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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4195 Introduced in Senate (IS)]

<DOC>

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.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Childhood Diabetes 
Reduction Act of 2024''.
    (b) Table of Contents.--The table of contents for 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.

            TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES

SEC. 101. HEALTH WARNING LABELING OF FOODS; RESTRICTION ON CERTAIN 
              ADVERTISEMENTS DIRECTED AT CHILDREN.

    (a) Health Warning Labeling.--Section 403 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 343) is amended--
            (1) by adding at the end the following:
    ``(z)(1) If it is a sugar-sweetened beverage intended for human 
consumption and is offered for sale, unless its label includes the 
following statement: `Food and Drug Administration Warning: Drinking 
beverages with added sugar can contribute to obesity, type-2 diabetes, 
and tooth decay. Not recommended for children.', and such statement 
is--
            ``(A) enclosed by a rectangular border in bold type and 
        readily legible under ordinary conditions alongside an icon 
        comprised of an exclamation point contained within a triangle; 
        and
            ``(B) prominently displayed on the front, or the principal 
        display, of the container, using not less than 5 percent of the 
        area of the front, or the principal display, of the container, 
        and, as applicable, on 2 sides of any multi-pack packaging or 
        on the exterior of any vending machine or self-service machine 
        from which the beverage is available.
    ``(2) If it is a food, including a beverage, containing any non-
sugar sweetener intended for human consumption and is offered for sale, 
unless its label includes the following statement: `Food and Drug 
Administration Warning: Contains non-sugar sweeteners. Not recommended 
for children.', and such statement is--
            ``(A) enclosed by a rectangular border in bold type and 
        readily legible under ordinary conditions alongside an icon 
        comprised of an exclamation point contained within a triangle; 
        and
            ``(B) prominently displayed on the front, or the principal 
        display, of the container, using not less than 5 percent of the 
        area of the front, or the principal display, of the container, 
        and, as applicable, on 2 sides of any multi-pack packaging or 
        on the exterior of any vending machine or self-service machine 
        from which the food is available.
    ``(3) If it is an ultra-processed food, including a beverage, 
intended for human consumption and is offered for sale, unless its 
label includes the following statement: `Food and Drug Administration 
Warning: Consuming ultra-processed foods and drinks can cause weight 
gain, which increases the risk of obesity and type-2 diabetes.', and 
such statement is--
            ``(A) enclosed by a rectangular border in bold type and 
        readily legible under ordinary conditions alongside an icon 
        comprised of an exclamation point contained within a triangle; 
        and
            ``(B) prominently displayed on the front, or the principal 
        display, of the container, using not less than 5 percent of the 
        area of the front, or the principal display, of the container, 
        and, as applicable, on 2 sides of any multi-pack packaging or 
        on the exterior of any vending machine or self-service machine 
        from which the food is available.
    ``(4) If it is a food, including a beverage, intended for human 
consumption and is offered for sale, and such food contains a nutrient 
of concern, such as added sugar, saturated fat, or sodium, or any other 
nutrient of concern, as the Secretary determines appropriate, at a 
level that increases, for individuals in the general population, the 
risk of disease or a health-related condition, as defined by the 
Secretary, unless its label includes the following statement for each 
nutrient of concern: `High in', followed by the specific nutrient of 
concern, and such statement is--
            ``(A) enclosed by an octagon border in bold type and 
        readily legible under ordinary conditions; and
            ``(B) prominently displayed on the front, or the principal 
        display, of the container, using not less than 5 percent of the 
        area of the front, or the principal display, of the container, 
        and, as applicable, on 2 sides of any multi-pack packaging or 
        on the exterior of any vending machine or self-service machine 
        from which the food is available.
    ``(5) The Secretary shall promulgate regulations to apply the 
labeling requirements under subparagraphs (1), (2), (3), and (4) with 
respect to food offered for sale by online retailers.
    ``(6) For purposes of this paragraph--
            ``(A) the term `non-sugar sweetener'--
                    ``(i) means any synthetic, naturally-occurring, or 
                modified non-nutritive sweetener that is not classified 
                as sugar and is used as an ingredient in manufactured 
                food, or sold on its own to be added to food; and
                    ``(ii) includes acesulfame K, aspartame, advantame, 
                cyclamates, monk fruit, neotame, saccharin, sucralose, 
                stevia, and stevia derivatives;
            ``(B) the term `sugar-sweetened beverage'--
                    ``(i) means any beverage intended for human 
                consumption to which one or more caloric sweeteners has 
                been added and that contains 25 or more calories per 12 
                fluid ounces of beverage; and
                    ``(ii) includes drinks and beverages commonly 
                referred to as `soda', `pop', `cola', `soft drinks', 
                `sports drinks', `energy drinks', `slushies', 
                `sweetened ice tea', `fruit juice', or any other drinks 
                and beverage; and
                    ``(iii) does not include--
                            ``(I) infant formula or oral rehydration 
                        fluids for children;
                            ``(II) any beverage for medical use;
                            ``(III) any beverage designed as 
                        supplemental, meal replacement, or sole-source 
                        nutrition that includes proteins, 
                        carbohydrates, and multiple vitamins and 
                        minerals;
                            ``(IV) any milk product;
                            ``(V) 100 percent natural fruit or 
                        vegetable juice with no added caloric or non-
                        sugar sweetener; or
                            ``(VI) any alcoholic beverage; and
            ``(C) the term `ultra-processed food'--
                    ``(i) for the period before the effective date of 
                the regulations under subclause (ii), means a food, 
                including a beverage, containing one or more industrial 
                ingredients, including surface-active agents, 
                stabilizers and thickeners, propellants, aerating 
                agents and gases, color and coloring adjuncts, 
                emulsifiers and emulsifier salts, flavoring agents and 
                adjuvants, flavor enhancers, surface-finishing, non-
                sugar sweeteners, and other ingredients, as the 
                Secretary determines appropriate; and
                    ``(ii) has the meaning given such term in 
                regulations promulgated by the Secretary, not later 
                than 1 year after the National Academies of Science, 
                Engineering, and Medicine issues a report pursuant to 
                section 201(c) of the Childhood Diabetes Reduction Act 
                of 2024, taking into consideration the recommendations 
                included in such report, for the period beginning on 
                the effective date of such regulations.'' and
            (2) in paragraph (r)--
                    (A) in subparagraph (2)(A)(vi), by inserting ``, 
                including if the Secretary determines that the food is 
                high in added sugar, saturated fat, sodium, or any 
                other nutrient of concern (as determined by the 
                Secretary pursuant to paragraph (z)(4)), or if the food 
                contains non-sugar sweetener or is an ultra-processed 
                food (as defined in paragraph (z)(6)(C))'' before the 
                period at the end; and
                    (B) in subparagraph (3)(A)--
                            (i) in subclause (i), by striking ``, and'' 
                        and inserting a semicolon;
                            (ii) in subclause (ii), by striking the 
                        period and inserting ``; and''; and
                            (iii) by adding at the end the following:
            ``(iii) if the food is not required to include a nutrition 
        warning label under subparagraph (1), (2), (3), or (4) of 
        paragraph (z).''.
    (b) Advertising.--Section 301 of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 331) is amended by adding at the end the 
following:
    ``(jjj)(1) Marketing or advertising a food for which labeling is 
required under section 403(z), in a manner that reasonably appears to 
be directed at children.
    ``(2) In determining whether any marketing or advertising 
reasonably appears to be directed to children for purposes of 
subparagraph (1), the Secretary shall consider the totality of the 
circumstances, including whether such marketing or advertising uses 
themes or promotional strategies for food described in section 403(z) 
that appeal to children, such as the use of fun or fantasy themes, 
athletes and celebrities, cross-promotions using fictional characters, 
cartoon characters, social media influencers, animation, children's 
music, actors, or situations representing children's daily life, or 
free gifts or toys, contests, interactive games, or mobile or computer 
applications.''.
    (c) NASEM Review.--The Secretary of Health and Human Services 
(referred to in this subsection as the ``Secretary'') shall seek to 
enter into a contract with the National Academies of Science, 
Engineering, and Medicine (referred to in this subsection as the 
``National Academies'') under which the National Academies--
            (1) convenes a committee of experts in the field of 
        nutrition science to review the science of ultra-processed food 
        (as defined in paragraph (z)(6)(C) of section 403 of the 
        Federal Food, Drug, and Cosmetic Act (21 U.S.C. 343)), as added 
        by subsection (a);
            (2) develops recommendations for defining the term ``ultra-
        processed food'' for purposes of paragraph (z)(6)(C)(ii) of 
        section 403 of the Federal Food, Drug, and Cosmetic Act, as 
        added by subsection (a); and
            (3) not later than 1 year after the date of enactment of 
        this Act, submits to the Secretary a report that includes the 
        recommendations developed under paragraph (2).
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Health and Human Services $5,000,000 
for each of fiscal years 2025 through 2029 for purposes of promulgating 
regulations and carrying out enforcement activities with respect to the 
labeling requirements under the amendments made by subsections (a) and 
(b).

SEC. 102. NATIONAL INSTITUTES OF HEALTH RESEARCH ON NUTRITION SCIENCE.

    Part A of title IV of the Public Health Service Act (42 U.S.C. 281 
et seq.) is amended by adding at the end the following:

``SEC. 404P. RESEARCH AND COLLABORATION ON NUTRITION SCIENCE.

    ``(a) In General.--The Director of NIH shall expand, intensify, and 
coordinate programs for the conduct and support of research with 
respect to nutrition science, including research on--
            ``(1) the health effects of ultra-processed foods on 
        consumers;
            ``(2) the specific food and beverage ingredients, 
        additives, sweeteners, and chemicals within ultra-processed 
        foods that may be harmful to health;
            ``(3) the safety profile of food and beverage ingredients, 
        additives, sweeteners, and chemicals that have been self-
        affirmed by food and beverage manufacturers as generally 
        recognized as safe without review of such status by the Food 
        and Drug Administration; and
            ``(4) the formulation of ultra-processed foods to have 
        hyper-palatable qualities and association with addiction.
    ``(b) Meetings on Nutrition.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of the Childhood Diabetes Reduction Act of 2024, and 
        every 5 years thereafter, the Director of NIH, in coordination 
        with the Commissioner of Food and Drugs, shall convene a public 
        meeting for the purpose of discussing research efforts aimed at 
        improving nutrition and reducing the incidence of diet-related 
        chronic disease, with the goal of informing Federal policy.
            ``(2) Participants.--
                    ``(A) In general.--Each meeting under paragraph (1) 
                shall involve a diverse group of stakeholders, 
                including food scientists and researchers, registered 
                dietitians and nutritionists, clinicians specializing 
                in nutrition-related diseases, Federal stakeholders, 
                and nongovernmental organizations focused on nutrition 
                and health.
                    ``(B) Consideration.--In selecting stakeholders 
                described in subparagraph (A) for participation for 
                each meeting under paragraph (1), the Director of NIH, 
                in coordination with the Commissioner of Food and 
                Drugs, shall ensure that stakeholders who have no 
                financial affiliation with manufacturers of ultra-
                processed food make up the majority of participants.
            ``(3) Topics.--Each meeting under paragraph (1) shall 
        include discussion of--
                    ``(A) current research findings related to 
                nutrition and chronic disease, including the impact of 
                food labeling requirements under section 403(z) of the 
                Federal Food, Drug, and Cosmetic Act;
                    ``(B) any gaps in such research and priorities for 
                future research;
                    ``(C) evidenced-based practices for improving 
                nutrition and innovative approaches to prevent and 
                manage chronic conditions through dietary innovations; 
                and
                    ``(D) such other topics as the Director of NIH, in 
                coordination with the Commissioner of Food and Drugs, 
                determines appropriate.
            ``(4) Report to congress.--The Director NIH, in 
        coordination with the Commissioner of Food and Drugs, shall 
        submit a report on each meeting under paragraph (1) to the 
        Committee on Health, Education, Labor, and Pensions of the 
        Senate and the Committee on Energy and Commerce of the House of 
        Representatives, and shall make each such report publicly 
        available on the website of the National Institutes of Health.
    ``(c) Definition.--In this section, the term `ultra-processed food' 
has the meaning given such term in section 403(z)(6) of the Federal 
Food, Drug, and Cosmetic Act.
    ``(d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $60,000,000 
for each fiscal years 2025 through 2029.''.

SEC. 103. NUTRITION AND PHYSICAL ACTIVITY PUBLIC EDUCATION CAMPAIGN.

    Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) 
is amended by striking section 399Y and inserting the following:

``SEC. 399Y. NUTRITION AND PHYSICAL ACTIVITY PUBLIC EDUCATION CAMPAIGN.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, and in collaboration 
with national, State, Tribal, and local partners, physical activity 
organizations, nutrition experts, physical activity experts, health 
professional organizations, and other organizations, as appropriate, 
shall develop a national public campaign to educate children and their 
caregivers concerning--
            ``(1) how to read and understand the nutrient warning 
        labels required under subparagraphs (1) through (4) of section 
        403(z) of the Federal Food, Drug, and Cosmetic Act;
            ``(2) the health risks associated with obesity, inactivity, 
        and poor nutrition, including consumption of foods described in 
        subparagraphs (1) through (4) of section 403(z) of the Federal 
        Food, Drug, and Cosmetic Act;
            ``(3) ways to incorporate physical activity into daily 
        living;
            ``(4) ways to support a healthy lifestyle and reduce the 
        risk of chronic illness, including obesity;
            ``(5) the benefits of good nutrition; and
            ``(6) strategies to improve eating and drinking habits, 
        such as identifying and selecting healthier food choices and 
        reducing consumption of added sugars, saturated fat, and 
        sodium.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for each of the 
fiscal years 2025 through 2029.''.

                   TITLE II--FEDERAL TRADE COMMISSION

SEC. 201. DEFINITIONS.

    In this title:
            (1) Child.--The term ``child'' means an individual who is 
        under the age of 13.
            (2) Child-directed advertising.--The term ``child-directed 
        advertising'' means any advertisement--
                    (A) that uses themes or promotional strategies that 
                appeal to children, which may include the use of--
                            (i) fun or fantasy themes, cartoon 
                        characters, social media influencers, 
                        animation, endorsements by celebrities and 
                        athletes, cross-promotions using fictional 
                        characters, children's music, actors, or 
                        situations representing children's daily life; 
                        or
                            (ii) free gifts or toys, contests, 
                        interactive games, or mobile or computer 
                        applications; or
                    (B) in media for which children comprise at least 
                30 percent of the audience, as determined by the 
                Commission, that is displayed using--
                            (i) traditional measured media, such as 
                        television, radio, and printed media; or
                            (ii) electronic media, content created by 
                        influencers, online videos, company-sponsored 
                        websites, social media, movies, and video 
                        games.
            (3) Commission.--The term ``Commission'' means the Federal 
        Trade Commission.
            (4) Junk food.--The term ``junk food'' means products with 
        labeling requirements described in subparagraph (1), (2), (3), 
        or (4) of paragraph (z) of section 403 of the Federal Food, 
        Drug, and Cosmetic Act (21 U.S.C. 343), as added by section 
        101(a) of this Act.

SEC. 202. RESTRICTIONS ON ADVERTISEMENTS FOR JUNK FOOD DIRECTED AT 
              CHILDREN; REQUIRED DISCLOSURE OF ANY HEALTH AND NUTRIENT 
              WARNING LABEL IN ADVERTISEMENTS.

    (a) Marketing or Advertising Junk Food to Children.--
            (1) In general.--It shall be unlawful for any person to 
        market or advertise, or produce or distribute any advertisement 
        or marketing material for, junk food by using child-directed 
        advertising.
            (2) Considerations.--In determining whether any marketing 
        or advertising uses child-directed advertising for purposes of 
        subparagraph (A), the Commission shall consider the totality of 
        the circumstances.
    (b) Required Disclosure.--It shall be unlawful for any person to 
market or advertise, or produce or distribute any advertisement or 
marketing material for, junk food without including in such 
advertisement or marketing material the relevant mandatory health or 
nutrient warning label or notice described in section 403(z) of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 343(z)).
    (c) Effective Date.--The prohibitions established in this section 
shall take effect on the date that is 1 year after the date of 
enactment of this Act.
    (d) Enforcement by the Commission.--
            (1) Unfair or deceptive act or practice.--A violation of 
        this section or a regulation promulgated under this section 
        shall be treated as a violation of a rule defining an unfair or 
        deceptive act or practice under section 18(a)(1)(B) of the 
        Federal Trade Commission Act (15 U.S.C. 57a(a)(1)(B)).
            (2) Powers of the commission.--
                    (A) In general.--Except as provided in subparagraph 
                (C), the Commission shall enforce this section in the 
                same manner, by the same means, and with the same 
                jurisdiction, powers, and duties as though all 
                applicable terms and provisions of the Federal Trade 
                Commission Act (15 U.S.C. 41 et seq.) were incorporated 
                into and made a part of this section.
                    (B) Privileges and immunities.--Except as provided 
                in subparagraph (C), any person who violates this 
                section or a regulation promulgated under this section 
                shall be subject to the penalties and entitled to the 
                privileges and immunities provided in the Federal Trade 
                Commission Act (15 U.S.C. 41 et seq.).
                    (C) Common carriers.--Notwithstanding section 4, 
                5(a)(2), or 6 of the Federal Trade Commission Act (15 
                U.S.C. 44, 45(a)(2), 46) or any jurisdictional 
                limitation of the Commission, the Commission shall also 
                enforce this Act, in the same manner provided in 
                subparagraphs (A) and (B), with respect to common 
                carriers subject to the Communications Act of 1934 (47 
                U.S.C. 151 et seq.) and Acts amendatory thereof and 
                supplementary thereto.
                    (D) Authority preserved.--Nothing in this section 
                shall be construed to limit the authority of the 
                Commission under any other provision of law.
                    (E) Rulemaking.--The Commission shall promulgate in 
                accordance with section 553 of title 5, United States 
                Code, such rules as may be necessary to carry out this 
                section.

SEC. 203. RESTORING THE FEDERAL TRADE COMMISSION'S ABILITY TO 
              PROMULGATE RULES ON CHILDREN'S ADVERTISING.

    (a) In General.--Section 18(h) of the Federal Trade Commission Act 
(15 U.S.C. 57a(h)) is repealed.
    (b) Conforming Amendment.--Section 18(a)(1) of such Act is amended 
in the matter preceding subparagraph (A), by striking ``Except as 
provided in subsection (h), the Commission'' and inserting ``The 
Commission''.
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