The White House set forth its vision on Thursday for how to “make America healthy again” with the release of an expansive report that blames a crisis of chronic disease in children on ultraprocessed foods, chemical exposures, lack of physical activity, stress and excessive use of prescription drugs, including antidepressants.
The report is the product of a presidential commission led by Health Secretary Robert F. Kennedy Jr. and does not offer specific policy prescriptions. Rather, it summarizes existing science and proposes new research, such as long-term studies comparing whole foods to ultraprocessed foods, and a national look at how chemical exposures might affect genetics.
It paints a bleak picture of American children, calling them “the sickest generation in American history.” The report makes the case that the federal government has invested far too much in research to develop treatments for chronic diseases like heart disease, cancer, obesity and depression — and far too little in understanding the causes of disease and how to prevent it.
It also assails “the overmedicalization of American children,” which it blames on pharmaceutical industry “capture” of the nation’s biomedical apparatus — including medical journals that publish the results of scientific studies — and “a critical policy failure where corporate profitability supersedes the health of children.”
Mr. Kennedy called the report “an invitation to the American people and the American press to have a complex conversation about a nuanced subject.” He said the White House did not have a budget or an estimate of how much it might cost to enact the report’s initiatives, but argued that they would save money in the end by reducing treatment costs.
The report reflects a consensus across government agencies and officials, including Mr. Kennedy; Agriculture Secretary Brooke Rollins; Lee Zeldin, the head of the Environmental Protection Agency; and the heads of the Food and Drug Administration and the National Institutes of Health, all of whom joined the health secretary on a morning conference call with reporters.
“We now have the most obese, depressed, disabled, medicated population in the history of the world, and we cannot keep going down the same road,” said Dr. Marty Makary, the head of the Food and Drug Administration. He added, “I hope this marks a grand pivot from a system that is entirely reactionary to a system that will now be proactive.”
President Trump is expected to hold a White House event Thursday afternoon to formally announce the report. Some members of Mr. Kennedy’s “Make America Healthy Again” movement have been invited to attend.
The report diverges drastically from standard government thinking about chronic disease prevention. The Centers for Disease Control and Prevention declares that “most chronic diseases are caused by a short list of risk factors: tobacco use, poor nutrition, physical inactivity and excessive alcohol use.”
But the Make America Healthy Again Commission — or the MAHA Commission — does not dwell on smoking or excessive alcohol use. Indeed, the Trump administration has dismantled the Office on Smoking and Health at the Centers for Disease Control and Prevention, and has fired the top tobacco regulator at the F.D.A.
Notably, there were no representatives of the C.D.C., the one federal agency that has been focused on chronic disease prevention, on the morning conference call. The agency lacks a permanent director, and Mr. Kennedy has stripped it of its mission to prevent chronic disease, which will now be handled by a new agency called the Administration for a Healthy America.
Rather, the report reflects the thinking of Mr. Kennedy, a former environmental lawyer who has long railed against ultraprocessed foods and chemicals as dangers to Americans’ health. Mr. Kennedy has repeatedly said that the United States is suffering from an epidemic of chronic illness that is particularly acute in children, citing the rising incidences of autism and attention deficit hyperactivity disorder.
The report, however, does not distinguish children by age range. That means it does not address any of the other behavioral health issues that post significant risks to teens and preteens, including smoking, vaping, drinking, opioids, cannabis use and sexually transmitted diseases, many of which can cause immediate and chronic severe health issues.
The report also does not address gun violence, which is the leading cause of death for children and teens.
The report says surprisingly little about vaccine safety, the issue that catapulted Mr. Kennedy to the fore during the coronavirus pandemic. It notes that “vaccines benefit children by protecting them from infectious diseases,” but that like any medicine, “vaccines can have side effects.”
It complains that “the expansion of childhood vaccine mandates and public health — combined with efforts to combat vaccine hesitancy” — has made “open scientific discussion and inquiry” about vaccines more difficult.
The report notes that American children are “uniquely vulnerable to environmental chemicals,” including the “forever chemicals” known as PFAS, microplastics and fluoride, which is added to water to prevent tooth decay.
It also singles out electromagnetic radiation exposure from cellphones and wearable devices, while noting that “a systematic review of over 50 studies found low to inadequate evidence on impact on children and called for more high-quality research.”
Echoing the concerns of many public health experts, the report says that young people in the United States consume far too many ultraprocessed foods, which studies have linked with a host of chronic health conditions, including obesity in children. The report blames American children’s poor diet on a food system that has prioritized profit over health; a lack of federal investment in nutrition research; and on “compromised dietary guidelines.”
It cites, for example, a recent study published in Nature Medicine, which estimated that sugar-sweetened beverages alone may be responsible for 1.2 million new cases of heart disease and 340,000 deaths worldwide.
The products, which include industrially manufactured foods and drinks like sodas, chicken nuggets, instant soups and many packaged snacks, make up nearly 70 percent of the calories consumed by children and adolescents in the United States.
They tend to be high in refined grains, added sugars and fats, and they drive greater calorie consumption, research suggests. The report also calls out food additives often found in ultraprocessed foods, like synthetic food dyes and artificial sweeteners, and which carry some health concerns.
Mr. Kennedy has previously said ultraprocessed foods are a major cause of chronic diseases in the United States, and has promised to “fix our food supply.” But administration actions in the past few months have, in some cases, contradicted that goal.
In March, the Agriculture Department abruptly ended a program that provided produce from local farms to schools. Scientists at Harvard and Cornell have lost funding for research aiming to improve the diets of children and teens. And Kevin Hall, a researcher who led some of the most highly cited studies on ultraprocessed foods, left the N.I.H. in April, citing censorship.
The report also scrutinizes the rise in prescription medications among children, specifically calling out antibiotics, weight loss drugs and mental health medications like antidepressants, antipsychotics and stimulants. The United States is facing a “crisis of overdiagnosis and overtreatment,” the report states.
Rates of prescriptions of many mental health medications have grown over the past decade, in part because of rising awareness about symptoms of mental illness. Researchers have pointed to the coronavirus pandemic as a major driver of antidepressant prescriptions, particularly for young women, but doctors had increasingly prescribed the drugs to children and teens for years before Covid hit.
The report posits that these drugs are not especially effective — antidepressants do not always outperform placebo in clinical trials, though a wealth of research shows that they tend to modestly improve depression symptoms — and warns about the risk of children becoming dependent on them.
While doctors do not consider antidepressants addictive, people who stay on the medications long-term can develop withdrawal symptoms after stopping, like mood changes, difficulty sleeping and stomach issues.
The report notes a challenge in treating children’s mental health: Even as children are exhibiting greater levels of mental health conditions, some researchers have raised concerns about overdiagnosis of these issues, especially A.D.H.D.
Mr. Trump established the commission in February to examine what he called the “growing health crisis in America.” But he asked the panel to begin by looking at chronic disease in children.
The panel’s report generated pushback even before its release. Some Republican lawmakers and industry representatives complained this week about the report’s expected focus on widely used agricultural chemicals, including glyphosate, the key ingredient in an herbicide marketed as Roundup. The chemical is mentioned in the report.
When Mr. Kennedy testified on Tuesday before members of the Senate Appropriations Committee, Senator Cindy Hyde-Smith, Republican of Mississippi, warned him and the commission not to insinuate that the agricultural chemical is unsafe or responsible for childhood disease because doing so could greatly damage farmers. She referred to scientific studies, including an assessment from the Environmental Protection Agency that found the chemical safe when used as directed.
“I trust your report will be described as an initial assessment of things to be considered but yet to be determined,” the senator said. Mr. Kennedy assured her that he understood that farmers rely on glyphosate and “we are not going to do anything to jeopardize that business model.”
Alice Callahan contributed reporting.
Sheryl Gay Stolberg covers health policy for The Times from Washington. A former congressional and White House correspondent, she focuses on the intersection of health policy and politics.
Dani Blum is a health reporter for The Times.
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