MAHA Commission Releases Make Our Children Healthy Again Strategy

The Strategy makes recommendations across three main categories: (1) research; (2) policy reforms; and (3) “process efficiencies and deregulations.” The Strategy broadly aligns with ongoing actions, initiatives, and priorities taken by Department of Health and Human Services (“HHS”) Secretary Robert F. Kennedy, Jr. Notably, the Strategy states that the U.S. Food and Drug Administration (“FDA”) will continue to work towards a Front-of-Pack Nutrition Information final rule and reforming the “Generally Recognized as Safe” (“GRAS”) process to “close the GRAS loophole.” The Strategy contains minimal discussion of so-called “ultra-processed foods” (“UPFs”) and pesticides, with recommendations for those topics highlighting ongoing work to create a standard definition for “UPFs” and pursuing research and programs regarding more targeted and precise use of pesticides, speeding up the approval process, and enhancing public awareness and confidence in pesticide review procedures. Unlike the Make Our Children Healthy Again Assessment (“Assessment”), the Strategy does not discuss seed oils. Further, the final version of the Strategy includes a few changes from a draft version of the Strategy leaked last month. Unlike the draft version, the final Strategy states, “over 60% of children’s calories,” as opposed to “nearly 70%” stated in the draft, come from highly processed foods; adds the recommendation that GRAS reform should include closing the “GRAS loophole;” and provides recommendations for actions on gluten and major food allergens.

As brief background, Executive Order (“EO”) 14212,² which established the MAHA Commission, requires the Commission to submit this Strategy to the President. This Strategy is informed by the Assessment, which was released in May and aimed to examine “the root causes of deteriorating child health.”³ Specifically, the Assessment identified “poor diet” marked by high consumption of so-called ultra-processed foods (“UPFs”), “the aggregation of environmental chemicals,” “lack of physical activity and chronic stress,” and “overmedicalization” as potential drivers of chronic childhood disease. The MAHA Commission is chaired by HHS Secretary Kennedy. Its members include FDA Commissioner Dr. Martin Makary, U.S. Department of Agriculture (“USDA”) Secretary Brooke Rollins, and other senior executive officials, as well as “other members of the Trump Administration invited to participate, at the discretion of the HHS Secretary and the [MAHA Commission’s] Executive Director.” According to the terms of the EO, after submitting the Strategy, the MAHA Commission cannot reconvene until the Chair and Executive Director recommend updates to the President on the Commission’s mission.

Importantly, the Strategy is simply a set of recommendations and does not constitute agency action in any particular area.

More details regarding the Strategy’s discussion of food follow.

Proposed Policy Reforms

The Strategy proposes several “policy reforms” to address the root causes of childhood chronic disease. The vast majority of the “reforms” are not new and, instead, summarize ongoing actions and initiatives taken under HHS Secretary Kennedy. In a notable departure from the Assessment, the Strategy largely does not address “UPFs” besides highlighting ongoing work to develop a standardized definition for “ultra-processed foods.”⁴ Other recommended policy reforms include:

• Developing guidance on “diagnostics and treatments for food allergies” and making recommendations that require “transparency in disclosures of ingredients that impact certain health conditions, such as gluten for those with Celiac disease, and other established food allergens.”
• Releasing the 2025-2030 Dietary Guidelines for Americans (“DGA”) by December 2025, which will “reform future DGA development processes,” including membership and scientific review, and “prioritize whole, minimally processed foods over packaged and highly processed alternatives.” The Strategy also calls on USDA and HHS to launch an education campaign based on the updated DGAs that “prioritizes whole foods, including protein foods, fruits, and vegetables, and minimizes high processed foods and added sugar.” During the press conference announcing the Strategy, USDA Secretary Rollins commented that the new DGA will be released “very soon” and will also “prioritize whole, healthy, and nutritious foods like whole fat dairy [and] meat.”
• Potentially revising the Front-of-Pack Nutrition Information proposed rule⁵ based on received comments and the 2025-2030 DGA and releasing a Front-of-Pack Nutrition Information final rule. During the press conference announcing the Strategy, HHS Secretary Kennedy further commented that Front-of-Pack labeling should be “established for sugars, for sodium, and for ultra-processed foods.”
• Continuing to “limit or prohibit use of” FD&C certified colors.
  • As part of the approach to certified colors, the Strategy recommends that USDA “apply the framework to food served through federal nutrition programs, especially the school lunch program.”
  • The Strategy also recommends USDA and HHS collaborate on research and policies that support domestic agriculture production of plants used as natural color sources.
  • Additionally, the Strategy notes that FDA will continue to expedite its review and approval of color additive petitions for colors from “natural sources” and explore ways to provide greater flexibility in connection with the use of "no artificial color" and other labeling claims.
• Finalizing a method for post-market assessment of chemicals in food.
• Reforming the GRAS process 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.”
• Modernizing nutrient requirements for infant formula and increasing testing for heavy metals and other contaminants.
• Exploring “the development of potential industry guidelines to limit the direct marketing of certain unhealthy foods to children, including by evaluating the use of misleading claims and imagery.”
• Continuing to support states in pursuing Supplemental Nutrition Assistance Program (“SNAP”) waivers that would place restrictions on the types of foods that can be purchased.
• Implementing the new DGA as the “guiding policy” for all meals served at Veteran Administration (VA) care facilities; providing “high quality and healthy food service in hospitals.”
• Developing “MAHA Boxes” to provide “whole, healthy food to SNAP participants.”
• Promoting whole, healthy foods across USDA’s 16 nutrition programs, including USDA’s Child and Adult Care Food Program (“CACFP”), and the National School Breakfast and Lunch programs in Head Start providers.

The Strategy also makes several recommendations intended to decrease regulatory hurdles for food manufacturers. Although the Strategy recommends reforming food standards of identity that are “outdated[,] unnecessary[,] and stifle innovation and no longer protect consumer interests,” it does not list additional standards of identity targeted for revision.6 Similarly, the Strategy recommends withdrawing “outdated or obsolete” guidance documents but does not further opine on guidance documents targeted for withdrawal. Other deregulatory recommendations include:

• Streamlining organic certification processes;
• Reducing burdens for small farms, Community Supported Agriculture programs, and improving the farm-to-school grants application process;
• Eliminating mandatory reduced-fat requirementsin federal nutrition programs and allowing school districts to offer full-fat milk;
  • During the press conference announcing the Strategy, FDA Commissioner Makary further expressed a commitment to promoting whole milk and “ending the war on natural saturated fats.”
• Removing zoning restrictions that “prevent mobile grocery units from serving food deserts,” “fast-track[ing] permits for grocery stores in underserved areas,” and “work[ing] with grocers on sustainable incentive programs that provide fresh, frozen, canned, or dried fruits and vegetables;”
• Providing “very small meat processors serving local markets” additional guidance on Hazard Analysis Critical Control Points that “ease compliance while maintaining safety standards;”
• Removing barriers preventing small dairy operations from processing and selling their own milk products locally;
• Working to reform the approval process for the full range of products that protect against weeds, pests, and disease to “increase the timely availability of more innovative growing solutions for farmers;” and
• Exploring opportunities to “introduce flexibility in manufacturing requirements while maintaining high standards to protect public health;”

The Strategy’s Research Recommendations

The Strategy makes several recommendations that would require multiple agencies to jointly research and assess the impacts of different ingredients and chemicals on health outcomes. These recommendations include:

• NIH launching an “Initiative on Chronic Disease” that will “leverage and align existing NIH research projects, improve NIH coordination on chronic disease research, and generate actionable results for diseases arising in childhood and adulthood;”
• NIH linking multiple datasets, including “claims information, electronic health records, and wearables data” into a single, integrated “Real World Data Platform” to aid researchers studying the causes of and developing treatments for chronic diseases;
• Expanding the use of “new approach methodologies” (“NAMs”) that reduce the reliance on animal studies in favor of using “human-relevant models such as organoids, computational simulations, and real-world data integration;”
• NIH leveraging its existing longitudinal birth cohort data to “deepen [the] understanding of chronic disease at various stages of life” and engage in research initiatives that include the importance of sleep and nutrition, health impacts of insulin resistance, potential health benefits of select high-quality supplements, and using fitness as a vital sign;”
• NIH partnering with FDA and USDA to conduct “high-quality nutrition research and ingredient assessments,” and expand “research on dietary patterns that support metabolic health.” This research will involve “fully utilize[ing] the newly created FDA and NIH Joint Nutrition Regulatory Science Program,” and USDA prioritizing “precision nutrition research” that “identifies how dietary exposures impact individuals;”
• NIH continuing to fund research to understand “the gut microbiome’s critical role in chronic disease development and progression in children;”
• VA and HHS studying the impact of food and lifestyle interventions to improve health outcomes and decrease costs;
• The Environmental Protection Agency (“EPA”), USDA, and NIH developing a “research and evaluation framework for cumulative exposure across chemical classes” that uses NAMs and computational tools to “improve methods for evaluating human health and environmental risks of chemical contaminants;”
• HHS, NIH, and EPA evaluating the risks and exposures of microplastics and synthetics; and
• USDA and EPA prioritizing research and programs that help growers adopt “precision agricultural techniques” in order to reduce pesticide use.

Additional Notable Recommendations

Agency Restructuring

The Strategy notes that HHS will reorganize to create the Administration for a Healthy America (“AHA”), which it describes as “a new agency structure specifically designed to coordinate and lead the Federal government's response to the chronic disease crisis through integrated prevention-focused programs and streamlined accountability.” HHS first announced this restructuring in March.⁷ Additionally, the Strategy notes that the National Institutes of Health (“NIH”) will launch two new offices:

• The Office of Research Innovation, Validation, and Application will “develop, validate, and scale NAMs and serve as an interagency coordination hub.”
• The Office of Research Innovations, Planning, and Analysis (“ORIPA”) will “improve disease-specific portfolio analysis, research prioritization, innovation, and Meta-Science, with an initial focus on increasing the chronic disease portfolio.”

Conflicts of Interest

Consistent with the Assessment, the Strategy outlines several recommendations that target perceived conflicts of interest. Those recommendations include FDA, EPA, and USDA “ensur[ing] that user-fee processes are transparent and efficient;” requiring HHS to publicly report research grants and consulting payments to entities that could create conflicts of interest; strengthening recusal requirements for advisory committee members, especially in matters that will have a “direct and predictable financial effect” on the advisory committee member; and HHS establishing a public database to disclose financial relationships and mandate recusal requirements pursuant to the Federal Advisory Committee Act. The Strategy also recommends that USDA mandate research applicants annually complete a disclosure form that provides “the amount, type, and source of all current and pending research support received by, or expected to be received by, the applicant at the time of the disclosure, and certify the disclosure is current, accurate, and complete.” Additionally, the Strategy recommends the HHS Secretary direct FDA, the Centers for Disease Control and Protection (“CDC”), and NIH to “review participation in any projects or initiatives funded by food and pharmaceutical companies through the CDC Foundation, Foundation for the NIH, or the Reagan-Udall Foundation.”

Collaborating with the Private Sector

To date, HHS Secretary Kennedy has achieved the bulk of his food-related agenda through voluntary action by food manufacturers. The Strategy affirms this approach and recommends “foster[ing] private sector collaboration with MAHA initiatives to accelerate innovation in health-focused technologies, agricultural solutions, and healthier nutrition outcomes.” Such partnerships would include:

• HHS and USDA working with restaurants to “increase education and awareness of age-appropriate healthy food options for children, consistent with the DGAs.”
• HHS, USDA, the Department of Education, the VA, and the Department of Defense working to “improve to improve access to whole, healthy foods in government-funded nutrition programs and meals, including in school meals, prisons, and VA hospitals, and ensure the availability of nutritious whole food for populations in need.”
• USDA and EPA launching a partnership with the private sector that focuses on “soil health and stewardship of the land.” This would include approaches to increase use of “precision application methods” for “targeted and precise pesticide applications.”

Next Steps

The Strategy confirms the Trump’s Administration ongoing commitments to pursuing changes to the food supply using primarily deregulatory tools. With the submission of the Strategy, the MAHA Commission cannot reconvene until the Chair and Executive update the Commission’s mission.

We will continue to closely monitor and keep you updated on similar developments that impact the food industry.

Authored by Martin Hahn, Elizabeth Fawell, Veronica Colas, and Chigozie Akah.