For his second term, President Trump has seemingly endorsed the movement to “Make America Healthy Again”. Popularized by Robert F. Kennedy Jr. to play off of the iconic MAGA brand (it is also referred to as “MAHA”), the purported primary goal of the movement is to end corporate control of the U.S food system and commit to public health. RFK Jr., who touted the idea as part of his own bid for president, was quickly named the top choice for Secretary of Human Health Services by the former president following his successful re-election, a position which was bestowed in exchange for a helpful endorsement. 

Over the past week, the appointment has generated significant discourse within the food and ag sector about how the former environmental lawyer’s health-centric vision for America might be incorporated into the president’s platform and received in D.C., where the interests of Big Ag are deeply entrenched. Underpinning all of this was the fact that there was no clear sign as to who might be tapped for Secretary of the Department of Agriculture.

We know now that the president has tapped Brook Rollins to lead the USDA. Rollins, a Texas native, is the president and CEO of America First Policy Institute and a loyalist of the Trump campaign. Coming from a background in criminal justice reform and economic policy, it is unclear exactly what her agricultural priorities might be, or how aligned with MAHA.

Because to really make Americans healthy, we first have to understand what it is that has created a very real and severe health crisis in one of the world’s wealthiest nations, from the landscape–both literal and figurative–of our food and farm systems to the initiatives already underway to address the root causes. We’ll need to build on the decades of good work that has been done to transform our food systems for better, using tried and true methods rather than Green Revolution-ing our way into a second Dust Bowl. We also have to pay serious attention to how upcoming efforts to undermine social welfare programs like health care & food access could place more Americans at greater risk.

First, the facts: 

• Diet-related chronic diseases are among the leading causes of death in the United States. 
• Poor nutrition is the leading cause of at least 600,000 American deaths each year, and food-related health impacts cost billions of dollars annually – the direct and indirect costs of diabetes alone total as much as $412 billion each year. 
• Six out of every ten adults in the United States have at least one chronic disease, and about four in ten have two or more chronic diseases, according to the Centers for Disease Control and Prevention.  
• Food insecurity is also linked to negative health outcomes. More than 47 million Americans live in food-insecure households, not only impacting the well-being of many Americans, but costing billions of dollars per year. The direct and indirect health-related costs of hunger and food insecurity in the US are estimated to be more than $160 billion a year.

The root causes of these issues have been allowed to proliferate for decades under both Republican and Democratic leadership. Addressing them is critical to the future health and wellness of our society, and we support all genuine efforts to do so. Below we have outlined a few key areas that must be addressed in order to actually make America healthy again, or perhaps finally.

1. Food Is Medicine, For All

Food has been known to impact human health for millennia, and there are many cultures globally that still actively practice forms of holistic nutrition as medicine. Here in the U.S., however, we have separated our food and health care systems almost entirely, leading to a proliferation of unhealthy foods in the average American’s diet and a health care system that is often too quick to prescribe rather than prevent.

In recent decades, though, there has been an emergence of “food is medicine” intervention programs that directly link food intake to the modern-day health care system. At a baseline level, there is increasing attention to the role food and nutrition play in prevention and treatment of diseases and overall well-being, particularly for food insecure populations, and there are also a host of Food is Medicine programs and interventions that proactively prevent or treat disease through food and nutrition, such as medically-tailored meals, medically-tailored groceries, produce prescriptions, and nutrition incentives. 

Food is Medicine programs are linked to many positive health outcomes, including lower health care costs, reduced hospital readmission rates, reduced inpatient admissions, reduced food insecurity, and better help addressing Type 2 diabetes. 

While Food is Medicine programs are improving health outcomes, to date,we still need greater focus on the connections between the way this food is produced and our health.

2. Nutrient Density & the Soil-Gut Microbiome Connection

We are what we eat, and therefore, we are what our food ate (credit to David Montgomery and Anne Biklé).  Critical to making America healthy is ensuring that there is healthy food available, and accessible. Food is now less nutritious than in the past due to poor soil, industrial production, and other factors. The advancement of regenerative agriculture and an increased focus on healthy soil is leading to the promise of more nutrient dense foods, yet federal policy continues to bolster commodification and intensification via industrial practices that degrade our soils. Coalitions like the Nutrient Density Alliance are working to mobilize consumers, farmers, and brands to increase awareness of the importance of nutrient dense foods, but there is still so much more that needs to be done to increase access to these foods in the American diet. 

3. Increasing Investment in Food Access

As mentioned above, food insecurity affects nearly 1 in 7 households, and is a major underlying cause of poor health, especially within marginalized communities. Population level programs like the Supplemental Nutrition Assistance Program (SNAP) support approximately 42 million Americans per year, reducing food insecurity broadly. SNAP is augmented by other federal programs that focus on increased access to healthy and nutrient dense foods, like Gus-NIP, which funds match programs at farmers markets, and Farm to Food Bank, which helps ensure donated items from agricultural producers make it to food banks rather than going to waste. The popular Local Food Purchase Assistance Cooperative Agreement Program (LFPA) and Local Foods for Schools Cooperative Agreement Program (LFS) have been critical for leveraging government procurement to support local farms and food systems and get these products out to communities. These programs provide the foundation for a healthier America, and we must protect and expand them if we are to seriously address diet-related health issues and move our consumption patterns away from what is easy to what is good for us.

4. Ultraprocessed Foods: The Undoing of the American Diet

Americans eat a lot–a lot–of ultraprocessed foods. Likely more than 50% of the average American’s diet consists of ultraprocessed foods,  which are those items in the grocery store that are often ready to eat, shelf-stable, and cheap. Think Fruit Loops and Mountain Dew, both which conjure sentiments of “natural” (Fruit! Dew!) while tasting unlike anything actually found in nature. Eating foods that are heavily processed has been linked to a higher risk of dying from any other cause, and has been shown to cause obesity, heart disease, mental health disorders, type 2 diabetes, a greater risk of cognitive impairment and strokes, and several other diseases. 

The U.S. dietary guidelines unfortunately do very little to steer us away from ultraprocessed foods, especially on food labels, which are overshadowed by bright packaging and the best ad campaigns a multi-billion dollar market can buy. Americans are deficient in many nutrients, and new metrics and guidelines are needed. But that means the FDA needs time, money, and research to develop a new system for nutrient profiling to quantify food nutritional quality. We also need to reckon with harmful agriculture practices.

5. The Terrible Proliferation of Pesticides

Agricultural pesticides have been linked to many types of diseases, yet we continue to use 1 billion pounds of chemical pesticides each year in the U.S.  

Although we have a strong organic agriculture sector and there has been decades of advocacy work to reduce pesticide use from groups like EWG and Pesticide Action Network, the FDA has done little to protect Americans from these harmful chemicals. In contrast, the EU has banned several pesticides that are used in the U.S., including neonicotinoids, paraquat, and atrazine–in fact, there are 85 pesticides banned in other countries that are still approved and applied in the U.S. 

And while there are arguments that farmers need pesticides to produce enough yields, it is also clear that organic and regenerative farmers are producing comparable or even greater yields, particularly under pressure from climate change, without these harmful substances. 

Making America Healthy 

With RFK Jr. at the helm of our nation’s health care system and Brooke Rollins leading the USDA (pending confirmations), there are so many questions that remain as to if and how we can really begin to address these issues, and so much that we will need to carefully consider and monitor. Here are just a few questions that are top of mind for us:

• Will President Trump, in his second term and with a new administration, actually help center food as a primary source of prevention and treatment of disease? 
• Will there be other actions from the administration that completely undercut our health care delivery system and who has access to it, like cutting millions of people from health insurance? 

• Most FIM programs are funded from Medicaid waivers–could Medicaid cuts have adverse impacts on these important programs? 
• Will food security programs like SNAP be cut, and how will that impact health? 
• Will the Trump administration actually help farmers transition to regenerative and organic practices so our food can have fewer chemicals and be more nutrient dense, which would take a seismic shift in Ag policy to move away from commodity subsidies?  
• Will the new administration actually take steps to level the playing field for small and medium farmers? 
• Under the first Trump administration, food safety regulations were degraded–will a second term lead to further harmful deregulation? 
• Our food system is dependent upon the underpaid labor of millions of undocumented farm and food workers, of whom President Trump has stated he will round up and deport. How does the potential harm done to these people, and the likely negative effects on food prices, farmers, and processors make America healthier?  

Marion Nestle said it perfectly in her recent Food Politics blog: “It’s too early to know how much of this is just talk, but I’m planning to do what I can to oppose measures I view as harmful, and to strongly support the ones I think will be good for public health.”

Let’s all stay diligent–closely monitoring the risks and opportunities that lay ahead. Eat well.