The United States released the Make America Healthy Again (MAHA) report on January 13, 2025. The report, issued by the Trump administration, focuses on the crisis of chronic diseases in children.

The report notes that despite the United States spending significantly more on healthcare than other high-income countries, the health of its children is deteriorating. The incidence of chronic diseases such as obesity, diabetes, neurodevelopmental disorders, cancer, and mental health issues is rising. The report analyzes four main drivers of this crisis: poor diet, accumulation of environmental chemicals, lack of physical activity, and over-medicalization, and proposes corresponding solutions.

1.Current Status of the Child Chronic Disease Crisis:

• Obesity: Over 1 in 5 children aged 6 and older in the U.S. are obese. The prevalence is rising sharply, accompanied by an increase in severe obesity rates.

• Diabetes: The incidence of diabetes among U.S. children is increasing. It is projected to rise further for both type 1 and type 2 diabetes by 2060.

• Neurodevelopmental Disorders: The incidence of neurodevelopmental disorders such as autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD) is increasing.

• Cancer: The incidence of childhood cancer in the U.S. has increased by over 40% since 1975.

• Mental Health Crisis: Mental health issues such as depression, anxiety, and suicidal ideation among American youth are becoming increasingly severe.

• Allergies and Autoimmune Diseases: The incidence of allergies and autoimmune diseases among U.S. children is also on the rise.

2.Drivers of the Child Chronic Disease Crisis:

• Poor Diet: The diet of U.S. children is disproportionately high in ultra-processed foods (UPFs), leading to nutrient loss, increased caloric intake, and health problems. UPF consumption varies greatly globally and is strongly linked to diseases like obesity and diabetes. Furthermore, the U.S. government's investment in nutrition research is insufficient and susceptible to influence from the food industry, and there are issues with the Dietary Guidelines.

• Accumulation of Environmental Chemicals: U.S. children are exposed to a wide range of synthetic chemicals that may pose long-term health risks, especially during critical developmental stages. However, current risk assessment methods may not fully capture the impact of these exposures. Moreover, funding and lobbying activities by the food, chemical, and pharmaceutical industries may affect the objectivity of research findings.

• Lack of Physical Activity and Chronic Stress: Over the past four decades, U.S. children have shifted from an active, play-based childhood to a sedentary, technology-driven lifestyle, resulting in increased physical and mental health problems. This is characterized by reduced physical activity, insufficient sleep, increased chronic stress, heightened feelings of loneliness, and excessive use of electronic devices.

• Over-Medicalization: U.S. children face issues of over-medicalization, including overuse of prescription drugs, unnecessary surgeries, and vaccinations. This phenomenon is influenced by corporate interests, medical education, research funding, and media promotion.

3.Proposed Solutions:

• Support Gold Standard Scientific Research: This includes addressing the replication crisis, establishing post-market surveillance systems, creating real-world data platforms, applying AI for health monitoring, reforming GRAS (Generally Recognized as Safe) regulation, conducting nutritional trials, implementing nationwide lifestyle interventions, studying drug safety, investing in alternative testing models, and conducting precision toxicology research.

• Develop a Comprehensive Strategy: Establish a "Make America Healthy Again Presidential Commission" responsible for advising on how to address the child chronic disease crisis. This includes investigating the scope of the crisis, communicating information to the public, and recommending relevant policies. The Commission is required to submit assessments and strategic reports within specified timeframes.