Conflicts of interest in Dietary Guidelines for Americans as researchers call for transparency

25 Mar 2022 --- The much-anticipated 2020-2025 Dietary Guidelines for Americans (DGA) is rife with conflicts of interest (COI), with 19 of the 20 committee members having at least one tie to an industry actor, including Kellogg, Abbott, Kraft, Mead Johnson, General Mills and Dannon.

This is according to a study funded by nonprofit The Nutrition Coalition, which speaks to NutritionInsight about making agencies realize that this COI could ultimately have a negative impact on population health.

“Not only is it possible to have a non-biased committee, but it is necessary. The committee should also be reflective of the demography of this country, across race, culture, and other socio-economic diversity,” says Ashka Naik, research director of Corporate Accountability. 

Lead author Dr. Mélissa Mialon of Trinity College Dublin, Ireland, elaborates that many researchers do not work with industry and thus could create a non-biased committee. 

“We have shown that money is not the reason why experts have so many COI here. Most DGAC members were able to get funding from federal agencies to support their research,” she states.COI may undermine the effectiveness of existing policies and processes to safeguard public health policy. 

Multiple industry connections revealed
Published in Public Health Nutrition, the study includes longitudinal data from archival sources on connections between members of the DGA’s advisory committee and actors.

It revealed that 95% of the committee members had COI with the members of the food or pharmaceutical industries – none of which responded to NutritionInsight’s request for comment. 

Additionally, International Life Sciences had connections with multiple committee members. The nonprofit is partially financed by food and chemical corporations, such as California Walnut Commission, California Almond Board and Beef Checkoff, according to the paper. 

Overall, research funding and membership of an executive board jointly accounted for more than 60% of the total number of COI documented.

Transparency is key
The researchers emphasize that trustworthy dietary guidelines result from a transparent, objective, and science-based process. 

“Our analysis has shown that the significant and widespread COI on the committee prevent the DGA from achieving the recommended standard for transparency without mechanisms in place to make this information publicly available,” they write. 

Disclosure of COI on DGA’s committee was recommended in 2017 by the National Academies of Sciences in order to increase transparency and manage bias, but public disclosure of the committee’s COI does not appear to have taken place.

Mialon hopes these findings will start a debate around why top-level experts are working with industry. “This could ultimately lead to protections in place.” 

Taking steps toward mitigating conflicts of interest 
Measuring the COI is the first step toward managing and then mitigating such conflicts or the perceptions conflict in the future, adds Naik. 

“In terms of tangible impact, this paper underscores an urgent need for strong and strategic safeguards to be put in place to ensure COIs are prevented, and not just disclosed, for the future evolution of the DGA, especially as the country continues to grapple with a massive crisis of diet-related diseases.

“Given that one in six US consumers has some diet-related disease, according to the CDC, it is imperative that our nation’s most important nutrition policy, the DGA, be free from industry bias. The public needs trustworthy, reliable guidelines to guide them toward better health,” adds Nina Teicholz, director of The Nutrition Coalition.

Further research could pinpoint some of the impacts of COI on the DGA’s formation. 

Addressing bias
Mialon acknowledges that having a COI doesn’t necessarily mean that one is biased, although there is that risk. 

Even if they’re not biased, COI can lead to a lack of independence for experts, she continues. It has already been shown that the scientific agenda, and a great deal of research in nutrition, is shaped by industry, Mialon argues.

“They have the financial means to do so – and we know industry is investing in a science that promotes its products.”

She also says industry is backing science that proposes alternatives to explain ill health in the population. This could mean placing the blame on a lack of physical activity, instead of the consumption of unhealthy F&B, for example. 

“Finally, COI can undermine the credibility of experts and potentially damage the reputation of the US Department of Agriculture (USDA) and Health and Human Services (HHS).” 

Inspiration from abroad
Dr. Angela Carriedo, policy secretariat at the World Public Health Nutrition Association, also points out that disclosure itself doesn’t address the issue of corporate influence on science and policy. 

“What is needed is independence from industry. Indeed, declaring COI does not prevent the person from participating with the potential for bias; it legitimizes the participation despite having declared them,” she states. 

Therefore, mechanisms to address COI include a due diligence process and a no engagement policy.

Naik points to the example of Canada, which deliberately prevented officials from meeting with industry lobbyists after facing years of criticism about food industry influence.

“Brazil can also be seen as a success model – the development of its guidelines was pretty free from influence from industry,” adds Mialon.

This isn’t the first time that the DGA has come under fire for its industry ties. At their time of release in 2021, some members of industry addressed these considerations, highlighting that insiders can participate in the public process the same way as any citizen. 

By Katherine Durrell