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MAHA REPORT 22  JUL / AUG 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS   article/fda-s-revolving-door-companies-often-hire-agency-staffers-who-managed-their- successful. 81 Wouters, O. J. (2020). Lobbying expenditures and campaign contributions by the pharmaceutical and health product industry in the United States, 1999-2018. JAMA Internal Medicine, 180(5), 688-697. 82 Campbell, E. G., Weissman, J. S., Ehringhaus, S., Rao, S. R., Moy, B., & Goold, S. D. (2007). Institutional academic-industry relationships. JAMA, 298(15), 1779–1786. https:// doi.org/10.1001/jama.298.15.1779. 83 Pradhan, R. (2023, December 15). Millions of dollars flow from pharma to patient advocacy groups. KFF Health News. https://kffhealthnews.org/news/article/health- 202-pharma-money-patient-advocacy-groups-public-citizen/. 84 Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutrition. 2019;22(5):936- 941. doi:10.1017/ S1368980018003762. 85 Gearhardt, A. N., Bueno, N. B., DiFeliceantonio, A. G., Roberto, C. A., Jiménez-Murcia, S., & Fernandez-Aranda, F. (2023). Social, clinical, and policy implications of ultra- processed food addiction. BMJ (Clinical research ed.), 383, e075354. https://doi.org/10.1136/bmj-2023-075354. 86 Mescoloto, S. B., Pongiluppi, G., & Domene, S. M. Á. (2024). Ultra-processed food consumption and children and adolescents’ health. Jornal de pediatria, 100 Suppl 1(Suppl 1), S18–S30. https://doi.org/10.1016/j.jped.2023.09.006. 87 Wang, L., Steele, E. M., Du, M., Pomeranz, J. L., O’Connor, L. E., Herrick, K. A., ... & Zhang, F. F. (2021). Trends in consumption of ultraprocessed foods among US youths aged 2-19 years, 1999-2018. Jama, 326(6), 519-530. 88 U.S. Department of Agriculture, Economic Research Service. (2020, November). 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Prevalence of processed foods in major US grocery stores. Nature Food. 93 U.S. Department of Agriculture, Agricultural Research Service. (2021, October). USDA Global branded food products database: How a unique public-private partnership has helped enhance public health and the sharing of open data (Version 3.1) [Fact sheet]. FoodData Central. https://fdc.nal.usda.gov/docs/USDA_Global_BFPD_1Pager_ Oct2021.pdf. 94 Juul, F., Parekh, N., Martinez-Steele, E., Monteiro, C. A., & Chang, V. W. (2022). Ultra-processed food consumption among US adults from 2001 to 2018. The American SECTION ONE: THE SHIFT TO ULTRA-PROCESSED FOODS Following World War II, much of Europe and Asia’s agricultural system was destroyed, and the United States responded by increasing its agricultural output through mechanization, synthetic fertilizers, industrial-scale farming, and shelf-stable processing techniques to feed the world. An outgrowth of this shift in food production and resulting abundant food supply was the increased development of ultra-processed foods, a category of industrially manufactured food products that undergo multiple physical and chemical processing steps and contain ingredients not commonly found in home kitchens. While there is no single, universally accepted definition of UPFs, the term is most commonly associated with the NOVA food classification system, “industrially manufactured food products made up of several ingredi- ents (formulations) including sugar, oils, fats and salt and food substances of no or rare culinary use.” 84 Food substances of no culinary use include additives such as flavors, colorants, non-sugar sweeteners, and emulsifiers. Although definitions vary, for the purposes of this assessment, UPFs refer broadly to packaged and ready-to-consume products that are formulated for shelf life and/or palatability but are typically high in added sugars, refined grains, unhealthy fats, and sodium and low in fiber and essential nutrients. Research suggests that the industrial processing required to create UPFs—through additives and nutritional alterations—is a key contributor to their harmful health effects in children. 85 86 Though UPFs may have been created with good intentions for convenience purposes, food safety, and to allow for the ability for longer shelf life and preservation (which was important to ship food around the world), UPF consumption has gone up at an exponential rate as share of the American diet. Today, nearly 70% of an American child’s calories come from UPFs, 87 a dramatic change since the 1960s when most food was cooked at home using whole ingredients. It also coincided with significant declines in food prices as a total share of Ameri- can household income. 88 Today, 90% of medical costs in the United States are tied to chronic conditions, 89 many of which are tied to diet. 90 The production of UPFs transforms the whole and healthy food produced by America’s farmers into food-like substances that have far different nutrient profiles than the original form. Farmers are the backbone of America - and the most innovative and productive in the world. We continue to feed the world as the largest food exporter. The greatest step the United States can take to reverse childhood chronic disease is to put whole foods produced by American farmers and ranchers at the center of healthcare. A Closer Look at Ultra-Processed Foods A growing body of research associates UPFs with negative health outcomes, including in children. 91 A closer examination of the statistics, particularly over time and in comparison with our global peers, reveals a troubling reality: • Roughly 70% of the over 300,000 branded food products available in grocery stores today are ultra-processed. 92 93 • Over 50% of the calories consumed by Americans come from UPFs, 94 while peer countries like Portugal, Italy, and France average UPF consumption rates of just 10–31%. 95 96 97 Meanwhile, over 40% of Americans are obese, 98 compared to less than 25% of the Por- tuguese, 99 Italian, 100 and French populations. 101 Research is beginning to point to three key reasons why UPFs are detrimental to children’s health: 1. Nutrient Depletion The rise in UPF consumption has led to the dominance of three key ingredients in American children’s diets: ultra-processed grains,