https://www.mcgill.ca/oss/article/m...h-and-nutrition/maha-report-mostly-data-vibes It’s an exercise in hypocrisy as RFK Jr’s commission seeks to protect kids while his boss endangers their health Who would be so callous as to not want our children to be healthy? The Make America Healthy Again movement, now firmly ensconced in the White House under the leadership of Robert F. Kennedy Jr, released a 73-page assessment last week called “The MAHA Report.” It’s meant to give a bird’s-eye view of the problem with American children’s health, paving the way for a multipronged strategy due next August. Most people will not read the document itself. Rather, they will hear the MAHA architects being interviewed about it, and these snippets will often sound reasonable. But the report is Orwellian: it blends in truths and falsehoods, and the solutions it proposes are often wildly contradicted by the actions of the Trump regime. It looks like science but the MAHA Report is mostly “data vibes.” Healthy enough to die for the state Simply summing up this report as a pack of lies does a disservice to the public. It gets some things right, which is precisely why it is so insidious. Chronic diseases are real, and many like diabetes and asthma affect a lot of children. Fruits and vegetables aren’t as appealing as sugary treats; ads for ultra-processed foods bombard the airwaves and the Internet; and teenagers struggle with anxiety, depression, and loneliness. The report gets the vibes right: it certainly feels like American children—and, I would argue, children in many countries of the Global North—are unwell. But vibes can be misleading. Americans have a distorted perception of how much local crime is committed, in part because sensational offenses get centre-stage in news reports, true-crime podcasts and scripted dramas. What feels right can be an exaggeration of reality. Then there’s the question of what spurred this report. When its authors write that their changes will ensure that all Americans “live longer, healthier lives, supported by systems to prioritize prevention, wellbeing, and resilience,” it sounds like music to my ears. But something interesting emerges in the first few pages of the report: the U.S. government wants more soldiers. “Over 75% of American youth,” the authors write, “are ineligible for military service—primarily due to obesity, poor physical fitness, and/or mental health challenges.” In fact, the introduction itself begins with positioning children’s afflictions as a “threat to our nation’s health, economy, and military readiness,” with Dr. Oz confirming on Fox News that being healthy is “a patriotic duty.” As pointed out by a user on the social media platform Bluesky, there’s a deep irony in making someone healthy enough to go and die for the state. The MAHA Report is not a beneficent, populist roadmap to eradicating diseases: it is in part a military document. Data needs to be interpreted Despite its footnotes that cite respectable data sources like U.S. department reports, the Cochrane Collaboration, and multiple meta-analyses, MAHA’s assessment is filled with questionable or misleading claims. Take its mention that the number of children diagnosed with cancer in the United States since 1975 has risen over 40%. There is a lot to unpack that the report does not even address. Better diagnostic tools and their increased use explain some of this rise: you can’t count what you’re not measuring. Even though many of these cancers are indeed more common now, children tend to survive them at a much higher rate thanks to scientific progress. A paper published this year and using the same data cited by the MAHA report concluded that the underlying causes of this increase in cancer incidence in children “remain unclear.” Instead of admitting to the complexity of understanding why children get cancer, Kennedy’s assessment points a hesitant finger in the direction of the modern American diet, aspartame, microplastics, and yes, electromagnetic radiation from cell phones and Wi-Fi routers. Then there’s diabetes. In the 1980s, type 2 diabetes in children was very rare, but its incidence has “consistently increased the past two decades.” One of the big reasons for this—not mentioned in the report—is a massive shift in diagnostics. In the past, many people had undiagnosed diabetes: they simply didn’t know they had it, or they were part of a large study that followed them over time, they had an abnormal blood glucose measurement on a blood test for the study but were never diagnosed as having diabetes by their doctor. While undiagnosed cases still exist, diagnosis has changed drastically. Routine diabetes screening for people with no symptoms became recommended in the late 1990s by professional groups; the red-flag threshold for fasting blood glucose was lowered in 1997; and a test measuring the amount of hemoglobin in your blood that is bound to glucose (the HbA1c test) came into use in 2009, adding convenience. All of that impacts who gets counted. When we look at how many American teenagers are being diagnosed with type 2 diabetes each year from 2003 to 2018 (per CDC data), we see something interesting: the line for “White, non-Hispanic” is basically flat. The lines for other ethnicities are the ones going up dramatically over time. Experts know that higher rates of diabetes among African-Americans and Hispanic people are associated with racial discrimination, food insecurity, and housing instability. Given the Trump regime’s crackdown on “DEI” (meaning anything focusing on women, queer people, and non-white ethnicities), the MAHA people are unlikely to do anything concrete about high rates of type 2 diabetes in non-whites. We also see in the MAHA Report a stubborn refusal to confront known answers to important problems. The United States does rank last in life expectancy among high-income countries, as it underlines, but the reason isn’t cell phone radiation. As toxicologist Ryan Marino pointed out, we know the major drivers of this: deaths from assaults (including gun violence), illicit drugs, COVID-19, a lack of access to healthcare (the U.S. being the only high-income country that does not guarantee health coverage), and truly horrendous mortality rates for infants and pregnant women. To ignore mountains of data and wonder out loud if food dyes are to blame is to bury your head in the sands of the square one fallacy: we’ll simply pretend we have no data on this so we can fund studies that will hold responsible the culprits we’ve chosen in advance. We see this clearly with autism: the report scares parents with skyrocketing rates without mentioning that diagnostic criteria have changed and that awareness of the condition has bloomed. The report makes no distinction between neurodivergent and functional children and those requiring constant care, in order to drum up a justification for an upcoming study conducted by a pseudoscientist charged with practicing medicine without a license, a study which will, of course, finger vaccines by torturing the data long enough. Studying autism is not easy, but the data we have right now shows the condition to have genetic roots (and absolutely no link to vaccines). Robert F. Kennedy Jr, meanwhile, played the square one fallacy, claiming he’d have figured out autism’s cause by September, before walking that back recently. This is not science; it’s motivated reasoning. “Throwing insulin at people” We now arrive at what the report gets completely wrong and how its proposed solutions are already contradicted by Donald Trump’s actions. The MAHA Report states that childhood health has, over the last three decades, “largely worsened,” calling today’s children “the sickest generation in American history in terms of chronic disease.” As Gideon Meyerowitz-Katz, an epidemiologist based in Australia, highlighted on social media, this portrait is heavily doctored. Life expectancy in the United States has steadily risen over the last 145 years (with two notable dips accounting for the 1918 influenza and COVID-19); the average number of years lived without disease or disability grew from 64.8 in 1990 to 66.2 just before the pandemic; and diseases that used to severely debilitate us if not outright kill us have often been tamed by modern medicine. Meanwhile, on the subject of diabetes, FDA Commissioner Marty Makary himself—one of the authors of the MAHA Report—declared on Fox News that “maybe we need to treat more diabetes with cooking classes, not just throwing insulin at people.” The body of evidence on cooking classes to improve health outcomes is that, while they make people feel better about what they eat, they don’t really change BMI, blood pressure, or blood cholesterol levels. Makary was using “common sense” and ignoring the evidence, but the truth is not always intuitive. That’s why we conduct studies, especially when it comes to changing individual habits to improve health, which is a notoriously difficult thing to achieve. Withholding life-saving medications like insulin is particularly egregious given that Makary is the chief of islet transplant surgery at Johns Hopkins, and the pancreatic islets secrete insulin. Alas, rolling back drug availabilities seems to be one of the goals of the MAHA branch of the U.S. government, which also demonizes stimulants for ADHD. How do RFK Jr and his co-authors justify their hard stance against mental health medication? In part by citing papers that don’t exist. As was revealed by Emily Kennard and Margaret Manto, at least seven of the studies listed in the MAHA Report—with many focused on medications aimed at children and teenagers—aren’t real, with their cited authors confirming as much. Did whoever write this section ask ChatGPT to generate papers that show these drugs are bad? This looks like fraud, either through laziness or malice, and I hope journalists keep asking RFK Jr and his cronies about these fake papers every chance they get. Finally, the MAHA report goes off the rails with the improbable boogeymen of the wellness industry. It calls the sugar substitute aspartame a possible carcinogen, even though you’ll be fine unless you consume 36 cans of diet soda every day. It scares the reader with ambiguous results over electromagnetic radiation, citing the National Toxicology Program which reported that a rare form of cancer was increased not in mice exposed to cell phone radiation, nor in female rats, but in male rats only. It demonizes plant-based oils and wants to bring back animal fats, regardless of what the evidence actually states. It says fluoride lowers IQ—actually, poor studies find such an association with fluoride levels much higher than typically found in American drinking water, while more robust ones do not. And it fearmongers about the number of injections American children get as more vaccines get added to the immunization schedule, daring to claim that anti-vaccine doctors have been silenced by the establishment, which “undermines the open dialogue” necessary to care for children. Ignorance is strength While the MAHA commission speaks out of one side of the government’s mouth to defend children’s health, some of its members speak out of the other side when they act to strip America of important regulations. CDC staff who respond to lead poisoning in children were fired recently. Congress voted to undo regulations that restrict the amount of toxic air pollutants emitted by American industries. Last April, the FDA suspended testing of milk and dairy products due to job cuts by RFK Jr, and millions of Americans will soon lose their Medicaid coverage, a program that gives health insurance to adults and children with limited income, as well as food assistance benefits. The MAHA Report is an exercise in hypocrisy. And this document has the audacity to cite the work of Kevin D. Hall not once but twice. An expert on ultra-processed food and a leader in conducting gold-standard science on diets, he left the NIH due to censorship enacted by aides of Robert F. Kennedy Jr himself when Hall’s results didn’t simplistically show that ultra-processed food is as addictive as drugs. Do not believe the words of the MAHA movement when they say they want to bring in transparent science, gum up the revolving door between industry and government, and kick out ultra-processed food. Their speeches and documents are Orwellian, and Trump’s latest executive order on gold-standard science and RFK Jr’s goal of barring government scientists from publishing in major, so-called “corrupt” scientific journals (in favour of in-house propaganda publications) are yet more salvoes worthy of the Ministry of Truth. Their actions give them away, not their words. The MAHA coalition is a clown car for the aggrieved minority. There are real health issues to probe, understand, and intervene on, but the quacks and contrarians of MAHA can only point to a mirage. While they wield governmental power, they do not represent the mainstream. The crowning of pseudoscience in the United States has mobilized many science communicators and experts to speak up, so if you want a media diet that is more evidence based, I encourage you to follow people like nutrition scientist Kevin Klatt, molecular biologist Dan Wilson, immunologist Andrea Love, exercise scientist Nick Tiller, biomedical scientist Susan Oliver, toxicologist Ryan Marino, registered dietitian Leah McGrath, epidemiologist Gid M-K, and of course our own Office at McGill. This list is not even close to being exhaustive, because so many actual experts are pushing back against the falsehoods of the minority associated with the MAHA commission. George Orwell’s Nineteen Eighty-Four ends with—spoiler alert—the protagonist finally giving in to authoritarianism and propaganda. “But it was all right, everything was all right, the struggle was finished. He had won the victory over himself. He loved Big Brother.” By listening to scientists outside the MAHA movement, we don’t have to agree that 2 + 2 equals 5. Take-home message: - The MAHA Report (Assessment) provides a roadmap for Robert F. Kennedy Jr’s department to address ill health in American children and teenagers - When the report shows diseases are more common now than they used to be, it never explains that this is due in part to better and more routinely used diagnostic tools - The report wrongly blames ill health on things like aspartame, fluoride, and cell phone radiation, and the section on how teenagers are allegedly overmedicalized cites scientific papers that do not exist - The actions of the Trump regime have so far endangered the health of children and teenagers, by rolling back regulations and eviscerating health agencies