President Trump and Robert F. Kennedy Jr., the health secretary, set forth their vision on Thursday for how to “make America healthy again” with the release of an expansive report on a crisis of chronic disease in children.
The report lays the blame on ultraprocessed foods, chemical exposures, stress, lack of physical activity and excessive use of prescription drugs, including antidepressants.
The product of a presidential commission led by Mr. Kennedy, the report paints a bleak picture of American children, calling them “the sickest generation in American history.” Rather than set out specific policy prescriptions, it offers up carefully selected studies and proposes new research.
But it is unmistakably Mr. Kennedy’s worldview, echoing many of the talking points — some intensely disputed — that the health secretary, a former environmental lawyer and outspoken vaccine skeptic, has repeated for decades.
The health secretary has long blamed a broken food system and environmental toxins for what he sees as an epidemic of childhood chronic disease. The document puts a heavy emphasis on both.
It spotlights ultraprocessed foods and drinks like sodas, chicken nuggets, instant soups and many packaged snacks, which make up nearly 70 percent of the calories consumed by children and adolescents. It calls attention, as well, to the stew of chemicals in air, food and water to which children are exposed, beginning in the womb.
In some cases, the report misrepresents existing scientific consensus. It implies, for example, 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. It calls for further scientific inquiry “into the links between vaccines and chronic disease,” despite dozens of studies that have failed to find a link.
Thursday’s release of the report featured a round-table discussion in the East Room of the White House between Mr. Trump and the Cabinet secretaries and other top administration officials who make up the commission.
The event reflected the topsy-turvy state of American politics, in which Republicans have suddenly sought an image as the party of good health even as Mr. Trump and Mr. Kennedy lay waste to the nation’s public health and biomedical science apparatus. Mr. Trump himself gave a nod to that state of affairs.
“Normally I’d say you’re very progressive,” he said of the group he had assembled. But Democrats, Mr. Trump added, have taken ownership of the word, “so therefore I’m not going to use it to describe you, but you are far forward thinkers.”
Mr. Kennedy called the 68-page report “a call to action for common sense,” and “an invitation to the American people and the American press to have a complex conversation about a nuanced subject.”
If there was a unifying theme to the document, it is that the government has invested far too much in research to develop treatments for chronic ailments like heart disease, cancer, obesity and depression — and far too little in understanding the causes of disease and how to prevent it. It also pointed a finger at the food and chemical industries and their corporate influence in federal policymaking.
It singles out pesticide manufacturers, in particular, saying they spend billions of dollars on research intended to sway policymakers — a “ghostwriting strategy,” the report said, that “mirrors tactics used by the tobacco industry to distort scientific consensus.”
Public health experts offered mixed reactions. Peter G. Lurie, the president of the nonprofit consumer advocacy group Center for Science in the Public Interest, called the document a “cherry-picked recapitulation of the secretary’s own pet peeves.”
And Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases, said the report “sows doubt in the safety of the childhood vaccine schedule” in the midst of a measles outbreak that continues to spread.
But Tracey Woodruff, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, and a former scientist for the Environmental Protection Agency, said the report “lists many of the toxic chemicals we have been pushing the government to address.”
She was thrilled to see the recognition of corporate influence on scientific research. “But,” she added, “you can’t do anything to solve the children’s health crisis if you are dismantling the E.P.A.”
Under the executive order Mr. Trump issued establishing what he called the “Make America Healthy Again Commission” — or the MAHA Commission — the panel has another 80 days to outline a strategy to combat childhood chronic disease.
Whatever steps Mr. Kennedy takes could put him on a collision course with industry. Moments after the report’s release on Thursday, the sugar industry issued a statement noting that sugar consumption is declining, and suggesting it was not to blame for childhood obesity.
The report suggests a number of new initiatives for the National Institutes of Health, which like other federal health agencies is suffering from mass layoffs and budget cuts. During a morning conference call with reporters, Mr. Kennedy said there is no budget for the agenda, and no estimate of how much it might cost, but argued that addressing the chronic disease would ultimately save taxpayers money.
“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,” Dr. Marty Makary, the head of the F.D.A., said on the call. He added, “I hope this marks a grand pivot from a system that is entirely reactionary to a system that will now be proactive.”
The report reflects a consensus across government agencies and officials, including Mr. Kennedy; Brooke Rollins, the agriculture secretary; Lee Zeldin, the head of the Environmental Protection Agency; and the leaders of the Food and Drug Administration and the N.I.H.
Notably, there were no representatives of the C.D.C., the one federal agency that has been focused on chronic disease prevention, at the White House or 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 is now planned to be handled by a new agency called the Administration for a Healthy America.
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. Mr. Kennedy has called on states to eliminate fluoridated drinking water, and two, Florida and Utah, passed bans this year. Both states are led by Republicans.
The document 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.”
But if Mr. Kennedy has one singular priority, he said on Thursday, it is ridding the American diet of 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” that have been too heavily influenced by food manufacturers.
The report notes that since World War II, there has been a rise in industrially manufactured foods and drinks, which tend to be high in refined grains, added sugars and fats, and 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 early research has linked to some health concerns.
But the administration’s actions in the past few months contradict the concerns laid out in the report.
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 over a 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.
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.”
