Health
Miami-Dade Mayor Vetoes Plan to Remove Fluoride From Drinking Water
The mayor of Miami-Dade County on Friday said she vetoed legislation that would remove fluoride from the drinking water in Florida’s most populous county, pushing back on a growing campaign against the mineral used to prevent cavities.
The veto by Mayor Daniella Levine Cava, a Democrat, comes at a moment when critics of adding fluoride to the water supply have a newly powerful ally: Robert F. Kennedy Jr., President Trump’s health secretary, who this week called for states to ban fluoride in drinking water. Utah recently became the first state to outlaw adding fluoride to public water, and several other states, including Florida, are considering similar action.
“The science is very clear,” Ms. Levine Cava said at a news conference on Friday. She added, “ending fluoridation could have real and lasting harm, especially for children and families who cannot afford regular dental care.”
The Miami-Dade Board of County Commissioners, a nonpartisan body, approved the measure to ban fluoride on April 1 in an 8 to 2 vote, with three commissioners absent. Nine votes are needed to override the mayor’s veto if all 13 commissioners are present, and it is unclear whether there will be enough support. The next scheduled board meeting is on May 6.
Six commissioners are Republican, including Kevin Marino Cabrera, an ally of Mr. Trump’s who will soon depart to become the country’s ambassador to Panama. Ms. Levine Cava is now the state’s highest-ranking elected Democrat, with Republicans having swept every other countywide elected office in Miami-Dade — including sheriff and elections supervisor — last year.
At the news conference on Friday, Ms. Levine Cava, flanked by dentists and doctors in their white medical coats, cited research supporting her decision.
“I’m doing what I believe is the correct thing to do in the interest of the community’s health, and I stand with our dental and medical experts,” she said.
Commissioner Roberto J. Gonzalez, who sponsored the legislation, accused Ms. Levine Cava of “acting like a typical politician, relying on partisan pollsters and tired talking points, while putting people’s health at risk.”
In a statement on Friday, he called on his colleagues on the commission to override the veto.
The measure would require Miami-Dade to stop adding fluoride to the water supply within 30 days. Ms. Levine Cava said she and her office were closely following efforts in the Florida Legislature to pass a similar ban at the state level.
Many experts have warned that removing fluoride from drinking water would be detrimental to oral health, and particularly cavity prevention. The Centers for Disease Control and Prevention has called fluoridation one of the “10 greatest public health achievements of the 20th century.”
But wariness about fluoride has taken on new life in recent years, especially after the coronavirus pandemic eroded trust in public health interventions. Opponents say they want to protect bodily autonomy and have raised concerns about the possible cognitive effects in children.
They point to a recent review paper, where an analysis of 74 studies conducted by researchers with the National Institutes of Health found that there was a connection between lower I.Q. scores in children with high levels of childhood or prenatal fluoride exposure. (The levels studied were twice as high as those recommended by the C.D.C., and some research has found no link.)
Ms. Levine Cava’s veto puts her at odds with Mr. Kennedy and other fluoride skeptics in the Trump administration, as well as with Gov. Ron DeSantis, a Republican, and his appointed surgeon general, Dr. Joseph A. Ladapo, who has been traveling around the state to speak against fluoridated water.
“Do we want forced medication or do we want people to be able to choose medication?” Mr. DeSantis said recently. “When you are forcing it into the water supply, that’s not really giving people a choice.”
Ahead of the mayor’s announcement, Dr. Ladapo, who has also called for a halt to using Covid vaccines, publicly urged Miami-Dade residents to ask the mayor to support the fluoride ban. “I’ll never understand how anyone feels entitled to add drugs to the water that other people drink,” he said.
Fluoride was first introduced to a city’s water supply in 1945 and began to become common practice across the country in the following decades. Studies show a direct correlation between fluoridation and an improvement in oral health.
“The growing distrust of credible, time-tested, evidence-based science is disheartening,” Dr. Brett Kessler, the president of the American Dental Association, said in a statement this week. “When government officials, like Secretary Kennedy, stand behind the commentary of misinformation and distrust peer-reviewed research, it is injurious to public health.”
Fluoridating water has been debated for years, in part because experts say that excessive exposure to fluoride over a long period can cause health problems. Federally mandated levels have lowered over the years, including after a recent court order.
On Monday, Lee Zeldin, the head of the Environmental Protection Agency, announced a decision to “expeditiously review new scientific information on potential health risks of fluoride in drinking water.”
“Without prejudging any outcomes, when this evaluation is completed, we will have an updated foundational scientific evaluation,” Mr. Zeldin said in a statement. He credited Mr. Kennedy for having “long been at the forefront of this issue.”
At a Miami-Dade commission meeting in April, most people who spoke during the public comment portion were against fluoridation. Days after the meeting, Ms. Levine Cava held a round-table discussion with doctors, dentists and others in the community that focused on its benefits.
Nearly 20 other cities and county governments in Florida have voted to remove fluoride from their water supplies since the November election. Among those, Miami-Dade County, with about 2.7 million people, is by far the largest. A bill under debate in the Florida Legislature would bar local municipalities from adding fluoride to water.
Miami-Dade’s politics have shifted sharply to the right in recent years, reflecting Florida’s transformation from a battleground state into one that votes reliably Republican. In November, Mr. Trump became the first Republican presidential candidate to win the county since 1988.
Patricia Mazzei contributed reporting
A federal prosecutor in Washington has contacted The New England Journal of Medicine, considered the world’s most prestigious medical journal, with questions that suggested without evidence that it was biased against certain views and influenced by external pressures.
Dr. Eric Rubin, the editor in chief of N.E.J.M., described the letter as “vaguely threatening” in an interview with The New York Times.
At least three other journals have received similar letters from Edward Martin Jr., a Republican activist serving as interim U.S. attorney in Washington. Mr. Martin has been criticized for using his office to target opponents of the administration.
His letters accused the publications of being “partisans in various scientific debates” and asked a series of accusatory questions about bias and the selection of research articles.
Do they accept submissions from scientists with “competing viewpoints”? What do they do if the authors whose work they published “may have misled their readers”? Are they transparent about influence from “supporters, funders, advertisers and others”?
News of the letter to N.E.J.M. was reported earlier by STAT, a health news outlet.
Mr. Martin also asked about the role of the National Institutes of Health, which funds some of the research the journals publish, and the agency’s role “in the development of submitted articles.”
Amanda Shanor, a First Amendment expert at the University of Pennsylvania, said the information published in reputable medical journals like N.E.J.M. is broadly protected by the Constitution.
In most cases, journals have the same robust rights that apply to newspapers — the strongest the Constitution provides, she added.
“There is no basis to say that anything other than the most stringent First Amendment protections apply to medical journals,” she said. “It appears aimed at creating a type of fear and chill that will have effects on people’s expression — that’s a constitutional concern.”
It’s unclear how many journals have received these letters or the criteria that Mr. Martin used to decide which publications to target. The U.S. attorney’s office in Washington did not respond to a request for comment.
“Our job is to evaluate science and evaluate it in an unbiased fashion,” Dr. Rubin said. “That’s what we do and I think we do it well. The questions seem to suggest that there’s some bias in what we do — that’s where the vaguely threatening part comes in.”
Jeremy Berg, the former editor in chief of the journal Science, said he thought the letters were designed to “intimidate journals to bend over backward” to publish papers that align with the administration’s beliefs — on climate change and vaccines, for example — even if the quality of the research is poor.
Robert F. Kennedy Jr., the nation’s health secretary, singled out N.E.J.M in an interview with the “Dr. Hyman Show” podcast last year as an example of a medical journal that has participated in “lying to the public” and “retracting the real science.”
Andrew Nixon, a spokesman for the Health and Human Services Department, declined to comment on whether Mr. Kennedy had any involvement with the letters.
In the interview, Mr. Kennedy said he would seek to prosecute medical journals under federal anti-corruption laws.
“I’m going to litigate against you under the racketeering laws, under the general tort laws,” he said. “I’m going to find a way to sue you unless you come up with a plan right now to show how you’re going to start publishing real science.”
Dr. Jay Bhattacharya, the new director of N.I.H., has vigorously criticized the leadership of scientific journals. Recently he co-founded a new journal as an alternative to traditional scientific publishing. It has published contrarian views on Covid.
Other prominent journals said they had not received the letter. On Friday, The Lancet, which is based in Britain, published a scathing editorial in solidarity, calling the letters “an obvious ruse to strike fear into journals and impinge on their right to independent editorial oversight.”
“Science and medicine in the U.S.A. are being violently dismembered while the world watches,” the editorial said.
One of Mr. Martin’s letters was sent to the journal Chest, a low-profile publication that publishes highly technical studies on topics like lung cancer and pneumonia. The New York Times reported last week that at least two other publishers had received nearly identically worded letters.
They declined to speak publicly for fear of retribution from the Trump administration.
Dr. Rubin said he, too, was worried about political backlash. Scientific journals rely on public funds in several indirect ways — for example, universities often use federal grants to pay for subscriptions.
“Are we concerned? Of course we are,” he said. “But we want to do the right thing.”
Mr. Martin gave the journals until May 2 to respond to his questions. N.E.J.M. has already responded to Mr. Martin with a statement that pushes back against his characterization of the journal.
“We use rigorous peer review and editorial processes to ensure the objectivity and reliability of the research we publish,” the statement read. “We support the editorial independence of medical journals and their First Amendment rights to free expression.”
This is not the N.E.J.M’s first brush with a Trump administration.
In 2020, the journal published an editorial condemning the president’s response to the pandemic — the first time the journal had supported or condemned a political candidate in its 208-year history.
Dr. Rubin said he doubted Mr. Martin’s letter was related to the editorial. The journal Chest didn’t write about Trump’s first term yet received a letter, he noted.
Social media can be a great source of fitness, nutrition and wellness tips — but it also has some potentially harmful content.
Enter “SkinnyTok,” a popular weight-loss trend making the rounds on TikTok.
Creators are pairing the hashtag with videos that share various ways to lose weight, many of them based on the goal of getting as thin as possible in a short amount of time.
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As of April 26, there were more than 60,000 videos from creators talking about SkinnyTok. One of those is Mandana Zarghami, 25, a business owner and influencer in Miami, Florida.
“What you eat in private will show in public,” Zarghami told her followers in a recent video.
The influencer spoke with Fox News Digital about her perception of the worldwide SkinnyTok trend.
“There’s an emphasis on portion control, prioritizing daily movement and knowing what foods will make you feel better from the inside out and more,” she said.
The creator acknowledged, however, that some of the content could be triggering for those who have battled disordered eating.
Mandana Zarghami, a TikTok creator, acknowledged that some of the SkinnyTok content could be triggering for those who have battled disordered eating. (Mandana Zarghami/TikTok)
“While some content under the SkinnyTok trend can promote motivation around health and wellness, it can also unintentionally glamorize unhealthy habits or unrealistic body standards if you’re following the wrong influencer or content creator,” Zarghami cautioned.
At the same time, she said, “you control what you consume.”
“What you eat in private will show in public.”
“It’s a little hard to be sensitive to each group, because a lot of the people who talk about SkinnyTok on their platforms also battled disordered eating and overcame it with healthy lifestyle choices,” Zarghami added.
Dr. Brett Osborn, a Florida neurosurgeon and longevity expert, said he has witnessed the “devastating consequences” of extreme thinness firsthand, including women with fractured bones caused by malnutrition.
“This is a growing crisis, and it is being dangerously celebrated on social media under hashtags like #SkinnyTok,” he told Fox News Digital.
“It’s a little hard to be sensitive to each group, because a lot of the people who talk about SkinnyTok on their platforms also battled disordered eating and overcame it with healthy lifestyle choices,” said influencer Mandana Zarghami (right). (iStock/TikTok-Mandana Zarghami)
“When young people chase after extreme thinness through starvation diets, they invite frailty into their lives. The body, deprived of caloric energy, becomes extremely fragile.”
In teenagers and young adults, malnutrition disrupts hormones, weakens immunity, impairs cognitive function and can cause lasting damage to their still-developing brains, according to Osborn.
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Physical effects of malnutrition can include hair loss, reduced bone density and, in severe cases, irreversible structural damage, he added.
Low body weight or minimal body fat does not equate to good health, the doctor said.
“Starvation is not a virtue – it is an abandonment of the body’s nutritional needs,” he said. “The SkinnyTok trend preys on impressionable youth, particularly young women, encouraging them to shrink rather than thrive.”
Low body weight or minimal body fat does not equate to good health, one doctor told Fox News Digital. (iStock)
Rather than focusing on “extreme thinness,” Osborn called for a focus on building muscle, which he described as the “cornerstone of vitality.”
“In older adults, muscle loss — or sarcopenia — is a medical warning sign linked to increased risks of falls, fractures, hospitalizations, cognitive decline and even mortality,” he cautioned.
“Muscle loss doesn’t just weaken the body — it erodes the mind, hastening the onset and progression of dementia. The body and the brain are interconnected, and when one suffers, so does the other.”
“Muscles are your shield against disease and decline. Being lean and strong, not thin and frail, is the true measure of health,” one doctor said. (iStock)
To those embracing the SkinnyTok trend, Osborn recommends that they shift the focus to building muscle.
“Muscles are your shield against disease and decline. Being lean and strong, not thin and frail, is the true measure of health,” he said.
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“Instead of glorifying starvation, we should teach our youth to nourish their bodies and minds, build resilience through muscle gained by strength training, and prioritize bodily function over any short-lived trend.”
Dr. Jillian Lampert, vice president of The Emily Program, an eating disorder treatment center based in Minnesota, also called out the potential risks of the SkinnyTok trend.
“It is a vicious cycle that quickly spirals from external messaging to internal criticism.”
“This content dangerously glorifies content that encourages people to take drastic measures to change their bodies,” she told Fox News Digital. “It also further ensnares people already struggling with their body image and thoughts of size and shape, reinforcing the notion that being thin at all costs is the norm.”
The behaviors in many of the videos are “often extreme” and highly limit foods or food groups, Lampert noted.
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The algorithms used by social media platforms make the content even more dangerous by amplifying the messages, according to the expert.
“Looking at one TikTok with even some less toxic body image content will teach the algorithms to send you more and more and more until your feed has become an avalanche of toxic content,” Lampert warned.
As people scroll through countless videos of “ideal” bodies and lifestyles, this often leads them to conclude that they’re not thin enough or attractive enough.
“This content dangerously glorifies content that encourages people to take drastic measures to change their bodies,” one expert told Fox News Digital. (iStock)
“Continual assessment of appearance and eating habits can make a person hypercritical and hyper-fixated on perceived flaws, thus fueling the cycle of eating less, which often leads to overeating and overexercising, which often leads to fatigue and loss of control around food,” said Lampert.
“It is a vicious cycle that quickly spirals from external messaging to internal criticism.”
Dr. Anastasia Rairigh, a Tennessee-based family physician and obesity medicine specialist at the virtual health platform PlushCare, warned that extreme weight-loss behaviors can be deadly.
“As a person severely limits their caloric intake, the body struggles to maintain the correct electrolyte balance,” she shared with Fox News Digital.
“When a person’s electrolytes are severely unbalanced, they can experience heart arrythmias or, in severe cases, cardiac arrest. Even if a person does not experience this, severe food deprivation can lead to damage to the heart, bones and brain.”
“Many of us that promote SkinnyTok focus on proper nutrition, walking over 10,000 steps a day and promoting a healthy and active lifestyle,” a creator told Fox News Digital. (iStock)
People who deprive themselves of food may also notice effects on cognition, mood and sleep, Rairigh warned.
“Modeling a healthy attitude toward food is critically important to combating the negative influence of toxic diet culture,” she said, recommending that people focus on food as a source of energy rather than an enemy.
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“Supporting young people to focus on activities and interests outside social media has been shown to be helpful as well,” she said.
“Encourage and facilitate positive activities in the real world as a counter to time spent on social media.”
“Modeling a healthy attitude toward food is critically important to combating the negative influence of toxic diet culture.”
Those who are showing signs of disordered eating should see a doctor, Rairigh advised.
“While disordered eating is deadly, there is hope and treatment. Do not be afraid to reach out for help.”
Zarghami, the TikTok creator, reiterated the importance of setting positive examples on social media.
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“Many of us that promote SkinnyTok focus on proper nutrition, walking over 10,000 steps a day and promoting a healthy and active lifestyle,” she told Fox News Digital.
“It’s so important to approach these trends with balance, focus on overall well-being rather than appearance, and encourage sustainable, nourishing choices that support both physical and mental health.”
The opioid overdose reversal medication commercially known as Narcan saves hundreds of thousands of lives a year and is routinely praised by public health experts for contributing to the continuing drop in opioid-related deaths. But the Trump administration plans to terminate a $56 million annual grant program that distributes doses and trains emergency responders in communities across the country to administer them, according to a draft budget proposal.
In the document, which outlines details of the drastic reorganization and shrinking planned for the Department of Health and Human Services, the grant is among many addiction prevention and treatment programs to be zeroed out.
States and local governments have other resources for obtaining doses of Narcan, which is also known by its generic name, naloxone. One of the main sources, a program of block grants for states to use to pay for various measures to combat opioid addiction, does not appear to have been cut.
But addiction specialists are worried about the symbolic as well as practical implications of shutting down a federal grant designated specifically for naloxone training and distribution.
“Reducing the funding for naloxone and overdose prevention sends the message that we would rather people who use drugs die than get the support they need and deserve,” said Dr. Melody Glenn, an addiction medicine physician and assistant professor at the University of Arizona, who monitors such programs along the state’s southern border.
Neither the Department of Health and Human Services nor the White House’s drug policy office responded to requests for comment.
Although budget decisions are not finalized and could be adjusted, Dr. Glenn and others see the fact that the Trump administration has not even opened applications for new grants as another indication that the programs may be eliminated.
Other addiction-related grants on the chopping block include those offering treatment for pregnant and postpartum women; peer support programs typically run by people who are in recovery; a program called the “youth prevention and recovery initiative”; and programs that develop pain management protocols for emergency departments in lieu of opioids.
The federal health secretary, Robert F. Kennedy Jr., has long shown a passionate interest in addressing the drug crisis and has been outspoken about his own recovery from heroin addiction. The proposed elimination of addiction programs seems at odds with that goal. Last year, Mr. Kennedy’s presidential campaign produced a documentary that outlined federally supported pathways out of addiction.
The grants were awarded through the Substance Abuse and Mental Health Services Administration, an agency within the federal health department that would itself be eliminated under the draft budget proposal, though some of its programs would continue under a new entity, the Administration for a Healthy America.
In 2024, recipients of the naloxone grants, including cities, tribes and nonprofit groups, trained 66,000 police officers, fire fighters and emergency medical responders, and distributed over 282,500 naloxone kits, according to a spokesman for the substance abuse agency.
“Narcan has been kind of a godsend as far as opioid epidemics are concerned, and we certainly are in the middle of one now with fentanyl,” said Donald McNamara, who oversees naloxone procurement and training for the Los Angeles County Sheriff’s Department. “We need this funding source because it’s saving lives every day.”
Matthew Cushman, a fire department paramedic in Raytown, Mo., said that through the naloxone grant program, he had trained thousands of police officers, firefighters and emergency medical responders throughout Kansas City and western rural areas. The program provides trainees with pouches of naloxone to administer in the field plus “leave behind” kits with information about detox and treatment clinics.
In 2023, federal figures started to show that national opioid deaths were finally declining, progress that many public health experts attribute in some measure to wider availability of the drug, which the Food and Drug Administration approved for over-the-counter sales that year.
Tennessee reports that between 2017 and 2024, 103,000 lives saved were directly attributable to naloxone. In Kentucky, which trains and supplies emergency medical workers in 68 rural communities, a health department spokeswoman noted that in 2023, overdose fatalities dropped by nearly 10 percent.
And though the focus of the Trump administration’s Office of National Drug Control Policy is weighted toward border policing and drug prosecutions, its priorities, released in an official statement this month, include the goal of expanding access to “lifesaving opioid overdose reversal medications like naloxone.”
“They immediately reference how much they want to support first responders and naloxone distribution,” said Rachel Winograd, director of the addiction science team at the University of Missouri-St. Louis, who oversees the state’s federally funded naloxone program. “Juxtaposing those statements of support with the proposed eliminations is extremely confusing.”
Mr. Cushman, the paramedic in Missouri, said that ending the naloxone grant program would not only cut off a source of the medication to emergency responders but would also stop classes that do significantly more than teach how to administer it.
His cited the insights offered by his co-instructor, Ray Rath, who is in recovery from heroin and is a certified peer support counselor. In training sessions, Mr. Rath recounts how, after a nasal spray of Narcan yanked him back from a heroin overdose, he found himself on the ground, looking up at police officers and emergency medical responders. They were snickering.
“Ah this junkie again, he’s just going to kill himself; we’re out here for no reason,” he recalled them saying.
Mr. Rath said he speaks with trainees about how the individuals they revive are “people that have an illness.”
“And once we start treating them like people, they feel like people,” he continued. “They feel cared about, and they want to make a change.”
He estimated that during the years he used opioids, naloxone revived him from overdoses at least 10 times. He has been in recovery for five years, a training instructor for the last three. He also works in homeless encampments in Kansas, offering services to people who use drugs. The back of his T-shirt reads: “Hope Dealer.”
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