HJNO Jul/Aug 2025

MAHA REPORT 48  JUL / AUG 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS   425 Calculations made from references 391, 399, and 400. 426 Lyu, H., Xu, T., Brotman, D., Mayer-Blackwell, B., Cooper, M., Daniel, M., ... & Makary, M. A. (2017). Overtreatment in the united states. PloS one, 12(9), e0181970. 427 Solmi, M., Fornaro, M., Ostinelli, E. G., Zangani, C., Croatto, G., Monaco, F., ... & Correll, C. U. (2020). Safety of 80 antidepressants, antipsychotics, anti-‑attention-‑deficit/ hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-‑review of 78 adverse effects. World Psychiatry, 19(2), 214-232. 428 Waters KA, Chawla J, Harris MA, et al. Cognition after early tonsillectomy for mild OSA. Pediatrics. 2020;145(2): e20191450. 429 Rosenfeld, R et al (2022). Clinical practice guideline: Tympanostomy tubes in children (update). 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Information for healthcare professionals: Suicidal behavior and ideation and antiepileptic drugs [FDA Alert]. https://wayback.archive - it.org/7993/20170404234152/https: / www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm100192.h tm. 442 Food and Drug Administration. (2018). Suicidality in Children and Adolescents Being Treated With Antidepressant Medications. FDA. https://www.fda.gov/drugs/ postmarket-drug-safety-information-patients-and-providers/suicidality-children-and-adolescents-being- treated-antidepressant-medications. 443 Swanson, J.M. et al 2017. Young adult outcomes in the follow-‑up of the multimodal treatment study of attention-‑deficit/hyperactivity disorder: Symptom persistence, source discrepancy, and height suppression. Journal of Child Psychology and Psychiatry, 58(6), pp.663-678. 444 Jensen, P. S., Arnold, L. E., Swanson, J. M., Vitiello, B., Abikoff, H. B., Greenhill, L. L., ... & Hur, K. (2007). 3-year follow-up of the NIMH MTA study. Journal of the American Academy of Child & Adolescent Psychiatry, 46(8), 989-1002. 445 Lee, J. M., Sharifi, M., Oshman, L., Griauzde, D. H., & Chua, K. P. (2024). Dispensing of glucagon-like peptide-1 receptor agonists to adolescents and young adults, 2020-2023. Jama, 331(23), 2041-2043. NEXT STEPS – SUPPORTING GOLD-STANDARD SCIENTIFIC RESEARCH AND DEVELOPING A COMPREHENSIVE STRATEGY To close critical research gaps and guide efforts to better combat childhood chronic disease in America, the following research initia- tives are recommended: 1. Addressing the Replication Crisis: NIH should launch a coordinated initiative to confront the replication crisis, investing in repro- ducibility efforts to improve trust and reliability in basic science and interventions for childhood chronic disease. 2. Post-Marketing Surveillance: NIH and FDA should build systems for real-world safety monitoring of pediatric drugs and create programs to independently replicate findings from industry-funded studies. 3. Real-World Data Platform: Expand the NIH-CMS autism data initiative into a broader, secure system linking claims, EHRs, and envi- ronmental inputs to study childhood chronic diseases. 4. AI-Powered Surveillance: Create a task force to apply AI and machine learning to federal health and nutrition datasets for early detection of harmful exposures and childhood chronic disease trends. 5. GRAS Oversight Reform: Fund independent studies evaluating the health impact of self- affirmed GRAS food ingredients, prioritiz- ing risks to children and informing transparent FDA rulemaking. 6. Nutrition Trials: NIH should fund long-term trials comparing whole-food, reduced-carb, and low-UPF diets in children to assess effects on obesity and insulin resistance. 7. Large-scale Lifestyle Interventions: Launch a coordinated national lifestyle-medicine initiative that embeds real-world randomized tri- als—covering integrated interventions in movement, diet, light exposure, and sleep timing—within existing cohorts and EHR networks. 8. Drug Safety Research: Support studies on long-term neurodevelopmental and metabolic outcomes of commonly prescribed pedi- atric drugs, emphasizing real-world settings and meaningful endpoints. 9. Alternative Testing Models: Invest in NewApproachMethodologies (NAMs), such as organ- on-a-chip, microphysiological systems, and computational biology, to complement animal testing with more predictive human-relevant models. 10. Precision Toxicology: Launch a national initiative to map gene–environment interactions affecting childhood disease risk, especially for pollutants, endocrine disruptors, and pharmaceuticals. Some of the steps to implement these research initiatives are already underway and others will begin this in the near future. In paral- lel, the MAHACommission will immediately begin working on developing the strategy to make our children healthy again—due inAugust 2025. We invite all of America, especially the private sector and academia, to be part of the solution.