In early January 2025, Gov. Gavin Newsom issued an executive order aimed at addressing the accessibility of ultra-processed foods within the context of California’s nutrition and public health standards, as reported by the Los Angeles Times. Newsom contends that the food we consume should not contribute to illness or lead to long-term health consequences.
In line with this philosophy, the executive order instructs state agencies to enhance access to fresh, nutritious foods, while advancing public health initiatives. The order focuses on curbing the ability of individuals utilizing government food assistance programs to purchase unhealthy, ultra-processed foods.
In concrete terms, the executive order outlines a series of actions California is undertaking to elevate the quality of public nutrition. The California Department of Public Health and the Office of Environmental Health Hazard Assessment have been charged with delivering recommendations by April 1, 2025.
Newsom’s initiatives represent a crucial first step toward the broader, systemic changes required to improve the health of individuals not only in California but across the United States. Of particular concern is the rising prevalence of poor health outcomes and obesity rates among school-aged children in California.
An estimated one in four adults living in California are obese according to the California Health Interview Survey. In addition to this, an estimated 10 million adults were found to be overweight.
These rates have increased from 19.3% in 2001 to 28.2% in 2021.
The increasing rates of obesity among both the adult and youth population pose urgent public health challenges, with the potential to lead to severe and long-lasting health consequences.
Numerous factors contribute to the poor health outcomes observed in these populations across California, including inadequate nutrition, insufficient physical activity and environmental influences. Specifically, a significant portion of California’s children consume diets high in ultra-processed foods, sugar-sweetened beverages, and convenience or fast foods. The overconsumption of such items is a major contributor to the deterioration of health over time.
Additionally, many low-income individuals reside in areas with limited access to nutritious food options, exacerbating the issue.
Most school-aged children also fail to meet the recommended 60 minutes of daily physical activity, a trend further fueled by the increasing prevalence of electronic device use, which fosters sedentary lifestyles. Moreover, limited access to safe outdoor spaces for exercise, such as parks, disproportionately affects children in urban or lower-income communities, further hindering opportunities for physical activity.
A critical examination of the role of nutrition in the health of school-age children necessitates a closer look at the food options available to students during school hours, which constitute most of their daily routine.
A significant number of public schools in California participate in the federally funded National School Lunch Program and School Breakfast Program, which are designed to provide nutritionally balanced meals. However, these programs often fall short in delivering healthy food options, as many of the meals served contain ultra-processed ingredients, such as packaged snacks, frozen or pre-prepared meals, sugary cereals and processed deli meats.
Vending machines within schools are typically stocked with ultra-processed foods as well, further contributing to students’ caloric intake. Research consistently shows that a diet high in ultra-processed foods is a primary factor in becoming overweight and obese, thus placing a significant portion of children at heightened risk for these health issues.
Parents, regardless of income level, should have the assurance that when sending their children to school, they are being provided with nutritious meals that foster both immediate health and long-term well-being.
To effect meaningful improvements in public health, both the American food supply and government-funded programs must undergo significant reform.
While Newsom’s initiatives represent a positive first step, more comprehensive and sustained efforts are needed to achieve lasting and impactful change across California and the broader nation.
Further progress can be initiated by revising meal standards to reduce the school system’s dependence on ultra-processed food options. Implementing stricter limitations on added sugars, sodium and saturated fats would help shift the focus toward more nutritionally valuable meal offerings.
Education plays a pivotal role in fostering sustainable change, and it is essential to educate both children and their families about the health risks associated with excessive consumption of ultra-processed foods. Additionally, sourcing ingredients from local California farmers presents an opportunity to improve nutritional quality by increasing the availability of fresh, whole foods for students, while simultaneously offering a more cost-effective solution.
In addition to the suboptimal nutritional offerings in school settings, similar challenges persist in certain hospital environments, where the quality of meals provided often falls short of ideal standards. Much like schools, hospitals are frequently equipped with vending machines stocked with convenient, ultra-processed snacks and meal options. Consequently, there is a pressing need to prioritize the enhancement of nutritional offerings within hospitals and other health care settings.
I recently witnessed this firsthand, when a friend who is undergoing cancer treatment in California wanted a snack while she waited for her tests, and the only options available to her were ultra-processed foods from a vending machine.
We know that healthy foods can heal, certainly more so than ultra-processed foods with additives, chemicals and dyes can. By promoting healthier, more nutritionally balanced options, health care institutions can play a more active role in improving patient care and supporting better health outcomes.
While Newsom’s executive order marks a significant step toward reducing the prevalence of ultra-processed foods in California, additional reforms are essential.
Although school systems face numerous challenges in providing nutritious meals, the implementation of stronger policies, comprehensive educational initiatives, and strategic local partnerships can further bolster California’s efforts to offer children and communities healthier food options, while minimizing reliance on ultra-processed foods.
Nicole Avena, PhD, is an associate professor of Neuroscience, Icahn School of Medicine at Mount Sinai and a visiting professor of Health Psychology, Princeton University. She has done groundbreaking work developing models to characterize food addition and the dangers of excess sugar intake. Avena can be found on LinkedIn.