WASHINGTON — While grain-based foods continue to be a fundamental part of American diets, the White House’s Make America Healthy Again (MAHA) Commission report identifies ultra-processed grains as a significant contributor to chronic diseases among U.S. children.
Released on May 22, the report follows a February executive order by President Donald Trump, which established the MAHA Commission. This group, composed of senior administration officials, is tasked with tackling what Department of Health and Human Services Secretary Robert F. Kennedy Jr. calls a “childhood chronic disease crisis” in the United States. The commission’s assessment will lead to a “make our children healthy again” strategy within 180 days, based on the report’s findings.
The commission singles out ultra-processed foods (UPFs) as a major cause of poor health in American children. It highlights ultra-processed grains, sugars, and fats as factors causing nutrient loss, increased calorie intake, and excessive consumption of food additives. As a result, children are consuming fewer whole foods essential for their health.
“Most American children’s diets are dominated by UPFs high in added sugars, chemical additives, and saturated fats, while lacking sufficient fruits and vegetables,” the report states. “This modern diet links to chronic diseases such as obesity, type 2 diabetes, cardiovascular disease, and some cancers. Excessive UPF consumption depletes essential micronutrients and dietary fiber, while increasing sugar and carbohydrate intake, which harms overall health.”
The report notes that about 70% of the more than 300,000 branded food products in grocery stores are UPFs. These foods provide half of all calories consumed by Americans, nearly 70% of calories for children, and more than half the diets of pregnant and postpartum women.
“The rise in UPF consumption has caused ultra-processed grains, sugars, and fats to dominate American children’s diets,” the report explains. “Once nearly nonexistent, these engineered ingredients now make up over two-thirds of children’s calorie intake. Ultra-processing displaces nutrient-rich whole foods, reducing intake of essential vitamins, minerals, fiber, and phytonutrients needed for healthy body functions.”
Specifically, ultra-processed grains—such as cakes, cookies, refined bread, candy, and snacks—are identified as sources of empty calories, leading to weight gain and obesity.
“These grains are a large part of the calories children get from UPFs,” the report says. “Processing removes bran and germ, which takes away key vitamins, minerals, and fiber. This can cause blood sugar spikes, raise type 2 diabetes risk, and reduce healthier whole grain consumption.”
The commission also points to “industrial processing” in UPF production as causing changes in fiber, protein, calorie density, and digestibility. These changes contribute to chronic diseases.
“Research suggests these alterations may disrupt brain reward pathways and hormones that regulate fullness,” the report adds. “They may encourage faster eating and weaken gut signals. Refined ingredients can quickly spike blood sugar and insulin and harm the gut microbiome.”
Enriched and fortified grains absent from report
The MAHA report does not mention enriched and fortified refined grains, which play a major role in U.S. nutrition. Enrichment restores nutrients lost during processing, while fortification adds nutrients not naturally present to address health needs.
Earlier this year, the Grain Foods Research Institute (GFRI) published a white paper noting the important role enriched and fortified grains have played in reducing nutrient deficiencies and improving diet quality affordably.
Erin Ball, executive director of the Grain Foods Foundation (GFF), a sister organization of GFRI, said in response to the MAHA report: “There is widespread misunderstanding about the public health benefits of enrichment and fortification. USDA food pattern models show it is difficult or impossible for some groups to meet nutrient targets without enriched grains. It’s a missed opportunity that the report ignores USDA’s work.”
According to GFRI’s analysis of National Health and Nutrition Examination Survey (NHANES) data, enriched and fortified grains provide substantial daily intakes of micronutrients like thiamin (45%), riboflavin (25%), niacin (28%), iron (38%), and folate (50%). These grains also remain key fiber sources and include affordable staples such as bread, tortillas, pasta, rice, and cereals.
Ball added, “There is a clear disconnect between the MAHA report and progress food manufacturers have made to improve nutrition, including more whole grain options. The report overlooks these efforts and lacks a strong grasp of industry and science.”
The GFRI paper also points out that refined grains are often grouped with red and processed meats, sugary drinks, fried foods, and high-fat dairy in so-called “unhealthy” diets. But when studied separately, refined grain intake does not increase risk for mortality, diabetes, heart disease, stroke, hypertension, or cancer.
This confusion partly arises because “refined grains” cover a wide range of products—from staple foods like enriched bread and cereal with low fat and sugar to indulgent treats like cakes and pastries high in fat and sugar.
Studies and the Dietary Guidelines for Americans often do not separate these types of grain foods, even though most refined grains consumed are staples, the paper states. Less than 25% are indulgent grain foods, which include desserts, stuffing, quick breads, biscuits, pies, and croissants. Data show most people consume indulgent grains moderately.
Ball said, “Public health often uses ‘refined grains’ to mean indulgent foods. We advocate distinguishing ‘staples’ from ‘indulgences’ to clarify their roles in a healthy diet. Both have a place, and this helps create realistic, evidence-based guidance that reflects actual eating habits.”
Industry responses and controversy
The North American Millers’ Association (NAMA) emphasized the importance of grain foods and their milling process in producing nutritious, safe, and affordable products year-round.
“Grain foods are affordable staples essential for a balanced diet,” said Jane DeMarchi, NAMA president. “Both whole and vitamin-enriched refined grains are crucial to public health. Processing alone does not determine nutritional value; we must look at individual foods and their role in diets. NAMA continues working with the Grain Foods Foundation to understand the nutritional benefits of our products.”
The MAHA report faced criticism over its use of science and references. Some cited broken study links and claims from researchers who said they were not involved in the cited work, fueling accusations that parts of the report were pieced together using artificial intelligence.
Still, industry groups welcomed the report as a starting point for dialogue with federal officials.
Jennifer Hatcher, chief public policy officer at FMI-The Food Industry Association, said, “The MAHA Commission’s assessment invites conversation with the administration. Public-private partnerships can help consumers make informed choices from the 32,000 products in an average grocery store. FMI members have always been part of the solution and will support realistic, science-based policies.”
NAMA’s DeMarchi called for greater collaboration as the MAHA work moves toward recommendations.
“We seek opportunities for stakeholders to support science- and risk-based decisions, which have guided U.S. regulation,” she said.
Erin Ball added that educating policymakers remains vital.
“It may be wise to discuss nutrition policy with members of Congress rather than directly with HHS now,” she said. “Groups like the American Bakers Association and NAMA are carefully navigating the complex political and evolving conversation about food ingredients.”
Food analyst Robert Moskow of TD Cowen noted the MAHA report could deepen negative perceptions of processed foods, hurting big packaged food brands.
“The administration’s negative messaging reinforces concerns about consumer trust in processed foods,” Moskow said. “The term ‘ultra-processed food’ targets industrial processing itself, making it harder for companies to improve their image just by changing ingredients.”
Erin Ball cautioned that “ultra-processed” remains a vague term.
“There is much imprecision in how ‘ultra-processed’ is used, and the science is not mature enough to clearly define or reject this category,” she said. “Further work is needed to clarify or debunk the concept of ‘ultra-processed foods.’”
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