just can’t stop eating them,” Prasad said

However, the level of processing alone doesn’t determine whether a food is unhealthy or not, Hall noted. Whole-grain bread, yogurt, tofu and infant formula are all highly processed, for instance, but they’re also nutritious.

Are ultraprocessed foods harmful?

Here’s the tricky part. Many studies suggest that diets high in such foods are linked to negative health outcomes. But these kinds of studies can’t say whether the foods themselves are the cause of the negative effects — or whether there’s something else about the people who eat these foods that might be responsible.

Ultraprocessed foods, as a group, tend to have higher amounts of sodium, saturated fat and sugar, and tend to be lower in fiber and protein. It’s not clear whether it’s just these nutrients that are driving the effects.

Hall and his colleagues were the first to conduct a small but influential experiment that directly compared the results of eating similar diets made of ultraprocessed versus unprocessed foods.

Published in 2019, the research included 20 adults who went to live at an NIH center for a month. They received diets of ultraprocessed and unprocessed foods matched for calories, sugar, fat, fiber and macronutrients for two weeks each and were told to eat as much as they liked.

When participants ate the diet of ultraprocessed foods, they consumed about 500 calories per day more than when they ate unprocessed foods, researchers found — and they gained an average of about 2 pounds (1 kilogram) during the study period. When they ate only unprocessed foods for the same amount of time, they lost about 2 pounds (1 kilogram).

Hall is conducting a more detailed study now, but the process is slow and costly and results aren’t expected until late next year. He and others argue that such definitive research is needed to determine exactly how ultraprocessed foods affect consumption.

“It’s better to understand the mechanisms by which they drive the deleterious health consequences, if they’re driving them,” he said.

Should ultraprocessed foods be regulated?

Some advocates, like Prasad, argue that the large body of research linking ultraprocessed foods to poor health should be more than enough to spur government and industry to change policies. She calls for actions such as increased taxes on sugary drinks, stricter sodium restrictions for manufacturers and cracking down on marketing of such foods to children.

“Do we want to risk our kids getting sicker while we wait for this perfect evidence to emerge?” Prasad said.

Last year, former FDA Commissioner Robert Califf broached the subject, telling a conference of food policy experts that ultraprocessed foods are “one of the most complex things I’ve ever dealt with.”

But, he concluded, “We’ve got to have the scientific basis and then we’ve got to follow through.”

How should consumers manage ultraprocessed foods at home?

In countries like the U.S., it’s hard to avoid highly processed foods — and it’s not clear which ones should be targeted, said Aviva Musicus, science director for the Center for Science in the Public Interest, which advocates for food policies.

“The range of ultraprocessed foods is just so wide,” she said.

Instead, it’s better to be mindful of the ingredients in foods. Check the labels and make choices that align with the current dietary guidelines, she suggested.

“We have really good evidence that added sugar is not great for us. We have evidence that high-sodium foods are not great for us,” she said. “We have great evidence that fruits and vegetables which are minimally processed are really good for us.”

It’s important not to vilify certain foods, she added. Many consumers don’t have the time or money to cook most meals from scratch.

“Foods should be joyous and delicious and shouldn’t involve moral judgment,” Musicus said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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