WASHINGTON — A much-awaited game plan for how the Trump administration will make Americans healthier largely steers clear of policy recommendations, instead calling for more research on nutrition, agricultural chemicals, and “potential benefits of select high-quality supplements,” among other topics.
That’s according to a draft version of a new report from the president’s Make America Healthy Again Commission led by health secretary Robert F. Kennedy Jr. The White House has yet to share a finalized version, which will likely undergo edits before its release.
While the document, titled “Make Our Children Healthy Again Strategy,” retreads key MAHA ground like the need to cut artificial food dyes and encourage physical activity, it also offers a more expansive view of where Kennedy plans to steer his agency. Details of the report, which was delivered to the White House on Tuesday but not made public, were first published by the New York Times. They have yet to be authenticated by White House officials.
Childhood vaccine schedule reform is on the agenda, though the report offers no details on how Kennedy will change the list of recommended childhood vaccines, if at all. He has for years cast suspicion on vaccines, often citing flawed research, and promoted the idea that early shots are harming children. The report similarly calls for “addressing vaccine injuries.”
“Together, this strategy will translate the work of the MAHA movement to policies that make a transformative and lasting impact for Americans and end the childhood chronic disease crisis,” says a draft document, dated Aug. 11 and published by Politico.
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The strategy notably avoids mention of the top causes of excess death among American children: firearms and motor vehicle crashes. It instead plays up the potential harms of screen time, inactivity and overmedicalization. One of the recommendations involves creating more barriers — like additional prior authorization — to prescribing certain medications, such as stimulants, to children on Medicaid.
“This report has one overriding implied message: More research needed,” Marion Nestle, a leading nutrition researcher and professor emeritus at New York University, said via email. But, she said, “we already know the problems. It’s way past time to start addressing them.”
Perhaps the most forceful regulatory proposals in the report have to do with marketing. One recommends the Health and Human Services Department work with other federal agencies to enforce laws on direct-to-consumer advertising of prescription drugs, including among social media influencers and telehealth companies. The move falls short of the full ban Kennedy previously talked about. A separate recommendation would create new industry guidelines to “limit the direct marketing of certain unhealthy foods to children,” though it seems those rules would still be voluntary. (Some of the largest food and beverage companies currently self-regulate under a program launched in 2006, but have frequently come under criticism for continuing to market foods low in nutritional value to kids.)
“Though still light on specifics, these draft recommendations are a bit of a mixed bag,” said Andrew Binovi, director of government affairs for the Physicians Committee for Responsible Medicine.
Among the ideas is promoting full-fat dairy products in schools and on federal nutrition programs, reforming laws that impede the local sale of meat and dairy and the use of mobile grocery stores, and moving the Food and Drug Administration away from animal testing. The report pitches bulked-up food education classes through the Department of Agriculture, and “MAHA boxes” full of healthy food for people in the Supplemental Nutritional Assistance Program, or SNAP.
Nestle says the first Trump administration tried to implement a similar plan with pre-packed food boxes distributed through food banks and other organizations, which was “a disaster for small farmers initially recruited to do these labor intensive and perishable boxes. It makes much more sense to make sure people have enough money to buy food.” Trump’s recent tax cut bill will reduce federal spending on SNAP by $186 billion over the next 10 years.
The report also suggests the government should incentivize more breastfeeding, either through the WIC program or other routes. There is little mention of ultra-processed foods, or UPFs, which are expected to be a focus of the updated Dietary Guidelines for Americans, due later this year. HHS is also crafting a definition of what constitutes a UPF.
“It appears that big food lobbyists have been busy and successful,” said Jerold Mande, CEO of the nutrition nonprofit Nourish Science, who previously held senior policymaking roles at the FDA and USDA under the George H.W. Bush, Clinton, and Obama administrations.
“Who expected the MAHA report to do more to get whole milk in schools than to get UPF out,” he added.
The report also says that the USDA will “prioritize precision nutrition research,” a line of research that aims to provide people with more personalized recommendations by taking into account their body’s individual needs and responses to certain foods. Former NIH nutrition researcher Kevin Hall warned in a recent STAT interview against focusing too much on individual solutions like precision nutrition rather than systemic reforms to the food environment when it comes to fighting chronic disease. Figuring out a person’s ideally tailored diet, he said, “is not a public health intervention.”
The draft report is “the most ambitious federal plan yet to confront childhood chronic disease,” said Marty Irby, president and CEO at Capitol South and Competitive Markets Action, who previously lobbied for ranchers and farmers. “Still, there are gaps: the USDA school lunch program continues to force dairy on many children — particularly kids of color — who are lactose intolerant, with little to no alternatives, and the plan offers little to promote local, farm-to-table food in schools.”
Aviva Musicus, science director for the Center for Science in the Public Interest, criticized the report as embodying “the idiosyncratic beliefs” of one person, Kennedy. “He might be right about food dyes, but the report’s recommendations to alter our vaccine framework, restructure government agencies, and promote meat and whole milk are going to promote disease, not health,” Musicus said.
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While the draft report is not a budget document, it is unclear how much funding would be needed for the various efforts or where it would come from. Already, Congress failed to deliver on the administration’s budget requests at HHS, including Kennedy’s crown jewel, the Administration for a Healthy America. The draft document suggests AHA will instead become a “new agency structure,” which could be done informally and without Congress, experts say.
Many of the proposals involve Medicaid, WIC, SNAP, and other assistance programs where funding has been cut. The federal budget bill signed into law on July 4 restricts access to food assistance and health coverage through Medicaid. For SNAP, commonly called food stamps, that means more stringent work requirements for recipients, and expanded cost-sharing with the federal government for states, including stricter penalties for local administrative errors.
Instead of regulation, the administration plans to run public awareness and education campaigns aimed at adolescents about physical fitness, screen time, substance use, vaping and “root cause issues that impact adult infertility.” Another initiative aims to train school and library workers on how to handle overdoses, and expand their access to the overdose-reversal medication Narcan, per the report. States will be encouraged to re-adopt the Presidential Fitness Test, which grades students on their ability to do things such as complete a mile run.
HHS will also establish an “infertility training center,” though the report offers limited details on what services would be offered at such a facility. (Kennedy allies have been pushing for widespread use of what’s called restorative reproductive medicine; some in traditional medicine have their reservations about it.)
Medical schools, which have already been pushed by the administration to add more nutrition lessons or risk funding cuts, might be pressured into adopting more holistic or functional medicine curriculum, which MAHA favors. The draft report highlights “accreditation reform” as a goal.
Elsewhere in the department, National Institutes of Health officials plan to launch two new offices, one focused on developing alternatives to animal testing, such as organ-on-a-chip technologies, and another to organize chronic disease research. NIH will also start a new task force on children’s health, and create a database of researchers’ funding sources, similar to the OpenPayments system run by the Centers for Medicare and Medicaid Services, per the draft report.
The commission’s recommendations, while largely centered at Kennedy’s HHS, also affect the USDA and the Environmental Protection Agency — though not as severely as some in the food and agriculture industries feared. Unlike the first report, which drew fire from agriculture groups for naming pesticides a driver of ill health, the latest document takes a friendly tone. Kennedy advisers have met with dozens of farmers and other people in the agriculture sector this summer.
While calling for more “innovative growing solutions,” the report also says the government ought to “ensure that the public has awareness and confidence in EPA’s robust pesticide review procedures.”
When it comes to air quality — a known driver of poor health, especially among children in low-income areas — the MAHA commission simply calls for more studies.
“The commission has a historic opportunity to protect America’s kids, but only if it resists corporate influence and turns bold ideas into real, accountable action,” Irby told STAT.
Here are other highlights from the document:
Mental health: More prior authorization
Pediatric mental health remains a key focus for Kennedy and his MAHA allies. In February, a White House executive order called mood stabilizers and antipsychotic drugs a “threat.” Kennedy has routinely taken aim at stimulants, in particular, calling them “poison” and overinflating their use in children, despite their efficacy in alleviating ADHD symptoms.
The draft echoes this language, highlighting the overmedicalization of children as a key challenge to overcome and calling for HHS to form a working group that will evaluate prescription patterns for SSRIs, antipsychotics, stimulants, and other drugs that children take. They also ask the Centers for Medicare and Medicaid Services to work with states to increase prior authorization requirements and tighten prescribing safeguards particularly for ADHD. The draft says the Veterans Administration will provide NIH with de-identifiable data on ADHD, diabetes, and pharmaceutical usage among spouses, dependents and survivors of veterans under 18.
It’s true that kids can be overmedicalized, said Jennifer Mathis, deputy director for the Bazelon Center for Mental Health Law. But it was “disheartening, however, that the leaked draft strategy makes no mention of well-established services that are critical for children with significant mental health needs, such as intensive care coordination, intensive behavior support, and mobile crisis services,” Mathis said.
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Rates of anxiety, depression and ADHD in the U.S. are increasing, but the scientific explanation for their rise is unclear. The report pegs them specifically to increased screen time, vaping, poor nutrition and lack of physical fitness. Screen time, in particular, is mentioned numerous times and cited as a major challenge facing youth development and a contributor to the rise in chronic diseases.
Although the scientific literature on screen use offers conflicting evidence for this assertion, the report asks NIH to increase research into the issue to improve mental health and addiction issues. The Surgeon General will also launch an initiative to educate and improve awareness on the effect of screens on children, especially limiting use at school.
Notably absent from the report, however, was the startling rise of youth suicide over the last two decades. Suicide is one of the leading causes of deaths in this demographic and is particularly pronounced among Black teenagers. One in five high school students seriously considered attempting suicide in 2023, according to a CDC report. But the report offers no suggestions for tackling this trend.
Fluoride: New scrutiny of water standards
In discussing the importance of water quality, the document focuses on one element: fluoride. The document does not directly name other contaminants, like PFAS or lead. The report states that the CDC and USDA will “educate Americans on the appropriate levels of fluoride, clarify the role of EPA in drinking water standards for fluoride under the Safe Drinking Water Act, and increase awareness of the ability to obtain fluoride topically through toothpaste,” closely echoing previous statements by Kennedy.
Experts largely agree that fluoridation at the level currently recommended by the CDC is safe, despite some growing concern that higher levels of fluoride intake could be associated with decreases in IQ.
The draft of the report also states the FDA will evaluate liquid drops and tablets. This process has already begun, with a public meeting in July which was preceded by a press release from the FDA announcing it was “initiating action to remove concentrated ingestible fluoride prescription drug products for children from the market.”
Electromagnetic radiation: Studies ahead
The report also says HHS plans to study electromagnetic radiation and health research “to identify gaps in knowledge, including on new technologies to ensure safety and efficacy.” The report doesn’t explain what sources of electromagnetic radiation its authors consider possible cause for concern. But Kennedy has claimed — contrary to scientific consensus — on Fox & Friends and on Joe Rogan’s podcast that technologies like cell phones and Wi-Fi may be contributing to cancer and other childhood chronic diseases in the U.S.
The bulk of research on radiation from cell phones and Wi-Fi suggests they are safe, and the NIH’s National Cancer Institute says that “the evidence to date suggests that cell phone use does not cause brain or other kinds of cancer in humans” and that the few high-quality animal studies available have established no evidence that Wi-Fi is harmful to human health. There is, however, mixed evidence on a possible connection between high amounts of exposure to electromagnetic radiation from power lines and childhood leukemia; if there is an association, researchers aren’t sure what the explanation would be. And there is clear evidence of a connection between X-ray exposure and cancer.
But while there’s not evidence of a link between cell phones and cancer, it’s true that the devices have changed dramatically since the advent of smartphones and that kids’ usage has skyrocketed, Emanuela Taioli, director of the Institute for Translational Epidemiology at Mount Sinai’s Icahn School of Medicine, wrote in an email. “Perhaps a new study on kids specifically is worth doing.”
Daniel Payne and Chelsea Cirruzzo contributed reporting.
If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: Call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.
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