Yesterday, I sat in a makeshift press room on Independence Avenue packed to the brim as RFK Jr. and the MAHA Commission released their strategy report to "Make Our Children Healthy Again"
Not the assessment from May that identified the problems to be solved.
But the “MAHA Strategy Report”
Their actual game plan.
120+ initiatives to "reverse the failed policies that fueled America's childhood chronic disease epidemic."
NIH Director, Dr. Jay Bhattacharya, summed it up nicely calling the report an attempt at addressing ‘the nightmare scenario' of the state of today's children’s health - a reality where our kids expect a shorter life span and a sicker existence than their parents and grandparents.
After reading through the whole thing (which I thoroughly recommend), I'll be honest: this isn't the regulatory hammer most people expected.
It's something else entirely.
So What Is It?
The MAHA Report (released in May 2025) mentioned ultra-processed foods more than 40 times.
The MAHA Strategy? Once.
In contrast, the word "research" appears in the strategy document 62x by my count, which provides a signal as to how they plan to "fix" things.
To my surprise there was little talk of outright banning chemicals or regulating food companies, and instead there’s a focus on realigning incentives.
And if you’re like me and believe incentives are the invisible hand that controls everything, this is where things get interesting.
Incentive Realignment.
Here's an indisputable truth that most people miss about health and healthcare
Everyone makes more money when kids are sick than when they're healthy.
And before you scream, ‘CONSPIRACY THEORIST!’ I’m not saying the government hates your kids. Or that your doctor, your pharmacist and your dietician are evil.
I’m also not saying that Big Food, Big Pharma and Big Insurance are in cahoots and exist only with nefarious intent.
I’m simply saying this:
Conflicts of interest matter
Pharma profits from treating chronic diseases
Food companies profit from addictive ultra-processed foods
Healthcare profits from managing symptoms, not preventing disease
Researchers get funding from the industries they're supposed to be reporting on.
And from that perspective, flipping the incentives seems like an effective play -
Especially in the context of a healthcare system where history has repeatedly proven that ‘centralized planning’ aka ‘government fixes’ has as much potential to screw things up as it does to correct anything.
So, yes, I like that the MAHA strategy isn't leaning on regulating the system to death.
But it’s gray and also…
Why Now?
Why is this happening under President Trump 2.0 instead of previous administrations?
I think the answer is simple: regulatory capture has reached a breaking point.
For decades, the agencies tasked with protecting public health have been funded, advised, and staffed by the industries they're supposed to regulate.
The revolving door between FDA officials and pharmaceutical companies, between USDA leadership and agribusiness, between CDC researchers and food corporations.
See Exhibit A:
COVID broke the spell.
People watched "follow the science" get weaponized while obvious conflicts of interest went unaddressed. Public trust in health institutions cratered. It’s been a disaster.
This created a political opening that didn't exist before.
An anti-establishment health agenda suddenly has mainstream appeal across party lines.
Parents watching their kids struggle with anxiety, ADHD, and obesity don't care about regulatory precedent - they want someone to blame the right people and fix it.
The timing isn't coincidental.
This approach only works when public faith in existing institutions is already broken-
And man oh man… is it broken.
The MAHA Strategy Gray Areas That Could Change Everything (Or Nothing)
Conflict of Interest Transparency
The document calls for public databases tracking industry payments to researchers. NIH will establish a publicly accessible researcher payment database tracking health industry payments to researchers, similar to CMS's Open Payments system for physicians (p. 9-10).
The good: You'll finally see which "independent" studies are funded by Big Food or Big Pharma.
The bad: Transparency doesn't stop conflicts- it just makes them visible if someone is actually looking. The same researchers will still be making recommendations and the public can't quit their day jobs to see who's funding research into Froot Loops.
Case in point, have you personally looked up your physician to see if they are collecting speaking fees or other payments from Big Pharma?
I have. But most people haven't.
Impact is limited by use.
Direct Primary Care Push
This one's buried in the report but could be huge.
HHS has committed to 'promote increased accessibility to direct care models' for families through education about the new flexibilities that allow use of health savings accounts with DPC (p. 12).
The good: DPC doctors spend 30-60 minutes per visit instead of 7 minutes. They focus on prevention instead of prescriptions. No insurance middlemen. Amazing outcomes.
The bad: Well, it only has an impact if the government communications strategy is effective. Direct care is transformative and incredible, but also hard to conceptualize for most people. They just don't get it.
Systemic change is hard and we've taught patients to rely on insurance for everything. I’m not sure that HHS PSAs are going to do much to change that.
And impact will depend on how effective they can be.
GRAS Reform (The Food Additive Loophole)
FDA will update regulations to reform the GRAS designation by "closing the 'GRAS loophole,' implementing a mandatory GRAS notification program, and increasing consumer transparency with respect to substances found in our nation's food supply" (p. 8).
The good: Companies can't just declare their own chemicals "Generally Recognized as Safe" anymore. Not sure who ever thought that was a good idea.
The bad: Like all well intentioned regulations "a mandatory GRAS notification program" will mean more bureaucracy that big companies can navigate better than small ones potentially reducing competition and making things worse for small businesses and consumers.
Quality Metrics Instead of Volume Metrics
HHS and CMS will develop ‘quality measures’ that promote children's health outcomes rather than just healthcare utilization (p. 11).
The good: Doctors potentially rewarded for keeping kids healthy instead of just seeing them more often.
The bad: "Quality measures" can be gamed just like volume metrics. And who decides what counts as quality?
Breaking Medical School Accreditation Monopolies
Here's where things get spicy - and I love it.
HHS and CMS will "address the current monopolies that exist for the accreditors of medical education programs by using their regulatory authorities to bring in competing accreditors of medical education programs, including those with a focus on treating the root causes of chronic disease in the United States" (p. 10).
The document adds: "Accreditation reform can also increase nutrition education and ensure medical school curricula better align with making America healthy again" (p. 10).
Here's what most people miss about this: if you control how doctors are trained, you control healthcare for the next 30 years.
This isn't about adding nutrition classes. It's actually about creating a parallel medical establishment.
Think about it: Every doctor practicing today was trained in schools accredited by the same handful of organizations. Those accreditors with all of their bias and ties to industry determine what counts as "evidence-based medicine," what gets taught as standard of care, what approaches are considered legitimate.
The current system produces doctors who spend 7 minutes per visit, prescribe medications for symptoms, bully patients who resist interventions/screenings and rarely address root causes.
That's not an accident. It’s a direct result of how most were trained.
Breaking this monopoly is powerful and could fundamentally reshape American healthcare.
Doctors trained differently might actually know how to treat metabolic dysfunction with diet, or recognize that anxiety might be connected to gut health, or understand that many chronic diseases have environmental triggers - which would be amazing.
OR it could create a bunch of quack schools churning out practitioners who think essential oils cure cancer.
The stakes are enormous.
Medical education shapes every healthcare interaction for decades. Change the training, change the system.
This is a must watch.
The Whole Milk Situation (Yes, Really… Milk)
The strategy report suggests that the Trump Administration will ‘deregulate’ foods to allow whole milk back into schools, overturning decades of low-fat recommendations and restrictions (p. 12).
This is either brilliant or insane, depending on who you ask and I personally don't think it's worth a ton of focus.
The MAHA logic: Fat doesn't make you fat. Ultra-processed carbs do. Whole milk is more satiating and has better nutrient absorption.
The conventional wisdom: Saturated fat causes heart disease. Kids need to consume low-fat diets.
The reality: Nobody really knows because nutrition science is mostly garbage.
BUT given that chicken nuggets, french fries and low-fat chocolate milk currently count as a 'healthy meal' according to current school lunch guidelines - it's hard to argue that whole milk is going to be the food that causes things to get worse.
Regardless - my newsfeed this morning was FULL of professional organizations whining about whole milk as if they think somehow current recommendations are producing outcomes of any value.
Do with that information what you will.
International Comparison Reality Check
Here's what the MAHA Strategy didn’t mention: other countries have already addressed childhood chronic disease in their own ways.
And if they have better outcomes (they do), how did they do it?
France banned certain food additives years ago. Denmark taxes sugar. Japan has school lunch programs that would make American parents cry.
But it’s not all rainbows and sunshine. Those countries ‘ban’ things more aggressively, which creates its own set of problems.
The MAHA approach seems designed for American political realities: a system where outright bans face massive resistance, and incentive realignment if done well, might actually work.
The question is whether this uniquely American solution - trying to fix broken incentives instead of just regulating bad actors - can produce the same health outcomes as more direct approaches used elsewhere.
Can you engineer better behavior instead of mandating it?
I don’t know, but I’d like to see us try, and we’re poised to find out.
More Research?
I read one critique that stated: ‘We already know all too well why kids in the U.S. are sick, why do we need more research?’
And they're not entirely wrong.
We don't need more studies to know things like:
Kids are more medicated than ever
Chemical exposure is at historic highs
Most medications treat symptoms, not causes
Kids spend too much time indoors & on screens
Ultra-processed foods are addictive & inflammatory
Why not just use common sense and save years of work & billions of dollars?
Why investigate everything from "Cumulative Exposure" (p. 4) to "Electromagnetic Radiation" studies (p. 7) to "Microplastics and Synthetics" evaluations (p. 5)?
It’s a great question. And I have thoughts.
But first, here’s what Dr. Jay Bhattacharya, Director of NIH had to say:
My take is:
I actually believe it IS the health agencies' jobs to "pursue rigorous, gold-standard scientific research to help ensure informed decisions that promote healthy outcomes for American children and families, as well as drive innovative solutions" (p. 4).
And while I’m not saying we should fund huge health bureaucracies, but if we’re going to, shouldn’t they be providing us with real data to make better choices for ourselves?
But what about our jobs as moms, dads, doctors and patients?
Well, I believe we should do what makes sense and remain open-minded and ready for change as the research unfolds.
Don't wait for government solutions.
Some principles are clear whether this strategy succeeds or fails:
Limit screen time
Move your body daily
Limit exposure to chemicals
Eat real food, not ‘food products’
Find healthcare providers who listen & focus on root causes
Question everything and everyone, especially when money is involved
The incentives in your personal life are under your control.
The system-wide incentives... we'll see.
The Bottom Line
This isn't the regulatory crackdown that many health advocates wanted or industry feared.
It does seem to be an attempt to change the game by changing the rules of the game.
Will it work? I don’t know.
The track record on "voluntary guidelines" and "industry partnerships" isn't encouraging, but the power might just lie in our hands.
Emphasis on realigning incentives and increasing transparency has the potential to create real change if enough people pay attention.
The most important thing isn't what the government does or doesn't do. It's whether you take control of your own health and that of your family.
Because at the end of the day, your health is your responsibility. Not RFK Jr.'s, not Trump's, not the food industry's.
Yours.
Because the system will keep making money off sick people until we stop participating.
So let’s start there.
Until next time,
Tiffany
What aspects of this strategy do you think will actually move the needle? Hit reply and let me know your thoughts.
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Wow, what a great article and summary of the announcement. Your commentary is thoughtful, balanced, and pragmatic as always.
Thanks, Tiffany for a thoughtful and insightful article.