The charitable interpretation is that it is simply a more sensitive and accurate way to say that.
It puts aside all the big is beautiful and similar takes and points to the fact that many American kids, especially those in certain parts of the country are now afflicted with metabolic syndrome (which is closely associated with mitochondrial disfunction). It is well-known that overloading mitochondria with sugar is quite bad for them and a key contributor to type 2 diabetes.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10036395/ https://pubmed.ncbi.nlm.nih.gov/32428560/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4408906/
Have you heard the term “sanewashing”? I don’t think the principle of charity requires us to replace false things he did say with thematically similar things that might have been reasonable. It’s like “explaining” that a crystal healer is just referring to the stress reduction benefits of aesthetically pleasing knickknacks.
My take is that overall he's right. The obesity epidemic should be our primary heath focus. Heart disease and obesity are the primary killers of americans.
You can in fact determine a huge percentage of americans including children are incredibly unhealthy just by looking. Increased focus on exercise and negative incentives on soft drinks and sugary beverages does seem like a major step in the right direction.