WASHINGTON — On Tuesday, a much-anticipated sequel to the Trump administration’s “Make America Healthy Again” report was unveiled, proposing initiatives to enhance children’s health. It emphasizes the need for improved nutrition, increased physical activity, and an assessment of vaccines and medications but falls short in detailing actions against pesticides and ultra-processed foods.

The report, titled “Make Our Children Healthy Again Strategy,” follows up on an initial assessment led by the White House and Health Secretary Robert F. Kennedy Jr. in May. This earlier review identified factors contributing to chronic illnesses in children.

The newly released document aims to be a strategic guide for addressing childhood diseases, although it frequently repackages previous measures from the administration as novel ideas.

The report centers on four main priorities: enhancing research investments, proposing policy changes like a “vaccine framework,” increasing public health awareness concerning children’s well-being, and collaborating with private enterprises. Notably, it overlooks crucial issues such as food insecurity and gun violence, which also critically impact children’s health.

Many public health experts said the report’s ideas for improving children’s health are good in theory, but it lacks a clear strategy.

“It’s lacking in substance,” commented Dr. Georges Benjamin, Executive Director of the American Public Health Association. “If a graduate student handed me this, I’d have them revise it.”

Marion Nestle, a professor emerita in nutrition, food studies, and public health at New York University, echoed similar sentiments, remarking that the report is “lacking in detailed content and regulatory measures.”

“Its overriding message is still ‘more research needed,’” Nestle said. “It does not say nearly enough about what needs to be done to improve the diets of America’s children.”

Plans to limit ultra-processed food and chemicals may also not go as far as some of Kennedy’s supporters had hoped, Nestle said.

“The report seems to twist itself into knots to make it clear that it will not be infringing upon food companies,” Nestle said in an email. “MAHA has so much bipartisan support. This was the time to regulate food marketing to kids — not ‘explore.’”

When it comes to environmental chemicals, the report “sort of defers back to industry best practices, relying on industry to make recommendations and to self-regulate,” said Avenel Joseph, vice president of policy at the Robert Wood Johnson Foundation.

“EPA already works with industry. EPA has already developed lots of different technologies that can detect chemicals,” Joseph said. “So I’m not sure what he is trying to change there.”

President Donald Trump established the MAHA commission in a February executive order, tasking it with identifying the “root causes” of chronic diseases such as diabetes, obesity and neurodevelopment disorders like autism in children. Along with Kennedy, the commission includes other high-ranking officials, including Agriculture Secretary Brooke Rollins and EPA ministrator Lee Zeldin.

The new report reflects many of Kennedy’s publicly shared beliefs, including concerns that children are overprescribed medications, are too sedentary and that technology like smartphones is taking a toll on their mental health. It also goes after vaccines for children, a long-time target of Kennedy’s, who says kids get too many shots before adulthood.

Much of the report includes actions that the administration has already announced.

Under “Policy Reforms,” it says that HHS and the Agriculture Department will soon release 2025-2030 dietary guidelines that “align with science, data, and health recommendations.” Updated guidelines are released every five years, and the government began work on the 2025 update under the Biden administration.

The same section points to continued efforts to develop a formal definition of “ultra-processed foods,” a process HHS announced it was starting in July. The report makes no other mentions of ultra-processed foods.

Another highlighted reform is helping schools re-establish the Presidential Fitness Test. Trump reinstated the national fitness assessment in July and put Kennedy in charge of administering it.

The report also says the Agriculture Department will also help states restrict the purchase of junk food through ​​Supplemental Nutrition Assistance Program (SNAP) waivers, an action that has already been taken in several states with HHS’ support.

Eric Mitchell, president of the Alliance to End Hunger, said the report runs contrary to the Trump administration’s actions, since Congress recently passed legislation to cut funding for SNAP and cancelled a $1 billion program to provide local farm produce to schools and food banks.

“We welcome the renewed national focus on improving and promoting nutrition,” Mitchell said in a statement. “Unfortunately, the Trump ministration’s actions to address hunger have so far come up short.”

On artificial food dyes — another topic that both Kennedy and FDA Commissioner Marty Makary have touted as a policy win — the report says the FDA will continue to pursue policies to limit or ban these additives. In April, Kennedy said the government plans to phase out all artificial dyes from the food supply by the end of next year.

Federal agencies, including the Federal Trade Commission and the Justice Department, will crack down on violations of prescription drug advertising laws, particularly on social media, the report says.

HHS will also work to address conflicts of interests in the government, including requiring public reporting of research grants and strengthening recusal requirements for members of advisory committees.

Kennedy has already taken steps that he says will cut down on conflicts of interest. In March, the CDC published a database listing the conflicts of past and current members of the agency’s vaccine advisory panel, most of which were already publicly available. In June, Kennedy fired all the members of that panel, citing “persistent conflicts of interest.” A recent study, however, found that the committee had record-low conflicts of interests for nearly the past decade. Kennedy’s new appointees to the panel have expressed skepticism about the safety of vaccines, raising concerns about their objectivity.

One of Kennedy’s major focuses as health secretary has been vaccines. Kennedy is a long-time anti-vaccine activist and the founder of Children’s Health Defense, an anti-vaccine advocacy group. The report calls for a new “vaccine framework,” with a focus on reviewing the childhood vaccine schedule, investigating vaccine injuries and ensuring “transparent, gold-standard science.”

In June, the CDC’s vaccine advisory committee — fully stocked with Kennedy’s appointees — said it would establish one working group to study the cumulative effects of the recommended childhood vaccines and another to re-evaluate vaccines that haven’t been reviewed in more than seven years.

In August, the agency tapped Retsef Levi — an MIT operations management professor who has claimed that Covid vaccines cause serious harm and death — to lead its Covid immunization workgroup. HHS also revived its vaccine safety task force.

“Parents can’t protect their children from illness if Secretary Kennedy decimates our vaccine system in this nation,” Joseph said.

Another section of the report dedicated to “Increasing Public Awareness and Knowledge” says it will “empower parents to make informed choices by increasing transparency and access to reliable health and nutrition information.” Fluoride, pesticides and “medical evidence” are among the awareness campaigns listed. The report also mentions the potential health risks of children’s screentime and vaping products, like THC. It makes one mention of alcohol use.

The administration further plans to remove barriers for small dairy farmers selling their own milk — which Nestle described as a “big win” for companies selling whole or raw milk products. Kennedy himself is a fan of raw milk, which is unpasteurized. Drinking raw milk can expose people to dangerous pathogens, including E. coli, salmonella and listeria.

While the report calls for more research into how exposure to chemicals, including pesticides, may affect children’s health, it stops short of banning pesticides, a longtime target of Kennedy’s. Rather, it says that the Environmental Protection Agency, “partnering with food and agricultural stakeholders, will work to ensure that the public has awareness and confidence in EPA’s pesticide robust review procedures.”

The MAHA Commission’s first report, released in May, was found to have a number of fake citations suggestive of artificial intelligence use.

Patrick Traynor, a professor in the department of computer and information science and engineering at the University of Florida, said there’s no clear evidence that AI was used to make the new report, which does not have any citations.

“We’ve done an overview and there’s nothing in particular that sticks out as great proof,” Traynor wrote in a message.