Health
As RFK Jr. Champions Chronic Disease Prevention, Key Research Is Cut
Robert F. Kennedy Jr. has spoken of an “existential threat” that he said can destroy the nation.
“We have the highest chronic disease burden of any country in the world,” Mr. Kennedy said at a hearing in January before the Senate confirmed him as the secretary of Health and Human Services.
And on Monday he is starting a tour in the Southwest to promote a program to combat chronic illness, emphasizing nutrition and lifestyle.
But since Mr. Kennedy assumed his post, key grants and contracts that directly address these diseases, including obesity, diabetes and dementia, which experts agree are among the nation’s leading health problems, are being eliminated.
These programs range in scale and expense. Researchers warn that their demise could mean lost opportunities to address an aspect of public health that Mr. Kennedy has said is his priority.
“This is a huge mistake,” said Dr. Ezekiel Emanuel, the co-director of the Healthcare Transformation Institute at the University of Pennsylvania’s Perelman School of Medicine.
Decades of Diabetes Research Discontinued
Ever since its start in 1996, the Diabetes Prevention Program has helped doctors understand this deadly chronic disease. The condition is the nation’s most expensive, affecting 38 million Americans and incurring $306 billion in one recent year in direct costs. With about 400,000 deaths in 2021, it was the eighth leading cause of death.
The program has been terminated, and the reason has little to do with its merits. Instead, it seems to be a matter of a lead researcher’s working in the wrong place at the wrong time.
The program began when doctors at 27 medical centers received funding from the National Institutes of Health for a study asking whether Type 2 diabetes could be prevented. The 3,234 participants had high risk of the disease.
The results were a huge victory. Those assigned to follow a healthy diet and exercise routine regularly reduced their chances of developing diabetes by 58 percent. Those who took metformin, a drug that lowers blood sugar, decreased their risk by 31 percent.
The program entered a new phase, led by Dr. David M. Nathan, a diabetes expert at Harvard Medical School. Researchers followed the participants to see how they fared without the constant attention and support of a clinical trial. The researchers also examined their genetics and metabolism and looked at measures of frailty and cognitive function.
Several years ago, the investigators had an idea. Some studies suggested that people with diabetes had a higher risk of dementia. But scientists didn’t know if it was vascular dementia or Alzheimer’s or what the precise risk factors were. The diabetes program could renew its focus on investigating this with its 1,700 aging participants.
The group added a new principal investigator, the dementia expert Dr. Jose A. Luchsinger. For administrative reasons, including the newfound focus on dementia, the program decided its money should flow through Dr. Luchsinger’s home institution, Columbia University, rather than through Harvard or George Washington University, where a third principal investigator works.
On March 7, the Trump administration cut $400 million in grants and contracts to Columbia, saying Jewish students were not protected from harassment during protests over the war in Gaza. The diabetes grant was among those terminated: $16 million a year that Columbia shared across 30 medical centers. The study ended abruptly.
Asked about the termination, Andrew G. Nixon, director of communications at the Department of Health and Human Services, provided a statement from the agency’s acting general counsel saying that “anti-Semitism is clearly inconsistent with the fundamental values that should inform liberal education” and that “Columbia University’s complacency is unacceptable.”
At the time their grant ended, the researchers had started advanced cognitive testing for evidence of dementia in patients, followed by brain imaging to look for amyloid, the hallmark of Alzheimer’s disease. They planned to complete the tests during the next two years.
Then, Dr. Luchsinger said, the group was going to look at blood biomarkers of amyloid and other signs of dementia, including brain inflammation. For comparison, they planned to perform the same tests on participants’ blood samples from 7 and 15 years ago.
“Very few studies have blood collected and stored going that far back,” Dr. Luchsinger said.
Now much of the work cannot begin, and the part that had started remains incomplete.
Another troubling question the researchers hoped to answer was whether metformin increases, decreases or has no effect on the risk of dementia.
“This is the largest and longest study of metformin ever,” Dr. Luchsinger said. Participants assigned to take the drug in the 1990s took it for more than 20 years.
“We thought we had the potential to put to rest this question about metformin,” Dr. Luchsinger said.
The only ways to save the program, Dr. Nathan said, are for Mr. Kennedy to agree to restore the funding at Columbia or to transfer the grant to a principal investigator at another medical center.
The study investigators are appealing to the diabetes caucus in Congress, hoping it can help make their case to the Health and Human Services.
“We hope the congressmen and senators might prevail and say: ‘This is crazy. This is chronic disease. This is what you wanted to study,’” Dr. Nathan said.
So far, there has been no change.
Include Diversity. Actually, That’s Too Much Diversity.
Compared with the Diabetes Prevention Program, a program to train pediatricians to become scientists is tiny. But pediatric researchers say that the Pediatric Scientist Development Program helps ensure that chronic childhood diseases are included in medical research.
It began 40 years ago when chairs of pediatric departments called for the creation of the program, which has been continually funded ever since by the National Institute of Child Health and Human Development.
Participants are clinicians who were trained in subspecialties like endocrinology and nephrology, practiced as clinicians and were inspired to go into research to help young patients with the diseases they had seen firsthand.
The highly competitive program pays for seven to eight pediatricians to train at university medical centers for a year, pairing them with mentors and giving them time away from the clinic to research conditions including obesity, asthma and chronic kidney disease.
In retrospect, the program’s fate was sealed in 2021 when its leaders applied for a renewal of their grant. It seemed pro forma. This was its eighth renewal.
This time, though, an external committee of grant reviewers told the investigators their proposal’s biggest weakness was a lack of diversity. The program needed to seek pediatricians who represented diverse ethnicities, economic backgrounds, states, types of research and pediatric specialties.
The critique said, for example, that “attention must be given to recruiting applicants from diverse backgrounds, including from groups that have been shown to be nationally underrepresented in the biomedical, behavioral, clinical and social sciences.”
So the program’s leaders sprinkled diversity liberally through a rewritten grant application.
“Diversity, in its broadest sense, was all over the grant,” said Dr. Sallie Permar, professor and chairwoman of pediatrics at Weill Cornell Medical College and director of the program. “It was exactly what the reviewers appreciated when we resubmitted.”
The grant was renewed in 2023. Now it is terminated. The reason? Diversity.
The termination letter, from officials in the National Institute of Child Health and Human Development, said there was no point in trying to rewrite the grant request. The inclusion of diversity made the application so out of line that “no modification of the project could align the project with agency priorities.”
Mr. Nixon, the health department spokesman, did not reply to queries about the pediatric program’s cancellation.
Participants in the program are distraught.
Dr. Sean Michael Cullen had been studying childhood obesity at Weill Cornell in New York. He has investigated why male mice fed a high-fat diet produced offspring that became fat, even when those offspring were fed a standard diet.
He hoped his findings would help predict in humans which children were at risk of obesity so pediatricians could try to intervene.
Now the funds are gone. He may seek private or philanthropic funding, but he doesn’t have any clear prospects.
Dr. Evan Rajadhyaksha is in a similar situation. He’s a childhood kidney disease specialist at Indiana University. When he was a resident, he cared for a little girl who developed kidney disease because of a condition in which some urine washes up from the bladder into the kidneys.
Dr. Rajadhyaksha has a hypothesis that vitamin D supplementation could protect children with this condition.
Now, that work has to stop. Without funding, he expects to leave research and return to clinical work.
Dr. Permar said she hadn’t given up. The program costs only $1.5 million each year, so she and her colleagues are looking for other support.
“We are asking foundations,” she said. “We are starting to ask industry — we haven’t had industry funding before. We are asking department chairs and children’s hospitals, are they willing to fund-raise?”
“We are literally looking under every couch cushion,” Dr. Permar said.
“But,” she said, federal support for the program “has been the foundation and cannot be supplanted.”
A federal prosecutor in Washington has contacted The New England Journal of Medicine, considered the world’s most prestigious medical journal, with questions that suggested without evidence that it was biased against certain views and influenced by external pressures.
Dr. Eric Rubin, the editor in chief of N.E.J.M., described the letter as “vaguely threatening” in an interview with The New York Times.
At least three other journals have received similar letters from Edward Martin Jr., a Republican activist serving as interim U.S. attorney in Washington. Mr. Martin has been criticized for using his office to target opponents of the administration.
His letters accused the publications of being “partisans in various scientific debates” and asked a series of accusatory questions about bias and the selection of research articles.
Do they accept submissions from scientists with “competing viewpoints”? What do they do if the authors whose work they published “may have misled their readers”? Are they transparent about influence from “supporters, funders, advertisers and others”?
News of the letter to N.E.J.M. was reported earlier by STAT, a health news outlet.
Mr. Martin also asked about the role of the National Institutes of Health, which funds some of the research the journals publish, and the agency’s role “in the development of submitted articles.”
Amanda Shanor, a First Amendment expert at the University of Pennsylvania, said the information published in reputable medical journals like N.E.J.M. is broadly protected by the Constitution.
In most cases, journals have the same robust rights that apply to newspapers — the strongest the Constitution provides, she added.
“There is no basis to say that anything other than the most stringent First Amendment protections apply to medical journals,” she said. “It appears aimed at creating a type of fear and chill that will have effects on people’s expression — that’s a constitutional concern.”
It’s unclear how many journals have received these letters or the criteria that Mr. Martin used to decide which publications to target. The U.S. attorney’s office in Washington did not respond to a request for comment.
“Our job is to evaluate science and evaluate it in an unbiased fashion,” Dr. Rubin said. “That’s what we do and I think we do it well. The questions seem to suggest that there’s some bias in what we do — that’s where the vaguely threatening part comes in.”
Jeremy Berg, the former editor in chief of the journal Science, said he thought the letters were designed to “intimidate journals to bend over backward” to publish papers that align with the administration’s beliefs — on climate change and vaccines, for example — even if the quality of the research is poor.
Robert F. Kennedy Jr., the nation’s health secretary, singled out N.E.J.M in an interview with the “Dr. Hyman Show” podcast last year as an example of a medical journal that has participated in “lying to the public” and “retracting the real science.”
Andrew Nixon, a spokesman for the Health and Human Services Department, declined to comment on whether Mr. Kennedy had any involvement with the letters.
In the interview, Mr. Kennedy said he would seek to prosecute medical journals under federal anti-corruption laws.
“I’m going to litigate against you under the racketeering laws, under the general tort laws,” he said. “I’m going to find a way to sue you unless you come up with a plan right now to show how you’re going to start publishing real science.”
Dr. Jay Bhattacharya, the new director of N.I.H., has vigorously criticized the leadership of scientific journals. Recently he co-founded a new journal as an alternative to traditional scientific publishing. It has published contrarian views on Covid.
Other prominent journals said they had not received the letter. On Friday, The Lancet, which is based in Britain, published a scathing editorial in solidarity, calling the letters “an obvious ruse to strike fear into journals and impinge on their right to independent editorial oversight.”
“Science and medicine in the U.S.A. are being violently dismembered while the world watches,” the editorial said.
One of Mr. Martin’s letters was sent to the journal Chest, a low-profile publication that publishes highly technical studies on topics like lung cancer and pneumonia. The New York Times reported last week that at least two other publishers had received nearly identically worded letters.
They declined to speak publicly for fear of retribution from the Trump administration.
Dr. Rubin said he, too, was worried about political backlash. Scientific journals rely on public funds in several indirect ways — for example, universities often use federal grants to pay for subscriptions.
“Are we concerned? Of course we are,” he said. “But we want to do the right thing.”
Mr. Martin gave the journals until May 2 to respond to his questions. N.E.J.M. has already responded to Mr. Martin with a statement that pushes back against his characterization of the journal.
“We use rigorous peer review and editorial processes to ensure the objectivity and reliability of the research we publish,” the statement read. “We support the editorial independence of medical journals and their First Amendment rights to free expression.”
This is not the N.E.J.M’s first brush with a Trump administration.
In 2020, the journal published an editorial condemning the president’s response to the pandemic — the first time the journal had supported or condemned a political candidate in its 208-year history.
Dr. Rubin said he doubted Mr. Martin’s letter was related to the editorial. The journal Chest didn’t write about Trump’s first term yet received a letter, he noted.
Social media can be a great source of fitness, nutrition and wellness tips — but it also has some potentially harmful content.
Enter “SkinnyTok,” a popular weight-loss trend making the rounds on TikTok.
Creators are pairing the hashtag with videos that share various ways to lose weight, many of them based on the goal of getting as thin as possible in a short amount of time.
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As of April 26, there were more than 60,000 videos from creators talking about SkinnyTok. One of those is Mandana Zarghami, 25, a business owner and influencer in Miami, Florida.
“What you eat in private will show in public,” Zarghami told her followers in a recent video.
The influencer spoke with Fox News Digital about her perception of the worldwide SkinnyTok trend.
“There’s an emphasis on portion control, prioritizing daily movement and knowing what foods will make you feel better from the inside out and more,” she said.
The creator acknowledged, however, that some of the content could be triggering for those who have battled disordered eating.
Mandana Zarghami, a TikTok creator, acknowledged that some of the SkinnyTok content could be triggering for those who have battled disordered eating. (Mandana Zarghami/TikTok)
“While some content under the SkinnyTok trend can promote motivation around health and wellness, it can also unintentionally glamorize unhealthy habits or unrealistic body standards if you’re following the wrong influencer or content creator,” Zarghami cautioned.
At the same time, she said, “you control what you consume.”
“What you eat in private will show in public.”
“It’s a little hard to be sensitive to each group, because a lot of the people who talk about SkinnyTok on their platforms also battled disordered eating and overcame it with healthy lifestyle choices,” Zarghami added.
Dr. Brett Osborn, a Florida neurosurgeon and longevity expert, said he has witnessed the “devastating consequences” of extreme thinness firsthand, including women with fractured bones caused by malnutrition.
“This is a growing crisis, and it is being dangerously celebrated on social media under hashtags like #SkinnyTok,” he told Fox News Digital.
“It’s a little hard to be sensitive to each group, because a lot of the people who talk about SkinnyTok on their platforms also battled disordered eating and overcame it with healthy lifestyle choices,” said influencer Mandana Zarghami (right). (iStock/TikTok-Mandana Zarghami)
“When young people chase after extreme thinness through starvation diets, they invite frailty into their lives. The body, deprived of caloric energy, becomes extremely fragile.”
In teenagers and young adults, malnutrition disrupts hormones, weakens immunity, impairs cognitive function and can cause lasting damage to their still-developing brains, according to Osborn.
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Physical effects of malnutrition can include hair loss, reduced bone density and, in severe cases, irreversible structural damage, he added.
Low body weight or minimal body fat does not equate to good health, the doctor said.
“Starvation is not a virtue – it is an abandonment of the body’s nutritional needs,” he said. “The SkinnyTok trend preys on impressionable youth, particularly young women, encouraging them to shrink rather than thrive.”
Low body weight or minimal body fat does not equate to good health, one doctor told Fox News Digital. (iStock)
Rather than focusing on “extreme thinness,” Osborn called for a focus on building muscle, which he described as the “cornerstone of vitality.”
“In older adults, muscle loss — or sarcopenia — is a medical warning sign linked to increased risks of falls, fractures, hospitalizations, cognitive decline and even mortality,” he cautioned.
“Muscle loss doesn’t just weaken the body — it erodes the mind, hastening the onset and progression of dementia. The body and the brain are interconnected, and when one suffers, so does the other.”
“Muscles are your shield against disease and decline. Being lean and strong, not thin and frail, is the true measure of health,” one doctor said. (iStock)
To those embracing the SkinnyTok trend, Osborn recommends that they shift the focus to building muscle.
“Muscles are your shield against disease and decline. Being lean and strong, not thin and frail, is the true measure of health,” he said.
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“Instead of glorifying starvation, we should teach our youth to nourish their bodies and minds, build resilience through muscle gained by strength training, and prioritize bodily function over any short-lived trend.”
Dr. Jillian Lampert, vice president of The Emily Program, an eating disorder treatment center based in Minnesota, also called out the potential risks of the SkinnyTok trend.
“It is a vicious cycle that quickly spirals from external messaging to internal criticism.”
“This content dangerously glorifies content that encourages people to take drastic measures to change their bodies,” she told Fox News Digital. “It also further ensnares people already struggling with their body image and thoughts of size and shape, reinforcing the notion that being thin at all costs is the norm.”
The behaviors in many of the videos are “often extreme” and highly limit foods or food groups, Lampert noted.
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The algorithms used by social media platforms make the content even more dangerous by amplifying the messages, according to the expert.
“Looking at one TikTok with even some less toxic body image content will teach the algorithms to send you more and more and more until your feed has become an avalanche of toxic content,” Lampert warned.
As people scroll through countless videos of “ideal” bodies and lifestyles, this often leads them to conclude that they’re not thin enough or attractive enough.
“This content dangerously glorifies content that encourages people to take drastic measures to change their bodies,” one expert told Fox News Digital. (iStock)
“Continual assessment of appearance and eating habits can make a person hypercritical and hyper-fixated on perceived flaws, thus fueling the cycle of eating less, which often leads to overeating and overexercising, which often leads to fatigue and loss of control around food,” said Lampert.
“It is a vicious cycle that quickly spirals from external messaging to internal criticism.”
Dr. Anastasia Rairigh, a Tennessee-based family physician and obesity medicine specialist at the virtual health platform PlushCare, warned that extreme weight-loss behaviors can be deadly.
“As a person severely limits their caloric intake, the body struggles to maintain the correct electrolyte balance,” she shared with Fox News Digital.
“When a person’s electrolytes are severely unbalanced, they can experience heart arrythmias or, in severe cases, cardiac arrest. Even if a person does not experience this, severe food deprivation can lead to damage to the heart, bones and brain.”
“Many of us that promote SkinnyTok focus on proper nutrition, walking over 10,000 steps a day and promoting a healthy and active lifestyle,” a creator told Fox News Digital. (iStock)
People who deprive themselves of food may also notice effects on cognition, mood and sleep, Rairigh warned.
“Modeling a healthy attitude toward food is critically important to combating the negative influence of toxic diet culture,” she said, recommending that people focus on food as a source of energy rather than an enemy.
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“Supporting young people to focus on activities and interests outside social media has been shown to be helpful as well,” she said.
“Encourage and facilitate positive activities in the real world as a counter to time spent on social media.”
“Modeling a healthy attitude toward food is critically important to combating the negative influence of toxic diet culture.”
Those who are showing signs of disordered eating should see a doctor, Rairigh advised.
“While disordered eating is deadly, there is hope and treatment. Do not be afraid to reach out for help.”
Zarghami, the TikTok creator, reiterated the importance of setting positive examples on social media.
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“Many of us that promote SkinnyTok focus on proper nutrition, walking over 10,000 steps a day and promoting a healthy and active lifestyle,” she told Fox News Digital.
“It’s so important to approach these trends with balance, focus on overall well-being rather than appearance, and encourage sustainable, nourishing choices that support both physical and mental health.”
The opioid overdose reversal medication commercially known as Narcan saves hundreds of thousands of lives a year and is routinely praised by public health experts for contributing to the continuing drop in opioid-related deaths. But the Trump administration plans to terminate a $56 million annual grant program that distributes doses and trains emergency responders in communities across the country to administer them, according to a draft budget proposal.
In the document, which outlines details of the drastic reorganization and shrinking planned for the Department of Health and Human Services, the grant is among many addiction prevention and treatment programs to be zeroed out.
States and local governments have other resources for obtaining doses of Narcan, which is also known by its generic name, naloxone. One of the main sources, a program of block grants for states to use to pay for various measures to combat opioid addiction, does not appear to have been cut.
But addiction specialists are worried about the symbolic as well as practical implications of shutting down a federal grant designated specifically for naloxone training and distribution.
“Reducing the funding for naloxone and overdose prevention sends the message that we would rather people who use drugs die than get the support they need and deserve,” said Dr. Melody Glenn, an addiction medicine physician and assistant professor at the University of Arizona, who monitors such programs along the state’s southern border.
Neither the Department of Health and Human Services nor the White House’s drug policy office responded to requests for comment.
Although budget decisions are not finalized and could be adjusted, Dr. Glenn and others see the fact that the Trump administration has not even opened applications for new grants as another indication that the programs may be eliminated.
Other addiction-related grants on the chopping block include those offering treatment for pregnant and postpartum women; peer support programs typically run by people who are in recovery; a program called the “youth prevention and recovery initiative”; and programs that develop pain management protocols for emergency departments in lieu of opioids.
The federal health secretary, Robert F. Kennedy Jr., has long shown a passionate interest in addressing the drug crisis and has been outspoken about his own recovery from heroin addiction. The proposed elimination of addiction programs seems at odds with that goal. Last year, Mr. Kennedy’s presidential campaign produced a documentary that outlined federally supported pathways out of addiction.
The grants were awarded through the Substance Abuse and Mental Health Services Administration, an agency within the federal health department that would itself be eliminated under the draft budget proposal, though some of its programs would continue under a new entity, the Administration for a Healthy America.
In 2024, recipients of the naloxone grants, including cities, tribes and nonprofit groups, trained 66,000 police officers, fire fighters and emergency medical responders, and distributed over 282,500 naloxone kits, according to a spokesman for the substance abuse agency.
“Narcan has been kind of a godsend as far as opioid epidemics are concerned, and we certainly are in the middle of one now with fentanyl,” said Donald McNamara, who oversees naloxone procurement and training for the Los Angeles County Sheriff’s Department. “We need this funding source because it’s saving lives every day.”
Matthew Cushman, a fire department paramedic in Raytown, Mo., said that through the naloxone grant program, he had trained thousands of police officers, firefighters and emergency medical responders throughout Kansas City and western rural areas. The program provides trainees with pouches of naloxone to administer in the field plus “leave behind” kits with information about detox and treatment clinics.
In 2023, federal figures started to show that national opioid deaths were finally declining, progress that many public health experts attribute in some measure to wider availability of the drug, which the Food and Drug Administration approved for over-the-counter sales that year.
Tennessee reports that between 2017 and 2024, 103,000 lives saved were directly attributable to naloxone. In Kentucky, which trains and supplies emergency medical workers in 68 rural communities, a health department spokeswoman noted that in 2023, overdose fatalities dropped by nearly 10 percent.
And though the focus of the Trump administration’s Office of National Drug Control Policy is weighted toward border policing and drug prosecutions, its priorities, released in an official statement this month, include the goal of expanding access to “lifesaving opioid overdose reversal medications like naloxone.”
“They immediately reference how much they want to support first responders and naloxone distribution,” said Rachel Winograd, director of the addiction science team at the University of Missouri-St. Louis, who oversees the state’s federally funded naloxone program. “Juxtaposing those statements of support with the proposed eliminations is extremely confusing.”
Mr. Cushman, the paramedic in Missouri, said that ending the naloxone grant program would not only cut off a source of the medication to emergency responders but would also stop classes that do significantly more than teach how to administer it.
His cited the insights offered by his co-instructor, Ray Rath, who is in recovery from heroin and is a certified peer support counselor. In training sessions, Mr. Rath recounts how, after a nasal spray of Narcan yanked him back from a heroin overdose, he found himself on the ground, looking up at police officers and emergency medical responders. They were snickering.
“Ah this junkie again, he’s just going to kill himself; we’re out here for no reason,” he recalled them saying.
Mr. Rath said he speaks with trainees about how the individuals they revive are “people that have an illness.”
“And once we start treating them like people, they feel like people,” he continued. “They feel cared about, and they want to make a change.”
He estimated that during the years he used opioids, naloxone revived him from overdoses at least 10 times. He has been in recovery for five years, a training instructor for the last three. He also works in homeless encampments in Kansas, offering services to people who use drugs. The back of his T-shirt reads: “Hope Dealer.”
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