activity, and overall diet quality to isolate the impact of UPF consumption on mortality risk.
As the consumption of UPFs has surged, children are increasingly neglecting the whole foods essential for their health. 141 142 Approximately 50% of children ages 2 to 18 skip discrete fruit entirely on any given day. 143 Research consistently shows that key micronutrients such as calcium, iron, potassium, and vitamin D, which are found in fruits and vegetables, are essential for children’s physiological functioning.1

144 145 146

Research also consistently links diets centered on whole foods to lower rates of obesity, type 2 diabetes, heart disease, certain cancers, and mental illness. 147 148 This is not surprising. Diet and lifestyle significantly influence gene expression and cellular biology – ultimately determining our health outcomes. 149 150 For instance:
• Leafy greens supply magnesium and folate critical for energy production and other benefits.151
Salmon delivers omega-3 fatty acids that help reduce cardiovascular risk and support brain health. 152 153
• Legumes offer fiber and resistant starch that help nourish beneficial gut bacteria. 154 155

141 Guthrie, J. F., & Lin, B.-H. (2024). Peeling open U.S. fruit consumption trends (Economic Research Report No. 341). U.S. Department of Agriculture, Economic Research Service. https://www.ers.usda.gov/publications/pub-details/?pubid=110658. 142 Kim, S. A., Moore, L. V., Galuska, D., Wright, A. P., Harris, D., Grummer-Strawn, L. M., Merlo, C. L., Nihiser, A. J., & Rhodes, D. G. (2014, August 8). Vital Signs: Fruit and vegetable intake among children-United States, 2003-2010. MMWR. Morbidity and Mortality Weekly Report, 63(31), 671–676. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6331a3.htm.
143 Hoy, M. K., Clemens, J. C., & Moshfegh, A. J. (2021, June). Intake of fruit by children and adolescents: What We Eat in America, NHANES 2017-2018 (FSRG Dietary Data Brief No. 38) [Data brief]. United States Department of Agriculture. https://www.ncbi.nlm.nih.gov/books/NBK588714/.
144 Panzeri, C., Pecoraro, L., Dianin, A., Sboarina, A., Arnone, O. C., Piacentini, G., & Pietrobelli, A. (2024). Potential Micronutrient Deficiencies in the First 1000 Days of Life: The Pediatrician on the Side of the Weakest. Current obesity reports, 13(2), 338–351. 145 Rivera, J. A., Hotz, C., González-Cossío, T., Neufeld, L., & García-Guerra, A. (2003). The effect of micronutrient deficiencies on child growth: A review of results from community-based supplementation trials. The Journal of Nutrition, 133(11), 4010S-4020S. https://doi.org/10.1093/jn/133.11.4010S.
146 Soliman, A., De Sanctis, V., & Elalaily, R. (2014). Nutrition and pubertal development. Indian journal of endocrinology and metabolism, 18(Suppl 1), S39–S47. https://doi.org/10.4103/2230-8210.145073.
147 Sofi, F., Cesari, F., Abbate, R., Gensini, G. F. & Casini, A. (2008) Adherence to Mediterranean diet and health status: meta-analysis. BMJ 337, a1344.
148 O’neil, A., Quirk, S. E., Housden, S., Brennan, S. L., Williams, L. J., Pasco, J. A., … & Jacka, F. N. (2014). Relationship between diet and mental health in children and adolescents: a systematic review. American journal of public health, 104(10), e31-e42. 149 Landecker, H. (2011). Food as exposure: Nutritional epigenetics and the new metabolism. BioSocieties, 6(2), 167
150 Mierziak, J., Kostyn, K., Boba, A., Czemplik, M., Kulma, A., & Wojtasik, W. (2021). Influence of the bioactive diet components on the gene expression regulation. Nutrients, 13(11), 3673.
151 Duthie, S. J. Folate and cancer: how DNA damage, repair and methylation impact on colon carcinogenesis. (2021) J. Inherit. Metab. Dis. 34, 101–109 (2011); Liu, D. et al. Increased provision of bioavailable Mg through vegetables could significantly reduce the growing health and economic burden caused by Mg malnutrition. Foods 10, 2513.
152 Tsoupras, A., Brummell, C., Kealy, C., Vitkaitis, K., Redfern, S., & Zabetakis, I. (2022). Cardio-protective properties and health benefits of fish lipid bioactives; the effects of thermal processing. Marine Drugs, 20(3), 187.
153 Innes, J. K. & Calder (2020), P. C. Marine omega-3 (n-3) fatty acids for cardiovascular health: an update for 2020. Int. J. Mol. Sci. 21, 1362.
154 Chen, Z., Liang, N., Zhang, H., Li, H., Guo, J., Zhang, Y., Chen, Y., Wang, Y., & Shi, N. (2024). Resistant starch and the gut microbiome: Exploring beneficial interactions and dietary impacts. Food Chemistry: X, 21, 101118.
155 Kadyan, S., Deka, G., Mudi, S. R., Bhardwaj, N., Singh, V., & Yadav, D. (2022). Prebiotic potential of dietary beans and pulses and their resistant starch for ageing-associated gut and metabolic health. Nutrients, 14(9),

1726. https://doi.org/10.3390/nu14091726.

The President’s Make America Healthy Again Commission

THE WHITE HOUSE

WASHINGTON

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