My Take on the MAHA Report

And my unsolicited suggestions for fixing the problem

Now that the Make America Healthy Again (MAHA) Commission has released its anticipated report, it’s time to dig in. The report identifies four key drivers of chronic disease in American children (they focused on kids, but this could equally apply to adults): (1) poor diet, (2) environmental chemicals, (3) lack of physical activity, and (4) over-medicalization. I’m going to focus on the first and third, because they’re squarely in my wheelhouse. But I would be remiss if I didn’t mention what the report omits: the leading cause of death for children and adolescents (ages 1-19) in the U.S. is firearm injuries. If we’re serious about making kids healthier, that cannot be left out.

What the Report Gets Right

The MAHA report is correct to sound the alarm on poor diet and declining physical activity. Nearly 70% of kids’ calories now come from ultra-processed foods (UPFs), and the data linking these foods to obesity, diabetes, and poor metabolic health is strong (For background: refer to my post on UPF). Our daily calorie intake has increased by approximately 300 calories since the 1950s. At the same time, technology has made it so we barely have to move to get those calories. Uber Eats can deliver 1,500 calories to your door while you’re still in bed.

Source: USDA Economic Research Service / Food Availability (Per Capita) Data System

We are also eating more of our meals outside the home—a shift that means we’ve largely outsourced control over ingredients and portion size. When someone else is cooking your food, it’s harder to make intentional choices about what goes into your body. And restaurants and fast food chains are in the business of delivering flavor, not nutritional balance.

Source: Data adapted from the CDC and the USDA ERS.

The result? We’re getting fatter as a population. Since the 1960s, overweight and obesity rates have skyrocketed. In 1960, about 13% of U.S. adults had obesity. Today, that number is over 42%. Combine that with the 30+ pounds of average adult weight gain since the 1950s, and the trend is unmistakable.

If you look at the obesity graphs, there’s a clear inflection point around 1980. Our genetics didn’t change in 1980—but our environment did. The workforce shifted: more people went to work outside the home, leaving a void in home-cooked meals and fueling an over-reliance on fast food and convenience foods. The total calories available in the food supply exploded—from about 3,200 per person per day in 1980 to nearly 4,000 by 2000.

Food manufacturers, accountable to shareholders, doubled down on marketing and product engineering to keep profits up. They created hyperpalatable foods that override natural satiety cues and made it socially acceptable to eat anywhere—in libraries, classrooms, even on public transit. Add technology to the mix, and now food comes to us with the tap of a screen. The result? We’re moving less, eating more, and increasingly disconnected from how food is made.

What I hope for from the commission…

I applaud the report’s call for more funding for nutrition research—and I agree that current funding is woefully inadequate. But if and when those funds are allocated, researchers must be free to publish findings without political interference. Kevin Hall, one of the top NIH researchers in this space, recently retired due to censorship around his work on UPFs. If we want science to lead, we have to let it speak.

I also agree with the report’s point about the dietary guidelines: they are written in complex, overly detailed language that misses the bigger picture. Nutrition education, as it stands, isn’t working—and that’s left a vacuum for influencers and pseudoscience to fill. When people are confused or mistrustful, they look elsewhere. And often, "elsewhere" means Instagram reels over peer-reviewed research.

It’s also important to recognize that many of the problems identified in the report—like sugar-sweetened beverages—aren’t new. We’ve seen real attempts to address them through policy. The Bloomberg administration tried to implement a soda tax in NYC and was slammed for promoting a "nanny state." Similarly, Michelle Obama’s early initiative to improve children’s food environments was derailed by lobbying and political resistance.

So how does the MAHA Commission plan to solve these issues? I sincerely hope it’s not by demonizing individual ingredients. We’ve tried that. The second part of this assessment is set to be released in August, promising to deliver the “how” behind the “what” outlined in this report. If they’re looking for solutions, here’s what I’d propose:

• Tax ultra-processed foods that meet certain nutrient criteria, much like we did with tobacco.

• Set regulatory limits on added sugars, sodium, and industrial fats in packaged foods.

• Fund independent nutrition research so industry isn’t the one footing the bill (and shaping the outcomes).

• Close the GRAS (Generally Recognized as Safe) loophole so companies can’t self-certify chemical additives without FDA oversight.

• Most importantly, help Americans access and afford nourishing, minimally processed food.

Final Thought

If we’re going to make America healthy again, we need more than commissions and campaign slogans. We need bold, evidence-based policies that reflect how dramatically our food environment has evolved—and the courage to stand up to the industries that profit from the status quo.

Let’s not squander this moment.