Back in October, I provided a comment at a public meeting for a National Academies of Science, Engineering and Medicine (NASEM) advisory committee that was set up to review the process to update the Dietary Guidelines for Americans. Their first charge was to write a report with recommendations on how the Dietary Guidelines Advisory Committee (DGAC) selection process could be improved to provide more transparency, minimize bias, and include committee members with a range of viewpoints.
After some time to assess the DGAC’s process and consider the public feedback they received, the committee released the report last Friday. It includes several important proposals that would be beneficial for the DGAC, and really all federal advisory committees (FACs), to employ. My assessment of the report will come later, but first, I want to talk a little bit more about the importance of FACs, generally.
Quick facts on FACs
FACs play an indispensible role in providing independent science advice for our government’s decision making. The government relies on this technical advice from scientists outside the government on everything from drug approvals to air pollution standards to appropriate pesticide use. There are over 1,000 advisory panels within the federal government, some of which offer technical scientific advice that may be used by agencies to inform key policy decisions. Some advisory committees are mandated by law, while others are created for ad hoc policy guidance. The Federal Advisory Committee Act requires that agencies take measures to ensure transparency and ample public participation, but how and the degree to which these are implemented varies depending on the agency.
In our most recent report, “Preserving Scientific Integrity in Federal Policymaking,” we discuss the opportunity to improve the way in which federal agencies obtain objective technical advice from advisory committees so that conflicts of interest are minimized and fully disclosed. Several studies have shown a positive association between authors’ financial conflicts of interest and recommendations that benefit those vested interests. Likewise, an individual on an advisory committee may choose to sideline the evidence and instead make recommendations that favor his or her special interest, especially if they stand to profit in some way. Federal advisory committees have been co-opted by industry for political reasons before, including when G.W. Bush administration officials pushed existing committee members out and replaced them with appointees in order to reject the prospect of stricter lead poisoning standards.
The DGAC plays the essential role of analyzing heaps of nutrition and epidemiological data and making recommendations to the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) to inform the Dietary Guidelines for Americans that is released every five years. As a lover of food and a student of food policy, I rely on the DGAC to translate science into objective recommendations that will ultimately shape federal nutrition guidance and regulations spanning from school lunches to nutrition facts labels. UCS commended the DGAC on its 2015 report to HHS and USDA, most notably for the way in which it followed the science to recommend that Americans consume no more than 10 percent of daily calories from added sugars.
NASEM’s report challenges undue influence of science
The NASEM committee’s report identified five values upfront that would enhance the integrity of the DGAC selection process, which closely echo the core values we identified for ensuring scientific integrity in federal policymaking:
- Enhance transparency
- Promote diversity of expertise and experience
- Support a deliberative process
- Manage biases and conflicts of interest
- Adopt state-of-the-art processes and methods
For the reasons I mentioned earlier, the fourth value could use strengthening to something more like “Minimize and manage biases and conflicts of interest,” to emphasize that conflicts should be avoided, if possible, to maximize objectivity.
As for its concrete guidance, the NASEM committee suggested changes to HHS and USDA’s process (see figure at right), including that when the departments first solicit nominations for the DGAC, they should “employ a third party to review nominations for qualified candidates.” This would add a crucial layer of independent review into the process, especially if, as NASEM recommends, the third party is an “organization without a political, economic, or ideological identity,” and not necessarily an expert in nutrition or dietary guidance. The NASEM committee would also add a public comment period after the provisional committee is selected by the departments, allowing an opportunity for the public to weigh in on any potential biases or conflicts of interest of the proposed members. We strongly agree with NASEM’s assertion that “candid information from the public about proposed members is critical for a deliberative process.”
The report also recommended that the departments create and make public strict policies on how to identify and manage conflicts of interest and mandate that committee members sign a form that captures nonfinancial conflicts of interest and biases, since that is not currently covered by the required Office of Government Ethics form. Additionally, the committee elaborated on what “management” of conflicts of interest looks like in practice and had some helpful ideas like granting waivers in limited amounts (and making them public) depending on the type of conflict, asking that individuals sell stock or divest property to avoid conflicts, excluding members with conflicts from certain discussions and voting, or allowing for a review of potential conflicts of interest to be discussed at the beginning of each meeting. The committee also suggested that a statement be added to the final DGAC report to review how biases and conflicts of interest were managed throughout the advisory committee’s work.
Overall, the report managed to cover most of the recommendations I made in my public comment, but one thing that I hope the committee explores in its future deliberations is the prevention of undue influence from department leadership after the DGAC report has been submitted, since that is where the translation of science into policy is most critical. DGAC is solely advisory and should not have a role in writing the final Dietary Guidelines report, but it would be appropriate for former DGAC members to have a role in peer review and to make sure that the report language fairly considers the best available science and aligns with DGAC’s recommendations. This last part of the process proved to be controversial in the most recent version of the Dietary Guidelines when the DGAC recommended that environmental sustainability concerns be included in the DGA because the overall body of evidence points to a dietary pattern higher in plant-based foods, and lower in meat, but the final report did not include these important concerns.
NASEM should follow its own advice on conflicts of interest
In light of this report, it seems that NASEM should follow its own advice as it considers itself to be a purveyor of nonpartisan, objective guidance for policymakers, but has been recently scrutinized for conflicts of interest on its own panels. This past December, the New York Times reported that NASEM put together a committee of 13 scientists to make recommendations on regulation of the biotechnology industry, and failed to disclose the clear conflicts of five of the committee members. In fact, the majority of committee members had conflicts (7 out of 13), and the NASEM study director was applying for a job at a biotechnology organization while he was putting together his recommendations for committee members. If that isn’t egregious enough, three of the committee members he recommended for the NASEM biotech panel were actually on the board of the organization at which he was seeking employment. This level of undisclosed conflict is completely inappropriate and should have been caught in the early stages of the committee selection process, not uncovered after the final report had already been released. NASEM should strive to “promote diversity of expertise and experience,” as the committee identified as a core value, rather than stack committees with individuals that have similar industry experience and connections.
Ode to independent science
Independent science at its core must be free from undue political or financial pressure. We of course acknowledge that all policy decisions are not made based on science alone, but in order to create the best possible government policies, the relied-upon science must be independent. We appreciate the work that this committee is putting into advising DGAC on how best to ensure the process facilitates truly objective science advice, because FACs are vulnerable to politicization or interference if not carefully managed. This report should be considered by all federal agencies and other entities, including NASEM itself, that seek to provide scientific advice to policymakers for the benefit of us all.