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Andrew J. White, M.D., is the chairman of the Department of Pediatrics at Saint Louis University School of Medicine. He holds the Robert W. Wilmott Endowed Chair and is a professor of Pediatrics and Pediatric Rheumatology and Immunology. He serves as the pediatrician-in-chief of SSM Health Cardinal Glennon Children's Hospital, in St. Louis.
With Boost From RFK Jr. And Tucker Carlson, Two Chronic Disease Entrepreneurs Vault Into Trump's Orbit
WASHINGTON — One would not expect such an exuberant affair — laughter, groans of recognition, and standing ovations — for a discussion about chronic disease.
But here in the chandeliered Kennedy Caucus Room on Capitol Hill, it's standing-room only for a roundtable featuring favorites of the political right, including psychologist Jordan Peterson, surgeon Marty Makary, and two new faces: the siblings Calley and Casey Means. The pair have gone from relative unknowns to emergent conservative rabble-rousers — now buzzing in the same orbit as Tucker Carlson, Joe Rogan, Robert F. Kennedy Jr., and even former President Donald Trump.
They, along with Kennedy, are striving to build a new, "Make America Healthy Again" identity for the GOP ahead of the election. Trump sees fixing the American chronic disease epidemic as a "legacy item," Calley Means said in an exclusive interview with STAT. That appears to be true, at least for now, and has suddenly thrust the Meanses into the mainstream. This week, they'll appear on two of the largest stages in the world: Rogan's podcast, and a virtual town hall hosted by Trump himself.
In their increasingly frequent public appearances, the Meanses lay out a sprawling argument for how polluted health care, government, and science have become with perverse financial incentives. They've positioned themselves as truth-tellers looking to solve the problem — possibly with help from their own companies.
If this all sounds familiar, that's because it is: Kennedy focused on many of the same issues in his presidential campaign (and still does in his newer role as a Trump campaign surrogate). But the Meanses have gone even further with their message, effectively activating conservative anxieties about personal freedoms, family values, and institutional corruption.
If the enthusiasm continues, the "MAHA" policy lineup may become central to Trump's health agenda should he be re-elected.
'He's getting Republicans to get it'
In recent weeks, the elder Means, 39 — a dark-haired, fast-talking startup founder — has become a bit of a celebrity among conservatives. And his sister, redheaded, polished, vegetable-prescribing Casey, 37, has lent her M.D. To legitimize claims about a broken health care system. She was, according to Sen. Ron Johnson (R-Wis.), the catalyst for the roundtable on the Hill.
Until recently, she was known mostly for starting the health tech company Levels, which connects a habit-tracking app to continuous glucose monitors. Then, earlier this year, the siblings published a 400-page diet and self help book, titled "Good Energy: The Surprising Connection Between Metabolism and Limitless Health." The Free Press, a website catering to those disillusioned with mainstream news, ran an excerpt about the personal heartbreak that radicalized the siblings.
Their mother, Gayle, died of stage 4 pancreatic cancer just weeks after receiving the diagnosis. Her cancer had somehow snuck up on clinicians at some of the most prestigious institutions in the world. How could that be? And then, as she lay on her death bed in early 2021, doctors recommended treatments that were unlikely to extend her life but that might, in a pandemic, isolate her from family in her final moments, the Meanses say. A clear picture of twisted medical incentives came into view.
In the years that followed, they shared their worldview in bits and pieces, mostly on social media and niche podcasts, plus some appearances by Calley on conservative talk shows. But it was Carlson's lengthy conversation with the Meanses that seems to have trampolined them and their ideas into the spotlight.
Their two-hour interview has garnered more than 3 million views since it was posted mid-August. In it, the host transforms into a fanboy. "I truly believe you guys are going to change the world," he tells the siblings. From there, the conservative media circuit beckoned: Kennedy, who had interviewed Calley months prior, reposted their interview right on the heels of Carlson's. The timing landed just so.
Their podcast interview recirculated shortly before Kennedy dropped out of the race and endorsed Trump. After joining the Trump transition team, Kennedy shouted the Meanses out by name, saying in a public appearance that he would put people like them atop the nation's health agencies if given his choice. (Calley had been a fan of Kennedy, donating $1,500 to his presidential campaign between September 2023 and April.) It's impressive how the siblings have captured Washington's short attention span, said Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco, and a Levels adviser. Lustig counts himself among Casey Means' friends and, as an author of several books on diet-related disease, read early manuscripts of "Good Energy." He said he knows firsthand how tough it is to make politicians care about chronic illness. "Calley is doing better than me," Lustig said. "He's getting Republicans to get it." While Means identifies as a conservative and has been promoting right-wing influencers, he insists he's pushing a nonpartisan issue. In the span of a few weeks this summer, he met with more than 100 congressional staffers and members on both sides of the aisle, he said, including Cory Booker (D-N.J.), Nancy Pelosi (D-Calif.), Thomas Massey (R-Ken.), Chip Roy (R-Texas), and the Freedom Caucus. He's exchanged cordial emails with the Biden White House and praised its recent nutrition summit. The ideas the siblings advocate aren't new, or even traditionally embraced on the right. Hippie liberals have for decades warned of environmental pollution and Big Agriculture's deleterious effect on the food supply. Calley Means' desire to remove sugary drinks from Supplemental Nutrition Assistance Program has been pushed by Democrats, including Booker. (In more recent years, however, restrictions on food purchases have been labeled by some on the left as classist or racist.) In 2022, the Biden White House announced its support for the "food is medicine" movement, and recommended states expand Medicaid coverage of the program. The National Institutes of Health is designating and funding "food is medicine centers of excellence" across the country, STAT previously reported. Partisan vacillations aside, everyone agrees on some facts: Chronic diseases are increasingly among the leading causes of death in the U.S., or contribute to them. Prevalence is up for many conditions that are difficult or expensive to manage, and the U.S. Is not stemming the tide of new cases fast enough. It's a pressing problem that often lacks a sense of urgency, and it's creeping into childhood. Still, Means' plans hinge so far on firing up a right-leaning base and, if Trump wins, persuading him to take executive action — starting with a state-of-emergency declaration on chronic disease. Sweeping proposals and walking the line on vaccines The issues are complicated, but Means is wary of getting bogged down by "complex policy debates," he said at the Kennedy Room event. He's an ideas guy with sweeping proposals: barring ultra-processed foods from SNAP, cutting federal research funding to scientists with conflicts of interest, plus having taxpayers cover the 45% of FDA's budget that comes from pharma companies, and splitting food and drug oversight into separate agencies. He wants food to be considered medicine, and tobacco subsidies to go toward fruits and vegetables (preferably organic ones). And Means wants an immediate end to direct-to-consumer pharmaceutical advertising — a swift death by executive order, he says. He agrees with a slate of complementary policy proposals Kennedy laid out last month in an op-ed. It is unclear just how many of these ideas have actually made a convert of Trump, who is famously anti-regulation, pro-ultra-processed foods, and friendly with the vaping industry. Environmentalists have slammed Trump for gutting protections meant to clean up air and water pollution, which are harmful to health. Other decisions he made as president directly contradict policies pushed by Kennedy and the Meanses. However, Trump has pledged in campaign materials to establish a commission to investigate the root causes of chronic disease if he is elected, and is leaning into Kennedy as a surrogate on health-related matters. Where Means' rhetoric has clearest echoes of Trump's is in his interpretations of facts, where he sows mistrust of the government, researchers, and the health care system by painting a picture of widespread collusion. Often, he says the dietary guidelines "recommend" that 10% of a 2-year-old's diet be sugar — a sign, to him, of industry meddling; they actually say to stay under 10%. Means also shares a social media-driven myth that government scientists promote sugary cereal as healthier than meat; the work he references was by Tufts University researchers testing a new food-scoring algorithm for weaknesses, and the cereal-versus-meat finding was one of them. "It worked well to rate thousands of products," said Dariush Mozaffarian, one of the study's authors. "Not surprisingly, some exceptions were seen." (The latest version downgrades cold cereals' ratings, and boosts scores for beef, lamb and eggs, among other foods.) Means advocates for firing all government nutrition scientists. He also claims 80% of researchers who receive funding from the NIH have conflicts of interest. While thousands of researchers have disclosed financial conflicts, STAT could not independently verify that figure. Other comments are more clearly aimed at a conservative audience. In parts of their interview with Carlson, the Meanses railed against the vilification of Covid provocateurs like Rogan and bans on the purchase of raw milk, plus the hazards of seed oils, needless IVF, and the birth control pill (which reflects a "disrespect of life," Casey said). "I had to wake up. I was so deep into this in my 20s," she says on the show about her focus on work instead of family and domestic life. And then there's the issue of vaccines, and the connection to Kennedy. In public appearances, the siblings skirt the issue. They don't say they're opposed to vaccines in general but lean into some vaccine-skeptic arguments, ranging from the mercenary reasons companies may want to get on the immunization schedule to parental freedoms and aluminum in shots. On Carlson's show, Casey questioned the need for infants to be inoculated against hepatitis B — a dog whistle for parents afraid vaccines will sicken their children. (Hep B vaccines protect against transmission of the virus from parent to child, and can prevent the chronic and incurable form of infection into adulthood.) When asked outright in an interview with STAT if he believes vaccines are effective, Calley said he didn't understand the question. "That's the same thing the other side does. It's like, what does 'position on vaccines' mean? I think the schedule is probably extremely problematic." Career pivots and big ideas The Meanses are the kind of figures party leaders thirst for: prodigal children. Those who've been through the muck — in this case, the hallowed halls of progressive bastions — and returned. In a way, the Meanses have indeed come home. They were raised in D.C. By "spiritual" parents who read them the Bible, but also Rumi and Ayn Rand. Their father, Grady, worked in the Ford White House as assistant to the vice president, and as a government economist on welfare programs and health care policy. Then, he started a consulting firm that eventually merged to become Price Waterhouse Coopers, and sold to IBM. Like their father, both siblings are Stanford-educated. They pursued white collars and white coats until something broke. Casey defected first, dropping out of medical residency on her 30th birthday. It's a cinematic story, retold often: She was in the operating room, gazing down upon a child with incessant sinus inflammation, and disturbed that she didn't know what was causing it — something she says she never learned. Means realized she was never taught about nutrition as a therapeutic tool, either. (This last assertion is disputed by a fellow Stanford-trained doctor, neurosurgeon Tyler Cole, who graduated around the same time as Means.) Casey became a functional medicine doctor, focused on holistic approaches to care, and editor of the International Journal of Disease Reversal and Prevention. She later started Levels. Calley studied political science and economics, and interned for the second Bush White House and the Heritage Foundation — a right-wing think tank now famous for "Project 2025" — before working on John McCain's presidential campaign. Then he got a Harvard MBA and bounced to consulting. (There was an interlude to start a custom wedding dress startup with his wife; it was acquired by David's Bridal in 2022.) The brief consulting chapter in the early 2010s, less than five years total, makes for fiery testimony. Means often mentions working on behalf of food and pharma, wielding the kind of backroom influence that watchdogs howl at. He claims to have funneled millions of dollars from Coca-Cola to the American Diabetes Association and the NAACP to secure soda's place in the American diet. Coca-Cola and the NAACP did not comment. A spokesperson for the American Diabetes Association confirmed that the group received Coca-Cola money around 2010, but declined to specify how much. Reporting in Vox suggests ADA accepted $1.1 million from Coke between 2010 and 2015. Means has also accused the American Academy of Pediatrics of pushing new obesity drugs like Wegovy in exchange for funding from drugmaker Novo Nordisk. He is staunchly opposed to expanding Medicare coverage of GLP-1 drugs, which have already cost the U.S. Health care system and federal government billions. "The idea that we have an obesity crisis and are trying to spend trillions of dollars of government money to jab kids is a real problem," he told STAT. A spokesperson for Novo Nordisk refuted the characterization of the company as buying influence. The company is not listed among the corporate donors the pediatrics group chooses to disclose. The AAP declined to comment. However, the guidelines call for early diagnosis and intense lifestyle counseling, as well as consideration of weight loss drugs for children 12 and up who are in the 95th weight percentile, and consultation for weight loss surgery for teenagers who have severe obesity. Means asserts professional medical associations and agencies that receive industry funding "cannot be trusted" to establish standards of care. He says the nation needs "right reports" from federal agencies like the Food and Drug Administration, National Institutes of Health, and Centers for Disease Control and Prevention, establishing how chronic disease should be dealt with. It's not clear what Means is describing. At times it sounds like he wants clinical guidelines written by people without any industry ties. But he also suggests diet and exercise should feature more prominently — and pharmaceuticals less so — in treatment recommendations for some conditions. And he calls for new, federally funded research to give the public solid answers on the health effects of ultra-processed foods and environmental toxins, among other things. "Before talking about banning glyphosate, let's just demand a study of what glyphosate is doing," he says as an example. However, there exist hundreds of studies of the herbicide, including ones linking it to human disease. When pressed on exactly what kind of studies would be acceptable, Means said only that the NIH should pay for foundational research, "looking at the health of large populations" and the factors that affect it. "Isolating the exact ingredient or the exact variable is, I think, really problematic. And again, divorcing us from our common sense," he told STAT. While there are large studies underway — including the NIH-funded All of Us research program — the clean-cut approach Means describes is complicated by reality. Scientists often need to study component parts, individual variables and multiple disease contributors in order to establish causality. This is what makes nutrition science and research on environmental exposures particularly challenging. The study of ultra-processed food is a methodological doozy. Researchers have documented UPF's links to chronic disease and warned of the dark magic that lets store-bought foods seemingly glide past the body's fullness triggers. But the science is still not definitive, in large part because it is hard and expensive to run the kinds of trials that prove certain foods cause illness over time. The lack of clarity, in turn, makes it challenging for the FDA to put its foot down or even define "ultra-processed" — a broad category that includes hot dogs, breakfast cereals and soda, but also infant formula, plant-based milks and sandwich bread, among other things. The FDA is, however, planning to improve its review process for food additives, which are found in UPFs. Finding the profit in 'MAHA' Whether or not the Meanses are granted their wishlist, they stand to profit when people buy into "MAHA." The siblings regularly mention their best-selling book and their companies. Levels, the company Casey co-founded, is riding a wave of booming interest in continuous glucose monitoring (CGM). The company has raised nearly $100 million in venture capital funding in three years. It reportedly has more than 20,000 members who pay $199 annually for basic functions, or another $199 per month for connection with a CGM. (Levels is not covered by insurance.) And the recent availability of over-the-counter CGMs could open the door to bio-monitoring for the masses, even as questions remain about who the devices are appropriate for beyond those with type 1 diabetes. The drive for more personal biomedical information is a constant in the Meanses' talks. Standard blood tests and an annual physical aren't enough. They say Americans should know all they can about their biomarkers in order to spot potential diseases and avoid medication. They often mention Mark Hyman, a physician, author and media personality who sells extensive lab tests for $500 through his company, Function Health. Once people know what's going on in their blood, they can address it with food and exercise, they say. That's where Calley's company, TrueMed, comes in. People with health savings accounts (HSAs) and flexible spending accounts (FSAs) can report their medical conditions and get a letter of medical necessity within two business days — and then use their plans to buy wellness products and gym memberships. TrueMed makes money by hooking up patients with the likes of Barry's (of bootcamp fame) and CrossFit, as well as makers of cold plunges, saunas, and supplements. The company was valued at more than $40 million last year. As of January, it had raised $20.5 million in VC funding. Its key angel investor is Hyman. Ready for their closeup When the Kennedy Room hearing ends, eager supporters line up to shake the Meanses' hands or take a selfie. The CEO of a "food is medicine" startup asks how he can help, and Calley scribbles the man's name down in a palm-size notebook and promises to get in touch. As staff clear the chairs and evening sets in, he sits for interviews with two reporters from national news outlets. Calley is friendly and chatty. Then he rushes into the drizzly night to catch a flight to his company's retreat in Las Vegas. The next day, he reposts a tweet from a fellow panelist asking if major news outlets will report on the event. "Mind blowing silence of mainstream media attention," Means writes. Correction, Oct. 8, 2024: A previous version of this story included an inaccurate description of how Robert F. Kennedy Jr. Learned of Calley Means, and when he appeared on the RFK podcast. STAT's coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
Pediatric Pulmonary Center (PPC)
Wynton C. Hoover, M.D.
Professor
Medical Faculty, Pediatric Pulmonary Center
Director, UAB Pediatric CF Care CenterDirector, Pediatric PCD CenterDirector Outpatient Clinical Services (Division)Associate Director, Pediatric Pulmonary Fellowship ProgramDirector, Pediatric Infant Pulmonary Function Lab
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