5 Takeaways From RFK’s First Make America Healthy Again Assessment

A sweeping report released last week 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.

“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.

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, calls the report's critique of kids’ diets “a breath of fresh air.”

“I think it’s terrific that the HHS secretary is concerned about child health and wants to do something about it,” Dr. Nestle says. “The report identified the problem and pulled no punches.”

But solving these problems will still be a tall order, Nestle says. “There is plenty that could be done, but the food industry will not like actions that might be effective, and whether MAHA is willing to and is permitted to take on the food, drug, and chemical industries also remains to be seen,” Nestle says.

Connie Diekman, RD, a registered dietitian in St. Louis and former president of the American Academy of Nutrition and Dietetics, says the report hits some important notes but misses a key aspect of unhealthy eating habits — that people may sometimes make poor food choices due to lack of knowledge about nutrition.

“Simply telling pulling to cut out ultra-processed foods will not work,” Diekman says. “We need to remember that people need food they can afford, food they enjoy, and food that helps them make it through, sometimes, a very chaotic day.”

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, the report argues. And they are more vulnerable than adults to health issues that come from environmental pollution, the MAHA commission says.

While the MAHA report identifies several important environmental health challenges arising from children’s exposure to pesticides and other chemicals, there’s a lack of good research to help identify the most effective solutions, says Jaymie Meliker, PhD, a professor of public health and preventive medicine at Stony Brook University in New York.

“The attention to complex mixtures of exposures to environment chemicals is important,” Dr. Meliker says. “The problem of assessing risk from mixtures has been well known for decades but we have very few tools and data sources to adequately solve the problem.”

At the same time, Meliker adds, government funding for environmental health research through the National Institutes of Health (NIH) — one way to avoid the bias involved in companies paying for studies of the chemicals they produce — is being slashed by the Trump administration, Meliker notes.

While it may be possible to reduce pesticide use and limit exposure to these chemicals, doing this might result in growing less food per acre of farmland, Meliker says.

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:

• Stimulants to treat attention deficit hyperactivity disorder (ADHD)
• Antidepressants and antipsychotics
• Antibiotics
• Asthma drugs
• GLP-1 drugs for obesity

Some experts have questioned RFK Jr.’s claims around the ill effects of children’s prescription medication, including for ADHD and depression, and challenged the notion that increasing treatment means kids are overmedicated.

“In the past, mental health and behavioral issues in children were underrecognized,” says Max Wiznitzer, MD, a pediatric neurologist at Rainbow Babies & Children’s Hospital in Cleveland, and a professor of pediatrics and neurology at Case Western Reserve University. “We are getting better at diagnosing them, so one should not conclude that an increasing in the number means overdiagnosing.”

When psychiatrists look at how many kids need to take a medicine to benefit, or to experience serious harms, childhood psychiatric medications like ADHD stimulant drugs have one of the best track records, says Ragy Girgis, MD, a professor of clinical psychiatry at Columbia University in New York City.

If there’s a problem, it’s not that kids are overmedicated, Dr. Wiznitzer says, it’s that their families often can’t access or afford treatment.

“There are waiting lists and the need to establish a therapeutic relationship with the therapist,” he says. “Therapy’s effect is slower in onset but more sustained in the long-term — some families can’t wait.”

4. Report Echoes RFK Jr.’s Skepticism About Childhood Vaccines

The report says the average number of vaccines a U.S. child is advised to get by age 1 — including some given to pregnant parents — has climbed to 29 injections today from just 3 in 1986.

Much of the language in the report echoes previous skepticism from Kennedy and other anti-vaccine activists.

During his confirmation hearings, Kennedy repeatedly said that scientists need to provide more proof that vaccines are safe and effective.

Calling into question decades of evidence supporting vaccine safety will lead to more deaths from vaccine-preventable diseases, says Stephen Morse, PhD, a professor of epidemiology at Columbia University Irving Medical Center in New York City.

“Vaccines save millions of lives,” Dr. Morse said, adding that Kennedy’s criticisms may lead more people to refuse vaccinations, making outbreaks more likely and increasing disability and deaths from measles, whooping cough, and other vaccine-preventable diseases.

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.

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.

“Increasing opportunities for children to get adequate physical activity should be a priority for their current and future well-being,” says James Gangwisch, PhD, an assistant professor and research scientists at Columbia University and the New York State Psychiatric Institute.

Physical activity has been shown to be protective against mood disorders and obesity in children, Dr. Gangwisch says. “Increased screen time has allowed less opportunity to get adequate exercise.”