MAHA Nutrition Plan: A Science-Based Rebuttal to MedPageToday's Narrative-Enforcing Opinion Article

MedPageToday is a reliable source of woefully misleading information, especially when trillions of dollars in medical revenue are being threatened by healthier children and adults.

Susan Mayne’s recent article, “What the MAHA Report Gets Right, and Wrong, on Nutrition,” presents itself as a critique of the Make America Healthy Again (MAHA) report’s nutrition recommendations. In reality, it reads more like a biased hit piece, dismissing well-founded concerns as “wrong” without fairly engaging with the science. Mayne’s analysis downplays or outright denies evidence on ultra-processed foods, food additives, and even the value of nutrient-dense whole foods like full-fat dairy and unprocessed meat.

As a defender of the MAHA plan, I this rebuttal to set the record straight. I will draw on robust, peer-reviewed research and authoritative reports to show that the MAHA report’s focal points – limiting ultra-processed foods and risky additives while promoting whole, wholesome foods (yes, including beef and whole milk) – are grounded in solid science and aligned with public health interests. Rather than “fringe” ideas, these recommendations reflect a growing consensus that our industrialized diet is driving an epidemic of chronic disease. Mayne’s one-sided critique, by contrast, neglects this consensus and risks perpetuating the status quo. Below, we address each area of contention with evidence and clarify the broader health and economic stakes at play.

Ultra-Processed Foods, Childhood Chronic Disease, and the Evidence Mayne Ignored

One of the MAHA report’s central directors aims at ultra-processed foods (UPFs) – especially ultra-processed grains, sugars, and fats – which are major drivers of childhood chronic disease. Mayne’s article portrays this as an overstatement, but the scientific literature resoundingly supports MAHA on this point. A 2024 systematic review in Nutrition Reviews examined 17 studies on UPF intake among children and adolescents and found that 14 of them (over 80%) showed a significant association between higher UPF consumption and greater overweight/obesity and cardiometabolic risks in youth. Only a few outlier studies found no association, and those were a small minority. The review’s authors concluded that the link between ultra-processed diets and excess weight in children is clear enough to “raise concerns for future health” and warrant policy action. This directly contradicts any suggestion that MAHA’s focus on UPFs is misplaced – if anything, it is urgently needed.

Crucially, the evidence goes beyond correlation. We now have experimental data showing that ultra-processed foods cause overeating and weight gain. In a landmark NIH-controlled trial, Hall et al. (2019) randomized adults to two weeks of an ultra-processed diet vs. two weeks of a minimally processed diet, with meals matched for calories, salt, sugar, fat, and fiber. The results were striking: on the ultra-processed diet, participants consumed about 500 extra calories per day and gained weight, whereas on the unprocessed diet they ate less and lost weight. This study was even highlighted as an important study by NIH:

The study result occured in spit of the fact that the meals being presented were equal in terms of nutrients – the only difference was the level of processing. As Dr. Kevin Hall noted, “this is the first study to demonstrate causality – that ultra-processed foods cause people to eat too many calories and gain weight.” In other words, something about UPFs (their hyperpalatability, texture, rapid digestibility, or additive content) drives overeating beyond an individual’s control. MAHA’s emphasis on reducing ultra-processed grains, sugars, and oils is therefore not a fad; it aligns with hard evidence that these foods are uniquely harmful, especially in environments where children are bombarded with them.

Mayne’s critique fails to acknowledge how children’s health in particular is tied to ultra-processed food consumption. Consider a study of Spanish preschoolers: those in the highest tertile of UPF intake already had significantly larger waistlines, higher body fat, elevated blood glucose, and lower HDL (“good”) cholesterol compared to peers with minimal UPFs in their dietpubmed.ncbi.nlm.nih.gov. The authors reported a clear dose-response relationship – every incremental increase in UPF intake was associated with worse cardiometabolic markers in these 3–6 year-olds (Khoury et al., 2024) Their conclusion was unequivocal: even at preschool age, high consumption of ultra-processed foods is associated with greater adiposity and metabolic risk factors. Likewise, a cohort study of over 2,000 children in Canada found that those with the highest ultra-processed food consumption in early childhood were significantly more likely to develop obesity by age 5, particularly among boys (Chao et al. (Chen, 2025). These findings persisted even after adjusting for factors like socioeconomic status and physical activity. How can one credibly label the MAHA report alarmist for spotlighting UPFs, when multiple studies in different populations and settings (Spain, Canada, and beyond) all point to the same outcome – children who eat more industrial junk foods are at higher risk of obesity and chronic disease? Denying this link is truly anti-scientific, and we must all ask the obvious question: What is MedPageToday’s motivation here?

Far from being a fringe notion, the idea that ultra-processed products fuel childhood obesity and illness has gained recognition among global health authorities. The World Health Organization now highlights the proliferation of ultra-processed snacks and sugary drinks as a key driver of the childhood obesity epidemic. Public health campaigns increasingly advise parents to limit ultra-processed items and instead offer whole foods from an early age. By deriding MAHA’s stance on UPFs, Mayne’s article is effectively undermining a core public health message – one backed by both empirical data and the lived reality that diet-related conditions in kids (from type 2 diabetes to fatty liver disease) have surged in tandem with diets high in processed snacks, refined starches, and sweetened beverages. Our children’s bodies are telling us the MAHA plan is right: we cannot reform kids’ health without confronting the ultra-processed products that now make up more than half of American calories.

In sum, the MAHA report’s characterization of ultra-processed grains, sugars, and fats as “major drivers” of childhood chronic disease is well-founded. The weight of evidence linking UPFs to pediatric obesity, metabolic dysfunction, and even excess calorie intake per se is overwhelming (Petridi et al., 2024). MedPageToday, and Mayne’s refusal to engage with this evidence – instead implying that MAHA is off-base – does a disservice to the public - and to medial professionals. It downplays a real and urgent problem. By defending ultra-processed foods, even implicitly, her article aligns more with the interests of Big Food than with the interests of children’s health. The science has moved on from the 1990s notion that “a calorie is a calorie” regardless of food quality. Highly processed, additive-laden calories do more damage, and our policies must reflect that. MAHA does; Mayne’s critique does not.

Beyond Salt, Sugar, and Fat: Why Food Additives Deserve Scrutiny

Another target of Susan Mayne’s criticism is the MAHA plan’s concern over a broad set of food additives – things like emulsifiers, synthetic dyes, preservatives, and other chemicals routinely added to processed foods. The article suggests that MAHA’s focus should stick to the usual suspects (sodium, added sugars, and saturated fats) and implies that worrying about emulsifiers or food coloring is unscientific scaremongering. This is a classic strawman. MAHA is ahead of the curve here: a growing body of research shows that many ubiquitous additives, long presumed safe, may have insidious effects on human health, especially in children. Dismissing these concerns outright betrays either ignorance of recent science or a deliberate bias. Let’s examine just a few categories:

Emulsifiers (chemicals that keep processed foods texturally uniform, such as carboxymethylcellulose, polysorbate-80, and others) have been spotlighted by researchers for their impact on the gut and metabolism. These compounds were approved decades ago under the assumption that, since they aren’t acutely toxic and mostly pass through the GI tract, they’re harmless. But modern research reveals a different story. In 2022, a double-blind randomized controlled trial was published in Gastroenterology (Chassaing et al.,) where healthy adults consumed a diet enriched with 15 grams/day of the emulsifier carboxymethylcellulose (CMC) for 11 days, compared to a control group on an identical emulsifier-free diet. The results were alarming: even in this short span, CMC perturbed the subjects’ gut microbiota – reducing microbial diversity – and led to metabolic changes indicative of poorer gut health (notably a drop in beneficial short-chain fatty acids).

“Relative to control subjects, CMC consumption modestly increased postprandial abdominal discomfort and perturbed gut microbiota composition in a way that reduced its diversity. Moreover, CMC-fed subjects exhibited changes in the fecal metabolome, particularly reductions in short-chain fatty acids and free amino acids. Furthermore, we identified 2 subjects consuming CMC who exhibited increased microbiota encroachment into the normally sterile inner mucus layer, a central feature of gut inflammation, as well as stark alterations in microbiota composition.”

Two of the volunteers on CMC showed pro-inflammatory shifts, including bacteria encroaching into the normally sterile mucus layer of the gut, a red flag for incipient inflammation. While not everyone had such dramatic changes in just 11 days, the study’s conclusion was broad and clear: “these results support the notion that the broad use of CMC in processed foods may be contributing to the increased prevalence of an array of chronic inflammatory diseases by altering the gut microbiome and metabolome.” In lay terms, an FDA-approved emulsifier found in everything from ice cream to salad dressing could be eroding our intestinal health and promoting inflammation that underlies conditions like inflammatory bowel disease, metabolic syndrome, and more. That is not a trivial finding – it’s a paradigm-shifting one. MAHA is entirely justified to call for caution on such additives. Mayne’s piece, however, gives the impression that unless an additive is sodium, sugar, or saturated fat, we need not worry. That attitude is dangerously out-of-date.

Synthetic food dyes are another case in point. The MAHA plan calls attention to artificial colorings, and for good reason: these chemicals (think Red 40, Yellow 5, etc.) have been implicated in behavioral issues in children for decades, yet U.S. regulators have dragged their feet on meaningful action. Far from MAHA indulging in baseless fears, a comprehensive scientific review by the California EPA’s Office of Environmental Health Hazard Assessment (OEHHA) in 2021 vindicated concerns about food dyes. After analyzing clinical trials and animal studies, OEHHA’s experts concluded that consumption of synthetic food dyes can result in hyperactivity and other neurobehavioral problems in sensitive childreno ehha.ca.gov. They found “evidence shows that synthetic food dyes are associated with adverse neurobehavioral outcomes in some children,” in the words of Dr. Lauren Zeise, OEHHA’s director.

Notably, this wasn’t one or two small studies; it was a two-year evaluation of all available research on seven FDA-approved dyes. It included double-blind “challenge” trials where kids were taken off dyes and then exposed to them again. The findings “demonstrated clearly that some children are likely to be more adversely affected by synthetic food dyes than others,” and animal studies further showed dyes can affect activity, memory, and even alter brain structure and neurotransmitters. Even more concerning, OEHHA reported that the FDA’s legal “safe” intake levels for these dyes (the Acceptable Daily Intakes set decades ago) do not account for these behavioral effects and may be woefully insufficient to protect kids’ brains today. In simple language: the amount of Red 40 or Yellow 5 that regulators say is “OK” in a child’s diet might still be enough to trigger hyperactivity or attention problems in a susceptible child. Europe is already ahead on this; the EU requires warning labels on foods containing certain artificial colors (“may have an adverse effect on activity and attention in children”). Some dyes, like Red No.3, have been banned outright in foods in Europe for years. The United States is only now catching up (for example, California passed a law in 2023 banning Red 3 and several other additives in candies). So when MAHA voices concern about synthetic dyes, it stands firmly on credible scientific and international consensus. To paint this as alarmism is to willfully ignore a body of evidence and expert opinion that these petrochemical colors are not benign splashes of fun, but potentially harmful to developing brains.

Similarly, preservatives and other additives beyond sugar or salt can pose health risks that Mayne’s critique glosses over. Take sodium nitrite and related compounds used to preserve processed meats (bacon, hot dogs, lunchmeat). These help keep meat appealingly pink and free of botulism – but they also form carcinogenic nitrosamines in our gut. In 2015, the World Health Organization’s cancer research arm (IARC) reviewed dozens of epidemiological studies and concluded that processed meats are definitively carcinogenic to humans (Group 1 classification), causing colorectal cancer who.intwho.int. The risk is dose-dependent: each 50 gram portion of processed meat (about one hot dog’s worth) eaten daily increases colorectal cancer risk by about 18%. That is not a trivial increase, nor a hypothetical rodent study – it’s observed in human populations. While sodium nitrite isn’t the only culprit (smoking and salting also play roles), it is a major one; in fact, many experts and public health bodies have urged food manufacturers to drop nitrites precisely to reduce this cancer risk. The MAHA report is absolutely right to lump certain preservatives into its concerns. Another example: tert-butylhydroquinone (TBHQ), a synthetic antioxidant that keeps oils and fats from going rancid in processed foods, was shown in recent toxicology studies to impair immune cell proteins and is suspected of being an endocrine disruptor. Or propyl paraben, a preservative in some baked goods, which research suggests can act as an estrogen mimic – so concerning that, again, California just banned it in foods effective 2027. The list goes on (BHA, titanium dioxide, etc.). The common thread is that the FDA’s Generally Recognized as Safe (GRAS) system for additives is badly broken, allowing hundreds of chemicals in foods that were never rigorously tested for long-term effects on metabolism, the microbiome, the brain, or cancer risk. Independent scientists are now uncovering many red flags. In this context, MAHA’s recommendation to scrutinize “a broad set of food additives” is not only reasonable – it is visionary from a public health perspective. Mayne’s narrow focus on just salt, sugar, and saturated fat (important as those are) completely misses this bigger picture. We cannot talk about making America healthy again while ignoring what Big Food is putting in the products that now constitute the majority of our calories. The MAHA plan recognizes that protecting health isn’t just about macronutrients; it’s about the whole chemical milieu of our food supply.

Lastly, it’s worth noting the synergy between ultra-processed foods and additives. Ultra-processed products are defined by containing multiple industrial additives (emulsifiers, sweeteners, flavor enhancers, dyes, etc.) – and these very additives may be part of why UPFs are so deleterious to health. It’s not just the refined flour or the sugar; it’s also the emulsifier that triggers gut inflammation (Chassaing et al.), the artificial color that might amp up a child’s nervous system oehha.ca.gov, the preservative that may perturb hormones or gut microbes.

MAHA’s critics might prefer to keep the public discussion limited to familiar territory (e.g. “eat less sugar and salt”), perhaps because that’s a simpler message or one that doesn’t threaten food industry practices too much. But confronting the full scope of diet-driven disease requires intellectual honesty about these less familiar contributors. By calling out emulsifiers, synthetic dyes, and preservatives, the MAHA report stands on solid scientific ground and aligns with a precautionary principle: if emerging evidence shows risk and there’s no nutritional necessity for these chemicals, why not reduce or remove them? This is especially urgent for children, who are still developing and may be more vulnerable to subtle developmental or metabolic disruptions.

In summary, MedPageToday, and Mayne’s portrayal of MAHA’s additive-focused recommendations as off-base is itself a form of denialism. The peer-reviewed evidence supports MAHA’s concern: emulsifiers have been shown to promote inflammatory changes; synthetic dyes do affect some kids’ behavior; and certain preservatives increase long-term disease risk (e.g. nitrites and cancer). A fair engagement with the science would acknowledge these facts and perhaps debate the degree of risk or best policy response. But waving away all additive concerns as “wrong” or even not-yet-determined is not a fair engagement – it’s a defense of an outdated status quo. Why? What is their agenda? Do they put Anti-MAHAism ahead of the well-being of our children?

The MAHA plan, by contrast, reflects modern nutritional science’s broader view of diet quality. Americans don’t just consume too many calories or grams of sugar – we consume a barrage of industrial chemicals with each meal. The MAHA report refuses to pretend those don’t matter. Any serious effort to improve public health must do the same.

Whole Foods, Full-Fat Dairy, and Beef: Correcting Nutrition Myths

The final area of contention is perhaps the most telling: Susan Mayne’s critique bristles at the MAHA report’s promotion of whole, unprocessed foods – from leafy greens and salmon to legumes, nuts, beef, and whole milk. The inclusion of the latter two (untrimmed red meat and full-fat dairy) seems to especially rankle, given they defy decades of conventional dietary advice to choose leaner and lower-fat animal products. Mayne’s position is that MAHA errs by encouraging foods that, in her view, are unhealthy (she likely raises the usual specter of saturated fat in beef and milk, or red meat’s link to heart disease). Once again, her position is stuck in the nutrition science of the 1980s, whereas MAHA’s is aligned with the latest evidence. Let’s break this down:

First, no one – not MAHA, not its defenders – is arguing that leafy greens, fatty fish, legumes, and nuts are anything but stellar choices. On those, even the staunchest critics agree. The article’s mention of them is perhaps perfunctory, since it’s hard to dispute the benefits of spinach or salmon. These foods are rich in vitamins, omega-3 fats, fiber, minerals, and antioxidants; countless studies link higher intake of vegetables, beans, and nuts to lower risks of heart disease, stroke, diabetes, and more. For example, a landmark randomized trial in Spain (PREDIMED) by Estrusch et al., 2018 found that a Mediterranean diet emphasizing plant-based foods, fish, and nuts reduced major cardiovascular events by ~30% compared to a low-fat diet. Greens and cruciferous vegetables are associated with protection against certain cancers; nuts and olive oil improve blood lipid profiles. In short, MAHA’s push for whole foods is solidly evidence-based, and Mayne doesn’t appear to challenge that directly.

The real friction comes with MAHA’s willingness to include unprocessed red meat and full-fat dairy as part of a healthy diet. Here, the article seemingly cannot resist falling back on outdated tropes – essentially treating beef and whole milk as dietary villains. However, the science has evolved, and modern research does not support blanket demonization of these foods. MAHA’s more nuanced stance – that nutrient-dense foods like beef and whole milk can be beneficial in a whole-foods diet – is backed by substantial evidence:

• Beef (unprocessed, especially lean cuts): Red meat has long been maligned primarily due to its saturated fat content and some epidemiologic links to heart disease. Yet, numerous controlled trials and reviews in the past decade have found that when consumed as part of a balanced diet, lean beef does not worsen cardiovascular risk markers. In fact, a controlled feeding study (the BOLD trial) showed that diets incorporating 4–5 ounces of lean beef daily lowered LDL “bad” cholesterol to the same extent as the gold-standard DASH diet (which emphasizes poultry/fish and plant proteins) (Rousell et al.). Participants with moderately high cholesterol were put on different healthy diet patterns, and those on the “Beef in an Optimal Lean Diet” (BOLD) ate beef regularly yet saw significant reductions in LDL and total cholesterol, just like those on the more traditional DASH plan. The researchers concluded that including lean beef in a heart-healthy diet is fully compatible with cardiovascular health, noting “favorable effects on CVD risk factors comparable to DASH” and even some additional benefits on certain blood lipoproteins. This would have been heresy to nutrition authorities a generation ago; today it’s peer-reviewed fact. Moreover, an influential 2019 meta-analysis of randomized trials found no significant effects on blood pressure or blood lipids when red meat consumption (in moderate amounts) was varied in the context of healthy diets – meaning moderate red meat didn’t stand out as a culprit. On the population level, recent re-examinations of cohort studies have greatly softened the presumed link between unprocessed red meat and health risks. Notably, a rigorous review in Annals of Internal Medicine (2019) concluded that the evidence tying red meat to outcomes like heart disease or cancer is of low certainty and that “reducing unprocessed red meat intake may have little or no effect on major cardiometabolic outcomes.” While that publication stirred controversy, it underlines that the case against moderate red meat is nowhere near as ironclad as once thought. Beef is also nutrient-dense: it’s a top source of highly bioavailable iron (critical for children and women of childbearing age, to prevent anemia), zinc, vitamin B12, and high-quality protein. In children, studies show that including red meat can improve iron status and that iron deficiency (which can impair cognitive development) often rises when red meat is entirely removed from kids’ diets. The MAHA plan appreciates these nuances – it does not vilify beef, but treats it as a whole food that, in appropriate portions and as part of an overall healthy pattern, can support health. Mayne’s critique, in casting MAHA as wrong to list beef among healthy foods, is the one clinging to a simplistic paradigm. It’s the old “meat = bad” dogma that fails to differentiate between a grass-fed steak and a fast-food hamburger with a refined bun, preservatives, and trans-fat fried toppings. Context matters, and MAHA and Popular Rationalism both recognizes that.

• CONTAMINATED (POLLUTED) vs. UNCONTAMINATED BEEF. It is time for Big Medicine to realize and admit they are wrong on red meat and dairy as necessarily a source of risky increases in cholesterol. MAHA’s focus is on getting pesticides, herbicides and hormones out of the diets of America’s children, and that includes school lunches and meats consumed by children. If one’s focus is on beef alone, there are two types; the types that are contaminated with these chemicals, and the types that are not. While this issue is not in the purview of the MedPageToday article, parents around the country seek organic and pasture-raised eggs, free-range and organic chicken, and hormone-free and grass-fed, organic beef to reduce the risks of developmental and health issues associated with contaminated foods.

• Whole milk and full-fat dairy: Perhaps most surprisingly to some, MAHA endorses foods like whole milk and other full-fat dairy (yogurt, cheese) instead of exclusively pushing low-fat versions. This too is borne out by current evidence, particularly for children. For decades, U.S. dietary guidelines have advised switching to low-fat or skim milk for children over age 2, largely to reduce saturated fat intake. However, multiple recent studies have turned that recommendation on its head. A 2020 systematic review and meta-analysis published in the American Journal of Clinical Nutrition by Vanderhout et al. examined 28 studies (over 20,000 children) comparing those who consumed whole milk (≈3.25% fat) with those who drank reduced-fat (0.5–2%) milk. The pooled results were striking: children who drank whole milk had 39% lower odds of being overweight or obese compared to those who drank low-fat milk. Eighteen of the studies found higher milk fat linked to lower child adiposity, while none found that low-fat milk drinkers were leaner.

  These findings undermine the conventional wisdom that skim milk is automatically “healthier” for kids’ weight. One hypothesis is that whole milk is more satiating, leading to lower overall calorie intake (whereas children on skim may compensate by eating more snacks or sugary foods). Another possibility is that milk fat contains bioactive compounds (like certain fatty acids) that have neutral or beneficial metabolic effects. Whatever the mechanism, international guidelines suggesting only low-fat dairy for kids are not evidence-backed, and may even be counterproductiv. Randomized trials are now being called for, but in the meantime, observational evidence consistently favors whole milk.

For adults, full-fat dairy is also experiencing a renaissance in nutritional science. Large epidemiological studies and meta-analyses have found that higher-fat dairy consumption is at worst neutral and often associated with better outcomes compared to low-fat versions. For instance, prospective studies have linked full-fat dairy intake to a lower risk of type 2 diabetes and no higher risk of cardiovascular disease. One expert review in 2020 (Hirahatake et al.) summarized the state of the science: “emerging evidence shows that the consumption of full-fat dairy foods has a neutral or inverse association with adverse cardiometabolic health outcomes,” including heart disease and diabetes. In plain terms, eating cheese, yogurt, or whole milk has not been found to increase heart attack or stroke risk – if anything, some data suggest it might reduce risk or aid weight management. Why might this be? Dairy fat comes packaged with a complex matrix of nutrients – calcium, phosphorus, fat-soluble vitamins, protein – and some fatty acids in dairy (like odd-chain fats) may have unique health benefits. Additionally, focusing on isolated saturated fat content is an outdated approach; we now know that the food matrix and replacement nutrients matter. If one cuts out dairy fat but replaces those calories with refined starch or sugar (as often happens when people switch to fat-free flavored yogurts or add extra sugar to skim latte for palatability), the net effect can be worse.

The MAHA report wisely promotes whole foods in their natural form, and full-fat dairy is exactly that: a minimally processed source of protein and fat that humans have consumed for millennia. Of course, moderation is key – it’s not suggesting people guzzle endless whole milk – but it rejects the reflexive vilification of dairy fat that old guidelines promulgated. Mayne’s criticism of MAHA on this front thus rings hollow, as it appears rooted in superseded dietary dogma. Encouraging a child to drink a glass of satisfying whole milk (instead of a can of soda or a sugary juice drink) is hardly irresponsible – in fact, it may be a boon for satiety and nutrition. The evidence supports MAHA’s stance that full-fat dairy can be part of a healthy diet for both children and adults. Characterizing that stance as “wrong” ignores a decade’s worth of research re-evaluating dairy’s role in cardiometabolic health.

In defending beef and whole milk, we are not advocating for an all-meat, all-dairy diet; rather, we are calling for balance and evidence-based nuance. The MAHA plan pairs these foods alongside vegetables, fish, nuts, and legumes – a pattern akin to many traditional diets associated with longevity and health. It’s the polar opposite of the ultra-processed Standard American Diet. By painting MAHA’s inclusive approach to whole foods as misguided, Mayne’s article sets up a false dichotomy: as if one cannot promote vegetables and also acknowledge that, say, a serving of unprocessed beef or a cup of whole yogurt may have a place. The best evidence today says they can coexist in a healthful diet. Indeed, one size does not fit all in nutrition, and some individuals (e.g. growing children, pregnant women, anemic patients) might benefit greatly from the nutrients in red meat and full-fat dairy.

One might also question the implicit double-standard: The article appears far less troubled by ultra-processed meat substitutes or sugary fat-free dairy desserts – items that check the “low saturated fat” box but fail on ultra-processing and additive counts – than by natural foods like a steak or whole milk. This again highlights a bias toward outdated nutrient-by-nutrient thinking, rather than looking at foods holistically. MAHA gets it right by emphasizing whole, real foods and dietary patterns, not single nutrients in isolation. And ironically, on environmental and economic grounds, supporting domestic producers of healthful whole foods (whether farmers of greens and nuts or ranchers of beef and dairy) could be seen as a strategic positive – though the scope of this rebuttal is health, it’s worth noting that sustainable, regenerative livestock farming and dairy production are evolving to address climate concerns, and outright demonizing these foods can have unintended consequences (like driving people to eat more highly processed meat replacements, which often are loaded with additives and refined ingredients).

In summary, the MAHA report’s promotion of whole foods – including all their examples from leafy greens to beef and whole milk – is strongly supported by nutritional science. Leafy greens, fish, legumes, and nuts have unquestioned benefits and are cornerstones of every healthy diet paradigm. Unprocessed red meat in moderate amounts has not been shown to harm health when part of a balanced diet, and provides important nutrients – it can be included much as it was in the heart-healthy Mediterranean diet (which, contrary to some misconceptions, is not vegetarian and traditionally included modest portions of meat).

Whole-fat dairy is enjoying a rehabilitation in the scientific literature, with studies in children and adults alike suggesting neutral or beneficial effects on weight and chronic disease risk. The MAHA plan reflects these developments, whereas Susan Mayne’s critique clings to an era of “full-fat = bad, red meat = bad” without grappling with the current evidence. By labeling MAHA’s approach as wrong, the article is effectively defending the older, reductionist dogma that has arguably failed us – after all, years of demonizing butter and beef did not halt the obesity or diabetes epidemics, partly because we encouraged people to eat fat-free junk food and refined carbs instead. MAHA correctly zeroes in on real food quality over simplistic nutrient fears. A professional, good-faith critique would have recognized this shift and debated details; Mayne’s did not, which is why we must set the record straight.

Public Health and Economic Stakes: The Cost of Ignoring Nutrition Science

Beyond the scientific arguments, it’s important to highlight what’s at stake for public health and the economy if we get this wrong. The MAHA nutrition plan isn’t just theory – it’s a response to a health crisis that is bankrupting our nation and threatening our children’s future. Diet-related chronic diseases (obesity, type 2 diabetes, cardiovascular disease, certain cancers) now account for the bulk of illnesses and health expenditures in the United States. According to the CDC, a staggering 90% of the nation’s $4.5 trillion annual health expenditures are for people with chronic and mental health conditions cdc.gov, of which diet is a major driver. Obesity alone (much of it rooted in poor diet quality and ultra-processed food intake) is estimated to cost the U.S. healthcare system $173 billion per year in direct medical costs cdc.gov, not to mention indirect costs from lost productivity and military readiness (over a third of young adults are now too obese to qualify for military servicecdc.gov). Childhood obesity, in particular, is imposing costs early: an estimated $1.3 billion per year (in 2019 dollars) in medical expenses can be attributed to obesity among U.S. children cdc.gov. These obese children often become obese adults with compounded health issues, creating a pipeline of high-cost chronic disease patients for decades to come. If we continue with business-as-usual nutrition advice – tinkering at the margins of salt and sugar while allowing the processed food industry to dictate our diet – these costs will only escalate. A recent World Obesity Federation report warned that by 2035, the global economic impact of overweight and obesity could reach an astounding $4 trillion annually if trends continue.

The possibility of a massive conflict of interest leading medical professionals and an alleged medical “news” outlet to mislead the public is not lost on the astute reader.

The broader economic implications of poor nutrition extend even further: lost productivity from diet-related disability, higher insurance premiums, and strains on programs like Medicare and Medicaid. Conversely, improving Americans’ diet quality (exactly what the MAHA plan endeavors to do) could save hundreds of billions in healthcare costs and enhance quality of life. For example, one modeling study found that improving children’s diets could dramatically cut rates of childhood obesity, saving tens of billions in future health expenses and increasing the healthy years of life for the next generation (Ling et al., 2022) onlinelibrary.wiley.com. On a societal level, healthier diets mean a stronger workforce and even national security benefits (fewer young people disqualified from service).

Why bring economics into a nutrition debate? Because it underscores that this isn’t about academic quibbles – it’s about real-world consequences. If an opinion article manages to sow doubt about sound nutrition recommendations, it can have a chilling effect on policy momentum. We’ve seen the food industry use such tactics for years: casting doubt on science to delay regulatory actions (much like Big Tobacco once did). Calling the MAHA report “wrong” on additives or ultra-processed foods, without a balanced analysis, gives political cover to those who oppose stricter food standards or public health interventions. The cost of inaction, however, will be borne by all of us – in hospital bills, in lost loved ones, in children living sicker, shorter lives than their parents.

The MAHA plan, as defended here, actually aligns well with many proposals public health experts have been championing: Limiting junk food marketing to kids, improving school meals with whole foods, incentivizing produce and minimally processed options, front-of-pack warnings on ultra-processed/high-additive products, perhaps even taxes on sugary drinks or ultra-processed products to disincentivize their overconsumption. Implementing such measures would come with challenges, but also tremendous payoff: A healthier population and a more sustainable health budget. By contrast, clinging to the status quo – or making only tepid, narrow tweaks – will not reverse our current trajectory. We risk, as a country, the first generation of children with shorter life expectancies than their parents, thanks largely to diet-driven diseases.

In this context, Mayne’s article is not just an academic disagreement; it’s emblematic of a regressive stance stuck in institutional molasses that public health can no longer afford. Labeling legitimate nutritional science as “wrong” or “alarmist” delays the changes needed to save lives and dollars. It confuses policymakers and the public, some of whom might throw up their hands and say, “Experts can’t agree on anything, so why bother changing?” That kind of doubt is exactly what certain vested interests want. But the truth is, experts do agree on the basics far more than is often portrayed: Almost everyone in the nutrition community now agrees we should eat fewer ultra-processed foods, more whole foods, and that diet quality (not just calorie counting) is paramount. They agree food environments need to change to make the healthy choice the easy choice. The MAHA report takes these evidence-based principles and tries to put them into an actionable plan. It deserves serious discussion on how to implement its ideas, not a strawman critique.

Conclusion

Susan Mayne’s critique of the MAHA nutrition report misses on all points. It cannot be anything but intentional; It fixates on preserving an old guard narrative – one that minimizes the dangers of ultra-processed foods and food chemicals, and that remains skeptical of whole foods like beef or whole milk – while sidestepping the robust scientific evidence that vindicates MAHA’s approach. In doing so, her article does a disservice to public understanding. It fails to fairly engage with the science, instead setting up the MAHA plan as a caricature to knock down. We have shown, point by point, that the MAHA report’s key contentions are strongly supported by high-quality research:

• Ultra-processed foods are indeed major drivers of obesity and metabolic disease in children (and adults) – reducing them is critical.

• A range of food additives (emulsifiers, dyes, preservatives and more) have been linked to meaningful adverse effects, from gut inflammation to hyperactivity to cancer, meriting far greater caution and regulatory scrutiny.

• Avoiding pesticides, herbicides and growth hormones not only helps your child: Your consumption patterns and habits will drive demand for food with far fewer toxic chemicals for all.

• Embracing whole foods, including traditionally stigmatized ones like full-fat dairy and unprocessed red meat, is consistent with modern nutrition science and can form part of a healthy, balanced diet.

Far from being “denialist,” the MAHA plan is an evidence-based blueprint for addressing America’s diet-fueled health crisis. The real denialism is found in those who pretend that our food system isn’t part of the problem – who deny the mounting research that what we eat (and how it’s processed) profoundly matters for health. Mayne’s article, intentionally or not, gives cover to that complacency.

It is time to move past such outdated thinking. The Make America Healthy Again report may not be perfect (no plan is), but on nutrition it gets far more right than wrong. It steers the conversation toward the quality of our food supply and the holistic mix of factors damaging our health. That is exactly where the conversation needs to be. We should be debating how best to reduce ultra-processed junk in schools, or how to incentivize businesses to remove harmful additives, or how to make whole foods more accessible to low-income families – not debating whether these are even issues at all. The latter debate has been settled by science: they are.

If we truly care about making America healthy, we should applaud MAHA’s courage in challenging entrenched interests and outdated guidelines. And we should hold critics to a high standard: no more hit pieces that obscure scientific consensus in favor of personal or political bias. Our children’s health, our nation’s fiscal future, and countless lives depend on us getting nutrition policy right. Let’s focus on the evidence and work together to implement it, rather than dismissing comprehensive plans with knee-jerk criticism. In that spirit, we provide the table below as a summary of key studies supporting the MAHA plan’s elements – a factual foundation on which constructive discussion should build.

Summary of Evidence Supporting MAHA Nutrition Plan Elements

Sources: Peer-reviewed studies and reviews as cited above (see reference brackets for source details). All evidence points to the importance of diet quality and whole foods – validating the MAHA plan’s emphasis on minimizing ultra-processed products and additives while maximizing natural, nutrient-rich foods (plants and animal-source) for improving health outcomes.

Chassaing B, Compher C, Bonhomme B, Liu Q, Tian Y, Walters W, Nessel L, Delaroque C, Hao F, Gershuni V, Chau L, Ni J, Bewtra M, Albenberg L, Bretin A, McKeever L, Ley RE, Patterson AD, Wu GD, Gewirtz AT, Lewis JD. Randomized Controlled-Feeding Study of Dietary Emulsifier Carboxymethylcellulose Reveals Detrimental Impacts on the Gut Microbiota and Metabolome. Gastroenterology. 2022 Mar;162(3):743-756. doi: 10.1053/j.gastro.2021.11.006. Epub 2021 Nov 11. PMID: 34774538; PMCID: PMC9639366.

Chen ZH, Mousavi S, Mandhane PJ, Simons E, Turvey SE, Moraes TJ, Subbarao P, Miliku K. Ultraprocessed Food Consumption and Obesity Development in Canadian Children. JAMA Netw Open. 2025 Jan 2;8(1):e2457341. doi: 10.1001/jamanetworkopen.2024.57341. PMID: 39888617; PMCID: PMC11786234.

Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018 Jun 21;378(25):e34. doi: 10.1056/NEJMoa1800389. Epub 2018 Jun 13. PMID: 29897866.

Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, Chung ST, Costa E, Courville A, Darcey V, Fletcher LA, Forde CG, Gharib AM, Guo J, Howard R, Joseph PV, McGehee S, Ouwerkerk R, Raisinger K, Rozga I, Stagliano M, Walter M, Walter PJ, Yang S, Zhou M. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019 Jul 2;30(1):67-77.e3. doi: 10.1016/j.cmet.2019.05.008. Epub 2019 May 16. Erratum in: Cell Metab. 2019 Jul 2;30(1):226. doi: 10.1016/j.cmet.2019.05.020. Erratum in: Cell Metab. 2020 Oct 6;32(4):690. doi: 10.1016/j.cmet.2020.08.014. PMID: 31105044; PMCID: PMC7946062.

Hirahatake KM, Astrup A, Hill JO, Slavin JL, Allison DB, Maki KC. Potential Cardiometabolic Health Benefits of Full-Fat Dairy: The Evidence Base. Adv Nutr. 2020 May 1;11(3):533-547. doi: 10.1093/advances/nmz132. PMID: 31904812; PMCID: PMC7231591.

Khoury N, Martínez MÁ, Garcidueñas-Fimbres TE, Pastor-Villaescusa B, Leis R, de Las Heras-Delgado S, Miguel-Berges ML, Navas-Carretero S, Portoles O, Pérez-Vega KA, Jurado-Castro JM, Vázquez-Cobela R, Mimbrero G, Andía Horno R, Martínez JA, Flores-Rojas K, Picáns-Leis R, Luque V, Moreno LA, Castro-Collado C, Gil-Campos M, Salas-Salvadó J, Babio N. Ultraprocessed Food Consumption and Cardiometabolic Risk Factors in Children. JAMA Netw Open. 2024 May 1;7(5):e2411852. doi: 10.1001/jamanetworkopen.2024.11852. PMID: 38758555; PMCID: PMC11102022.

Ling J, Chen S, Zahry NR, Kao TA. Economic burden of childhood overweight and obesity: A systematic review and meta-analysis. Obes Rev. 2023 Feb;24(2):e13535. doi: 10.1111/obr.13535. Epub 2022 Nov 27. PMID: 36437105; PMCID: PMC10078467.

NIH Clinical Center News, July 2019, Accessed 6/21/2025 https://www.cc.nih.gov/news/2019/summer/story-01

Petridi E, Karatzi K, Magriplis E, Charidemou E, Philippou E, Zampelas A. The impact of ultra-processed foods on obesity and cardiometabolic comorbidities in children and adolescents: a systematic review. Nutr Rev. 2024 Jun 10;82(7):913-928. doi: 10.1093/nutrit/nuad095. PMID: 37550263.

Roussell MA, Hill AM, Gaugler TL, West SG, Heuvel JP, Alaupovic P, Gillies PJ, Kris-Etherton PM. Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins. Am J Clin Nutr. 2012 Jan;95(1):9-16. doi: 10.3945/ajcn.111.016261. Epub 2011 Dec 14. PMID: 22170364; PMCID: PMC3238465.

Vanderhout SM, Aglipay M, Torabi N, Jüni P, da Costa BR, Birken CS, O'Connor DL, Thorpe KE, Maguire JL. Whole milk compared with reduced-fat milk and childhood overweight: a systematic review and meta-analysis. Am J Clin Nutr. 2020 Feb 1;111(2):266-279. doi: 10.1093/ajcn/nqz276. PMID: 31851302; PMCID: PMC6997094.