II 

118TH CONGRESS 

2D SESSION S. 4195 

To require warning labels on sugar-sweetened foods and beverages, foods 

and beverages containing non-sugar sweeteners, ultra-processed foods, 

and foods high in nutrients of concern, such as added sugar, saturated 

fat, or sodium, to restrict junk food advertising to children, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 18, 2024 

Mr. SANDERS (for himself, Mr. BOOKER, and Mr. WELCH) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To require warning labels on sugar-sweetened foods and beverages, foods and beverages containing non-sugar sweeteners, ultra-processed foods, and foods high in nutrients 

of concern, such as added sugar, saturated fat, or sodium, to restrict junk food advertising to children, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Childhood Diabetes Reduction Act of 2024’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Sec. 101. Health warning labeling of foods; restriction on certain advertisements directed at children. 

Sec. 102. National Institutes of Health research on nutrition science. 

Sec. 103. Nutrition and physical activity public education campaign. 

TITLE II—FEDERAL TRADE COMMISSION 

Sec. 201. Definitions. 

Sec. 202. Restrictions on advertisements for junk food directed at children; required disclosure of any health and nutrient warning label in 

advertisements. 

Sec. 203. Restoring the Federal Trade Commission’s ability to promulgate rules 

on children’s advertising. 

3 TITLE I—DEPARTMENT OF 

4 HEALTH AND HUMAN SERVICES 

5 SEC. 101. HEALTH WARNING LABELING OF FOODS; RE6 STRICTION ON CERTAIN ADVERTISEMENTS 

7 DIRECTED AT CHILDREN. 

8 (a) HEALTH WARNING LABELING.—Section 403 of 

9 the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 

10 343) is amended— 

11 (1) by adding at the end the following: 

12 ‘‘(z)(1) If it is a sugar-sweetened beverage intended 

13 for human consumption and is offered for sale, unless its 

14 label includes the following statement: ‘Food and Drug 

15 Administration Warning: Drinking beverages with added 

16 sugar can contribute to obesity, type-2 diabetes, and tooth 

17 decay. Not recommended for children.’, and such state18 ment is— 


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1 ‘‘(A) enclosed by a rectangular border in bold 

2 type and readily legible under ordinary conditions 

3 alongside an icon comprised of an exclamation point 

4 contained within a triangle; and 

5 ‘‘(B) prominently displayed on the front, or the 

6 principal display, of the container, using not less 

7 than 5 percent of the area of the front, or the prin8 cipal display, of the container, and, as applicable, on 

9 2 sides of any multi-pack packaging or on the exte10 rior of any vending machine or self-service machine 

11 from which the beverage is available. 

12 ‘‘(2) If it is a food, including a beverage, containing 

13 any non-sugar sweetener intended for human consumption 

14 and is offered for sale, unless its label includes the fol15 lowing statement: ‘Food and Drug Administration Warn16 ing: Contains non-sugar sweeteners. Not recommended for 

17 children.’, and such statement is— 

18 ‘‘(A) enclosed by a rectangular border in bold 

19 type and readily legible under ordinary conditions 

20 alongside an icon comprised of an exclamation point 

21 contained within a triangle; and 

22 ‘‘(B) prominently displayed on the front, or the 

23 principal display, of the container, using not less 

24 than 5 percent of the area of the front, or the prin25 cipal display, of the container, and, as applicable, on 


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1 2 sides of any multi-pack packaging or on the exte2 rior of any vending machine or self-service machine 

3 from which the food is available. 

4 ‘‘(3) If it is an ultra-processed food, including a bev5 erage, intended for human consumption and is offered for 

6 sale, unless its label includes the following statement: 

7 ‘Food and Drug Administration Warning: Consuming 

8 ultra-processed foods and drinks can cause weight gain, 

9 which increases the risk of obesity and type-2 diabetes.’, 

10 and such statement is— 

11 ‘‘(A) enclosed by a rectangular border in bold 

12 type and readily legible under ordinary conditions 

13 alongside an icon comprised of an exclamation point 

14 contained within a triangle; and 

15 ‘‘(B) prominently displayed on the front, or the 

16 principal display, of the container, using not less 

17 than 5 percent of the area of the front, or the prin18 cipal display, of the container, and, as applicable, on 

19 2 sides of any multi-pack packaging or on the exte20 rior of any vending machine or self-service machine 

21 from which the food is available. 

22 ‘‘(4) If it is a food, including a beverage, intended 

23 for human consumption and is offered for sale, and such 

24 food contains a nutrient of concern, such as added sugar, 

25 saturated fat, or sodium, or any other nutrient of concern, 


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1 as the Secretary determines appropriate, at a level that 

2 increases, for individuals in the general population, the 

3 risk of disease or a health-related condition, as defined 

4 by the Secretary, unless its label includes the following 

5 statement for each nutrient of concern: ‘High in’, followed 

6 by the specific nutrient of concern, and such statement 

7 is— 

8 ‘‘(A) enclosed by an octagon border in bold type 

9 and readily legible under ordinary conditions; and 

10 ‘‘(B) prominently displayed on the front, or the 

11 principal display, of the container, using not less 

12 than 5 percent of the area of the front, or the prin13 cipal display, of the container, and, as applicable, on 

14 2 sides of any multi-pack packaging or on the exte15 rior of any vending machine or self-service machine 

16 from which the food is available. 

17 ‘‘(5) The Secretary shall promulgate regulations to 

18 apply the labeling requirements under subparagraphs (1), 

19 (2), (3), and (4) with respect to food offered for sale by 

20 online retailers. 

21 ‘‘(6) For purposes of this paragraph— 

22 ‘‘(A) the term ‘non-sugar sweetener’— 

23 ‘‘(i) means any synthetic, naturally-occur24 ring, or modified non-nutritive sweetener that is 

25 not classified as sugar and is used as an ingreVerDate Sep 11 2014 04:36 May 11, 2024 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4195.IS S4195

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1 dient in manufactured food, or sold on its own 

2 to be added to food; and 

3 ‘‘(ii) includes acesulfame K, aspartame, 

4 advantame, cyclamates, monk fruit, neotame, 

5 saccharin, sucralose, stevia, and stevia deriva6 tives; 

7 ‘‘(B) the term ‘sugar-sweetened beverage’— 

8 ‘‘(i) means any beverage intended for 

9 human consumption to which one or more ca10 loric sweeteners has been added and that con11 tains 25 or more calories per 12 fluid ounces of 

12 beverage; and 

13 ‘‘(ii) includes drinks and beverages com14 monly referred to as ‘soda’, ‘pop’, ‘cola’, ‘soft 

15 drinks’, ‘sports drinks’, ‘energy drinks’, 

16 ‘slushies’, ‘sweetened ice tea’, ‘fruit juice’, or 

17 any other drinks and beverage; and 

18 ‘‘(iii) does not include— 

19 ‘‘(I) infant formula or oral rehydra20 tion fluids for children; 

21 ‘‘(II) any beverage for medical use; 

22 ‘‘(III) any beverage designed as sup23 plemental, meal replacement, or sole-source 

24 nutrition that includes proteins, carboVerDate Sep 11 2014 04:36 May 11, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4195.IS S4195

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1 hydrates, and multiple vitamins and min2 erals; 

3 ‘‘(IV) any milk product; 

4 ‘‘(V) 100 percent natural fruit or veg5 etable juice with no added caloric or non6 sugar sweetener; or 

7 ‘‘(VI) any alcoholic beverage; and 

8 ‘‘(C) the term ‘ultra-processed food’— 

9 ‘‘(i) for the period before the effective date 

10 of the regulations under subclause (ii), means a 

11 food, including a beverage, containing one or 

12 more industrial ingredients, including surface13 active agents, stabilizers and thickeners, propel14 lants, aerating agents and gases, color and 

15 coloring adjuncts, emulsifiers and emulsifier 

16 salts, flavoring agents and adjuvants, flavor 

17 enhancers, surface-finishing, non-sugar sweet18 eners, and other ingredients, as the Secretary 

19 determines appropriate; and 

20 ‘‘(ii) has the meaning given such term in 

21 regulations promulgated by the Secretary, not 

22 later than 1 year after the National Academies 

23 of Science, Engineering, and Medicine issues a 

24 report pursuant to section 201(c) of the Child25 hood Diabetes Reduction Act of 2024, taking 


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1 into consideration the recommendations in2 cluded in such report, for the period beginning 

3 on the effective date of such regulations.’’ and 

4 (2) in paragraph (r)— 

5 (A) in subparagraph (2)(A)(vi), by insert6 ing ‘‘, including if the Secretary determines 

7 that the food is high in added sugar, saturated 

8 fat, sodium, or any other nutrient of concern 

9 (as determined by the Secretary pursuant to 

10 paragraph (z)(4)), or if the food contains non11 sugar sweetener or is an ultra-processed food 

12 (as defined in paragraph (z)(6)(C))’’ before the 

13 period at the end; and 

14 (B) in subparagraph (3)(A)— 

15 (i) in subclause (i), by striking ‘‘, 

16 and’’ and inserting a semicolon; 

17 (ii) in subclause (ii), by striking the 

18 period and inserting ‘‘; and’’; and 

19 (iii) by adding at the end the fol20 lowing: 

21 ‘‘(iii) if the food is not required to include a nu22 trition warning label under subparagraph (1), (2), 

23 (3), or (4) of paragraph (z).’’. 


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1 (b) ADVERTISING.—Section 301 of the Federal Food, 

2 Drug, and Cosmetic Act (21 U.S.C. 331) is amended by 

3 adding at the end the following: 

4 ‘‘(jjj)(1) Marketing or advertising a food for which 

5 labeling is required under section 403(z), in a manner that 

6 reasonably appears to be directed at children. 

7 ‘‘(2) In determining whether any marketing or adver8 tising reasonably appears to be directed to children for 

9 purposes of subparagraph (1), the Secretary shall consider 

10 the totality of the circumstances, including whether such 

11 marketing or advertising uses themes or promotional 

12 strategies for food described in section 403(z) that appeal 

13 to children, such as the use of fun or fantasy themes, ath14 letes and celebrities, cross-promotions using fictional char15 acters, cartoon characters, social media influencers, ani16 mation, children’s music, actors, or situations representing 

17 children’s daily life, or free gifts or toys, contests, inter18 active games, or mobile or computer applications.’’. 

19 (c) NASEM REVIEW.—The Secretary of Health and 

20 Human Services (referred to in this subsection as the 

21 ‘‘Secretary’’) shall seek to enter into a contract with the 

22 National Academies of Science, Engineering, and Medicine 

23 (referred to in this subsection as the ‘‘National Acad24 emies’’) under which the National Academies— 


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1 (1) convenes a committee of experts in the field 

2 of nutrition science to review the science of ultra3 processed food (as defined in paragraph (z)(6)(C) of 

4 section 403 of the Federal Food, Drug, and Cos5 metic Act (21 U.S.C. 343)), as added by subsection 

6 (a); 

7 (2) develops recommendations for defining the 

8 term ‘‘ultra-processed food’’ for purposes of para9 graph (z)(6)(C)(ii) of section 403 of the Federal 

10 Food, Drug, and Cosmetic Act, as added by sub11 section (a); and 

12 (3) not later than 1 year after the date of en13 actment of this Act, submits to the Secretary a re14 port that includes the recommendations developed 

15 under paragraph (2). 

16 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

17 authorized to be appropriated to the Secretary of Health 

18 and Human Services $5,000,000 for each of fiscal years 

19 2025 through 2029 for purposes of promulgating regula20 tions and carrying out enforcement activities with respect 

21 to the labeling requirements under the amendments made 

22 by subsections (a) and (b). 


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1 SEC. 102. NATIONAL INSTITUTES OF HEALTH RESEARCH 

2 ON NUTRITION SCIENCE. 

3 Part A of title IV of the Public Health Service Act 

4 (42 U.S.C. 281 et seq.) is amended by adding at the end 

5 the following: 

6 ‘‘SEC. 404P. RESEARCH AND COLLABORATION ON NUTRI7 TION SCIENCE. 

8 ‘‘(a) IN GENERAL.—The Director of NIH shall ex9 pand, intensify, and coordinate programs for the conduct 

10 and support of research with respect to nutrition science, 

11 including research on— 

12 ‘‘(1) the health effects of ultra-processed foods 

13 on consumers; 

14 ‘‘(2) the specific food and beverage ingredients, 

15 additives, sweeteners, and chemicals within ultra16 processed foods that may be harmful to health; 

17 ‘‘(3) the safety profile of food and beverage in18 gredients, additives, sweeteners, and chemicals that 

19 have been self-affirmed by food and beverage manu20 facturers as generally recognized as safe without re21 view of such status by the Food and Drug Adminis22 tration; and 

23 ‘‘(4) the formulation of ultra-processed foods to 

24 have hyper-palatable qualities and association with 

25 addiction. 

26 ‘‘(b) MEETINGS ON NUTRITION.— 


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1 ‘‘(1) IN GENERAL.—Not later than 1 year after 

2 the date of enactment of the Childhood Diabetes Re3 duction Act of 2024, and every 5 years thereafter, 

4 the Director of NIH, in coordination with the Com5 missioner of Food and Drugs, shall convene a public 

6 meeting for the purpose of discussing research ef7 forts aimed at improving nutrition and reducing the 

8 incidence of diet-related chronic disease, with the 

9 goal of informing Federal policy. 

10 ‘‘(2) PARTICIPANTS.— 

11 ‘‘(A) IN GENERAL.—Each meeting under 

12 paragraph (1) shall involve a diverse group of 

13 stakeholders, including food scientists and re14 searchers, registered dietitians and nutrition15 ists, clinicians specializing in nutrition-related 

16 diseases, Federal stakeholders, and nongovern17 mental organizations focused on nutrition and 

18 health. 

19 ‘‘(B) CONSIDERATION.—In selecting stake20 holders described in subparagraph (A) for par21 ticipation for each meeting under paragraph 

22 (1), the Director of NIH, in coordination with 

23 the Commissioner of Food and Drugs, shall en24 sure that stakeholders who have no financial afVerDate Sep 11 2014 04:36 May 11, 2024 Jkt 049200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S4195.IS S4195

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1 filiation with manufacturers of ultra-processed 

2 food make up the majority of participants. 

3 ‘‘(3) TOPICS.—Each meeting under paragraph 

4 (1) shall include discussion of— 

5 ‘‘(A) current research findings related to 

6 nutrition and chronic disease, including the im7 pact of food labeling requirements under section 

8 403(z) of the Federal Food, Drug, and Cos9 metic Act; 

10 ‘‘(B) any gaps in such research and prior11 ities for future research; 

12 ‘‘(C) evidenced-based practices for improv13 ing nutrition and innovative approaches to pre14 vent and manage chronic conditions through di15 etary innovations; and 

16 ‘‘(D) such other topics as the Director of 

17 NIH, in coordination with the Commissioner of 

18 Food and Drugs, determines appropriate. 

19 ‘‘(4) REPORT TO CONGRESS.—The Director 

20 NIH, in coordination with the Commissioner of 

21 Food and Drugs, shall submit a report on each 

22 meeting under paragraph (1) to the Committee on 

23 Health, Education, Labor, and Pensions of the Sen24 ate and the Committee on Energy and Commerce of 

25 the House of Representatives, and shall make each 


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1 such report publicly available on the website of the 

2 National Institutes of Health. 

3 ‘‘(c) DEFINITION.—In this section, the term ‘ultra4 processed food’ has the meaning given such term in sec5 tion 403(z)(6) of the Federal Food, Drug, and Cosmetic 

6 Act. 

7 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 

8 purpose of carrying out this section, there are authorized 

9 to be appropriated $60,000,000 for each fiscal years 2025 

10 through 2029.’’. 

11 SEC. 103. NUTRITION AND PHYSICAL ACTIVITY PUBLIC 

12 EDUCATION CAMPAIGN. 

13 Title III of the Public Health Service Act (42 U.S.C. 

14 241 et seq.) is amended by striking section 399Y and in15 serting the following: 

16 ‘‘SEC. 399Y. NUTRITION AND PHYSICAL ACTIVITY PUBLIC 

17 EDUCATION CAMPAIGN. 

18 ‘‘(a) IN GENERAL.—The Secretary, acting through 

19 the Director of the Centers for Disease Control and Pre20 vention, and in collaboration with national, State, Tribal, 

21 and local partners, physical activity organizations, nutri22 tion experts, physical activity experts, health professional 

23 organizations, and other organizations, as appropriate, 

24 shall develop a national public campaign to educate chil25 dren and their caregivers concerning— 


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1 ‘‘(1) how to read and understand the nutrient 

2 warning labels required under subparagraphs (1) 

3 through (4) of section 403(z) of the Federal Food, 

4 Drug, and Cosmetic Act; 

5 ‘‘(2) the health risks associated with obesity, in6 activity, and poor nutrition, including consumption 

7 of foods described in subparagraphs (1) through (4) 

8 of section 403(z) of the Federal Food, Drug, and 

9 Cosmetic Act; 

10 ‘‘(3) ways to incorporate physical activity into 

11 daily living; 

12 ‘‘(4) ways to support a healthy lifestyle and re13 duce the risk of chronic illness, including obesity; 

14 ‘‘(5) the benefits of good nutrition; and 

15 ‘‘(6) strategies to improve eating and drinking 

16 habits, such as identifying and selecting healthier 

17 food choices and reducing consumption of added 

18 sugars, saturated fat, and sodium. 

19 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

20 are authorized to be appropriated to carry out this section 

21 $10,000,000 for each of the fiscal years 2025 through 

22 2029.’’. 


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1 TITLE II—FEDERAL TRADE 

2 COMMISSION 

3 SEC. 201. DEFINITIONS. 

4 In this title: 

5 (1) CHILD.—The term ‘‘child’’ means an indi6 vidual who is under the age of 13. 

7 (2) CHILD-DIRECTED ADVERTISING.—The term 

8 ‘‘child-directed advertising’’ means any advertise9 ment— 

10 (A) that uses themes or promotional strat11 egies that appeal to children, which may include 

12 the use of— 

13 (i) fun or fantasy themes, cartoon 

14 characters, social media influencers, ani15 mation, endorsements by celebrities and 

16 athletes, cross-promotions using fictional 

17 characters, children’s music, actors, or sit18 uations representing children’s daily life; or 

19 (ii) free gifts or toys, contests, inter20 active games, or mobile or computer appli21 cations; or 

22 (B) in media for which children comprise 

23 at least 30 percent of the audience, as deter24 mined by the Commission, that is displayed 

25 using— 


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1 (i) traditional measured media, such 

2 as television, radio, and printed media; or 

3 (ii) electronic media, content created 

4 by influencers, online videos, company5 sponsored websites, social media, movies, 

6 and video games. 

7 (3) COMMISSION.—The term ‘‘Commission’’ 

8 means the Federal Trade Commission. 

9 (4) JUNK FOOD.—The term ‘‘junk food’’ means 

10 products with labeling requirements described in 

11 subparagraph (1), (2), (3), or (4) of paragraph (z) 

12 of section 403 of the Federal Food, Drug, and Cos13 metic Act (21 U.S.C. 343), as added by section 

14 101(a) of this Act. 

15 SEC. 202. RESTRICTIONS ON ADVERTISEMENTS FOR JUNK 

16 FOOD DIRECTED AT CHILDREN; REQUIRED 

17 DISCLOSURE OF ANY HEALTH AND NUTRIENT 

18 WARNING LABEL IN ADVERTISEMENTS. 

19 (a) MARKETING OR ADVERTISING JUNK FOOD TO

20 CHILDREN.— 

21 (1) IN GENERAL.—It shall be unlawful for any 

22 person to market or advertise, or produce or dis23 tribute any advertisement or marketing material for, 

24 junk food by using child-directed advertising. 


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1 (2) CONSIDERATIONS.—In determining whether 

2 any marketing or advertising uses child-directed ad3 vertising for purposes of subparagraph (A), the 

4 Commission shall consider the totality of the cir5 cumstances. 

6 (b) REQUIRED DISCLOSURE.—It shall be unlawful 

7 for any person to market or advertise, or produce or dis8 tribute any advertisement or marketing material for, junk 

9 food without including in such advertisement or marketing 

10 material the relevant mandatory health or nutrient warn11 ing label or notice described in section 403(z) of the Fed12 eral Food, Drug, and Cosmetic Act (21 U.S.C. 343(z)). 

13 (c) EFFECTIVE DATE.—The prohibitions established 

14 in this section shall take effect on the date that is 1 year 

15 after the date of enactment of this Act. 

16 (d) ENFORCEMENT BY THE COMMISSION.— 

17 (1) UNFAIR OR DECEPTIVE ACT OR PRAC18 TICE.—A violation of this section or a regulation 

19 promulgated under this section shall be treated as a 

20 violation of a rule defining an unfair or deceptive act 

21 or practice under section 18(a)(1)(B) of the Federal 

22 Trade Commission Act (15 U.S.C. 57a(a)(1)(B)). 

23 (2) POWERS OF THE COMMISSION.— 

24 (A) IN GENERAL.—Except as provided in 

25 subparagraph (C), the Commission shall enforce 


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1 this section in the same manner, by the same 

2 means, and with the same jurisdiction, powers, 

3 and duties as though all applicable terms and 

4 provisions of the Federal Trade Commission 

5 Act (15 U.S.C. 41 et seq.) were incorporated 

6 into and made a part of this section. 

7 (B) PRIVILEGES AND IMMUNITIES.—Ex8 cept as provided in subparagraph (C), any per9 son who violates this section or a regulation 

10 promulgated under this section shall be subject 

11 to the penalties and entitled to the privileges 

12 and immunities provided in the Federal Trade 

13 Commission Act (15 U.S.C. 41 et seq.). 

14 (C) COMMON CARRIERS.—Notwithstanding 

15 section 4, 5(a)(2), or 6 of the Federal Trade 

16 Commission Act (15 U.S.C. 44, 45(a)(2), 46) 

17 or any jurisdictional limitation of the Commis18 sion, the Commission shall also enforce this 

19 Act, in the same manner provided in subpara20 graphs (A) and (B), with respect to common 

21 carriers subject to the Communications Act of 

22 1934 (47 U.S.C. 151 et seq.) and Acts amend23 atory thereof and supplementary thereto. 

24 (D) AUTHORITY PRESERVED.—Nothing in 

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1 thority of the Commission under any other pro2 vision of law. 

3 (E) RULEMAKING.—The Commission shall 

4 promulgate in accordance with section 553 of 

5 title 5, United States Code, such rules as may 

6 be necessary to carry out this section. 

7 SEC. 203. RESTORING THE FEDERAL TRADE COMMISSION’S 

8 ABILITY TO PROMULGATE RULES ON CHIL9 DREN’S ADVERTISING. 

10 (a) IN GENERAL.—Section 18(h) of the Federal 

11 Trade Commission Act (15 U.S.C. 57a(h)) is repealed. 

12 (b) CONFORMING AMENDMENT.—Section 18(a)(1) of 

13 such Act is amended in the matter preceding subpara14 graph (A), by striking ‘‘Except as provided in subsection 

15 (h), the Commission’’ and inserting ‘‘The Commission’’. 

Æ 


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