“Expert Panels with the FDA” are a series of roundtable discussions to provide an open public discourse on the latest medical and scientific information on several important topics. At this roundtable, experts will be asked to discuss health concerns related to the use of talc products. Dr. Marty Makary is the Commissioner of the Food and Drug Administration (FDA). Relevant to this discussion is this academic paper published by RealClearJournals’ Journal of the Academy of Public Health. Read more: Reviewing the Safety of our Foods and Drugs: An Urgent Need for a Comprehensive Reevaluation by FDA of Talc in The American Food and Drug Supply. Dr. George F. Tidmarsh, co-author of the study, spoke at the FDA roundtable.

DR. MARTY MAKARY, FDA COMMISSIONER: Can anyone comment on the types of food and candy that talc, where talc is commonly found in the United States? DR. GEORGE F. TIDMARSH: Well, we looked into this as best we can and published with my colleague Arman Sharma, who’s here today. And it’s difficult to actually find exact composition within foods. It is easy to find it within pharmaceuticals. So as I began my investigation of this area, I literally went to the pharmacy and picked up Centrum vitamins, and you can read down the list, and there’s talc. You can pick up Nexium, over-the-counter Nexium. You can read the ingredient list, and you can see talc. In the prescription labels, and you mentioned this, Dr. Makary, of several of the top ten prescribed drugs, you can look at the package insert, and talc is there. Now those tend to be the branded pharmaceuticals that were first on the market. The generic equivalents generally use magnesium stearate, so it’s clear that the industry moved away from talc. However, the legacy prescriptions did not, because it’s not always easy to just change the excipients. And that’s an important point we should bring up. The last thing I will say is that if you look at an index called a codex, and it’s an international volume that describes which foods certain additives can be added, and the codex lists literally hundreds of foods in which talc can be added. This includes cheeses, so sometimes the powder coating on cheese is talc. It includes flour, so in several countries, in not the developing world, talc is added for flowability and bleaching, and as an additive. So I refer you to the codex listing that at least says which foods can contain talc. MAKARY: And I saw in this recent article reviewing the safety of food and drugs, an urgent need for a comprehensive re-evaluation by FDA of talc in the American food supply and drug supply, of which you’re a co-author of this paper. There is a citation of a study that analyzed flour using near-infrared spectroscopy and found that there was in fact talcum powder in wheat flour. Now wheat flour is one of the most common things in the food supply, and we’ve all heard about processed wheat flour and ultra-processed wheat flour. So it seems like there’s a suggestion there that there could be talc in one of the most common foods that is consumed. TIDMARSH: It certainly is possible, and I literally went around to the grocery store and picked up every brand of flour I could to see if it has listed talc. I couldn’t find any that did, but as you reference, in certain countries, talc is added. It’s very possible it’s added into flour in this country, but we don’t know about it because they’re not required to add it as an ingredient because it’s not a so-called active. So to me the scary thing is how pervasive this could be in terms of our everyday exposure.

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