A sweeping report released Thursday by the Trump administration’s Make America Healthy Again (MAHA) Commission takes aim at unhealthy lifestyle habits, environmental toxins, and prescription medicines and vaccines that the government says are contributing to a surge in chronic disease among children.
The commission, chaired by Health and Human Services Secretary Robert F. Kennedy Jr., is asking federal agencies to take a close look at how ultra-processed foods, chemicals in the environment, screen time, and overuse of prescription drugs and vaccines might negatively impact kids’ health, according to the report. The MAHA Commission plans to outline more detailed plans for assessing these risks within 100 days, and share its findings within six months.
Estimates of chronic disease rates among U.S. children vary depending on the definition and source, with USA Today reporting the percentage may fall between 10 and 50 percent.
“To turn the tide and better protect our children, the United States must act decisively,” the report says. “During this administration, we will begin reversing the childhood chronic disease crisis by confronting its root causes — not just its symptoms.”
Here’s a look at some of the key areas that the report targets as potential causes of what it describes as a childhood chronic disease epidemic.
1. MAHA Wants Kids to Eat More Whole Foods
The report emphasizes the role of ultra-processed foods, including sodas and sugary treats, on the rising number of children with obesity and chronic diseases. Ultra-processed foods, it points out, are heavy on calories but light on nutrients, and often full of artificial colorings and additives that may have harmful health effects.
Although the strength of research varies, studies have linked ultra-processed foods to an increased risk of heart disease, cancer, type 2 diabetes, mental health disorders, and early death.
On top of eating too many ultra-processed foods, children aren’t getting enough whole foods that promote better physical and mental health, such as leafy greens, beans, nuts, salmon, beef, and whole milk, the report argues.
Marion Nestle, PhD, MPH, a retired professor of nutrition, food studies, and public health at New York University, told the Washington Post she thought the nutrition recommendations were spot-on.
“It paints a devastating portrait of what American society has done to children,” she told the Post. “The big question is okay, now what?”
The nonprofit Center for Science in the Public Interest released a statement that said while there are many benefits to improving kids’ diets, other Trump administration policies — like cutting SNAP benefits and free school lunches — are making it harder for parents to deliver on that goal.
2. HHS Officials Criticize Farmers for Pesticide Use
Children are exposed to pesticides and a wide variety of other toxic chemicals and pollutants through the food they eat, the air they breathe, and the toys and other consumer products they handle every day, according to the report. And they are more vulnerable than adults to health issues that come from environmental pollution, the MAHA commission says.
Philip Landrigan, MD, a pediatrician and epidemiologist who directs the Program for Global Public Health and the Common Good at Boston College, told The New York Times that the report did a great job of calling out the dangers of synthetic chemicals and pesticides for children’s health. “The first 18 pages of the report are brilliant,” Dr. Landrigan said.
But he called the report’s assessment of the threat posed by pesticides “really an understatement.” He pointed out to the Times, for example, that studies of the pesticide chlorpyrifos show “clearly that it causes brain damage in kids and reduces children’s IQ and causes behavioral problems.”
The MAHA report also stopped short of calling two common crop pesticides, glyphosate and atrazine, unsafe, after pushback from lobbyists and lawmakers, The New York Times reported.
The American Farm Bureau Federation (AFBF), however, said in a statement that the report overstates the role of farming and agricultural practices in making kids sick.
“As a farmer myself, I can confidently say that farmers and ranchers share the goal of improving health outcomes in America,” AFBF President Zippy Duvall said in a statement.
3. America’s Children Are Overmedicated, MAHA Commission Asserts
Children and teens are taking too many prescription medicines, some of which may not be necessary or may make them sick, the report argues. One in five U.S. kids have taken at least one prescription in the past 30 days, and more than 1 in 4 take at least one daily prescription drug, according to the report.
In particular, the report calls out a surge in prescriptions for:
Some experts have questioned RFK Jr.’s claims around the ill effects of children’s prescription medication, including for ADHD and depression.
“There is some concern, even more so in the field, that many children with depression and mental health disorders do not get access to the mental health services that they need, and that includes the comprehensive treatment that we would recommend, which is beyond just SSRIs, but also therapy and other supports,” Lisa Fortuna, MD, MPH, a child psychiatrist and chair of the American Psychiatric Association’s Council on Children, Adolescents, and Their Families, previously told The Hill.
4. Report Echoes RFK Jr.’s Skepticism About Childhood Vaccines
The report highlights a surge in the number of recommended childhood vaccines and questions whether U.S. children and teens are getting meaningful health benefits, despite a consensus among scientists that vaccines have been widely studied and prevent serious infection while promoting herd immunity.
Much of the language in the report echoes previous skepticism from Kennedy and other anti-vaccine activists, the Washington Post noted.
The report says the average number of vaccines a U.S. child is exposed to by age 1 — including some given to pregnant parents — has climbed to 29 injections today from just 3 in 1986.
Jason Schwartz, PhD, an associate professor of public health at Yale University in New Haven, Connecticut, who specializes in vaccine policy, told the Post that there are numerous ongoing surveillance systems that monitor vaccine safety. He added there is scant evidence that the cumulative effect of childhood vaccines harms children’s immune systems.
In rare cases, some children do have serious reactions to vaccinations — for example, about 4 in 10,000 infants between 12 and 23 months old who get their first MMR shot experience febrile seizures, which can be disturbing but cause no permanent harm.
5. MAHA Says Screen Time Is Robbing Kids of Physical Activity
Childhood today involves very little active play or physical activity; most kids and teens have adopted a lifestyle that is far too sedentary and driven by screen time and technology use, according to the report. By adolescence, for example, nearly half of teens report being online almost constantly.
The result has been a steep decline in aerobic fitness, with more than 70 percent of kids and 85 percent of teens failing to get at least an hour of daily moderate-to-vigorous physical activity — the minimum amount recommended by the Centers for Disease Control and Prevention (CDC) for optimal health, according to the report.
Jenny Radesky, MD, chair of the council on communications and media at the American Academy of Pediatrics (AAP), told the Washington Post that the MAHA report focused more on “pop theory, like a rewiring of a generation,” rather than scientific studies on the impacts of screen time on children.
Still, the report’s emphasis on screen time “reflects their understanding of how worried American families are about this,” she said.
All children and teens need adequate sleep (8 to 12 hours, depending on age), physical activity (one hour), and time away from digital media, according to the AAP. Families should designate media-free times together such meal time and media-free zones in the home such as bedrooms, the AAP recommends.
Beyond excessive amounts of screen time, the report called out several other factors that are contributing to reduced physical activity in kids and teens. These include less time dedicated to recess and gym classes in public schools and a sharp decline in the number of students who have an active commute to school, such as walking or biking.
