A Summary of the MAHA Report – Part I

For those who want to know the nuggets in it.

The following text is comprised from the report itself using those bold font points of significance and their explaining and supportive points. For those who’ve not gone through the usual exhaustive government report, this summary should make it easier to read and understand. Other parts of this summary will be posted later.

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Purpose of the Report/Assessment

This report—Make Our Children Healthy Again: Assessment—is a call to action.

To Make Our Children Healthy Again, we must begin with a shared understanding of the magnitude of the crisis and subsequently what’s likely driving it.

· Poor Diet

· Aggregation of Environmental Chemicals

· Lack of Physical Activity and Chronic Stress

· Overmedicalization

By examining each of these drivers, this assessment equips MAHA Commission stakeholders and partners with the facts needed to identify where and how policy interventions will likely have the most impact.

(The sections that follow analyze the evidence, spotlight gaps, and map the terrain—laying the groundwork for coordinated, high-impact solutions.)

The health of American children is in crisis. (See point chart titled “Life Expectancy and Health Expenditure Per Capita By Country (1970-2023)” for specific data.)

Today, American farmers feed the world, American companies lead the world, and American energy powers the world. But the same forces of modernization and industrialization have also introduced threats to our health and revealed growing inefficiencies in our ability to respond to them.

America will begin reversing the childhood chronic disease crisis during this administration by getting to the truth of why we are getting sick and spurring pro-growth policies and innovations to reverse these trends.

The Chronic Disease Crisis: A Generation at Risk

America’s children are facing an unprecedented health crisis. This chronic disease crisis has far-reaching consequences: Over 75% of American youth (aged 17-24) are ineligible for military service—primarily due to obesity, poor physical fitness, and/or mental health challenges. (See pie-chart in report for specific percentage groupings.)

Childhood Obesity is a Worsening Health Crisis. (See line chart titled “Prevalence of Obesity Amongst G7 Countries, Ages 5-19 (1990-2022)” for details. The U.S. data exceeds all other countries.)

Diabetes is Increasing among American Youth. (See line chart titled “Prevalence of Pre-Diabetes Ages 12-19 (1999-2018)” It continues to rise over the duration of years.)

Rates of Neurodevelopmental Disorders are Increasing. (See bar chart titled “Autism Rates Amongst Children by Age 8 (1992-2022)” which show continued exponential rate of increase in more recent years.)

Childhood Cancer Incidence Has Risen Dramatically. (See line graph titled “Cancer Rates Per 100,000 Ages 0-19 (1975-2022)” Childhood cancer incidence has risen over 40% since 1975.

American Youth face a Mental Health Crisis. (See bar graph titled “Had at Least One Major Depressive Episode (MDE) in Past Year, Ages 12 to 17, by Sex (2004-2022)”

Allergies are Widespread, and Autoimmune Disorders are Rising. (See line chart titled “Prevalence of Food Allergies, Ages 0-17 (1997-2018)” A continual increase over the years.)

What is Driving the Increase in Childhood Chronic Disease?

The food American children are eating. The American food system is safe but could be healthier. Most American children’s diets are dominated by ultra-processed foods (UPFs) high in added sugars, chemical additives, and saturated fats, while lacking sufficient intakes of fruits and vegetables. (For specific data, see bullet points in report.)

American children’s exposure to environmental chemicals. The cumulative load of thousands of synthetic chemicals that our children are exposed to through the food they eat, the water they drink, and the air they breathe may pose risks to their long-term health, including neurodevelopmental and endocrine effects. (For specific data, see bullet points in report.)

American children’s pervasive technology use. Over the past four decades, American children have transitioned from an active, play-based childhood to a sedentary, technology-driven lifestyle, contributing to declines in physical and mental health. Specifically, these declines have been driven by increased screen time, reduced physical activity, and psychosocial stressors like loneliness, chronic stress, and sleep deprivation. (For specific data, see bullet points in report.)

American children are highly medicated – and it’s not working. The health system has aggressively responded to these increases in childhood chronic disease with increasing rates of pharmaceutical drug prescriptions which may cause further harm to the health of American children when used inappropriately. (For specific data, see bullet points in report.)

Corporate Capture and the Revolving Door

Although the U.S. health system has produced remarkable breakthroughs, we must face the troubling reality that the threats to American childhood have been exacerbated by perverse incentives that impact the regulatory bodies and federal agencies tasked with overseeing them.

These corporations are:

· The food industry (For specific data, see report.)

· The chemical-manufacturing industry (For specific data, see report.)

· The pharmaceutical industry (For specific data, see report.)

S E C T I O N O N E

The Shift to Ultra-Processed Foods

Following World War II, much of Europe and Asia’s agricultural system was destroyed, and the United States responded by increasing its agricultural output through mechanization, synthetic fertilizers, industrial-scale farming, and shelf-stable processing techniques to feed the world.

Farmers are the backbone of America - and the most innovative and productive in the world. We continue to feed the world as the largest food exporter. The greatest step the United States can take to reverse childhood chronic disease is to put whole foods produced by American farmers and ranchers industrial-scale farming, and shelf-stable processing techniques to feed the world. (It should be noted that the actual report provides footnotes to studies supporting the various findings.)

A Closer Look at Ultra-Processed Foods

A growing body of research associates UPFs with negative health outcomes, including in children. Research is beginning to point to three key reasons why UPFs are detrimental to children’s health:

1. Nutrient Depletion

The rise in UPF consumption has led to the dominance of three key ingredients in American children’s diets: ultra-processed grains, sugars, and fats. These engineered components, virtually nonexistent a century ago, now account for over two-thirds of all calories consumed by American children.

Ultra-Processed Grains: Found in cakes, cookies, refined breads, candy, and snacks, these grains make up a large portion of the UPF calories that dominate daily intake. Processing grains involves the removal of the bran and germ, which strips away essential vitamins, minerals, and fiber.

Ultra-Processed Sugars: Found in 75% of packaged foods,105 the average American consumes17 teaspoons of added sugars daily, which amounts to 60 pounds annually.

Ultra-Processed Fats: Over the course of the 20th century, U.S. dietary fats shifted from minimally processed animal-based sources like butter and lard—rich in fat-soluble vitamins A, D, and E, supporting brain and immune health—to industrial fats from refined seed oils, such as soybean, corn, safflower, sunflower, cottonseed, and canola. Industrial refining reduces micronutrients, such as vitamin E and phytosterols. Moreover, these oils contribute to an imbalanced omega-6/omega-3 ratio, a topic of ongoing research for its potential role in inflammation.

2. Increased Caloric Intake

UPFs drive increased caloric intake and weight gain. Industrial processing inherent in UPF production leads to significant changes in fiber, protein, caloric density, and digestibility. Research suggests that these alterations could interfere with brain reward pathways and satiety hormones, promote faster eating, and compromise gut fullness signals. The refined ingredients in these foods can rapidly spike blood sugar and insulin levels as well as damage the gut microbiome.

Multiple peer-reviewed studies demonstrate that whole foods, on the other hand, contain built-in satiety mechanisms that help regulate appetite and reduce overeating. Specifically:

· Whole foods rich in dietary fiber stimulate the release of key satiety hormones.

· Foods that require more chewing increase oral exposure time, enhancing satiety signals.

· Protein is the most effective macronutrient for providing a satiating effect. In addition to

· stimulating the release of satiety hormones, protein requires more energy to digest than

carbohydrates or fats, leading to a higher calorie burn during digestion.

3. Inclusion of Food Additives

Over 2,500 food additives—including emulsifiers, binders, sweeteners, colorings, and preservatives—may be used to mimic the taste and texture of conventional food and increase its shelf life.

· Certain food colorings, such as red 40, which is present in widely-consumed products have been associated with behavioral issues in children, such as increased hyperactivity and symptoms consistent with ADHD.

· Titanium Dioxide, widely used in a range of candies and sauces, may cause cellular and DNA damage.

· Propylparaben, a preservative used in baked goods and snacks, shows estrogenic activity, potentially disrupting hormonal balance.

· Butylated Hydroxytoluene (BHT), found in common snacks and cereals, is a preservative that may be associated tumor growth in rodent studies.

· Artificial Sweeteners like aspartame, sucralose, and saccharin, used widely in diet sodas and sugar-free foods, have been observed to interfere with the gut microbiome in some studies.

One notable example of concern around food additives is infant formula. In recent years, some American parents have turned to European formula brands, driven by supply concerns and questions regarding the number and types of additives found in U.S. formulas.

Additives in processed foods are consumed in complex combinations, where cumulative and synergistic effects may amplify harm beyond individual components. Yet, testing often ignores these interactions, particularly in children. With dozens of additives consumed daily, these overlooked risks could be significantly impacting children’s health.

The Impact of Ultra-Processed Foods and the Vital Role of Whole Foods in Children’s Health

Human health and biology rely heavily on dietary inputs. During gestation, fetal development depends on maternal nutrition, influencing everything – from membrane composition and mitochondrial integrity to nervous system wiring and hormone regulation. This programming ultimately determines the child’s long-term metabolic, cognitive, and immune resilience. UPFs make up over 50% of the diets of pregnant and postpartum mothers, despite evidence that increased UPF consumption during pregnancy negatively impacts health outcomes for their children.

As the consumption of UPFs has surged, children are increasingly neglecting the whole foods essential for their health. Approximately 50% of children ages 2 to 18 skip discrete fruit entirely on any given day. Research consistently shows that key micronutrients such as calcium, iron, potassium, and vitamin D, which are found in fruits and vegetables, are essential for children’s physiological functioning.

The Driving Forces Behind American Children’s Food Crisis

UPFs are built into the fabric of the post-World War II American society and economy. The convenience of “fast food” and the food processing and delivery industry that facilitates them is viewed, internationally, as a distinctly “American” innovation. UPFs have allowed us to save money and to “eat on the run,” but today’s over-reliance on UPFs is damaging the health of American children. This crisis results, in large part, from decades of policies that have undermined the food system and perpetuated the delivery of unhealthy food to our children.

Consolidation of the Food System

Our agricultural system has historically focused on abundance and affordability. Today’s diet-related chronic disease crisis, demand a closer examination of this pattern and its broader impact. Key observations include:

● Farmers today receive a small share of consumer food spending; in 2023, only 16 cents of every dollar spent on food went to farmers, while 84 cents was absorbed by food manufacturers, marketers, and distributors.

● A small number of corporations control a large share of food production, processing, distribution, and retail. Many of the core products of “Big Food” companies are UPFs and nutrient-poor foods and beverages. This trend of consolidation began in earnest in the late 1980s and early 1990s, when the two largest U.S. tobacco companies transformed into major players in the packaged food industry through aggressive acquisitions. Four companies control 80% of the meat market in the U.S.

Distorted Nutrition Research and Marketing

The public depends on scientific research and the media for information about the food we consume. The food industry has increasingly influenced these critical sources of public information, diminishing the integrity of information available to consumers:

· A BMJ analysis found that while industry spent over $60 billion on drug, biotechnology, and medical device research in nutrition science,173 the government spent $1.5 billion on nutrition research.

· Government funding by the NIH for nutrition research is only 4-5% of its total budget175 and in some cases can be subjected to influence by food industry-aligned researchers.

· Industry funding skews the outcomes of nutrition research. A meta-analysis further

· revealed that 0% of interventional nutrition studies funded by the industry reported unfavorable health conclusions regarding soft drinks, juices, and milk, while 37% of studies backed by non-industry funding did; the likelihood of reaching a favorable conclusion in studies that received industry funding was 7.61 times higher compared to studies that did not receive any industry funding.

Compromised Dietary Guidelines

The Dietary Guidelines for Americans (DGA) have been the foundation of national nutrition policy. While the DGA’s do emphasize the importance of whole foods such as fruits, vegetables, whole grains, lean proteins, and unsaturated fats as well as recommend limiting added sugars, saturated fats, and excess sodium,185 they are often presented in technical language that can be difficult for the average person to understand.

Specifically, the DGA:

· Maintain problematic reductionist recommendations.

· Remain largely agnostic to how foods are produced or processed.

· Do not explicitly address UPFs.

The DGA have a history of being unduly influenced by corporate interests. For example:

· The infamous 1992 Food Pyramid, which was influenced by research from the sugar industry, recommended carbohydrates at the base of the pyramid and made no differentiation between refined grains and whole grains.

· In 2015, the DGAC recommendation to reduce processed meat consumption faced pushback from the meat production industry, which led to these recommendations being removed from the final published guidelines.

· A recent analysis found that 95% of the 2020DGAC members had some form of relationship with industry actors, most often through research funding but also as board members, speakers/honoraria, or consultants.

Government Programs Compounding the Issue

Over the past 50 years, several well-intentioned government programs have been launched to improve children’s nutrition and access to food. However, as these programs have grown in size and complexity, many have drifted from their original goals:

Traditional Field Crops vs. Specialty Crops

While specialty crop coverage has been expanding, it still only accounted for 17% of the entire federal crop insurance portfolio by liability during crop year 2017, and subsidies for fruits, vegetables, tree nuts, and support for organic foods account for a mere 0.1% of the 2018 Farm Bill. Just over 80% of Farm Bill spending is devoted to the Supplemental Nutrition Assistance Program, described further below.

The Supplemental Nutrition Assistance Program (SNAP) served on average 42 million low-income Americans per month with Federal SNAP spending totaling $113 billion in fiscal year 2023. 1 in 5 American children 17 and under receive SNAP benefits. SNAP participants can buy everything on grocery store shelves with the exception of alcohol, hot foods, tobacco and non-food products.

· Children receiving SNAP benefits are more likely to consume greater quantities of sugar sweetened beverages and processed meats compared to income-eligible nonrecipients;

by one estimate, nearly twice as much will be spent by SNAP on UPFs and sugar-sweetened beverages ($21 billion) compared to fruits and vegetables ($11 billion) in FY2025.

· SNAP participants face worsening health outcomes compared to non-participants, exhibiting elevated disease risks: according to one study, they are twice as likely to develop heart disease, three times more likely to die from diabetes, and have higher rates of metabolic disorders.

o The costs for these preventable diseases fall directly on taxpayers. Roughly 60% of SNAP participants received Medicaid in 2019, highlighting the connection between healthcare costs and suboptimal nutritional services.

SNAP currently has incentives in place to encourage increased consumption of fruit, vegetables, dairy, and whole grains. These incentive programs encourage healthy eating by making nutritious food more accessible and affordable through coupons, discounts, gift cards, bonus items, or extra funds.

The School Breakfast Program and National School Lunch Program (NSLP) operates in nearly

100,000 schools covering more than 30 million children,216 with an annual cost of $24 billion,217 and yet:

· Schools that receive federal lunch subsidies are required to follow a meal pattern that limits added sugars, sodium, and carbohydrates, but do not set limits on UPF consumption, leading to excessive intake of sugar, processed carbohydrates, processed fats, and sodium among children.

· To get into schools, many food companies have reformulated their products with minor ingredient adjustments to qualify for the federal Smart Snack program by meeting the school nutrition standards, which children can purchase separate from school meals.

o There are concerns that providing these snacks in school can confuse students’ perceptions of healthy foods, especially since Smart Snacks are often virtually indistinguishable from less-nutritious versions of fast-food products available outside of school.

While the U.S. has long had programs that both incentivize fruits and vegetables, other countries’ school lunch programs have additional standards and guidelines.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one example of a government program that is focused exclusively on the nutritional health of its participants—pregnant and breastfeeding women, women who recently had a baby, infants, and children up to 5 years of age.

END OF SECTION #1 – More to follow!