I am preparing a podcast and post around the notion of precision nutrition
I say “notion” because, while “precision nutrition” is a topic being given serious attention by some serious scientists, it is almost an oxymoron – a nonsensical expression – in that, as a species, we are designed to thrive on a wide variety of foods in varying quantities. Until we started to modify foods through industrialization, we were fairly self-regulating in our consumption of appropriate and healthy foods.
Precision didn’t enter into it.
But industrial processing of foods has changed that, and I will get into why that is in my podcast and post next week. What is happening with precision nutrition, and its close cousins personalized nutrition and nutrigenetics and its second cousin, Food As Medicine, is an important, complex, and dynamic topic in this era of AI, ultraprocessed food, and the increasing dominance of industrial food companies like PepsiCo and General Mills in our food environment.
Pepsi as a precision nutrition wannabe?
I mention the makers of a protein water (Pepsi) and Cookies & Crème Cheerios Protein (General Mills) because they are part of the Big Food effort to usurp the science, dominate the regulatory environment, and commercialize the concept of precision nutrition and personalized nutrition. I recommend not reading a scientific paper or piece of social media about precision or personalized nutrition without doing a check for the commercial interests that may be involved.
Put precision and personalized nutrition in the control of medicine, not Big Food
I’ll get into this and provide at least one reason why personalized nutrition should be usurped, not by Pepsi and General Mills, but by the medical profession. I have long argued that personalized nutrition should be a regular part of personal medical care. I am skeptical of it outside that framework. All coming next week.
Operation Stork Speed
In March 2025, RFK, Jr. announced Operation Stork Speed to revise the Food and Drug Administration’s 30-year old infant formula requirements. This week, another year and a half gone by, the FDA announced the first of the three phases of its proposed formula standards updates.
Phases One and Two: Easy
The current phase would primarily update vitamins A and D and six minerals. Phase two will deal with 11 more vitamins and inositol, a sugar alcohol that is an important component of breast milk. These first two phases have importance but will be relatively easy for the FDA to navigate to success.
Phase Three: Hard?
This three-part phasing is clever on the part of the FDA and RFK, Junior. I approve. They are isolating the goal of bringing the first two parts to shore before navigating the shoals facing the third phase.
The macronutrients in formula: protein, fat, and carbs
The third part will question the three macronutrient standards. First, there is protein. Translate this as “whey and casein from milk”. Second, is fats. Translate this as questions and controversy about seed oils. And, third is carbohydrates. Translate this as “sugar”.
Protein is the one macronutrient around which there seems to be little controversy. Most protein used in formula is whey and casein from cow’s milk with a balance designed to closely mimic breast milk.
The MAHA distaste for seed oils in formula
As for the fats infants need, essential omega-3 fatty acids are likely to be added as mandatory ingredients in this phase, but because they are critical to infant development they are already usually incorporated in formula.
Linoleic acid is an omega-6 fatty acid and is also critical and already a requirement. Omega-6 fatty acids are sourced from seed oils, as are the alpha-linoleic omega-3 fatty acids, where they are cheap and abundant. That is where the potential for controversy comes in. Make America Healthy Again does not like the seed oil sourcing, but babies must have these linoleic and alpha-linoleic acids and non-seed oil sources are expensive.
A crazy bad idea
MAHA proponents, including the recently resigned FDA Commissioner Marty Makary, would like to see linoleic acid removed as a requirement in formula. This is such a wacko idea that better minds will almost certainly prevail. Instead a sufficient maximum limit on the amount of linoleic acid is a possibility in this last phase.
The type of sugar matters
So it is not the vitamins and minerals. It is not the protein. It is not the fat. It is the carbohydrate used in most American formula that is the problem. That carbohydrate is non-lactose sugar, which is linked to obesity and to harming the development of our infants, as I wrote in Eating in America at the end of August.
Mimicking mom’s milk means lactose
The carbohydrate in breast milk is lactose. The enzyme lactase in the small intestine breaks the lactose down into glucose and galactose, which are then absorbed into the bloodstream. Then the galactose is, primarily, metabolized into glucose in the liver. All this takes time, reducing the level of spiking of blood sugar in the infant and the risk of metabolic disorder and obesity.
Glucose in formula and the risk of infant obesity
But many formulas use reduced or no lactose, instead adding other sugars, including corn syrup or corn syrup solids, which contain only glucose. Studies have shown that use of formula with glucose and other non-lactose sugars is linked to the development of obesity in infants. One study estimated that the risk of obesity at two years old is elevated by 16% for infants who consumed lactose-reduced formula through their first 12 months.
Action is urgently required
Starting children on a trajectory of obesity in their first 1,000 days is unacceptable. But sugar is the foundation of much of our ultra-processed food environment. Big Formula, and Big Food, of which it is a part, don’t like the government even thinking about regulating sugar. This is why the third phase of formula updating is likely to be the most contentious and delayed, especially if Kennedy sticks to his MAHA guns and tries to fight Big Formula on carbohydrate regulation.
Most infants drink formula
On any given day, four out of five American infants 0 to 12 months old consume no breast milk. They mainly drink formula, although a small percentage drink cow’s milk. The FDA needs to take non-lactose sugar out of American formula. The science is there, and the Europeans have already banned corn syrup from most formula.
Lose the non-lactose sugars
Kennedy and his people in the FDA were smart to save the lactose fight for last while the vitamin and mineral changes are locked down in the first two phases of formula regulation revisions. I’ll be hoping for the best, but Kennedy and MAHA have so far failed badly in making real progress when hindered by Big Food -- as they are likely to be in pushing for changes to formula sugar standards.
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References
Ordovas JM, Ferguson LR, Tai ES, Mathers JC. Personalised nutrition and health. BMJ. Jun 13 2018;361:bmj.k2173. https://doi.org/10.1136/bmj.k2173
Berciano S, Figueiredo J, Brisbois TD, et al. Precision nutrition: Maintaining scientific integrity while realizing market potential. Front Nutr. 2022;9:979665. https://doi.org/10.3389/fnut.2022.979665
Operation Stork Speed. October 29, 2026. https://www.fda.gov/food/infant-formula-homepage/operation-stork-speed
Abrams SA, Brenna JT, Clemens R, et al. Food and Drug Administration Expert Panel on Infant Formula “Operation Stork Speed” June 2025: Part 1, Nutrient Considerations. Adv Nutr. Apr 2026;17(4):100583. https://doi.org/10.1016/j.advnut.2025.100583
Infant Formula Notice of Proposed Rulemaking Infant Formula Nutrient Requirements. October 29, 2026. https://www.fda.gov/food/infant-formula-homepage/infant-formula-notice-proposed-rulemaking-infant-formula-nutrient-requirements
Paquette AF, Carbone BE, Vogel S, et al. The human milk component myo-inositol promotes neuronal connectivity. Proc Natl Acad Sci U S A. Jul 25 2023;120(30):e2221413120. https://doi.org/10.1073/pnas.2221413120
Committee on the Evaluation of the Addition of Ingredients New to Infant Formula, Institute of Medicine, National Academy of Sciences. Infant Formula: Evaluating the Safety of New Ingredients National Academies Press; 2004. http://www.nap.edu/catalog/10935.html
Shahabi B, Hernández-Martínez C, Jardí C, Aparicio E, Arija V. Maternal Omega-6/Omega-3 Concentration Ratio During Pregnancy and Infant Neurodevelopment: The ECLIPSES Study. Nutrients. 2025;17(1):170. https://doi.org/10.3390/nu17010170
Burrin DG, Hair AB, Donovan SM. Charting a New Era to Modernize United States Infant Formula Regulation. *heavy industry involvement including Nestle! Advances in Nutrition. 2026;17(4) https://doi.org/10.1016/j.advnut.2026.100606
TheMedicalBiochemistryPage. Galactose Metabolism. TheMedicalBiochemistryPage LLC. Updated June 29, 2026. https://themedicalbiochemistrypage.org/galactose-metabolism/
Mokhtari P, Schmidt KA, Babaei M, Goran MI. Altered Nutrient Composition of Lactose-Reduced Infant Formula. Nutrients. 2024;16(2):276. https://doi.org/10.3390/nu16020276
Anderson CE, Whaley SE, Goran MI. Lactose-reduced infant formula with corn syrup solids and obesity risk among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Am J Clin Nutr. Oct 6 2022;116(4):1002–1009. https://doi.org/10.1093/ajcn/nqac173
Rossen LM, Simon AE, Herrick KA. Types of Infant Formulas Consumed in the United States. Clin Pediatr (Phila). Mar 2016;55(3):278–85. https://doi.org/10.1177/0009922815591881
Rips-Goodwin AR, Jun D, Griebel-Thompson A, Kong KL, Fazzino TL. US infant formulas contain primarily added sugars: An analysis of infant formulas on the US market. Journal of Food Composition and Analysis. 2025/05/01/ 2025;141:107369. https://doi.org/10.1016/j.jfca.2025.107369
