In a sweeping new report, the White House outlined what it sees as the drivers of disease in American children.
“To turn the tide and better protect our children, the United States must act decisively,” reads the report, which was produced by a presidential commission tasked with combating childhood disease. “During this administration, we will begin reversing the childhood chronic disease crisis by confronting its root causes — not just its symptoms.”
The document echoes talking points Health Secretary Robert F. Kennedy Jr. has championed for decades: the idea that our modern environment is making people sick, and that corporations exert too much influence on research and medicine.
The report provides little in the way of specific solutions to address these issues, though the commission is also expected to release recommendations later this year. What the document does offer is the clearest articulation yet of Mr. Kennedy’s “Make America Healthy Again” movement, and what the broad coalition hopes to accomplish in the coming months and years. Here’s what the new report tells us.
The report paints a bleak picture of American childhood.
The report presents today’s children as stressed, sleep-deprived and addicted to their screens. It describes rising rates of conditions like obesity, diabetes and mental illness as a crisis that threatens the nation’s health, economy and military readiness. “Today’s children are the sickest generation in American history in terms of chronic disease,” the report says.
And it lashes out against technology companies and social media platforms that it says have helped create a “technology-driven lifestyle.” It cites Jonathan Haidt, whose best-selling book “The Anxious Generation” links the rise of smartphones and social media to worsening mental health among children — a theory that some researchers have criticized for relying on inconclusive research. The report also notes that rates of loneliness among children have risen over the past several decades, a concern that researchers and public health experts have also raised for years.
It takes aim at vaccines.
The report reiterates many of Mr. Kennedy’s frequent talking points about vaccines — with one notable exception. It does not suggest, as he has for decades, that childhood vaccines may be responsible for the rise in autism diagnoses among American children.
But it implies that the increase in routine immunizations given to children may be harmful to them, which many scientists say is based on an incorrect understanding of immunology. The shots administered to children today are more efficient, and they contain far fewer stimulants to the immune system — by orders of magnitude — than they did decades ago, experts say.
Vaccines are also largely responsible for the sharp drop in deaths among children under 5.
“The growth of the vaccination schedule does reflect the fact that we can prevent a lot more suffering and death in children than we could generations ago,” said Jason Schwartz, an associate professor of health policy at the Yale School of Public Health.
“Rather than celebrating that, it’s often seen as a reason for skepticism or concern,” he said.
The report also repeats Mr. Kennedy’s assertion that childhood vaccines have not been tested in clinical trials involving placebos. In fact, new vaccines are tested against placebos whenever it is necessary, feasible and ethical to do so.
Some European countries, including Britain, do not mandate vaccinations as most American states do, the report notes. While that’s true, misinformation and mistrust have led to record numbers of measles cases in Europe, and have cost Britain its measles elimination status.
The report notes correctly that surveillance systems in the United States for detecting side effects related to vaccines have serious shortcomings. But detection of rare side effects requires huge amounts of data, which is difficult to collect from the nation’s fragmented health care system.
The report urges federal agencies to “build systems for real-world safety monitoring of pediatric drugs” — which presumably include vaccines — but it is unclear how those initiatives would differ from the systems already in use.
It puts a major emphasis on ultraprocessed foods.
The report says that “the food American children are eating” is causing their health to decline.
“It’s terrific to see such a clear, direct admission from the government that we are failing our children’s health — and that our food is one dominant driver,” said Dr. Dariush Mozaffarian, the director of the Food Is Medicine Institute at Tufts University.
Nearly 70 percent of the calories consumed by children and adolescents in the United States come from ultraprocessed foods. These industrially-manufactured foods and drinks, like sodas, chicken nuggets, instant soups and packaged snacks, have been linked with a greater risk of obesity, Type 2 diabetes, heart disease and other conditions.
The report appropriately calls out an excess of ultraprocessed foods and not enough fruits and vegetables as problems with children’s diets, Dr. Mozaffarian said, but it “misses the massive problem of high salt,” which can cause high blood pressure in children. He also said he wished it had focused more on the “many other severe deficiencies in the American diet,” like a lack of legumes, nuts, minimally processed whole grains, fish, yogurt and healthy plant oils.
Marion Nestle, an emerita professor of nutrition, food studies and public health at New York University, said that overall, the report “did a phenomenal job” describing how ultraprocessed foods are harming children’s health.
The question, she said, is how the administration will fix the problems that are articulated in the report. “In order for them to do anything about this, they’re going to have to take on corporate industry,” including agriculture, food and chemical industries, she said.
Food manufacturers, for example, could make healthier foods and stop marketing “junk food” to children, she said. Such changes would most likely require federal regulations, she said, because historically, companies have resisted making them voluntarily.
The report highlights a lack of government funding for nutrition research as part of the problem — a point scientists have been making for years. The situation has worsened during President Trump’s second term, however, as many diet researchers have had federal grants abruptly terminated. Kevin Hall, whose research on ultraprocessed foods is prominently cited in the new report, left his post at the National Institutes of Health in April, citing censorship.
The report points a finger at synthetic chemicals but pulls some punches.
The commission’s report accurately describes worsening health among American children, said Dr. Philip Landrigan, a pediatrician and epidemiologist who directs the Program for Global Public Health and the Common Good at Boston College.
And it notes a number of synthetic chemicals, like pesticides and microplastics, that may play a role. “The first 18 pages of the report are brilliant,” Dr. Landrigan said.
But he said it understated the known risks of many chemicals.
For example, the report’s authors downplay the hazards of phthalates, used to make plastics, and of certain pesticides that have been deemed dangerous to children’s health but remain widely used.
“They mentioned correctly that phthalates can trigger hormone dysregulation, but they could have also said that phthalates produce birth defects of the male reproductive organs and can lead to infertility,” Dr. Landrigan said.
While the report mentions concerns about crop-protection tools such as pesticides, “that’s really an understatement,” Dr. Landrigan said. He noted that studies of the widely used insecticide chlorpyrifos show “clearly that it causes brain damage in kids and reduces children’s I.Q. and causes behavioral problems.”
The pesticide was banned from household use 25 years ago because of the risks to children, and banned from use on all crops three years ago. But the Environmental Protection Agency recently permitted its use on fruits like apples and oranges because of lawsuits brought by the manufacturer and growers’ associations.
The report also stopped short of calling two common pesticides used on many food crops, glyphosate and atrazine, unsafe after pushback from farmers, industry lobbyists and Republican lawmakers.
Dr. Landrigan and colleagues from the Consortium for Children’s Environmental Health recently advocated in The New England Journal of Medicine for a national approval process for all existing and new chemicals. Independent scientific assessments would be required to show the chemicals were not toxic to anyone, especially children, and post-marketing surveillance would be required.
Yet the federal agencies that could regulate chemical exposures have been gutted in recent layoffs.
Dr. Georges Benjamin, executive director of the American Public Health Association, pointed out that the report called for “gold-standard research,” even as the administration had drastically cut funding for science and halted payments to universities like Harvard and Columbia.
“They’re not walking the walk,” he said. “They’re just talking.”
Dani Blum is a health reporter for The Times.
Apoorva Mandavilli reports on science and global health, with a focus on infectious diseases, pandemics and the public health agencies that try to manage them.
Roni Caryn Rabin is a Times health reporter focused on maternal and child health, racial and economic disparities in health care, and the influence of money on medicine.
Alice Callahan is a Times reporter covering nutrition and health. She has a Ph.D. in nutrition from the University of California, Davis.
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